A Case of Rectal Cancer with Disseminated Carcinomatosis of the Bone Marrow Treated Successfully with FOLFOXIRI plus Bevacizumab Chemotherapy

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  • 直腸癌による播種性骨髄癌症に対してFOLFOXIRI/bevacizumab療法が有効であった1例

Abstract

<p>We report a case of a 62-year-old female who presented with lumbago after low anterior resection for rectal cancer with peritoneal dissemination. Blood tests had already shown disseminated intravascular coagulation (DIC). Based on spinal MRI and histopathological examination of bone marrow tissue, a diagnosis of disseminated carcinomatosis of the bone marrow (DCBM) was made, and FOLFOXIRI plus bevacizumab chemotherapy was immediately initiated. After induction, serum CEA markedly decreased and DIC gradually improved over three courses of administration, which enabled the patient to be discharged to home temporarily. However, there was little improvement in her general condition and signs of delirium appeared just before the fourth administration. Therefore, systemic chemotherapy was discontinued and replaced by palliative care. Subsequently, the patient died about three months after initiation of chemotherapy. The prognosis for patients with rectal cancer with DCBM is extremely poor, but urgent chemotherapy was transiently effective in this case. However, long-term survival was not obtained, which suggests the importance of earlier treatment intervention.</p>

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