A Case of Postoperative Brain and Spinal Metastases from Rectal Cancer Successfully Treated with Oxaliplatin/fluorouracil/leucovorin

Takeshi Kubota¹⁾²⁾, Jun Kamiyama¹⁾, Hirosumi Itoi¹⁾ and Eigo Otsuji²⁾

Department of Surgery, Meiji University of Oriental Medicine Hospital¹⁾
Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine²⁾

Metastatic brain tumors are generally treated with radiotherapy because many anticancer drugs cannot cross the blood-brain barrier. We report a case of postoperative brain and spinal metastases from rectal cancer treated with oxaliplatin/fluorouracil/leucovorin (modified FOLFOX-6). A 49-year-old-man underwent Miles' operation with D2 lymphadenectomy for type 2 rectal cancer and segmental resection for liver metastasis. Nine months later, the patient underwent a surgery for cerebellar metastasis during treating with oral uracil and tegafur (UFT) following 5-fluorouracil/leucovorin. He then underwent gamma knife therapy for brain metastases and surgical resection for spinal metastasis 20 months after the first operation and 11 months after cerebellar metastasis surgery. Modified FOLFOX-6 was started thereafter due to recurring brain metastases and residual spinal metastasis. One year later, target lesions were evaluated as making a partial response based on response evaluation criteria in solid tumors (RECIST) and no more new metastases had developed as of this wrinting.

Key words
rectal cancer, brain metastasis, FOLFOX

Reprint requests
Takeshi Kubota Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine
465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566 JAPAN

Accepted
April 23, 2008

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