Gene Sequencing for Selection of Chemotherapy Drugs Combined with Stereotactic Body Radiation Therapy for Stage IV Colon Cancer: A Case Report

病例報告：利用基因定序選擇第四期大腸癌化學治療藥物並合併立體定位放射線治療（SBRT）

黃姚儒(Yao-Ru Huang) ； 陳尚文(Shang-Wen Chen) ； 丁禮莉(Lai-Lei Ting) ； 郭嘉駿(Chia-Chun Kuo) ； 邱仲峰(Jeng-Fong Chiou)

《放射治療與腫瘤學》 20卷1期 (2013/03) Pp. 65-75

https://doi.org/10.6316/TRO/201320(1)65

摘要

我們報告一名31歲女性診斷為大腸癌合併多處肺轉移個案：藉由血液基因定序結果，我們挑選最合適之化療藥物組合，並在成功控制腫瘤狀況後，對於原發部位進行外科手術切除並對殘餘肺部轉移腫瘤進行立體定位放射線治療，經電腦斷層正子攝影顯示，達到完全緩解（CR）。目前臨床上雖有數篇關於回溯性分析基因表現與臨床藥物反應、甚至預後之相關學術研究，但是藉由基因定序、整合多種基因表現結果而選擇化療藥物尚待更多研究。本篇屬於試驗性的前瞻性臨床研究來評定基因定序與大腸癌治療的臨床結果，希望藉由更多後續相關研究可以達成將來依照個人不同基因組成而選擇最佳療效之化療藥物。

關鍵字

大腸直腸癌 ； 基因定序 ； 立體定位放射線治療 ； 化學治療

並列摘要

Gene sequencing may be a feasible means of individualizing cancer treatment. By investigating the correlation between genetic profiles and treatment outcomes of chemotherapy, it may be possible to determine effective treatment strategies according to individual genotypes in cancer patients. Despite great advances in drugs for cancer treatment, treatment outcomes may be improved by analyzing genetic markers that indicate treatment efficacy. We report the treatment for a patient with metastatic colon cancer in which gene sequencing was used for the selection of an effective chemotherapy regimen. In addition, we describe the entire course of treatment, including the combination of surgical resection for local control and radiotherapy to eradicate distant metastases. This is a pilot report of the clinical use of gene sequencing for determining a treatment regimen. Further clinical trials are needed to optimize the personalization of cancer treatment.

並列關鍵字

Colorectal carcinoma ； Gene sequence ； SBRT (Stereotactic Body Radiation Therapy) ； Chemotherapy