结直肠癌（CRC）不可切除的复发性淋巴结转移在临床上被认为是一种不治之症，预后极差。在此，我们报告一例男性KRAS野生型结直肠癌病例，结直肠癌术后出现巨大腹部淋巴结转移（直径12厘米）。 3次瘤内注射溶瘤病毒（H101）结合4个周期的小剂量口服卡培他滨后，转移淋巴结的大小在抗癌药物的作用下显着缩小，并实现了完全缓解（CR）和无进展生存期(PFS) 为 19 个月。主要不良反应为轻度发热，经物理降温后缓解。目前患者身体状况良好，腹部淋巴结一年多未复发。在此基础上，我们提出溶瘤病毒和卡培他滨的联合治疗可能是治疗结直肠癌患者不可切除的复发性淋巴结转移的一种有前景的临床治疗策略。© 2024 Wang et al.

Unresectable recurrent lymph node metastasis of colorectal cancer (CRC) is considered as an incurable disease clinically and has a very poor prognosis. Here, we report a male KRAS wild-type CRC case with a huge abdominal lymph node metastasis (12 cm in diameter) after CRC surgery. After three intratumoral injections of oncolytic virus (H101) combined with four cycles of low-dose oral capecitabine, the size of the metastatic lymph node shrank remarkably in response to the anticancer drug and a complete response (CR) was achieved with progression-free survival (PFS) of 19 months. The main adverse reaction was mild fever, which was relieved after physical cooling. The patient is in a general good condition now without any relapse of abdominal lymph node for over a year. On this basis, we propose that the combination therapy of oncolytic virus and capecitabine could be a promising clinical therapeutic strategy for unresectable recurrent lymph node metastasis in CRC patients.© 2024 Wang et al.