The patient was a 64-year-old man who underwent medical examination for anorexia and hematochezia. An abdominal computed tomography (CT) scan showed a large advanced rectal cancer with multiple metastases to the liver. We judged a radical operation to be impossible and performed a sigmoid colostomy for unresectable rectal cancer with multiple liver metastases. Postoperatively, we started XELOX therapy and confirmed the patient had a complete response (CR) using the Response Evaluation Criteria in Solid Tumors (RECIST) after completion of the 5th course. In addition, the multiple liver metastases reduced remarkably in size and were judged as having a partial response (PR). To date, the patient has completed 22 courses and these good effects continue.

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