Iwahashi M, Nakamori M, Tani M, Yamaue H, Sakaguchi S, Nakamura M, Ueda K, Ichiro M, Nishino E, Tanimura H
Second Department of Surgery, Wakayama Medical University, School of Medicine, Wakayama, Japan.
Oncology. 2001;61(1):16-22. doi: 10.1159/000055347.
TS-1(S-1) has been developed as a new oral anticancer drug based on the biological modulation of 5-fluorouracil. We treated a patient with highly advanced gastric carcinoma with a new combination chemotherapy of S-1 and low-dose cisplatin. Remarkable tumor reduction was observed after two cycles of this therapy in the primary tumor and metastatic lymph nodes, and the ascites disappeared. This was concluded to be a partial response. The only adverse effect was skin pigmentation of the fingers (grade 1), leading to early timing of operation after chemotherapy. The gastric tumor showed evident invasion to the serosa. Lymph nodes around the stomach were swollen. Peritoneal dissemination was also recognized in the omentum and mesocolon. Total gastrectomy with regional lymph node dissection was performed. Disseminated tumors were all resected. Histological examination showed that no tumor cells were detected in the gastric primary lesion, metastatic lymph nodes or disseminated peritoneal tumors, suggesting pathological complete remission. It was suggested that this regimen could be a potent combined therapy for the treatment of patients with highly advanced gastric carcinoma, and it could be useful as neoadjuvant chemotherapy. Further studies are necessary to evaluate the efficacy of this therapy.
TS-1（S-1）是一种基于5-氟尿嘧啶生物调节作用开发的新型口服抗癌药物。我们用S-1与低剂量顺铂的新联合化疗方案治疗了一名晚期胃癌患者。该治疗两个周期后，原发肿瘤和转移淋巴结明显缩小，腹水消失。这被判定为部分缓解。唯一的不良反应是手指皮肤色素沉着（1级），这使得化疗后手术时机提前。胃肿瘤显示出明显的浆膜侵犯。胃周围淋巴结肿大。在大网膜和结肠系膜中也发现了腹膜播散。进行了全胃切除术及区域淋巴结清扫。所有播散性肿瘤均被切除。组织学检查显示，在胃原发灶、转移淋巴结或播散性腹膜肿瘤中均未检测到肿瘤细胞，提示病理完全缓解。提示该方案可能是治疗晚期胃癌患者的有效联合疗法，且可作为新辅助化疗。有必要进一步研究以评估该疗法的疗效。
