Gomi Takashi, Ohtoshi Masahiro, Tamaki Nobuyuki, Momoi Hirohito, Kanaya Seiichiro, Katayama Tetsuo, Wada Yasuo
Dept. of Surgery, National Himeji Hospital.
Gan To Kagaku Ryoho. 2002 Feb;29(2):301-4.
TS-1, a DPD inhibitory fluoropyrimidine, is a novel oral formation of 5-fluorouracil (5-FU). In patients with advanced gastric cancer, the response rate was reportedly over 40%. We report three cases of advanced gastric cancer treated using TS-1 in combination with a low-dose of cisplatinum (CDDP) that well responded. Case 1: A 62-year-old women underwent total gastrectomy. Ten weeks later, she suffered intestinal obstruction due to peritoneal recurrence of gastric cancer. Eighty mg of TS-1 in combination with bi-weekly administration of CDDP (10 mg) improved her intestinal obstruction. Case 2: A 50-year-old man suffered peritoneal recurrence of gastric cancer. Computed tomography (CT) showed intestinal obstruction, ascites, and hydronephrosis. After 100 mg of TS-1 in combination with bi-weekly administration of CDDP (20 mg) for 1 year, CT showed almost complete improvement of peritonitis carcinomatosa. Case 3: A 58-year-old man, who suffered advanced gastric cancer with peritonitis carcinomatosa, was administrated 100 mg of TS-1 in combination with bi-weekly administration of CDDP (20 mg). After 2 months of administration, remarkable improvement was observed in the upper gastrointestinal series. Adverse reactions, which were grade 1 for stomatitis, were observed only in case 1. All three patients are alive (case 1 and 2 have survived more than one year) and therapy is continuing. In conclusion, combined chemotherapy of TS-1 and low-dose CDDP was effective and well tolerable for advanced gastric cancer patients. It was suggested that effective biochemical modulation might be achieved by these two drugs.
替吉奥（TS-1）是一种二氢嘧啶脱氢酶（DPD）抑制性氟嘧啶，是5-氟尿嘧啶（5-FU）的新型口服制剂。据报道，晚期胃癌患者的缓解率超过40%。我们报告3例晚期胃癌患者采用替吉奥联合低剂量顺铂（CDDP）治疗后反应良好的病例。病例1：一名62岁女性接受了全胃切除术。10周后，她因胃癌腹膜复发而出现肠梗阻。80毫克替吉奥联合每两周一次给予顺铂（10毫克）改善了她的肠梗阻。病例2：一名50岁男性患有胃癌腹膜复发。计算机断层扫描（CT）显示肠梗阻、腹水和肾盂积水。在100毫克替吉奥联合每两周一次给予顺铂（20毫克）治疗一年后，CT显示癌性腹膜炎几乎完全改善。病例3：一名58岁男性患有晚期胃癌伴癌性腹膜炎，给予100毫克替吉奥联合每两周一次给予顺铂（20毫克）。给药2个月后，上消化道造影显示明显改善。仅在病例1中观察到不良反应为1级的口腔炎。所有3例患者均存活（病例1和2已存活超过一年）且治疗仍在继续。总之，替吉奥与低剂量顺铂联合化疗对晚期胃癌患者有效且耐受性良好。提示这两种药物可能实现有效的生化调节。
