Nakajima Nobuhisa, Hata Yoshinobu, Matsuoka Shinichi, Itoh Touichi, Maeda Yoshiaki, Osada Tadahiro, Sano Fumio
Dept. of Surgery, Sapporo Social Insurance General Hospital.
Gan To Kagaku Ryoho. 2002 Nov;29(12):2442-6.
A 56-year-old man who underwent distal gastrectomy at another hospital was admitted to our hospital because of advanced gastric cancer with synchronous liver metastasis. As we considered that the metastatic liver tumor was unresectable one, an intra-arterial catheter was inserted and weekly chemotherapy including methotrexate (MTX) (intra-venous) and 5-fluorouracil (5-FU) (intra-arterial) was started. The metastatic liver tumor was gradually reduced and resulted in partial response (PR) after 12 courses. Eight months later, the size of the metastatic liver tumor increased and lung metastasis occurred, so we started a new regimen of chemotherapy using CPT-11 (intra-venous) and CDDP (intra-arterial). After 4 courses of this regimen, we gained PR both in the metastatic liver and lung tumor. This case indicates that the combination therapy of systemic and hepatic arterial infusion chemotherapy is a treatment option in cases of advanced gastric cancer with liver metastasis.
一名56岁男性，曾在另一家医院接受远端胃切除术，因晚期胃癌伴同步肝转移入住我院。由于我们认为转移性肝肿瘤无法切除，遂插入动脉导管，并开始每周进行化疗，化疗药物包括甲氨蝶呤（MTX）（静脉注射）和5-氟尿嘧啶（5-FU）（动脉注射）。转移性肝肿瘤逐渐缩小，12个疗程后出现部分缓解（PR）。8个月后，转移性肝肿瘤大小增加并出现肺转移，于是我们开始使用伊立替康（CPT-11）（静脉注射）和顺铂（CDDP）（动脉注射）进行新的化疗方案。该方案治疗4个疗程后，转移性肝肿瘤和肺肿瘤均获得PR。该病例表明，全身化疗与肝动脉灌注化疗联合治疗是晚期胃癌伴肝转移病例的一种治疗选择。
