Yabushita K, Konishi K, Kuroda Y, Fukushima W, Sahara H, Saitoh F, Kadoya N, Taniya T, Hirosawa H, Tsuji M
Department of Surgery, Toyama Prefectural Central Hospital, Japan.
Gan To Kagaku Ryoho. 1992 Nov;19(13):2231-4.
A 62-year-old male patient with progressive gastric cancer and multiple liver metastases (H3, P0, ss gamma, n4) underwent total gastrectomy (R1). After 2 years and 2 months, he was re-hospitalized with epigastric tumor caused by re-manifestation of liver metastasis as well as inappetence. Since a large focus of liver metastasis and intraportal tumor embolism was identified, a continuous intraarterial infusion tube utilizing Infuse-A-Port was inserted in the hepatic artery. After conducting 2 cycles of PMUE intra-arterial chemotherapy, the tumor size was reduced by 84% (PR); and CEA, which had been high upon rehospitalization, recovered to the normal level. After discharge, the patient has been receiving 5-FU arterial infusion as an outpatient and undergoing UFT oral chemotherapy. The efficacy has continued and he has been well for 3 years since operation. Often operations for gastric cancer accompanied with multiple liver metastasis meet with little success, and almost no case of prolonged survival has been reported. In this case, the effectiveness of PMUE arterial infusion chemotherapy was clear, the patient has been well for 3 years since operation, and is an interesting example with seemingly good prospects for long-survival.
一名62岁男性患者,患有进展期胃癌并伴有多发肝转移(H3,P0,ssγ,n4),接受了全胃切除术(R1)。2年零2个月后,他因肝转移复发导致上腹部肿瘤以及食欲不振而再次入院。由于发现了较大的肝转移灶和门静脉内肿瘤栓塞,通过Infuse-A-Port在肝动脉中插入了持续动脉内输液管。在进行了2个周期的PMUE动脉内化疗后,肿瘤大小缩小了84%(PR);再次入院时升高的癌胚抗原(CEA)恢复到了正常水平。出院后,患者一直在门诊接受5-氟尿嘧啶动脉内输注并口服优福定化疗。疗效持续,自手术以来他已经健康生活了3年。通常,伴有多发肝转移的胃癌手术成功率很低,几乎没有长期生存的病例报道。在这个病例中,PMUE动脉内灌注化疗的有效性是明确的,患者自手术以来已经健康生活了3年,是一个似乎有良好长期生存前景的有趣例子。