Yoshimizu Nobunari, Saikawa Yoshiro, Kubota Tetsuro, Akiba Yasutada, Yoshida Masashi, Otani Yoshihide, Kumai Koichiro, Hibi Toshihumi, Kitajima Masaki
Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Gastric Cancer. 2003;6(3):185-90. doi: 10.1007/s10120-003-0239-2.
S-1 has been developed as a new oral anticancer drug, based on the biological modulation of 5-fluorouracil. We report a patient with highly advanced gastric carcinoma who was treated successfully with a new combination chemoradiotherapy using S-1 and cisplatin (CDDP). The patient was a 37-year-old man who was diagnosed with advanced gastric carcinoma (T4N3M0) that had invaded the diaphragm and the paraaortic tissues. Remarkable tumor reduction was observed in the primary tumor and metastatic lymph nodes around the stomach after three cycles of the therapy. Radiological examination before surgery determined that a partial response (PR) had been achieved by the initial therapy. Adverse effects included only a gastrointestinal disorder that was limited to grade 2 when low-dose CDDP was utilized in the regimen, while an initial high dose of CDDP resulted in grade 3 toxicity, due to myelosuppression. The patient underwent curative surgery, including total gastrectomy, D2 lymph node dissection, and splenectomy, after completion of the radiochemotherapy regimen. No surgical complication was observed. No tumor cells were detected by pathological evaluation of the resected stomach and all the regional lymph nodes, confirming a pathological complete response (CR; grade 3). This regimen is a potent treatment for advanced gastric carcinoma, especially when used as preoperative chemotherapy to control cancer cells.
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。我们报告了一名患有高度进展期胃癌的患者，该患者采用S-1和顺铂（CDDP）联合新的放化疗方案治疗成功。患者为一名37岁男性，被诊断为晚期胃癌（T4N3M0），肿瘤已侵犯膈肌和腹主动脉旁组织。三个周期的治疗后，在胃周围的原发肿瘤和转移淋巴结中观察到明显的肿瘤缩小。手术前的影像学检查确定初始治疗已取得部分缓解（PR）。不良反应仅包括胃肠道紊乱，当方案中使用低剂量CDDP时，该不良反应仅限于2级，而初始高剂量CDDP由于骨髓抑制导致3级毒性。完成放化疗方案后，患者接受了根治性手术，包括全胃切除术、D2淋巴结清扫术和脾切除术。未观察到手术并发症。通过对切除的胃和所有区域淋巴结的病理评估未检测到肿瘤细胞，证实为病理完全缓解（CR；3级）。该方案是晚期胃癌的有效治疗方法，尤其是用作术前化疗以控制癌细胞时。
