Yamamoto Makoto, Niinobu Takahiro, Taniguchi Hiroaki, Kotobuki Tadahide, Fukunaga Koutarou, Kawai Minoru
Dept. of Surgery, Ibaraki Iseikai Hospital.
Gan To Kagaku Ryoho. 2004 Oct;31(11):1689-92.
We report three successful cases with continuous systemic chemotherapy for advanced gastric cancer. Case 1: A 67-year-old male with gastric cancer. Abdominal CT showed the invasion in the pancreas and as a result, continuous systemic infusion of low-dose cisplatin (CDDP 20 mg/day) and 5-fluorouracil (5-FU 1,000 mg/day) was performed. This infusion chemotherapy, CDDP and 5-FU, was continued for 5 days and discontinued for 25 days. Three months after the chemotherapy, the main tumor was remarkably reduced (downstaging was obtained), and consequently, total gastrectomy was performed. Case 2: A 78-year-old male with gastric cancer and hepatic multiple metastases. Abdominal CT scan before operation did not reveal the hepatic metastasis. In the operation for distal gastrectomy, we found multiple metastases on the surface of the liver. Continuous systemic infusion of low-dose CDDP (20 mg/day) and 5-FU (1,000 mg/day) was performed. This infusion chemotherapy, CDDP and 5-FU, was continued for 5 days and discontinued for 2 days. One month after the chemotherapy, Liver metastases had almost disappeared. Case 3: A 73-year-old male had received a distal gastrectomy based on the diagnosis of gastric cancer. The tumor marker, CA19-9, immediately decreased after the operation, but had increased again. He was treated with a combination chemotherapy of TS-1 and CDDP. The treatment consisted of 4 weeks of TS-1 administration (100 mg daily) followed by a 2-week break. CDDP of 10 mg/day was infused intravenously (day 1-5). Four weeks after the infusion, CA19-9 had returned to almost normal. We conclude that the combination chemotherapy of 5-FU (or TS-1) and CDDP might be an effective treatment for advanced and metastatic gastric cancer.
我们报告了三例晚期胃癌持续全身化疗成功的病例。病例1:一名67岁的男性胃癌患者。腹部CT显示肿瘤侵犯胰腺,因此进行了低剂量顺铂(顺铂20毫克/天)和5-氟尿嘧啶(5-氟尿嘧啶1000毫克/天)的持续全身输注。这种顺铂和5-氟尿嘧啶的输注化疗持续5天,停药25天。化疗三个月后,主要肿瘤明显缩小(实现了降期),因此进行了全胃切除术。病例2:一名78岁的男性胃癌患者,伴有肝脏多发转移。术前腹部CT扫描未显示肝转移。在远端胃切除术的手术中,我们发现肝脏表面有多发转移。进行了低剂量顺铂(20毫克/天)和5-氟尿嘧啶(1000毫克/天)的持续全身输注。这种顺铂和5-氟尿嘧啶的输注化疗持续5天,停药2天。化疗一个月后,肝转移几乎消失。病例3:一名73岁的男性因胃癌诊断接受了远端胃切除术。术后肿瘤标志物CA19-9立即下降,但随后又再次升高。他接受了替吉奥和顺铂的联合化疗。治疗包括4周的替吉奥给药(每日100毫克),随后休息2周。每天10毫克的顺铂静脉输注(第1 - 5天)。输注四周后,CA19-9已恢复至几乎正常水平。我们得出结论,5-氟尿嘧啶(或替吉奥)和顺铂的联合化疗可能是晚期和转移性胃癌的有效治疗方法。