Kimura Yutaka, Yasuda Takushi, Fujiwara Yoshiyuki, Takiguchi Shuji, Miyata Hiroshi, Nagano Hiroaki, Yano Masahiko, Monden Morito
Dept of Surgery and Clinical Oncology, Graduate School of Medicine, Osaka University.
Gan To Kagaku Ryoho. 2004 Oct;31(11):1825-7.
The prognosis of patients with hepatic metastasis of gastric cancer is poor, and standard therapies for patients are not established. Here we present two cases of hepatic metastasis from gastric cancer. In both cases, no other organ metastasis except the liver was confirmed, in which hepatic arterial infusion chemotherapy with 5-FU, adriamycin and cisplatin (FAP) were performed because TS-1 chemotherapy was not an effective chemotherapy. Case 1: An 80-year-old man had distal gastrectomy for type 2 gastric cancer (Stage II) in January 2001. A liver S8 metastatic recurrence was discovered in the 18th month post operation. After chemotherapy with TS-1 for 5 courses, a hepatic arterial infusion treatment was performed for 7 courses. The effect was PR, but the treatment was canceled because of a catheter obstruction. The patient is living without recurrence. Case 2: This case was a 73-year-old man who had distal gastrectomy for type 0 IIc gastric cancer (Stage IA) in May 1999. Multiple hepatic metastases recurred in the 32nd month post operation. After chemotherapy with TS-1 for 2 courses, a hepatic arterial infusion treatment was performed for 10 courses. The effect was CR, but a peritoneal recurrence was discovered, and a systemic chemotherapy was performed. The patient is living without recrudescence of hepatic metastasis. The hepatic arterial infusion chemotherapy with FAP was effective for gastric cancer patients with liver metastasis because TS-1 chemotherapy was not an effective chemotherapy. It is necessary to consider combined chemotherapy in addition to systemic chemotherapy.
胃癌肝转移患者的预后较差,且尚未确立针对此类患者的标准治疗方法。在此,我们介绍两例胃癌肝转移病例。两例患者均未发现除肝脏以外的其他器官转移,由于替吉奥(TS-1)化疗无效,因此对其进行了氟尿嘧啶、阿霉素和顺铂(FAP)肝动脉灌注化疗。病例1:一名80岁男性于2001年1月因2型胃癌(II期)接受了远端胃切除术。术后第18个月发现肝脏S8转移复发。接受替吉奥化疗5个疗程后,进行了7个疗程的肝动脉灌注治疗。疗效为部分缓解(PR),但因导管阻塞而停止治疗。患者目前无复发存活。病例2:该病例为一名73岁男性,于1999年5月因0 IIc型胃癌(IA期)接受了远端胃切除术。术后第32个月出现多发肝转移复发。接受替吉奥化疗2个疗程后,进行了10个疗程的肝动脉灌注治疗。疗效为完全缓解(CR),但发现有腹膜复发,遂进行全身化疗。患者目前无肝转移复发存活。由于替吉奥化疗无效,FAP肝动脉灌注化疗对胃癌肝转移患者有效。除全身化疗外,有必要考虑联合化疗。