Kobayashi Daisuke, Honda Ichiro, Kato Tsuyoshi, Mori Masahiro
Dept. of Surgery, Shinshiro Municipal Hospital.
Gan To Kagaku Ryoho. 2006 Sep;33(9):1313-6.
We report a case in which paclitaxel (PTX) plus 5-FU therapy was remarkably effective for advanced gastric cancer with peritoneal metastasis. The patient was a 41-year-old woman who had type 4 gastric cancer with peritoneal metastasis. PTX plus 5-FU therapy was performed. The regimen included 600 mg/body/day of 5-FU by continuous iv administration from day 1 to 5 and consequent administration of PTX (90 mg/body) on days 8, 15 and 22 for 28 days repetitively. After 4 courses were completed, abdominal CT revealed that ascites had disappeared and the stomach wall had become thinner. Thus,we considered the patient had a partial response, and performed total gastrectomy. After the operation, PTX plus 5-FU therapy was used for 8 courses with the same regimen. No serious adverse event was observed,and the patient maintained good QOL throughout the treatment. No sign of progressive disease was seen for 12 months after the operation. However, 18 months after beginning the treatment, peritoneal metastasis became worse, and she died 19 months after treatment had begun. Considering the effectiveness and mild toxicity, PTX plus 5-FU therapy is thought to be useful for advanced gastric cancer.
我们报告了一例紫杉醇（PTX）联合5-氟尿嘧啶（5-FU）治疗对晚期胃癌伴腹膜转移显著有效的病例。患者为一名41岁女性，患有4型胃癌伴腹膜转移。采用PTX联合5-FU治疗。治疗方案包括从第1天至第5天持续静脉输注5-FU，剂量为600mg/体/天，随后在第8、15和22天给予PTX（90mg/体），每28天重复一次。完成4个疗程后，腹部CT显示腹水消失，胃壁变薄。因此，我们认为患者有部分缓解，并进行了全胃切除术。术后，采用相同方案继续进行PTX联合5-FU治疗8个疗程。未观察到严重不良事件，患者在整个治疗过程中生活质量良好。术后12个月未见疾病进展迹象。然而，治疗开始18个月后，腹膜转移恶化，患者在治疗开始19个月后死亡。考虑到其有效性和轻度毒性，PTX联合5-FU治疗被认为对晚期胃癌有用。
