Ikeda Eiji, Shigematsu Tadashi, Hidaka Kentaro, Nishikawa Atsushi, Katayama Masanobu, Okajima Tatsuya, Kawahara Takeshi, Tanaka Motoo, Banba Masamichi
Dept. of Internal Medicine, Saiseikai Shiga Prefectural Hospital.
Gan To Kagaku Ryoho. 2007 Mar;34(3):423-6.
The patient was a 66-year-old male with extremely advanced gastric cancer type 3 and diagnosed with adenocarcinoma by endoscopic biopsies specimens. Combined chemotherapy of TS-1, CDDP and docetaxel was prescribed in order for tumor reduction and downstaging. TS-1 (80 mg/m(2)) was administered 28 days followed by 14 days rest as one course. CDDP (8 mg/m(2)) was administered on days 1, 2, 14 and 15 and docetaxel (40 mg/m(2)) was administered on day 1 and 14, followed by 4 weeks rest as one course. After 2 courses of treatment, a CT scan revealed a minor response of tumor reduction. Therefore, total gastrectomy, partial pancreas body and tail resection, and D 2 lymph node dissection were performed. The patient had undergone adjuvant chemotherapy of TS-1 and biweekly docetaxel after surgery with no recurrence for 13 months. Adverse reactions were grade 3 neutropenia and grade 2 diarrhea. Combined chemotherapy of TS-1, low-dose CDDP and docetaxel were intensive and required constant patient monitoring. However, it proved effective and feasible as a neoadjuvant chemotherapy regimen for advanced gastric cancer.
该患者为一名66岁男性,患有极晚期3型胃癌,经内镜活检标本诊断为腺癌。为了缩小肿瘤和降低分期,采用了替吉奥(TS-1)、顺铂(CDDP)和多西他赛的联合化疗方案。替吉奥(80 mg/m²)给药28天,随后休息14天为一个疗程。顺铂(8 mg/m²)在第1、2、14和15天给药,多西他赛(40 mg/m²)在第1天和第14天给药,随后休息4周为一个疗程。经过2个疗程的治疗后,CT扫描显示肿瘤有轻微缩小反应。因此,进行了全胃切除术、胰体尾部分切除术和D2淋巴结清扫术。患者术后接受了替吉奥辅助化疗和每两周一次的多西他赛治疗,13个月无复发。不良反应为3级中性粒细胞减少和2级腹泻。替吉奥、低剂量顺铂和多西他赛的联合化疗强度较大,需要持续对患者进行监测。然而,它被证明是一种用于晚期胃癌的有效且可行的新辅助化疗方案。