Rino Yasushi, Sekino Yusuke, Yamada Takanobu, Nakayama Takahiro, Arai Hiromasa, Kanari Masahiro, Saeki Hiroyuki, Yukawa Norio, Wada Nobuyuki, Masuda Munetaka, Higashida Tetsuhiro, Imada Toshio
Dept. of Surgery, Yokohama City University, School of Medicine.
Gan To Kagaku Ryoho. 2007 Jul;34(7):1095-8.
We treated two patients in whom irinotecan (CPT-11)+cisplatin (CDDP) and irradiation showed efficacy against brain metastases of gastric cancer. CPT-11 and CDDP were administered on days 1 and 15 of a 28-day cycle at 60 mg/m(2) and 30 mg/m(2), respectively. The first patient was a 63-year-old man,who complained of headache and weakness. In March 2003, he was diagnosed as having Stage IV gastric cancer with peritoneal dissemination (T3, Nx, P1) and underwent total gastrectomy with D1 dissection. Chemotherapy with S-1 was continued after surgery. Two years and two months later, a metastatic tumor was found in the upper lobe of the right lung. The protocol was changed to S-1+CDDP, but progression of his disease occurred. The weekly paclitaxel (PTX) therapy was tried instead. Seven months later, he developed headache and weakness, and multiple brain metastases were diagnosed by CT scanning. We performed total brain irradiation (30 Gy) and started CPT-11+CDDP therapy, which was continued on a fortnightly basis at 60 mg/m(2) and 30 mg/m(2), respectively. The brain metastases regressed (PR), and this therapy led to a marked improvement in his quality of life. The second patient was a 78-year-old man, who complained of weakness of the lower extremities and dizziness. In November 2003, he was diagnosed as having stage IB gastric cancer (T2 (ss), N0, P0), and underwent total gastrectomy and splenectomy with D2 dissection. One year and four months later, local recurrence at the anastomosis was detected, as well as a metastatic tumor in the right lung. S-1, S-1+CDDP, and weekly PTX therapy were all tried. One year later, the patient was admitted with weakness and dizziness,and brain metastases were detected by CT scanning. We then performed Cyber Knife treatment and administered CPT-11+CDDP. As a result, his brain metastases partially regressed (PR).
我们治疗了两名患者，其中伊立替康（CPT - 11）+顺铂（CDDP）联合放疗对胃癌脑转移显示出疗效。在28天的周期中，分别于第1天和第15天给予CPT - 11和CDDP，剂量分别为60mg/m²和30mg/m²。首例患者为63岁男性，主诉头痛和乏力。2003年3月，他被诊断为IV期胃癌伴腹膜播散（T3，Nx，P1），并接受了D1根治性全胃切除术。术后继续用S - 1进行化疗。两年零两个月后，在右肺上叶发现转移瘤。治疗方案改为S - 1+CDDP，但病情仍进展。遂改用每周一次的紫杉醇（PTX）治疗。7个月后，他出现头痛和乏力，CT扫描诊断为多发脑转移。我们进行了全脑照射（30Gy）并开始CPT - 11+CDDP治疗，分别以60mg/m²和30mg/m²的剂量每两周进行一次。脑转移瘤缩小（PR），该治疗使他的生活质量有了显著改善。第二例患者为78岁男性，主诉下肢无力和头晕。2003年11月，他被诊断为IB期胃癌（T2（ss），N0，P0），并接受了D2根治性全胃切除术和脾切除术。一年零四个月后，发现吻合口局部复发以及右肺转移瘤。先后尝试了S - 1、S - 1+CDDP和每周一次的PTX治疗。一年后，患者因乏力和头晕入院，CT扫描发现脑转移。随后我们进行了射波刀治疗并给予CPT - 11+CDDP。结果，他的脑转移瘤部分缩小（PR）。
