Yamamitsu Susumu, Kimura Hiromichi, Yamada Yoshiyuki, Inui Noriaki, Hiyama Shigemi, Hirata Koichi, Kimura Yasutoshi, Yamaguchi Kouji, Shirasaka Tetsuhiko
Sapporo Tsukisamu Hospital.
Gan To Kagaku Ryoho. 2007 Sep;34(9):1405-11.
Recently, it became possible to reduce the size of tumors in patients with advanced or relapsed gastric cancer by chemotherapy with the combination of several kinds of anti-cancer drugs which are all effective and allowed for use with gastric cancer patients. However, chemotherapy alone can not cure patients with advanced gastric cancer that was shown to improve median survival time (MST), compared with patients provided with the best supportive care (BSC). According to reports from Europe, US and Japan,the MST of patients with advanced gastric cancer and those with peritoneal expansion treated by chemotherapy is almost 7-12 months and 5-6 months,respectively, both of which are short and unsatisfactory. From March 2002, we started to treat patients with advanced gastric cancer (stage IV) with a new regimen; intermittent dosage of 5-FU (-->S-1), CDDP and paclitaxel utilizing the difference of cell cycle between normal and cancer cells (intermittent FP . weekly PTX). In the present study, therefore, we analyzed advanced gastric cancer patients with peritoneal expansion (9 cases, 4 with cancerous peritonitis) treated with this regimen. The results were as follows. The one-and 2-year survival rate was 55.6% and 27.8%, respectively, and the MST was 14 months. Four patients (44.4%) had hematological toxicities over grade 3. All of them had anemia (3 cases) and neutropenia (3 cases). Toxicities of thrombocytopenia were all under grade 1 and nonhematological toxicities were all under grade 2, which were clinically manageable. These results, although the sample was small, suggested that this may contribute to the extension of survival time of patients with stage IV advanced gastric cancer with peritoneal expansion.
最近，通过联合使用几种对胃癌患者有效的抗癌药物进行化疗，已能够缩小晚期或复发性胃癌患者的肿瘤大小。然而，单独化疗并不能治愈晚期胃癌患者，与接受最佳支持治疗（BSC）的患者相比，化疗仅能改善中位生存时间（MST）。根据欧洲、美国和日本的报告，接受化疗的晚期胃癌患者和腹膜转移患者的MST分别约为7 - 12个月和5 - 6个月，均较短且不尽人意。从2002年3月起，我们开始采用一种新方案治疗晚期胃癌（IV期）患者；利用正常细胞和癌细胞的细胞周期差异，间歇性给予5 - FU（→S - 1）、顺铂和紫杉醇（间歇性FP.每周一次PTX）。因此，在本研究中，我们分析了采用该方案治疗的伴有腹膜转移的晚期胃癌患者（9例，4例伴有癌性腹膜炎）。结果如下。1年和2年生存率分别为55.6%和27.8%，MST为14个月。4例患者（44.4%）出现3级以上血液学毒性。所有患者均有贫血（3例）和中性粒细胞减少（3例）。血小板减少毒性均在1级以下，非血液学毒性均在2级以下，临床可处理。尽管样本量较小，但这些结果表明，这可能有助于延长伴有腹膜转移的IV期晚期胃癌患者的生存时间。
