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[1例胃癌伴多发肝转移行胃切除加淋巴结清扫术及口服S-1与顺铂动脉灌注联合化疗获完全缓解的病例]

[A case of complete response treated by gastrectomy with lymphadenectomy and combined chemotherapy of peroral S-1 and CDDP by arterial infusion for gastric cancer with multiple liver metastasis].

作者信息

Adachi Atsushi, Uchiyama Tetsuji, Uchisako Hiroyuki, Hashimoto Hiroaki

机构信息

Dept. of Surgery, Iwakuni Medical Center, Japan.

出版信息

Gan To Kagaku Ryoho. 2008 Mar;35(3):503-6.

Abstract

A 70-year-old female was admitted to our hospital with high fever about 5 days before this writing, along with anemia and hyperglycemia. Upper gastrointestinal series and endoscopy revealed type 1 gastric cancer in the greater curvature. CT and MRI showed multiple liver metastasis in the right lobe. Distal partial gastrectomy with lymphadenectomy and cannulation of hepatic artery was performed. The pathological findings revealed moderately-differentiated adenocarcinoma, T2, N0, H1, M0, stage IV. The postoperative chemotherapy with S-1 (80 mg/day) was administered for 4 weeks followed by 1 week rest and CDDP (50 mg) administered once every 4 weeks by arterial infusion. Two months after operation the tumor marker values have become normal, and CT can hardly detect the metastatic liver tumors. At 8 months after operation, CT and MRI revealed complete disappearance of these tumors. Then, 12 months after operation, FDG-PET revealed no accumulation. Now, at 18 months, the CR stage has been maintained. Combined use of peroral S-1 and CDDP by arterial infusion is effective for multiple liver metastasis after gastrectomy in gastric cancer.

摘要

一名70岁女性在撰写本文前约5天因高热、贫血和高血糖入住我院。上消化道造影和内镜检查显示胃大弯处为1型胃癌。CT和MRI显示右叶有多处肝转移。行远端胃部分切除术、淋巴结清扫术及肝动脉插管术。病理结果显示为中分化腺癌,T2,N0,H1,M0,IV期。术后用S-1(80mg/天)进行4周化疗,随后休息1周,每4周通过动脉灌注给予顺铂(50mg)。术后2个月肿瘤标志物值恢复正常,CT几乎检测不到转移性肝肿瘤。术后8个月,CT和MRI显示这些肿瘤完全消失。然后,术后12个月,FDG-PET显示无聚集。现在,术后18个月,维持完全缓解(CR)状态。口服S-1与动脉灌注顺铂联合应用对胃癌胃切除术后多发肝转移有效。

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