Yamaki Sou, Iwata Shingo, Ohtsuka Kazuo, Kitaoka Akihiro, Masumoto Hirofumi, Katoh Hitoshi
Dept. of Surgery, Takeda General Hospital.
Gan To Kagaku Ryoho. 2008 May;35(5):821-3.
The patient was a 54-year-old female with gastric cancer. As laparotomy showed diffuse peritoneal dissemination, only laparotomy was performed and chemotherapy was conducted with a combination of S-1 80 mg/m(2) (2 weeks administration and 1 week rest) and paclitaxel (PTX) 50 mg/m(2) (day 1, 8). After 5 courses of this regimen, endoscopy showed the tumor was reduced in size and PET-CT revealed no evidence of metastasis. She underwent total gastrectomy with D2 lymph node dissection and Roux-en Y reconstruction. Peritoneal metastasis histologically disappeared, and the final findings were T1, N0, H0, P0, CY0, M0, Stage I A, Cur A. The only adverse effect was grade 1 stomatitis during this chemotherapy. CT showed no findings of recurrence 11 months after the operation. The S-1/PTX combination chemotherapy was thought to be effective for gastric cancer with peritoneal dissemination and made curative operation possible in this case.
该患者为一名54岁的胃癌女性。剖腹探查显示弥漫性腹膜播散,仅进行了剖腹手术,并采用S-1 80 mg/m²(给药2周,休息1周)和紫杉醇(PTX)50 mg/m²(第1天、第8天)联合进行化疗。经过5个疗程的该方案治疗后,内镜检查显示肿瘤体积缩小,PET-CT检查未发现转移迹象。她接受了D2淋巴结清扫的全胃切除术及Roux-en Y重建术。组织学检查显示腹膜转移消失,最终检查结果为T1、N0、H0、P0、CY0、M0,ⅠA期,A组治愈性切除。此次化疗期间唯一的不良反应为1级口腔炎。术后11个月CT检查未发现复发迹象。S-1/PTX联合化疗被认为对腹膜播散性胃癌有效,且在该病例中使根治性手术成为可能。