Matsutani Takeshi, Suzuki Seiji, Mizutani Takashi, Miyamoto Masayuki, Maruyama Hiroshi, Yokoyama Tadashi, Yanagi Ken, Matsushita Akira, Kashiwabara Moto, Matsuda Akihisa, Nishi Yoshifumi, Arai Hiroki, Sasajima Koji, Tajiri Takashi
Dept. of Surgery, Nippon Medical School Tama- Nagayama Hospital.
Gan To Kagaku Ryoho. 2008 Jul;35(7):1193-5.
A 75-year-old man with advanced gastric cancer underwent distal gastrectomy with lymph node dissection(D1)and Roux-en Y reconstruction. Pathological staging was Stage IV (T3N3P1CY1M1), and curability was Cur C. He started adjuvant chemotherapy with oral administration of S-1(100 mg/body weight), but experienced grade 3 anorexia for one month. Abdominal computed tomography(CT)2 months postoperatively showed multiple liver metastases and ascites. We then conducted tailored S-1/CPT-11 as second-line chemotherapy(S-1 80 mg/body weight on days 1-5 and 8-12, CPT-11 60 mg/body weight on days 1 and 8). After 5 courses of this therapy, CT showed that the liver metastases and ascites had disappeared, leading to a complete response(CR). The only adverse event was general grade 1 fatigue. He continues to undergo oral administration of S-1(80 mg/body weight)as maintenance therapy, and maintained CR for 12 months since undergoing chemotherapy. Adverse events in tailored S-1/CPT-11 combination therapy are mild and tolerable, making this regimen a potential therapeutic strategy for patients with advanced or recurrent gastric cancer.
一名75岁的晚期胃癌男性患者接受了远端胃切除术加淋巴结清扫（D1）及Roux-en Y重建术。病理分期为IV期（T3N3P1CY1M1），根治性为C期。他开始口服S-1（100毫克/体重）进行辅助化疗，但出现了1个月的3级厌食症。术后2个月的腹部计算机断层扫描（CT）显示多发肝转移和腹水。然后我们进行了个体化的S-1/伊立替康作为二线化疗（S-1 80毫克/体重，第1 - 5天和第8 - 12天给药；伊立替康60毫克/体重，第1天和第8天给药）。经过5个疗程的这种治疗后，CT显示肝转移和腹水消失，达到完全缓解（CR）。唯一的不良事件是1级全身疲劳。他继续口服S-1（80毫克/体重）作为维持治疗，自接受化疗以来维持CR状态达12个月。个体化的S-1/伊立替康联合治疗的不良事件轻微且可耐受，使该方案成为晚期或复发性胃癌患者的一种潜在治疗策略。
