Tanizaki Keiko, Nishioka Kiyonori, Kobayashi Kenji, Igarashi Yuko, Tsukao Yukiko, Tanida Tsukasa, Komori Takamichi, Matsumoto Takashi, Takachi Kou, Aoki Taro, Uemura Yoshio
Dept. of Surgery, Kinki Central Hospital.
Gan To Kagaku Ryoho. 2008 Nov;35(12):2048-50.
The patient was a 75-year-old woman, who was diagnosed with type 3 gastric cancer. Total gastrectomy with D2-#10 lymph node dissection and partial hepatic resection was performed. Histological findings showed it to be stage IV (pT2N1M0P0CY0H1) and AFP producing gastric cancer. After the operation, liver metastasis was found, and RFA, partial hepatic resections, hepatic intra-arterial infusion chemotherapy (5-FU, CDDP), intravenous chemotherapy (docetaxel, paclitaxel, CPT-11) were applied. Although liver metastasis was disappeared, paraaortic lymph node recurrence appeared, and chemotherapy was not effective. Radiation therapy (2 Gy/day, total 50 Gy) for paraaortic lymph node metastasis was performed. The metastatic node underwent complete remission following a radiation therapy. Three years and six months passed since the first operation, and the patient has shown no signs of relapse. Therefore, our case suggests radiation therapy could be an effective treatment modality for the lymph node metastasis in AFP producing gastric cancer.
该患者为一名75岁女性，被诊断为3型胃癌。实施了D2-#10淋巴结清扫的全胃切除术及部分肝切除术。组织学检查结果显示为IV期（pT2N1M0P0CY0H1）且为产生甲胎蛋白的胃癌。术后发现肝转移，遂应用射频消融、部分肝切除术、肝动脉内灌注化疗（5-氟尿嘧啶、顺铂）及静脉化疗（多西他赛、紫杉醇、伊立替康）。尽管肝转移消失，但腹主动脉旁淋巴结复发，化疗无效。对腹主动脉旁淋巴结转移进行了放射治疗（2Gy/天，共50Gy）。放疗后转移淋巴结完全缓解。自首次手术已过去三年零六个月，患者无复发迹象。因此，我们的病例提示放射治疗可能是治疗产生甲胎蛋白胃癌淋巴结转移的有效治疗方式。
