Shiochi Hideki, Yamada Minoru, Kishina Manabu, Murawaki Yoshiyuki, Miura Masahiko, Azumi Takane, Yuuki Takafumi, Tanaka Shinsuke, Kono Michimori, Yoshimura Teiji, Yoshida Manabu, Shabana Masanobu
Dept. of Gastroenterology, Matsue City Hospital.
Gan To Kagaku Ryoho. 2009 May;36(5):843-6.
We report a case of a 64-year-old male with a-fetoprotein(AFP)-producing gastric cancer accompanied by large liver metastases and multiple lymph node metastases. The patient's serum AFP level was 42,307 ng/mL and a biopsy specimen showed AFP-positive tumor cells immunohistochemically. Systemic chemotherapy by tegafur gimeracil oteracil potassium(S-1)and local therapy for the hepatic metastases consisting of transcatheter arterial embolization (TAE)and infusion of epirubicin(EPI)to the hepatic arteries decreased the serum AFP level and reduced the gastric cancer and metastases. Due to the increase of AFP and lymph node metastases, we had to successively change the regimen to paclitaxel(PTX), a combination of cisplatin(CDDP)/irinotecan(CPT-11)and S-1. Continuous systemic chemotherapy in combination with various drugs for gastric cancer treatment followed by TAE and hepatic infusion chemotherapy for hepatic metastases proved effective. The patient survived for 3 years and 2 months.
我们报告一例64岁男性,患有产生甲胎蛋白(AFP)的胃癌,伴有肝脏大转移灶和多发淋巴结转移。患者血清AFP水平为42,307 ng/mL,活检标本经免疫组化显示AFP阳性肿瘤细胞。采用替吉奥(S-1)进行全身化疗,以及对肝转移灶采用经导管动脉栓塞术(TAE)和向肝动脉注入表柔比星(EPI)的局部治疗,降低了血清AFP水平,缩小了胃癌及转移灶。由于AFP升高和淋巴结转移,我们不得不先后将治疗方案改为紫杉醇(PTX)、顺铂(CDDP)/伊立替康(CPT-11)联合S-1。持续采用多种药物联合进行全身化疗治疗胃癌,随后对肝转移灶进行TAE和肝灌注化疗,证明是有效的。该患者存活了3年零2个月。