Sugawara Hiromitsu, Ichiki Masataka, Sai Keijyou, Kamata Keisuke, Ansai Makoto, Nakano Yoshiyuki, Kawamura Masashi, Ichinose Azusa, Miyazaki Shukichi
Dept. of Surgery, JR Sendai Hospital.
Gan To Kagaku Ryoho. 2009 May;36(5):855-8.
We have recently experienced a case in which S-1/CDDP combination therapy proved remarkably efficacious for a rapid, extensive lymph node recurrence with metastasis into a Virchow node that had developed after resection of advanced gastric carcinoma accompanied with a marked invasion of the esophagus. The patient, a woman aged 73, underwent a total gastrectomy upon left thoracolaparotomy for a gastric carcinoma at the cardia with a 5-cm involvement of the esophagus. On day 65 post-operation, a diagnosis of Virchow node and para-aortic lymph node recurrence was made on the basis of CT scan findings. Of tumor markers checked, CEA and CA19-9 were noted to be increased to as high as 37.55 ng/mL and 3,235 U/mL, respectively. The patient received three courses of S-1/CDDP combination therapy, with a consequent noticeable contraction of the Virchow node and enlarged para-aortic lymph node. Further, she was given two courses of S-1 therapy, which resulted in normalization of tumor markers. The patient has since been on continued chemotherapy without any sign of recurrence.
我们最近遇到了这样一个病例,对于一名晚期胃癌伴食管明显侵犯患者,在切除术后出现快速、广泛的淋巴结复发并转移至魏尔啸淋巴结,S-1/顺铂联合疗法被证明具有显著疗效。该患者为一名73岁女性,因贲门部胃癌伴5厘米食管受累,经左胸腹联合切口行全胃切除术。术后第65天,根据CT扫描结果诊断为魏尔啸淋巴结及主动脉旁淋巴结复发。在检查的肿瘤标志物中,癌胚抗原(CEA)和糖类抗原19-9(CA19-9)分别升高至37.55纳克/毫升和3235单位/毫升。该患者接受了三个疗程的S-1/顺铂联合治疗,随后魏尔啸淋巴结和肿大的主动脉旁淋巴结明显缩小。此外,她又接受了两个疗程的S-1治疗,肿瘤标志物恢复正常。此后,该患者一直在持续化疗,没有任何复发迹象。