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[晚期胃癌伴食管明显受累手术后Virchow淋巴结复发采用S-1/顺铂联合治疗的显著临床反应——1例报告]

[Noticeable clinical response to S-1/CDDP combination therapy for Virchow node recurrence after surgery for advanced gastric carcinoma with marked involvement of the esophagus - report of a case].

作者信息

Sugawara Hiromitsu, Ichiki Masataka, Sai Keijyou, Kamata Keisuke, Ansai Makoto, Nakano Yoshiyuki, Kawamura Masashi, Ichinose Azusa, Miyazaki Shukichi

机构信息

Dept. of Surgery, JR Sendai Hospital.

出版信息

Gan To Kagaku Ryoho. 2009 May;36(5):855-8.

Abstract

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.

摘要

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。

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