Seshimo Ken, Kanagawa Taiichiro, Yamashita Yutaka, Oishi Masahiro, Kodera Masahito, Yamamura Masao, Katoh Hiroshi, Ikeda Hideaki, Yokomichi Naosuke, Kobayashi Keita, Takita Keiko
Dept. of Surgery, Tottori Municipal Hospital.
Gan To Kagaku Ryoho. 2009 Oct;36(10):1741-4.
The patient was a 63-year-old male with multiple peritoneal disseminations of advanced gastric cancer. He underwent chemotherapy with a combination of S-1 120 mg/day (3 weeks administration and 2 weeks rest) and cisplatin (CDDP) 60 mg/m(2) (day 8). After 3 courses of this regimen, CT revealed no evidence of ascites. He then underwent laparatomy. Peritoneal dissemination appeared, and the findings were sT3, N0, H0, P1, CY1, M1(PLE), sStage IV. A bypass operation was performed. As second-line chemotherapy, he received combination chemotherapy with S-1 and paclitaxel (PTX) 60 mg/m(2) (div), 20 mg/m(2) ( ip) (day 1, 8). However, he complained of ascites after 16 courses. We tried weekly administration of PTX and tri-weekly administration of irinotecan (50 mg/m(2)) with S-1. This treatment was successfully continued for 20 courses. The adverse effect was anemia (grade 2). He died two years eight months after surgery. The chemotherapy with S-1/CDDP, S-1/PTX, and S-1/PTX/irinotecan was thought to be effective for advanced gastric cancer with peritoneal dissemination.
该患者为63岁男性，患有晚期胃癌伴多发腹膜播散。他接受了S-1 120毫克/天（给药3周，休息2周）和顺铂（CDDP）60毫克/平方米（第8天）联合化疗。经过3个疗程的该方案治疗后，CT显示无腹水迹象。随后他接受了剖腹手术。出现了腹膜播散，检查结果为sT3、N0、H0、P1、CY1、M1（PLE），s分期为IV期。进行了旁路手术。作为二线化疗，他接受了S-1与紫杉醇（PTX）60毫克/平方米（静脉滴注）、20毫克/平方米（腹腔注射）（第1、8天）的联合化疗。然而，16个疗程后他出现了腹水。我们尝试了紫杉醇每周给药以及伊立替康（50毫克/平方米）与S-1每三周给药一次。该治疗成功持续了20个疗程。不良反应为贫血（2级）。他在手术后两年零八个月死亡。S-1/CDDP、S-1/PTX以及S-1/PTX/伊立替康化疗被认为对伴有腹膜播散的晚期胃癌有效。
