Kitano Yoshinori, Hatabe Shigeru, Inoue Kiyohiko, Funai Sadao, Tanaka Akira
Department of Surgery, Sakai Hospital, Kinki University School of Medicine, Japan.
Gan To Kagaku Ryoho. 2010 Jan;37(1):161-3.
The patient is a 62-year-old male who was treated for macroscopic-type 3 gastric cancer by total gastrectomy (D2) and splenectomy. His disease was recorded as pT3, pN2, Stage IIIB, curability B, and S-1 was started as postoperative adjuvant chemotherapy. One year later, during the adjuvant chemotherapy, CT revealed para-aortic lymph node enlargement. Recurrence was diagnosed, and S-1 (100mg/body, days 1-28) + CPT-11 (80 mg/body, days 1, 8, 15, and 22) combination therapy was started. After 4 courses, the lymph node had markedly regressed (regression rate: 72. 2%), and CPT-11 administration was changed to biweekly (days 1, 15, 28). A total of 9 courses were administered, and during the 9th course it disappeared. Adverse events during the 9 courses consisted of only grade 1 alopecia and grade 2 diarrhea and leukopenia, and none of them were serious. At the patient's request, only oral S-1 was continued thereafter, however, CR has been maintained for 30 months. S-1+CPT-11 combination therapy can be conducted safely on an outpatient basis, and it has been superior in terms of continuity of treatment.
该患者为62岁男性,因肉眼可见的3型胃癌接受了全胃切除术(D2)和脾切除术。其病情记录为pT3、pN2、IIIB期、可治愈性B,术后开始使用S-1进行辅助化疗。一年后,在辅助化疗期间,CT显示主动脉旁淋巴结肿大。确诊为复发,开始使用S-1(100mg/体,第1 - 28天)+伊立替康(80mg/体,第1、8、15和22天)联合治疗。4个疗程后,淋巴结明显缩小(缩小率:72.2%),伊立替康的给药改为每两周一次(第1、15、28天)。共进行了9个疗程,在第9个疗程时淋巴结消失。9个疗程期间的不良事件仅包括1级脱发、2级腹泻和白细胞减少,均不严重。应患者要求,此后仅继续口服S-1,然而,完全缓解已维持30个月。S-1+伊立替康联合治疗可在门诊安全进行,且在治疗连续性方面更具优势。