Kojima Yuichi, Kii Takayuki, Takiuchi Hiroya, Kuwakado Shin, Kawabe Shinichiro, Gotoh Masahiro, Yoshida Motoki, Higuchi Kazuhide, Egashira Yutaro, Tanigawa Nobuhiko
2nd Dept. of Internal Medicine, Osaka Medical College.
Gan To Kagaku Ryoho. 2010 Jul;37(7):1381-4.
We report a resected case of effective treatment with S-1+CPT-11 combination chemotherapy for advanced gastric cancer. The patient was a 65-year-old man who had a type 3 gastric cancer from the middle body of the stomach to the angle. An abdominal CT scan demonstrated bulky lymph node metastasis (cType 3, T3, N2, M0, cStage IIIb), which was then treated with S-1+CPT-11 (S-1 80 mg/m2 day 1-21, CPT-11 80 mg/m2 day 1, 15/5 weeksx2 courses)as neoadjuvant chemotherapy. After 2 courses of chemotherapy, the primary lesion and regional metastatic lymph nodes were reduced by CT (cType 3, T2, N2, M0, cStage IIIa). Total gastrectomy with D3 nodal dissection was performed. The histological diagnosis was pT2 (ss), pN0, sH0, pCY0, sP0, sM0, tub2, INF beta, ly0, v1, n0, stage I b, Cur A, and the histological effect of the main tumor was judged to be Grade 1b. He was treated by S-1 after surgery. The patient has been in good health without a recurrence for 3 years after surgery. This case suggests that neoadjuvant chemotherapy with S-1+CPT-11 is a potential regimen for advanced gastric cancer.
我们报告了1例晚期胃癌患者接受S-1联合CPT-11化疗并取得有效治疗效果的病例。患者为一名65岁男性,患有胃中体至胃角部的3型胃癌。腹部CT扫描显示有巨大淋巴结转移(cType 3,T3,N2,M0,cStage IIIb),随后接受S-1联合CPT-11(S-1 80 mg/m² 第1 - 21天,CPT-11 80 mg/m² 第1天,每5周重复15天,共2个疗程)作为新辅助化疗。2个疗程化疗后,CT显示原发灶和区域转移淋巴结缩小(cType 3,T2,N2,M0,cStage IIIa)。遂行D3淋巴结清扫的全胃切除术。组织学诊断为pT2(ss),pN0,sH0,pCY0,sP0,sM0,tub2,INFβ,ly0,v1,n0,I b期,Cur A,主要肿瘤的组织学疗效判定为1b级。术后给予S-1治疗。患者术后3年身体健康,无复发。该病例表明,S-1联合CPT-11新辅助化疗是晚期胃癌的一种潜在治疗方案。