Sugishita Hiroki, Ishida Naoki, Yoshida Motohira, Sato Koichi, Doi Takashi, Horiuchi Atsushi, Watanabe Yuji
Department of Surgery, Division of Gastrointestinal Surgery and Surgical Oncology, Ehime University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2010 Jul;37(7):1385-8.
A 57-year-old man underwent total gastrectomy with D2 lymphadenectomy for advanced gastric cancer. The post operative diagnosis was Stage IIIB (tubular adenocarcinoma, moderately-differentiated type, SE, N2, M0). The patient's postoperative course was uneventful, and S-1 was administered as adjuvant chemotherapy. However, about 14 months later, a gradual left cervical lymph node swelling became evident, with an increase in the level of the tumor marker CA19-9, suggesting recurrence of the gastric cancer. After obtaining informed consent, S-1 (100 mg/body), cisplatin (60 mg/m2), and docetaxel (40 mg/m2) combination chemotherapy (DCS) was performed. After 5 courses of DCS, the patient's swollen left cervical lymph nodes became non-palpable, and also undetectable by diagnostic imaging, together with normalization of the CA19-9 level. At three months since the last chemotherapy, the patient showed no signs of recurrence. DCS is a potentially effective treatment for recurrent gastric cancer with resistance to S-1.
一名57岁男性因进展期胃癌接受了D2淋巴结清扫的全胃切除术。术后诊断为IIIB期（管状腺癌，中分化型，SE，N2，M0）。患者术后恢复顺利，并接受S-1辅助化疗。然而，约14个月后，左侧颈部淋巴结逐渐肿大，肿瘤标志物CA19-9水平升高，提示胃癌复发。在获得知情同意后，进行了S-1（100mg/体）、顺铂（60mg/m²）和多西他赛（40mg/m²）联合化疗（DCS）。5个疗程的DCS治疗后，患者左侧颈部肿大的淋巴结触诊不可及，诊断性影像学检查也未发现，同时CA19-9水平恢复正常。自最后一次化疗3个月以来，患者无复发迹象。DCS对于对S-1耐药的复发性胃癌可能是一种有效的治疗方法。
