Funaki Hiroshi, Ohnishi Toshio, Ohno Yukako, Tomita Yasuto, Hosokawa Kenzo, Yokoi Miki, Yoshitani Shinichiro, Kinami Shinichi, Omote Kazuhiko, Ueda Nobuhiko, Nakano Yasuharu, Kosaka Takeo
Dept. of Surgical Oncology, Kanazawa Medical University.
Gan To Kagaku Ryoho. 2010 Nov;37(12):2430-2.
A 79-year-old man complaining of epigastralgia was examined and diagnosed with advanced gastric cancer (UML, Type 5, Ant-Less-Gre, cT4a, cN1, cH0, cP1, cStage IV). A poor prognosis was predicted, but we tried preoperative chemotherapy hoping for a down-staging of the tumor. We chose a regimen of S-1 plus cisplatin as follows: S-1 (60 mg/m2) was administered orally for 3 weeks followed 2 weeks of rest, and cisplatin (50 mg/m2) was administered by intravenous drip on day 8. After three cycles of treatment, diagnostic laparoscopic examination revealed a suspected serosal invasion of the main tumor, but peritoneal dissemination was not seen, and abdominal washing cytology was negative. After the fourth cycle of treatment, total gastrectomy with lymph node dissection (D1+No. 7, 8a, 9, R0) was performed. Histological examination of the resected specimens revealed no residual cancer cells in the primary lesion or regional lymph nodes, resulting in a diagnosis of complete response to chemotherapy according to the Japanese Classification of Gastric Carcinoma. The postoperative course was uneventful, and he has been fine as an outpatient.
一名79岁主诉上腹痛的男性接受检查后被诊断为进展期胃癌（UML，5型，胃窦部少，cT4a，cN1，cH0，cP1，c期IV）。预计预后较差，但我们尝试进行术前化疗以期肿瘤降期。我们选择了如下S-1联合顺铂的方案：S-1（60mg/m²）口服3周，随后休息2周，顺铂（50mg/m²）在第8天静脉滴注。经过三个周期的治疗，诊断性腹腔镜检查显示主肿瘤疑似浆膜侵犯，但未见腹膜播散，且腹腔冲洗细胞学检查为阴性。在第四个周期治疗后，进行了全胃切除术及淋巴结清扫（D1+第7、8a、9组，R0）。切除标本的组织学检查显示原发灶及区域淋巴结无残留癌细胞，根据日本胃癌分类诊断为化疗完全缓解。术后病程平稳，他作为门诊患者情况良好。
