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[1例晚期胃癌伴多发肝转移患者经术前及术后S-1/CPT-11联合化疗成功治疗的切除病例]

[A resected case of advanced gastric cancer with multiple liver metastasis successfully treated by preoperative and postoperative S-1/CPT-11 combination chemotherapy].

作者信息

Matsumoto Kotaro, Morisaki Takashi, Hirano Tatsuya, Sada Masayuki

机构信息

Dept. of Surgery, Hamanamachi Hospital.

出版信息

Gan To Kagaku Ryoho. 2011 May;38(5):819-22.

Abstract

A 75-year-old man was admitted for anemia, and a tar stool found by endoscopic examination revealed a type 3 advanced gastric cancer in the lower stomach. Multiple liver metastases 4 cm in diameter were shown on CT. Because we thought that the case was unresectable, S-1/CPT-11 chemotherapy was performed. S-1 (80mg/body/day) was orally administered for 2 weeks followed by a drug-free 1 week, and CPT-11 (100mg/body/day) was given intravenously on days 1 and 8. After 3 courses of chemotherapy, the primary lesion, the regional lymph nodes, and the metastatic lesion of the liver were slightly reduced in size. He was judged as clinical PR, and distal gastrectomy and lymph node dissection were performed. One month after surgery the tumor marker values became normal, and CT could hardly detect metastatic liver tumors. Now, after 3 years, the PR stage has been maintained. Combined use of peroral S-1 and CPT-11 by intravenous infusion is effective for multiple liver metastasis after gastrectomy in gastric cancer.

摘要

一名75岁男性因贫血入院,内镜检查发现柏油样便,提示胃下部有3型进展期胃癌。CT显示肝脏有多个直径4厘米的转移灶。由于我们认为该病例无法切除,遂进行S-1/CPT-11化疗。S-1(80毫克/体/天)口服2周,随后停药1周,CPT-11(100毫克/体/天)于第1天和第8天静脉给药。化疗3个疗程后,原发灶、区域淋巴结及肝脏转移灶大小略有缩小。他被判定为临床部分缓解(PR),遂行远端胃切除术及淋巴结清扫术。术后1个月肿瘤标志物值恢复正常,CT几乎检测不到肝脏转移瘤。现在,3年过去了,PR状态得以维持。口服S-1联合静脉输注CPT-11对胃癌胃切除术后的多发肝转移有效。

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