Hamakawa Takuya, Kurokawa Yukinori, Takiguchi Shuji, Takahashi Tsuyoshi, Yamasaki Makoto, Miyata Hiroshi, Nakajima Kiyokazu, Mori Masaki, Dok Yuichiro
Dept. of Gastroenterological Surgery, Osaka University, Graduate School of Medicine.
Gan To Kagaku Ryoho. 2011 Nov;38(12):2342-4.
Combination of docetaxel, cisplatin, and S-1 (DCS) is expected as a new treatment regimen for far advanced gastric cancer. We performed DCS chemotherapy for six patients, including four cases with invasion to pancreas, three cases with para-aortic lymph node metastasis, and two cases with liver metastasis. Clinical stages were either IIIC or IV for all of the patients. The patients received 2-4 courses of docetaxel (40 mg/m²) and cisplatin (60 mg/m²) on day 1, and S-1 (80 mg/m²) on days 1-14 every 4 weeks. The response rate was 83% (5 PR and 1 SD), and the disease control rate was 100%. Grade 3/4 neutropenia, grade 3 febrile neutropenia, and grade 3 diarrhea were observed in three cases (50%), one case (17%), and one case (17%), respectively. Four of six patients underwent R0 surgery after DCS chemotherapy, and no severe complication was occurred. Histological responses were Grade 2 for two cases, Grade 1b for one case, and Grade 1a for one case, respectively. DCS regimen showed a high objective tumor response, and also is one of the promising regimens as neoadjuvant setting for far advanced gastric cancer.
多西他赛、顺铂和S-1（DCS）联合方案有望成为晚期胃癌的一种新治疗方案。我们对6例患者进行了DCS化疗，其中4例侵犯胰腺，3例主动脉旁淋巴结转移，2例肝转移。所有患者的临床分期均为IIIC期或IV期。患者每4周在第1天接受2 - 4个疗程的多西他赛（40 mg/m²）和顺铂（60 mg/m²），并在第1 - 14天接受S-1（80 mg/m²）。有效率为83%（5例部分缓解和1例疾病稳定），疾病控制率为100%。分别有3例（50%）、1例（17%）和1例（17%）观察到3/4级中性粒细胞减少、3级发热性中性粒细胞减少和3级腹泻。6例患者中有4例在DCS化疗后接受了R0手术，未发生严重并发症。组织学反应分别为2级2例、1b级1例和1a级1例。DCS方案显示出较高的客观肿瘤反应，也是晚期胃癌新辅助治疗中有前景的方案之一。
