Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 1-1-2 Nakao, Yokohama, Asahi-Ku 241-0815, Japan.
Surg Today. 2012 Oct;42(10):983-7. doi: 10.1007/s00595-012-0155-3. Epub 2012 Mar 8.
We report a case of advanced gastric carcinoma treated successfully by four courses of neoadjuvant chemotherapy (NAC) with paclitaxel and cisplatin. The patient was a 43-year-old man with advanced gastric cancer, clinically diagnosed as P0H0M0CY0T3N2, which had invaded the upper body of the stomach and esophagus. He was entered into a clinical trial and received the following NAC regimen: paclitaxel 80 mg/m(2), and cisplatin 25 mg/m(2), on days 1, 8, and 15, followed by a rest on day 22, as one course. The lymph nodes had reduced in size to 59% after two courses and to 40% after four courses, with no sign of severe toxicity. Subsequently, he underwent D2 total gastrectomy with pancreatico-splenectomy. On microscopic examinations, no tumor cells were detected in the ulcer scar of the resected stomach or the regional lymph nodes. Thus, we discuss the potential of long-term NAC, especially for responders to two initial courses.
我们报告了一例成功接受紫杉醇和顺铂新辅助化疗（NAC）四疗程治疗的晚期胃癌病例。该患者为 43 岁男性，患有晚期胃癌，临床诊断为 P0H0M0CY0T3N2，肿瘤已侵犯胃上部和食管。他参加了一项临床试验，接受了以下 NAC 方案：紫杉醇 80 mg/m²，顺铂 25 mg/m²，于第 1、8 和 15 天给药，随后在第 22 天休息，为一个疗程。两疗程后，淋巴结缩小至 59%，四疗程后缩小至 40%，无严重毒性迹象。随后，他接受了 D2 全胃切除术伴胰脾切除术。显微镜检查发现，切除胃的溃疡疤痕或区域淋巴结中均未检测到肿瘤细胞。因此，我们讨论了长期 NAC 的潜力，特别是对两个初始疗程有反应者。
