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两例伴有癌性腹膜炎的晚期胃癌患者通过使用多西他赛和顺铂实现腹水消失并获得良好生活质量

[Two cases of advanced gastric cancer with peritonitis carcinomatosa that showed disappearance of ascites and obtained a good quality of life by using DIF and paclitaxel].

作者信息

Okumura Kenji, Tani Souichiro, Shiogai Youji, Kodama Masashi, Mekata Eiji, Tan Tohru

机构信息

Dept. of Surgery, Shinsei Hospital.

出版信息

Gan To Kagaku Ryoho. 2012 Apr;39(4):667-70.

Abstract

We report two cases of advanced gastric cancer. The first was a 77-year-old man who had experienced distal gastrectomy about 35 years ago. He complained of abdominal bloating, and a gastrointestinal scope showed that he had advanced gastric cancer. CT scan revealed massive ascites. Dissemination of the peritoneum was suspected, and chemotherapy using S-1 (80mg/m², biweekly)plus paclitaxel (50mg/m², on days 1 and 8) was selected, He had no major side effects and the ascites disappeared. He was able to receive 18 courses on an outpatient basis. The second case was a 79-year-old man who had total gastrectomy performed 1 year ago. Invasion to the diaphragm and lymph node metastasis were detected. We selected S-1 (80 mg/m²)as adjuvant chemotherapy but that caused severe fatigue. Eventually he refused the drug. Six month later, he had abdominal bloating and CT scan revealed that he had massive ascites. UFT-E (1. 5 g/body) was administered and paclitaxe (l 50 mg/m²) was added. The ascites disappeared and he has had a stable life. DIF (S-1, UFT) plus paclitaxel is considered to be a useful chemotherapy combination against advanced gastric cancer that has peritoneal dissemination or ascites, even for older patients.

摘要

我们报告两例晚期胃癌病例。第一例是一名77岁男性,约35年前接受了远端胃切除术。他主诉腹胀,胃肠镜检查显示患有晚期胃癌。CT扫描显示大量腹水。怀疑有腹膜播散,选择使用S-1(80mg/m²,每两周一次)加紫杉醇(50mg/m²,第1天和第8天)进行化疗,他没有严重的副作用,腹水消失。他能够在门诊接受18个疗程的治疗。第二例是一名79岁男性,1年前接受了全胃切除术。检测到有膈肌侵犯和淋巴结转移。我们选择S-1(80mg/m²)作为辅助化疗,但这导致了严重的疲劳。最终他拒绝了该药物。6个月后,他出现腹胀,CT扫描显示有大量腹水。给予优福定(UFT-E,1.5g/人)并加用紫杉醇(150mg/m²)。腹水消失,他的生活一直稳定。S-1、优福定(UFT)加紫杉醇被认为是一种有效的化疗组合,可用于治疗有腹膜播散或腹水的晚期胃癌,即使是老年患者。

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