Ohno Tomoyoshi, Horiguchi Noriyuki, Asukai Koki, Miura Aki, Koguchi Hiroki, Shimizu Shuya, Matsunaga Seijiro, Togawa Shozo, Hasegawa Izumi, Sakakibara Kenji
Dept. of Gastroenterology, Social Insurance Chukyo Hospital, Japan.
Gan To Kagaku Ryoho. 2012 Jul;39(7):1123-6.
The patient was a 66-year-old male, admitted and diagnosed as having advanced gastric cancer with peritoneal dissemination, leading to ascites and obstructive jaundice. After reducing the degree of obstructive jaundice, combination chemotherapy of S-1 80mg/m2/day(2 weeks administration and 1 week rest)and docetaxel(TXT)40mg/m2(day 1)was administered from February, 2008. After 3 courses of this regimen, CT revealed no evidence of ascites, and this chemotherapy was successively continued on an outpatient basis until June, 2009. After the relapse of ascites from July, 2009, combination chemotherapy of irinotecan(CPT-11)60mg/m2 and cisplatin(CDDP)30mg/m2 biweekly was performed as second-line chemotherapy, and the ascites disappeared again after around 2 courses of this regimen. This chemotherapy was continued on an outpatient basis until February, 2010. No major adverse reaction to either chemotherapy was observed. This case suggests that these chemotherapies, such as the combination chemotherapy of S-1 plus TXT as a first-line treatment and CPT-11 plus CDDP as the following second-line treatment, can be administered to an outpatient, can keep good patient's QOL and can be one of the effective chemotherapy options for advanced gastric cancer with peritoneal dissemination.
该患者为66岁男性,因晚期胃癌伴腹膜播散入院,出现腹水和梗阻性黄疸。在减轻梗阻性黄疸程度后,自2008年2月起给予S-1 80mg/m²/天(给药2周,休息1周)联合多西他赛(TXT)40mg/m²(第1天)的化疗方案。该方案进行3个疗程后,CT显示无腹水迹象,此化疗方案继续在门诊进行,直至2009年6月。自2009年7月腹水复发后,采用伊立替康(CPT-11)60mg/m²和顺铂(CDDP)30mg/m²每2周一次的联合化疗作为二线化疗,该方案进行约2个疗程后腹水再次消失。此化疗在门诊持续至2010年2月。未观察到两种化疗有严重不良反应。该病例表明,这些化疗方案,如一线治疗采用S-1联合TXT的联合化疗,二线治疗采用CPT-11联合CDDP的联合化疗,可在门诊进行,能保持患者良好的生活质量,且可作为晚期胃癌伴腹膜播散的有效化疗选择之一。