Deguchi Koichi, Nishikawa Kazuhiro, Iwase Kazuhiro, Kawada Junji, Aono Toyokazu, Yoshida Hiroshi, Nomura Masaya, Tamagawa Hiroshi, Matsuda Chu, Deguchi Takashi, Higashi Shigeyoshi, Okumura Yuichiro, Noguchi Yuki, Nomura Masatoshi, Takagi Mari, Fukui Akiko, Tanaka Yasuhiro
Dept. of Surgery, Osaka General Medical Center.
Gan To Kagaku Ryoho. 2013 Nov;40(12):2253-5.
We report a case of human epidermal growth factor receptor(HER)2-positive advanced gastric cancer successfully treated with a combination of capecitabine, cisplatin(CDDP), and trastuzumab as first-line chemotherapy. A 66-year-old woman diagnosed as having advanced gastric cancer underwent chemotherapy after abdominal computed tomography (CT)revealed multiple metastases to the liver, lung, lymph nodes, and peritoneum. Histopathological examination indicated a type 3, tub1, cT3(SS), N3, H1, P1, M1(LYM, PUL), cStage IV gastric tumor. Because overexpression of HER2 protein was observed in primary tumor immunostaining, combination therapy of capecitabine+CDDP+trastuzumab was administered as first-line chemotherapy. After 4 courses, CT scans revealed decreased primary tumor size, liver lesion, lymph nodes, and elimination of the lung lesion, thereby suggesting a partial response(PR). The grade 3 adverse events were neutropenia, anemia, and anorexia. After discontinuation of CDDP because of elevation of serum creatinine levels, combination therapy with capecitabine and trastuzumab was continued.
我们报告了一例人表皮生长因子受体（HER）2阳性晚期胃癌患者，采用卡培他滨、顺铂（CDDP）和曲妥珠单抗联合作为一线化疗方案成功治疗。一名66岁被诊断为晚期胃癌的女性患者，在腹部计算机断层扫描（CT）显示肝脏、肺、淋巴结和腹膜多发转移后接受了化疗。组织病理学检查显示为3型、tub1、cT3（SS）、N3、H1、P1、M1（LYM，PUL），c期IV型胃肿瘤。由于在原发性肿瘤免疫染色中观察到HER2蛋白过表达，因此采用卡培他滨+CDDP+曲妥珠单抗联合治疗作为一线化疗方案。4个疗程后，CT扫描显示原发性肿瘤大小减小、肝脏病灶、淋巴结减小，肺部病灶消失，提示部分缓解（PR）。3级不良事件为中性粒细胞减少、贫血和厌食。因血清肌酐水平升高停用顺铂后，继续采用卡培他滨和曲妥珠单抗联合治疗。
