Takishita Chie, Yajima Kazuhito, Iwasaki Yoshiaki, Ohashi Manabu, Iwanaga Tomohiro, Oohinata Ryouki
Dept. of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital.
Gan To Kagaku Ryoho. 2014 Dec;41(13):2611-4.
We report a case of complete response (CR) following induction chemotherapy using S-1 for a patient with early gastric cancer accompanied by multiple synchronous bone metastases. An asymptomatic 70-year-old woman was diagnosed with early gastric cancer by upper gastrointestinal endoscopy during a periodic medical examination. An abdomino-pelvic computed tomography (CT) scan revealed no primary tumor in the stomach and the absence of lymph node or liver metastases. However, osteoplastic changes were detected in the lumbar vertebrae and the ilium. Multiple synchronous bone metastases from early gastric cancer were detected on magnetic resonance imaging, bone scintigraphy, and positron emission tomography- CT. After a regimen consisting of 15 courses of S-1 plus cisplatin (CDDP), and an additional 5 courses of S-1 were administered, clinical CR was confirmed for the bone metastases. Laparoscopic distal gastrectomy with D1 lymphadenectomy was performed for treating the primary gastric cancer 33 months after the initiation of chemotherapy. Pathological CR was also achieved for the primary gastric cancer. Imaging analysis did not show disease progression 48 months after the initiation of chemotherapy. Synchronous bone metastases from early gastric cancer are extremely rare, and a good outcome was achieved in the present case through induction chemotherapy.
我们报告了1例早期胃癌伴多发同步骨转移患者使用S-1进行诱导化疗后获得完全缓解（CR）的病例。一名无症状的70岁女性在定期体检期间通过上消化道内镜检查被诊断为早期胃癌。腹部盆腔计算机断层扫描（CT）显示胃内无原发性肿瘤，且无淋巴结或肝转移。然而，在腰椎和髂骨发现了骨增生性改变。通过磁共振成像、骨闪烁显像和正电子发射断层扫描-CT检测到早期胃癌的多发同步骨转移。在给予15个疗程的S-1加顺铂（CDDP）方案以及另外5个疗程的S-1后，骨转移灶确认达到临床CR。化疗开始33个月后，为治疗原发性胃癌进行了腹腔镜远端胃切除术及D1淋巴结清扫术。原发性胃癌也实现了病理CR。化疗开始48个月后影像学分析未显示疾病进展。早期胃癌的同步骨转移极为罕见，本例通过诱导化疗取得了良好的治疗效果。
