Wada Yuma, Okada Kazuyuki, Ebisui Chikara, Yanagisawa Tetsu, Okamura Shu, Fukuchi Nariaki, Murata Kouhei, Yokouchi Hideoki, Kinuta Masakatsu
Dept. of Surgery, Suita Municipal Hospital.
Gan To Kagaku Ryoho. 2014 Nov;41(12):2411-3.
A 66-year-old woman was diagnosed with unresectable advanced gastric cancer with Schnitzler metastasis in January 2012. She was treated with combination chemotherapy comprising S-1 and docetaxel (DTX). However, in January 2013, after 13 courses of treatment, a computed tomography (CT) indicated peritoneal dissemination growth. The chemotherapy regimen was changed to a combination of S-1 and irinotecan (CPT-11), but after a single course of treatment the patient complained of stomachaches and vomiting. The patient developed ileus from the stenosis of the rectum, and a transanal ileus tube was used to decompress the bowel tract. Due to the patient's poor general condition, a metallic stent was inserted, and she could resume eating. Thereafter, we changed the chemotherapy regimen to weekly paclitaxel (PTX). However, 1 year and 4 months after starting treatment she died of regrowth of the peritoneal disseminating lesions. We recommend a combination of chemotherapy and metallic stent placement to improve quality of life and long-term survival.
一名66岁女性于2012年1月被诊断为伴有施尼茨勒转移的不可切除晚期胃癌。她接受了由S-1和多西他赛（DTX）组成的联合化疗。然而，在2013年1月，经过13个疗程的治疗后，计算机断层扫描（CT）显示腹膜播散性生长。化疗方案改为S-1和伊立替康（CPT-11）联合，但在一个疗程的治疗后，患者出现腹痛和呕吐。患者因直肠狭窄发展为肠梗阻，并使用经肛门肠梗阻导管对肠道进行减压。由于患者一般状况较差，插入了金属支架，她能够恢复进食。此后，我们将化疗方案改为每周一次的紫杉醇（PTX）。然而，在开始治疗1年零4个月后，她死于腹膜播散性病变的复发。我们建议联合化疗和放置金属支架以提高生活质量和长期生存率。
