Kuga Yoshio, Kitamura Shosuke, Okanobu Hideharu, Sakimoto Hideto, Nishida Toshihiro
Dept. of Internal Medicine, Japan Labour Health and Welfare Organization Chugoku Rosai Hospital.
Gan To Kagaku Ryoho. 2016 Oct;43(10):1211-1214.
We reported a case of human epidermal growth factor receptor 2(HER2)-positive advanced gastric cancer with multiple liver metastases that responded well to a combination of trastuzumab, capecitabine, and cisplatin(T-XP therapy)as first-line chemotherapy. A 73-year-old man was admitted to our hospital in December 2012 for liver dysfunction. Based on computed tomography(CT)and gastroendoscopy findings, he was diagnosed with advanced gastric cancer with multiple liver metastases. Because HER2 protein overexpression was observed in the primary tumor, he was treated with T-XP therapy. After 5 courses of treatment, the sizes of the primary tumor and multiple liver metastases were reduced on CT scans. In March 2013, a Billroth I distal gastrectomy with D2 lymph node dissection was performed. Liver metastasis was not detected. No residual cancer cells were found in the stomach or lymph nodes. The patient subsequently received oral administration of S-1 alone for 2 weeks followed by a 2-week rest period as 1 course. This was repeated for 19 courses. The postoperative course was uneventful, and there was no detectable liver metastasis 36 months after the original diagnosis. Therefore, T-XP therapy is an option for the management of HER2-positive advanced gastric cancer with liver metastasis.
我们报告了一例人表皮生长因子受体2（HER2）阳性的晚期胃癌伴多发肝转移患者，其作为一线化疗方案接受曲妥珠单抗、卡培他滨和顺铂联合治疗（T-XP疗法）后反应良好。一名73岁男性于2012年12月因肝功能不全入住我院。根据计算机断层扫描（CT）和胃镜检查结果，他被诊断为晚期胃癌伴多发肝转移。由于在原发肿瘤中观察到HER2蛋白过表达，他接受了T-XP疗法治疗。经过5个疗程的治疗，CT扫描显示原发肿瘤和多发肝转移灶的大小均缩小。2013年3月，患者接受了毕罗氏I式远端胃切除术及D2淋巴结清扫术。未检测到肝转移。在胃或淋巴结中未发现残留癌细胞。患者随后接受单药S-1口服治疗，每2周为1个疗程，停药2周，如此重复19个疗程。术后恢复顺利，自最初诊断36个月后未检测到肝转移。因此，T-XP疗法是治疗HER2阳性晚期胃癌伴肝转移的一种选择。
