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[一例老年不可切除胃癌患者接受紫杉醇和雷莫西尤单抗治疗的病例]

[A Case of an Elderly Patient with Unresectable Gastric Cancer Treated by Paclitaxel and Ramucirumab].

作者信息

Kimura Yutaka, Makari Yoichi, Mikami Johta, Yoshimura Junpei, Inoue Toshiya, Sawada Genta, Nakahira Shin, Yamamura Jun, Kamigaki Shunji, Nakata Ken, Yamamoto Tameyoshi, Ikeda Naoki, Tsujie Masaki, Fujita Junya, Ohzato Hiroki

机构信息

Dept. of Surgery, Sakai City Medical Center.

出版信息

Gan To Kagaku Ryoho. 2016 Nov;43(12):2404-2406.

Abstract

An 80-year-old man was admitted to our hospital with appetite loss in December 2014. Gastroduodenal scope, abdominal computed tomography(CT), and laparoscopy revealed type 4 advanced gastric cancer(poorly differentiated adenocarcinoma) with multiple lymph node(LN)involvement and multiple peritoneal metastasis. S-1(80mg/body)was administrated between January 2015 and September 2015 in the outpatient clinic. A partial response was obtained, but a gastric tumor, ascites, and LN re-growth were observed. Since October 2015, paclitaxel(PTX)(70mg/m2; day 1, 8, and 15)and ramucir- umab(RAM)(8mg/kg; day 1 and 15)have been administered. After 2 courses, bi-weekly PTX plus RAM were continued for grade 3 neutropenia and grade 2 anorexia. The tumor and LNs partially responded, and the ascites disappeared. With this dosage and administration schedule, the partial response(PR)was maintained for approximately 8 months without any severe adverse reactions. This successful case might indicate that it is important for elderly patients with gastric cancer that progressed with prior chemotherapy regimens to consider appropriate reduction of the PTX dosage, schedule, and continuation of RAM.

摘要

2014年12月,一名80岁男性因食欲减退入住我院。胃十二指肠镜检查、腹部计算机断层扫描(CT)和腹腔镜检查显示为4型进展期胃癌(低分化腺癌),伴有多处淋巴结(LN)受累和多处腹膜转移。2015年1月至9月在门诊给予S-1(80mg/体)治疗。获得了部分缓解,但观察到胃肿瘤、腹水和LN复发。自2015年10月起,给予紫杉醇(PTX)(70mg/m²;第1、8和15天)和雷莫西尤单抗(RAM)(8mg/kg;第1和15天)。2个疗程后,因3级中性粒细胞减少和2级厌食症,继续每两周给予PTX加RAM治疗。肿瘤和LN部分缓解,腹水消失。采用此剂量和给药方案,部分缓解(PR)维持了约8个月,无任何严重不良反应。该成功病例可能表明,对于先前化疗方案进展的老年胃癌患者,考虑适当降低PTX剂量、调整给药方案并继续使用RAM非常重要。

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