Kitayama Yoshihiro, Sugimoto Takemi, Ishikawa Hideaki, Yoden Yousuke
Dept. of Surgery, Kiyoukai Okamoto Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(12):1743-1746.
The patient was an 84-year-old male who underwent a total gastrectomy for advanced gastric carcinoma. He received S-1 chemotherapy, but his serum tumor marker(CEA, CA19-9)level increased 6 months post operation. Computed tomography suggested lymph node swelling ofthe portcaval space(No.12p), and we treated him with chemotherapy that consisted of4 courses of Tmab plus SOX(trastuzumab plus S-1 plus oxaliplatin). The abdominal CT scan that was performed after 3 courses ofchemotherapy and PET-CT that was performed after 4 courses of chemotherapy suggested that the metastatic lesion had disappeared. We therefore assumed that a complete response had been achieved by Tmab plus SOX chemotherapy. A combination ofS -1 and cisplatin(SP)has been the standard regimen for advanced gastric cancer, but the combination ofS -1 plus oxaliplatin was demonstrated to be non-inferior to SP. We report this case with a review of the literature, because the patient with HER2-positive recurrent gastric cancer achieved a complete response after Tmab plus SOX chemotherapy.
该患者为一名84岁男性，因晚期胃癌接受了全胃切除术。他接受了S-1化疗，但术后6个月血清肿瘤标志物（癌胚抗原、糖类抗原19-9）水平升高。计算机断层扫描显示门腔间隙（第12p组）淋巴结肿大，我们对他采用了由4个疗程的曲妥珠单抗联合SOX（曲妥珠单抗加S-1加奥沙利铂）组成的化疗方案。3个疗程化疗后进行的腹部CT扫描以及4个疗程化疗后进行的PET-CT显示转移病灶已消失。因此，我们认为曲妥珠单抗联合SOX化疗已实现完全缓解。S-1和顺铂（SP）联合方案一直是晚期胃癌的标准治疗方案，但S-1加奥沙利铂联合方案被证明不劣于SP。我们报告该病例并复习文献，因为该HER2阳性复发性胃癌患者在曲妥珠单抗联合SOX化疗后实现了完全缓解。
