Hagino Shigeta, Fujimura Takashi, Kurata Toru, Shoji Yasuhiro, Sasaki Shozo, Terada Itsuro, Yoshikawa Akemi, Kitagawa Hirohisa, Izumi Ryohei, Saito Katsuhiko
Dept. of Surgery, Toyama City Hospital.
Gan To Kagaku Ryoho. 2018 Dec;45(13):2327-2329.
We encountered a case of type 4 gastric cancer with esophageal invasion that responded to neoadjuvant chemotherapy containing S-1 and oxaliplatin(SOX)followed by surgery, which could be curative resection. A 46-year-old man was referred to our hospital because of abnormal upper gastrointestinal series findings. He was diagnosed with type 4 advanced gastric cancer with esophageal invasion, cT4b(diaphragm)N2M0, Stage ⅢC, and 3 courses of neoadjuvant SOX therapy were administered. Adverse events were minor. After NAC, the primary lesion and lymph nodes showed marked reductions on CT; total gastrectomy and subtotal thoracic esophagectomy were performed. The pathological response to NAC was evaluated as Grade 2 in the primary tumor and Grade 3 in the lymph node; overall, NAC showed considerable antitumor effects. The final diagnosis was ypT3N0M0P0CY0H0, StageⅡA, and was judged as curatively resected. Currently, we are continuing to administer adjuvant chemotherapy containing S-1.
我们遇到一例侵犯食管的4型胃癌患者,该患者对含S-1和奥沙利铂(SOX)的新辅助化疗有反应,随后接受了手术,手术为根治性切除。一名46岁男性因上消化道造影检查结果异常转诊至我院。他被诊断为侵犯食管的4型进展期胃癌,cT4b(膈肌)N2M0,ⅢC期,并接受了3个疗程的新辅助SOX治疗。不良事件轻微。新辅助化疗后,CT显示原发灶和淋巴结明显缩小;遂行全胃切除术和胸段食管次全切除术。新辅助化疗的病理反应在原发肿瘤中评估为2级,在淋巴结中评估为3级;总体而言,新辅助化疗显示出相当大的抗肿瘤效果。最终诊断为ypT3N0M0P0CY0H0,ⅡA期,判定为根治性切除。目前,我们正在继续给予含S-1的辅助化疗。