Iwata Makoto, Tabata Masami, Nakamura Shinichiro, Nakamura Shunta, Segi Yuki, Fujimura Yu, Desaki Ryosuke, Kobayashi Motoyuki, Ohsawa Ichiro, Kato Kenji, Sanda Takayuki
Dept. of Surgery, Matsusaka Central General Hospital.
Gan To Kagaku Ryoho. 2019 Dec;46(13):2404-2406.
Case 1: A 67-year-old male underwent distal gastrectomy for advanced gastric cancer. Postoperative histopathological examination indicated pT2a, pN2, M0, pStage ⅢA. He received 4 courses of TS-1 with paclitaxel chemotherapy and TS-1 chemotherapy for 2 years. Three years and 5 months after surgery, computed tomography suggested lymph node metastasis of the mediastinum, so TS-1 with cisplatin(CDDP)therapy was administered. Five years and 10 months after surgery, recurrence occurred and docetaxel and CPT-11 were administered with no response. Since HER2 was overexpressed in the primary tumor, he was treated with capecitabine, CDDP, and trastuzumab(XPT)therapy. After 1 year and 6 months, the patient was considered to have achieved a complete response(CR), and after further trastuzumab therapy for half a year, CR was maintained for 12 years and 3 months after surgery. Case 2: A 59-year-old female underwent total gastrectomy for advanced gastric cancer. Postoperative histopathological examination indicated pT3, pN3a, M0, pStageⅢB. She received TS-1 chemotherapy for 1 year and 8 months. Computed tomography suggested paraaortic lymph node metastasis, and XPT therapy was administered. The patients responded well, and alternate administration of XPT and capecitabine and docetaxel(XT) was performed. Three years and 5 months after surgery, recurrence of lymphadenopathy occurred and intensity-modulated radiation therapy in addition to XPT/XT alternate therapy was introduced, leading to a CR 5 years and 8months after surgery. XT therapy was continued afterward, and CR was maintained for 9 years and 2 months after surgery.
病例1：一名67岁男性因晚期胃癌接受了远端胃切除术。术后组织病理学检查显示为pT2a、pN2、M0、pⅢA期。他接受了4个疗程的替吉奥联合紫杉醇化疗以及2年的替吉奥化疗。术后3年零5个月，计算机断层扫描显示纵隔淋巴结转移，因此给予替吉奥联合顺铂（CDDP）治疗。术后5年零10个月，出现复发，给予多西他赛和伊立替康治疗，但无反应。由于原发肿瘤中HER2过表达，他接受了卡培他滨、顺铂和曲妥珠单抗（XPT）治疗。1年零6个月后，患者被认为达到完全缓解（CR），在进一步接受半年曲妥珠单抗治疗后，术后12年零3个月维持CR状态。病例2：一名59岁女性因晚期胃癌接受了全胃切除术。术后组织病理学检查显示为pT3、pN3a、M0、pⅢB期。她接受了1年零8个月的替吉奥化疗。计算机断层扫描显示腹主动脉旁淋巴结转移，给予XPT治疗。患者反应良好，随后进行了XPT与卡培他滨和多西他赛（XT）交替给药。术后3年零5个月，出现淋巴结病复发，除了XPT/XT交替治疗外，还引入了调强放射治疗，术后5年零8个月达到CR。此后继续进行XT治疗，术后9年零2个月维持CR状态。
