Matsumoto Keita, Goto Ayana, Tajirika Toshihiro, Tochii Koya, Kimura Masaki, Hanatate Fumika, Sekino Takafumi, Matsunami Hidetoshi
Dept. of Surgery, Matsunami General Hospital.
Gan To Kagaku Ryoho. 2020 Feb;47(2):267-270.
Case 1: A 59-year-old man was diagnosed with type 3 gastric cancer cStage Ⅲ(MU, Gre, tub2>por, cT4aN2M0)induced by gastric perforation. The first surgery involving resection of the lesser curvature of stomach lymph node was judged to be difficult, and eventually exploratory laparotomy was performed. He received 3 courses of chemotherapy using S-1 plus oxaliplatin(SOX)(S-1 120mg/m2/day, day 1-14, oxaliplatin 100 mg/m2, day 1, followed by 7 days of rest). He subsequently underwent curative laparotomy gastrectomy plus D2(-No. 10)lymph node dissection, and Roux-en-Y reconstruction. Histological type was judged to be Grade 3. Case 2: A 69-year-old man was diagnosed with type 2 esophageal gastric junctional cancer,(GE, Less, tub2, cT4aN3M1[LYM])of cStage Ⅳ. He received 6 courses of chemotherapy using trastuzu- mab plus S-1 plus oxaliplatin(HER plus SOX)(trastuzumab 8mg/kg[2nd course 6mg/kg], day 1, S-1 120mg/m2/day, day 1-14, oxaliplatin 100mg/m2[5th course 80 mg/m2], on day 1, followed by 7 days of rest). He subsequently underwent laparotomy of the lower esophageal total gastrectomy plus D2(-No. 10, +No. 16, No. 110)lymph node dissection, and Roux-en-Y reconstruction as conversion surgery. Histological type was Grade 3. Both were impressive cases suggesting the usefulness of SOX therapy as a multidisciplinary treatment strategy for advanced gastric cancer.
病例1：一名59岁男性被诊断为因胃穿孔诱发的Ⅲ型胃癌（cStageⅢ，MU，Gre，tub2>por，cT4aN2M0）。首次手术涉及胃小弯淋巴结切除，被判定难度较大，最终进行了剖腹探查术。他接受了3个疗程的S-1联合奥沙利铂（SOX）化疗（S-1 120mg/m²/天，第1 - 14天，奥沙利铂100mg/m²，第1天，随后休息7天）。随后他接受了根治性剖腹胃切除术加D2（-第10组）淋巴结清扫及Roux-en-Y重建术。组织学类型判定为3级。病例2：一名69岁男性被诊断为Ⅱ型食管胃交界癌（GE，Less，tub2，cT4aN3M1[LYM]），cStageⅣ期。他接受了6个疗程的曲妥珠单抗联合S-1加奥沙利铂（HER加SOX）化疗（曲妥珠单抗8mg/kg[第2疗程6mg/kg]，第1天，S-1 120mg/m²/天，第1 - 14天，奥沙利铂100mg/m²[第5疗程80mg/m²]，第1天，随后休息7天）。随后他接受了食管下段全胃切除术加D2（-第10组，+第16组，第110组）淋巴结清扫及Roux-en-Y重建术作为改道手术。组织学类型为3级。这两个病例都令人印象深刻，表明SOX疗法作为晚期胃癌多学科治疗策略的有效性。
