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HER2阳性晚期胃癌伴多发肝肺转移多学科治疗后的长期生存

Long-term survival after multidisciplinary treatments for HER2-positive advanced gastric cancer with multiple liver and lung metastases.

作者信息

Yoshioka Satoshi, Takahashi Naoto, Fujisaki Muneharu, Takeshita Kenji, Takano Yuta, Yano Fumiaki, Toya Naoki, Eto Ken

机构信息

Department of Surgery, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa, Chiba, 277-8567, Japan.

Department of Surgery, The Jikei University School of Medicine, 3-19-18 Nishi-Shinbashi, Minato-Ku, Tokyo, 105-8471, Japan.

出版信息

Surg Case Rep. 2023 Aug 7;9(1):139. doi: 10.1186/s40792-023-01714-8.

Abstract

BACKGROUND

Trastuzumab-based chemotherapy is a standard treatment regimen for human epithelial growth factor 2 (HER2)-positive gastric cancer. This is a case of a patient who has survived 12 years after being diagnosed with advanced gastric cancer with multiple liver and lung metastases.

CASE PRESENTATION

A woman in her 70s underwent total gastrectomy, cholecystectomy, and left hepatic lobectomy for gastric cancer with liver metastasis. One month after the surgery, multiple liver metastases appeared. After two courses of S-1 + CDDP chemotherapy, the liver metastases disappeared, and new lung metastases occurred. Because the primary tumor was HER2 positive, S-1 + CDDP + trastuzumab chemotherapy was performed. After one course of chemotherapy, the blood test showed pancytopenia, and CDDP was discontinued. S-1 + trastuzumab chemotherapy was then initiated, and as a result, the lung metastases disappeared. The patient is alive without recurrence 12 years after the surgery.

CONCLUSIONS

We encountered a case of long-term survival after multidisciplinary treatments for HER2-positive advanced gastric cancer with multiple liver and lung metastases.

摘要

背景

基于曲妥珠单抗的化疗是人类表皮生长因子2(HER2)阳性胃癌的标准治疗方案。本文报道了1例被诊断为伴有多发肝肺转移的晚期胃癌患者存活12年的病例。

病例介绍

一名70多岁的女性因胃癌伴肝转移接受了全胃切除术、胆囊切除术和左肝叶切除术。术后1个月,出现多发肝转移。经过两个疗程的S-1+顺铂化疗,肝转移消失,但出现了新的肺转移。由于原发肿瘤HER2阳性,遂进行S-1+顺铂+曲妥珠单抗化疗。化疗一个疗程后,血液检查显示全血细胞减少,停用顺铂。随后开始S-1+曲妥珠单抗化疗,结果肺转移消失。术后12年,患者仍存活且无复发。

结论

我们遇到了1例HER2阳性、伴有多发肝肺转移的晚期胃癌患者经多学科治疗后长期存活的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fabe/10406778/612d7ac3091b/40792_2023_1714_Fig1_HTML.jpg

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