Konishi K, Yabushita K, Tsugawa K, Kuroda Y, Tsuji M, Demachi H
Dept. of Surgery, Toyama Prefectural Central Hospital.
Gan To Kagaku Ryoho. 1995 Nov;22(13):1969-72.
We encountered a case of non-curatively resected gastric cancer (p1, n4) who responded well to sequential MTX/5-FU therapy and PMUE therapy. A 63-year-old man was admitted to our hospital with complaints of nausea and vomiting. Upper gastrointestinal examination and CT scan revealed Borrmann type 3 gastric cancer with pyloric stenosis and multiple paraaortic lymphnodal metastasis. The patient underwent palliative gastrectomy for extensive gastric cancer (H0, P1, N4, T3, Stage IV b). Histological examination of the resected stomach revealed poorly differentiated adenocarcinoma with paraaortic lymphnodes metastasis (n4) and peritoneal dissemination (p1). Chemotherapy with sequential MTX/5-FU was given 13 times. Ten months after the operation, abdominal pain and back pain required analgesic treatment. Abdominal CT scan revealed increased size of paraaortic lymphnodes, suggesting recurrence. Sequential MTX/5-FU therapy was switched by PMUE therapy. Lymphnode size became smaller and habitual analgesics could be discontinued. Since then he was given MTX/5-FU and PMUE therapies alternately on an ambulant basis. The patient resumed his daily activities at 2 years and 8 months after the operation.
我们遇到一例非根治性切除的胃癌（p1，n4）患者，其对序贯甲氨蝶呤/5-氟尿嘧啶疗法和PMUE疗法反应良好。一名63岁男性因恶心和呕吐症状入院。上消化道检查和CT扫描显示为Borrmann 3型胃癌伴幽门狭窄和多发主动脉旁淋巴结转移。该患者因广泛性胃癌（H0，P1，N4，T3，IV b期）接受了姑息性胃切除术。切除胃的组织学检查显示为低分化腺癌伴主动脉旁淋巴结转移（n4）和腹膜播散（p1）。序贯甲氨蝶呤/5-氟尿嘧啶化疗进行了13次。术后10个月，腹痛和背痛需要镇痛治疗。腹部CT扫描显示主动脉旁淋巴结肿大，提示复发。序贯甲氨蝶呤/5-氟尿嘧啶疗法改为PMUE疗法。淋巴结大小变小，常规镇痛药可以停用。此后，他在门诊交替接受甲氨蝶呤/5-氟尿嘧啶和PMUE疗法。患者术后2年8个月恢复了日常活动。
