Saikawa Y, Kubota T, Furukawa T, Kumai K, Yoshino K, Ishibiki K, Kitajima M
Department of Surgery, School of Medicine, Keio University, Tokyo, Japan.
Surg Today. 1994;24(9):819-22. doi: 10.1007/BF01636313.
A patient with advanced gastric cancer with multiple liver metastases was treated by reduction surgery at the primary site as well as by the intraarterial administration of mitomycin C (MMC) and cisplatin (CDDP) through a reservoir catheter inserted into the proper hepatic artery. After a palliative subtotal gastrectomy, MMC 8 mg/m2 was administered intraarterially (i.a.) followed by the administration of CDDP 80 or 40 mg/m2 i.a. with an interval of less than 1 week. After the completion of five courses of this regimen, a complete reduction of the hepatic tumors was achieved, while the level of serum carcinoembryonic antigen decreased to the normal range. The patient is currently alive with signs of disease recurrence at 17 months after initial diagnosis, while additional therapy with MMC + CDDP was continuously undergone until 17 months' after initial diagnosis with various interval. Although thrombocytopenia occurred during the treatment, it resolved within a few weeks after completing the combination chemotherapy without any specific treatment. The present case showed a better prognosis than we had expected, which suggested that combination chemotherapy with MMC and CDDP might thus be clinically useful because of its excellent antitumor activity and low toxicity.
一名患有晚期胃癌并伴有多处肝转移的患者接受了原发部位的减瘤手术,以及通过插入肝固有动脉的储库导管动脉内给予丝裂霉素C(MMC)和顺铂(CDDP)。在姑息性胃大部切除术后,动脉内给予MMC 8 mg/m²,随后间隔不到1周动脉内给予CDDP 80或40 mg/m²。完成五个疗程的该方案后,肝肿瘤完全缩小,同时血清癌胚抗原水平降至正常范围。该患者目前在初次诊断后17个月仍存活,但有疾病复发迹象,在初次诊断后17个月内持续接受MMC + CDDP的额外治疗,间隔时间各不相同。虽然治疗期间出现了血小板减少症,但在完成联合化疗后的几周内自行缓解,无需任何特殊治疗。本病例的预后比预期更好,这表明MMC和CDDP联合化疗因其出色的抗肿瘤活性和低毒性可能在临床上有用。