Itoh T, Anzai K, Ishii M, Nishida H, Kawada T, Akita Y, Onuki M, Mitamura K, Kawamura M, Arai K
Second Dept. of Internal Medicine, Showa University School of Medicine.
Gan To Kagaku Ryoho. 1994 Mar;21(4):495-500.
Seven cases of nonresectable gastric carcinoma with lymph node metastasis were treated with combination chemotherapy [CDDP 75 mg/m2 i.v. day 1 (A method: Ccr > or = 50 ml/min) or 20 mg/m2 i.v. day 1, 2, 4, 5 (B method: Ccr < 50 ml/min), MMC 10 mg/m2 i.v. day 1, etoposide 50 mg/body i.v. day 3, 4, 5, 5'-DFUR 2,100 mg/body po 4 day/week] every 4 weeks as a neoadjuvant chemotherapy. After treatment, the size of the primary tumor was reduced in four of seven cases. The lymph nodes disappeared in one case and were reduced in size in four cases. Metastatic liver tumors were found in four cases. They disappeared in one case and the size was reduced in one of seven cases. One patient with renal dysfunction was treated with B method. However, renal dysfunction did not become worse. Five patients were operated after chemotherapy. Absolute curative resection was performed in three of them. The total rate of curative resection was 43% (3/7). Four patients were alive for 19 months after operation. The main side effects of this therapy were nausea, anorexia and bone marrow suppression, which, were found in all patients. These results suggest that this combination chemotherapy is as effective as neoadjuvant chemotherapy for advanced gastric carcinoma.
七例伴有淋巴结转移的不可切除胃癌患者接受了联合化疗[顺铂75mg/m²静脉滴注第1天（A方法：内生肌酐清除率（Ccr）≥50ml/min）或20mg/m²静脉滴注第1、2、4、5天（B方法：Ccr＜50ml/min），丝裂霉素10mg/m²静脉滴注第1天，依托泊苷50mg/体静脉滴注第3、4、5天，去氧氟尿苷2100mg/体口服每周4天]，每4周进行一次新辅助化疗。治疗后，七例患者中有四例原发肿瘤大小缩小。一例患者的淋巴结消失，四例患者的淋巴结缩小。四例患者发现有肝转移瘤。其中一例转移瘤消失，七例中有一例转移瘤大小缩小。一名肾功能不全患者采用B方法治疗。然而，肾功能不全并未加重。五例患者在化疗后接受了手术。其中三例进行了根治性切除。根治性切除的总率为43%（3/7）。四名患者术后存活了19个月。该治疗的主要副作用为恶心、厌食和骨髓抑制，所有患者均出现这些副作用。这些结果表明，这种联合化疗作为晚期胃癌的新辅助化疗同样有效。
