Kinoshita K, Kato M, Sawa T, Yoshimitsu S, Tomita F, Takano Y, Yonemura Y, Miyazaki I, Matsui H
Dept. of Surgery, National Sanatorium Tsuruga Hospital.
Gan To Kagaku Ryoho. 1993 Apr;20(5):651-5.
The patient, a 65-year-old male with far advanced gastric cancer of H3N4 (Stage 4), was assumed inoperable on admission and chemotherapy using CDDP, MMC and UFT(PMU) was carried out. As a result, the levels of AFP and CEA were reduced notably, and PR effects were recognized in liver and lymphnode metastatic lesion. Thus, 2 months later, reduction surgery was performed, during which primary lesion was resected and a reservoir tube for chemotherapy was placed in the common hepatic artery. Subsequently, the chemotherapy with Etoposide added to PMU(PMUE) was continued by utilization of a reservoir, so that liver metastasis decreased more than 90% from the maximum. However, metastasis lesions of left lobe of the liver had enlarged with reincrease of AFP and CEA since 6 months after the operation. A month later left lobectomy of the liver was performed. Residual metastases of the liver were then enlarged. PMUE with Ca antagonist was used with little effect then. The patient died of liver failure 15 months after initial admission.
该患者为一名65岁男性，患有H3N4期（IV期）进展期胃癌，入院时被认为无法手术，遂采用顺铂、丝裂霉素和替加氟（PMU）进行化疗。结果，甲胎蛋白（AFP）和癌胚抗原（CEA）水平显著降低，肝脏和淋巴结转移灶出现部分缓解（PR）效果。因此，2个月后进行了缩小手术，术中切除了原发灶，并在肝总动脉放置了化疗储液管。随后，通过储液管继续使用在PMU基础上加用依托泊苷的化疗方案（PMUE），肝脏转移灶较最大时减少了90%以上。然而，术后6个月起，肝脏左叶转移灶随AFP和CEA再次升高而增大。1个月后进行了肝脏左叶切除术。此后肝脏残余转移灶增大。使用加用钙拮抗剂的PMUE方案效果不佳。患者在初次入院15个月后死于肝衰竭。
