Tohyama Y, Kojima K, Shirota Y, Yasuda S, Nakamura T, Nihei Z, Hirayama R, Mishima Y
Dept. of Surgery, Haibara General Hospital.
Gan To Kagaku Ryoho. 1996 Jun;23(7):933-6.
A 39-year-old man was referred for epigastric fullness and a mass in the umbilical region. A giant mass was palpated in the epigastric region, while a mass 1 cm in diameter with a hemorrhagic tendency was felt in the umbilical region. Fluoroscopy of the upper gastrointestinal tract and gastroscopy revealed a Borrmann 3 tumor in the upper part of the gastric corpus. The tumor was found by CT scanning to be growing clearly across the wall of the stomach, and the invasion to the transverse colon was suspected by the enema. The tumor was unresectable because of the extensive tumor invasion of the abdominal wall. Therefore, the patient received 2 courses of combined chemotherapy with 5'-DFUR, CDDP, and MMC. As a result, the tumor in the epigastric region was reduced dramatically, and it became unpalpable 6 months after treatment. At the same time, the tumor in the umbilical region disappeared. Both CT scanning and upper gastrointestinal radiography disclosed tumor reduction, and sufficient oral ingestion became possible. The administration of 5'-DFUR has since been continued as maintenance therapy. Aside from transient anorexia and slight leukopenia, the patient developed no symptoms during the treatment period. At present. 2 years and 9 months after starting chemotherapy, the patient is in good health.
一名39岁男性因上腹部饱胀及脐部肿物前来就诊。上腹部可触及巨大肿物，脐部可触及一个直径1cm且有出血倾向的肿物。上消化道透视及胃镜检查显示胃体上部为Borrmann 3型肿瘤。CT扫描发现肿瘤明显侵及胃壁全层，灌肠检查怀疑肿瘤侵犯横结肠。由于肿瘤广泛侵犯腹壁，无法进行手术切除。因此，患者接受了2个疗程的5'-DFUR、顺铂和丝裂霉素联合化疗。结果，上腹部肿物明显缩小，治疗6个月后触不到了。同时，脐部肿物消失。CT扫描及上消化道造影均显示肿瘤缩小，患者能够正常经口进食。此后持续给予5'-DFUR进行维持治疗。治疗期间，除了短暂的厌食和轻度白细胞减少外，患者未出现其他症状。目前，化疗开始2年9个月后，患者健康状况良好。
