Saito E, Kunii Y, Wada G, Tsuchiya S, Yamasaki T, Sakakibara N
First Dept. of Surgery, Juntendo University School of Medicine.
Gan To Kagaku Ryoho. 1997 Jul;24(9):1153-6.
A 66-year-old woman was admitted to our clinic for appetite loss and abdominal distension in August 1995. Endoscopic study revealed an advanced gastric cancer in the upper body of her stomach. Abdominal CT study revealed massive ascites and para-aortic lymph nodal involvement. Cytological study of the ascites revealed class V. She was diagnosed to be in the terminal stage of gastric cancer with carcinomatosa peritonitis. Combination chemotherapy with 5-fluorouracil (5-FU) and low-dose cisplatin (CDDP) was given by continuous intravenous injection of 5-FU 500 mg/day, and intermittent intravenous injection of CDDP 30 mg/week was performed for reduction of the ascites and her complaint. Endoscopic study 6 weeks after starting chemotherapy could not find crater of the gastric cancer but only a shallow ulcerative lesion. The biopsy specimen of that lesion was group III. No ascites and over 50% reduction of the para-aortic lymph node were found by the abdominal CT study. This state persisted over 4 weeks. No myelo-suppression, renal dysfunction or any severe side effect were observed during chemotherapy. Her performance status improved from 3 to 1.
1995年8月，一名66岁女性因食欲减退和腹胀入住我院。内镜检查发现其胃体部患有进展期胃癌。腹部CT检查显示大量腹水和主动脉旁淋巴结受累。腹水细胞学检查结果为V级。她被诊断为晚期胃癌伴癌性腹膜炎。采用5-氟尿嘧啶（5-FU）和低剂量顺铂（CDDP）联合化疗，持续静脉注射5-FU 500毫克/天，并间歇性静脉注射CDDP 30毫克/周，以减少腹水并缓解其症状。化疗开始6周后的内镜检查未发现胃癌溃疡，仅发现一个浅表溃疡性病变。该病变的活检标本为III组。腹部CT检查未发现腹水，主动脉旁淋巴结缩小超过50%。这种状态持续了4周以上。化疗期间未观察到骨髓抑制、肾功能障碍或任何严重副作用。她的体能状态从3级改善到1级。
