内容紹介
A Recurrent Gastric Cancer with Peritoneal Metastasis 15 Years after Distal Gastrectomy Successfully Treated with S-1 and Weekly Intravenous and Intraperitoneal Injections of Paclitaxel
Summary
Fifteen years after receiving a distal gastrectomy for advanced gastric cancer, a 70-year-old woman was admitted to our hospital because of abdominal fullness due to ascites. Although cytological examination showed adenocarcinoma cells in the fluid, no examination revealed the primary lesion. Peritoneal metastasis was detected via immunohistochemistry using the cell block technique. After chemotherapy failure(S-1 plus CDDP, weekly PTX, and S-1 plus DOC), the patient received S-1 and weekly intravenous and intraperitoneal injections of PTX. The ascites decreased, and she has been doing well. Our experience with this case suggests that S-1 and weekly intravenous and intraperitoneal injections of PTX is a promising means of treating gastric cancer with peritoneal metastasis.
要旨
症例は70歳,女性。15年前に3型胃癌に対して幽門側胃切除を受けていたが,今回,腹水貯留を認め紹介入院となった。腹水細胞診でclass Ⅴ,腺癌を認めたが,画像上は原発巣を指摘できなかった。腹水検体に対してセルブロックを行い,免疫組織化学染色を施行することで胃癌の腹膜播種と診断した。S-1/CDDP療法をはじめとする化学療法を施行したがPDとなり,S-1+paclitaxel経静脈・腹腔内併用療法に変更したところ,腹水の著明な減少を認めた。S-1+paclitaxel経静脈・腹腔内併用療法は胃癌腹膜播種症例に対して,今後その有効性が期待できる治療法である。
目次
Summary
Fifteen years after receiving a distal gastrectomy for advanced gastric cancer, a 70-year-old woman was admitted to our hospital because of abdominal fullness due to ascites. Although cytological examination showed adenocarcinoma cells in the fluid, no examination revealed the primary lesion. Peritoneal metastasis was detected via immunohistochemistry using the cell block technique. After chemotherapy failure(S-1 plus CDDP, weekly PTX, and S-1 plus DOC), the patient received S-1 and weekly intravenous and intraperitoneal injections of PTX. The ascites decreased, and she has been doing well. Our experience with this case suggests that S-1 and weekly intravenous and intraperitoneal injections of PTX is a promising means of treating gastric cancer with peritoneal metastasis.
要旨
症例は70歳,女性。15年前に3型胃癌に対して幽門側胃切除を受けていたが,今回,腹水貯留を認め紹介入院となった。腹水細胞診でclass Ⅴ,腺癌を認めたが,画像上は原発巣を指摘できなかった。腹水検体に対してセルブロックを行い,免疫組織化学染色を施行することで胃癌の腹膜播種と診断した。S-1/CDDP療法をはじめとする化学療法を施行したがPDとなり,S-1+paclitaxel経静脈・腹腔内併用療法に変更したところ,腹水の著明な減少を認めた。S-1+paclitaxel経静脈・腹腔内併用療法は胃癌腹膜播種症例に対して,今後その有効性が期待できる治療法である。