内容紹介
Curative Resection of a Case of Advanced Gastric Cancer with Peritoneal Dissemination Responding Well to Combination Chemotherapy of Docetaxel, Cisplatin and S-1
Summary
We report a curative resection of a case with advanced gastric cancer responding remarkably well to combination chemotherapy of docetaxel, cisplatin and S-1. The patient was a 71-year-old man with gastric cancer of Borrmann type 3 accompanied with N3. Staging laparoscopy revealed peritoneal dissemination. He was administered docetaxel intravenously at 40 mg/m2 on day 1, cisplatin intravenously at 60 mg/m2 on day 1, and S-1 orally at 80 mg/m2 on days 1 to 14. This treatment was repeated every 28 days as one course. According to gastroscope and CT findings, a significant tumor reduction was obtained after 4 courses. After 6 courses, a CT scan revealed partial response of the lymph node metastasis, and the serum CEA value was normalized. Curative total gastrectomy was performed. The histological effect of the primary lesion was judged to be grade 2. Combination chemotherapy of S-1, cisplatin and docetaxel can be effective and feasible for advanced gastric cancer.
要旨
症例は71歳,男性。進行胃癌に対し,審査腹腔鏡を施行。UME,circ,Type 3,por,sT4a(SE),sN2,sH0,sP1,sCY1,cM0,StageⅣと診断され,docetaxel(40 mg/m2,day 1),cisplatin(60 mg/m2,day 1),S-1(80 mg/m2,day 1～14)の併用によるDCS療法を施行した。4コース終了後の効果判定で原発巣CR,6コース終了後の効果判定でリンパ節PR,腫瘍マーカーの正常化を認めた。根治切除可能と判断し,胃全摘術,脾臓合併切除,D2郭清を施行した。病理組織学的診断はtub2,pT3(SS),pN1,pStageⅡB,組織学的効果判定はGrade 2であった。根治切除不能胃癌に対するDCS療法は有効な治療法の一つであると考えられ,根治切除に対する手術介入の意義については今後検証が必要である。
目次
Summary
We report a curative resection of a case with advanced gastric cancer responding remarkably well to combination chemotherapy of docetaxel, cisplatin and S-1. The patient was a 71-year-old man with gastric cancer of Borrmann type 3 accompanied with N3. Staging laparoscopy revealed peritoneal dissemination. He was administered docetaxel intravenously at 40 mg/m2 on day 1, cisplatin intravenously at 60 mg/m2 on day 1, and S-1 orally at 80 mg/m2 on days 1 to 14. This treatment was repeated every 28 days as one course. According to gastroscope and CT findings, a significant tumor reduction was obtained after 4 courses. After 6 courses, a CT scan revealed partial response of the lymph node metastasis, and the serum CEA value was normalized. Curative total gastrectomy was performed. The histological effect of the primary lesion was judged to be grade 2. Combination chemotherapy of S-1, cisplatin and docetaxel can be effective and feasible for advanced gastric cancer.
要旨
症例は71歳,男性。進行胃癌に対し,審査腹腔鏡を施行。UME,circ,Type 3,por,sT4a(SE),sN2,sH0,sP1,sCY1,cM0,StageⅣと診断され,docetaxel(40 mg/m2,day 1),cisplatin(60 mg/m2,day 1),S-1(80 mg/m2,day 1～14)の併用によるDCS療法を施行した。4コース終了後の効果判定で原発巣CR,6コース終了後の効果判定でリンパ節PR,腫瘍マーカーの正常化を認めた。根治切除可能と判断し,胃全摘術,脾臓合併切除,D2郭清を施行した。病理組織学的診断はtub2,pT3(SS),pN1,pStageⅡB,組織学的効果判定はGrade 2であった。根治切除不能胃癌に対するDCS療法は有効な治療法の一つであると考えられ,根治切除に対する手術介入の意義については今後検証が必要である。