内容紹介
A Case of Advanced Gastric Cancer Effectively Treated with Weekly Paclitaxel as Neoadjuvant Chemotherapy
Summary
We report a patient with advanced gastric cancer responding remarkably to neoadjuvant chemotherapy consisting of weekly paclitaxel. The patient was a 50-year-old male who had large advanced gastric cancer, suspected of invasion to the duodenum and pancreas and severe lymph node metastasis[cT4(pancreas), cN2, cH0, cP0, cM0, cStageⅣ]. He was treated with weekly paclitaxel as neoadjuvant chemotherapy. According to gastroscope and CT findings, a significant tumor reduction was obtained after 3 courses. Therefore, distal gastrectomy with D2 nodal dissection were performed. The histological diagnosis was pT2, pN2, pStageⅢA, and the histological effect of the main tumor was judged to be Grade 2. The patient has now been in good health without recurrence for 3 years after surgery. This case suggests that neoadjuvant chemotherapy with weekly paclitaxel is a potentially effective regimen for advanced gastric cancer.
要旨
症例は50歳台,男性。膵浸潤の可能性がある進行胃癌と診断。腫瘍によると思われる発熱も認められ,手術は困難と判断し,術前化学療法の方針とした。経口摂取が不能であったため,weekly paclitaxel単独療法を開始した。3か月後の上部消化管内視鏡検査とCTで胃腫瘍とリンパ節の著明な縮小を認めたため,開腹幽門側胃切除(D2)の根治切除術が施行可能となった。術後病理診断ではpT2,pN2,pStageⅢA(胃癌取扱い規約第13版に準拠)であり,術後補助化学療法としてS-1を1年間内服とした。現在術後3年経過し,再発は認めていない。
目次
Summary
We report a patient with advanced gastric cancer responding remarkably to neoadjuvant chemotherapy consisting of weekly paclitaxel. The patient was a 50-year-old male who had large advanced gastric cancer, suspected of invasion to the duodenum and pancreas and severe lymph node metastasis[cT4(pancreas), cN2, cH0, cP0, cM0, cStageⅣ]. He was treated with weekly paclitaxel as neoadjuvant chemotherapy. According to gastroscope and CT findings, a significant tumor reduction was obtained after 3 courses. Therefore, distal gastrectomy with D2 nodal dissection were performed. The histological diagnosis was pT2, pN2, pStageⅢA, and the histological effect of the main tumor was judged to be Grade 2. The patient has now been in good health without recurrence for 3 years after surgery. This case suggests that neoadjuvant chemotherapy with weekly paclitaxel is a potentially effective regimen for advanced gastric cancer.
要旨
症例は50歳台,男性。膵浸潤の可能性がある進行胃癌と診断。腫瘍によると思われる発熱も認められ,手術は困難と判断し,術前化学療法の方針とした。経口摂取が不能であったため,weekly paclitaxel単独療法を開始した。3か月後の上部消化管内視鏡検査とCTで胃腫瘍とリンパ節の著明な縮小を認めたため,開腹幽門側胃切除(D2)の根治切除術が施行可能となった。術後病理診断ではpT2,pN2,pStageⅢA(胃癌取扱い規約第13版に準拠)であり,術後補助化学療法としてS-1を1年間内服とした。現在術後3年経過し,再発は認めていない。