内容紹介
A Case of Abdominal Para-Aortic Lymph Node Recurrence of Gastric Cancer Treated with Radiotherapy, Surviving More Than 5 Years
Summary
A 66-year-old man was diagnosed with advanced type 2 gastric cancer and underwent total gastrectomy. The pathological diagnosis was T3N2H0P0CY0M0, stageⅢB gastric cancer. Consequently, the patient received adjuvant S-1 therapy for 12 months. Thirty months after the operation, para-aortic lymph node recurrence was evident by computed tomography(CT). As a result, combination chemotherapy with paclitaxel, 5-fluorouracil, and cisplatin was initiated. However, after three courses of chemotherapy, abdominal CT showed progressive disease of the recurrent lymph node. Thereafter, radiotherapy at a total dose of 56 Gy was performed. After the radiotherapy treatment, abdominal CT demonstrated a remarkable reduction of the recurrent lymph node. The patient remains alive, with no signs of relapse, 70 months later. Therefore, this case suggests that radiotherapy may represent an effective treatment for localized remote lymph node recurrence of gastric cancer.
要旨
症例は66歳,男性。2型進行胃癌と診断され,胃全摘術が施行された。病理組織学的検査の結果,T3N2H0P0CY0M0,stageⅢBと診断され,術後12か月間S-1による補助化学療法を行った。術後13か月目のCT検査で大動脈周囲リンパ節再発を認めた。paclitaxel,5-fluorouracil,cisplatinによる化学療法を開始した。3コース後のCT検査で化学療法の効果はprogressive diseaseであった。再発巣が限局していたため,放射線療法を計56 Gy施行した。再発リンパ節は著明に縮小し無治療で経過観察中であるが,放射線療法後70か月経過した現在,無増悪生存中である。本症例のように限局したリンパ節再発に対して,放射線療法は治療法の一つとなり得る。
目次
Summary
A 66-year-old man was diagnosed with advanced type 2 gastric cancer and underwent total gastrectomy. The pathological diagnosis was T3N2H0P0CY0M0, stageⅢB gastric cancer. Consequently, the patient received adjuvant S-1 therapy for 12 months. Thirty months after the operation, para-aortic lymph node recurrence was evident by computed tomography(CT). As a result, combination chemotherapy with paclitaxel, 5-fluorouracil, and cisplatin was initiated. However, after three courses of chemotherapy, abdominal CT showed progressive disease of the recurrent lymph node. Thereafter, radiotherapy at a total dose of 56 Gy was performed. After the radiotherapy treatment, abdominal CT demonstrated a remarkable reduction of the recurrent lymph node. The patient remains alive, with no signs of relapse, 70 months later. Therefore, this case suggests that radiotherapy may represent an effective treatment for localized remote lymph node recurrence of gastric cancer.
要旨
症例は66歳,男性。2型進行胃癌と診断され,胃全摘術が施行された。病理組織学的検査の結果,T3N2H0P0CY0M0,stageⅢBと診断され,術後12か月間S-1による補助化学療法を行った。術後13か月目のCT検査で大動脈周囲リンパ節再発を認めた。paclitaxel,5-fluorouracil,cisplatinによる化学療法を開始した。3コース後のCT検査で化学療法の効果はprogressive diseaseであった。再発巣が限局していたため,放射線療法を計56 Gy施行した。再発リンパ節は著明に縮小し無治療で経過観察中であるが,放射線療法後70か月経過した現在,無増悪生存中である。本症例のように限局したリンパ節再発に対して,放射線療法は治療法の一つとなり得る。