内容紹介
A Case of Mediastinal Lymph Node Gastric Cancer Recurrence During S-1 Adjuvant Therapy Successfully Treated with Cisplatin+Capecitabine as Second-Line Chemotherapy
Summary
S-1 adjuvant chemotherapy following radical surgery has been the standard therapy for the pStageⅡ/Ⅲ gastric cancer in Japan. However, there are few reports regarding treatment for gastric cancer recurrence during S-1 therapy. Here, we present a case of recurrent gastric cancer during S-1 adjuvant therapy that showed partial response to CDDP+capecitabine therapy. A 72-year-old man was diagnosed as having gastric cancer. We performed a distal gastrectomy+D2 dissection, with Roux-en Y reconstruction. The patient was treated with S-1 for adjuvant chemotherapy. Six months after operation, multiple mediastinal lymph node recurrence developed. CDDP+CPT-11 was applied for two courses as first-line treatment for the recurrence. However, the disease progressed with worsening mediastinal lymph node metastases(progressive disease). After two courses of CDDP+capecitabine as second-line chemotherapy, the recurrence site became smaller. After five courses, partial response(PR)had been achieved. Two years and five months after gastrectomy, capecitabine monotherapy was applied as third-line chemotherapy.
要旨
根治術後のpStageⅡ/Ⅲ胃癌に対するS-1の術後補助化学療法が標準治療として行われているが,S-1内服中の再発に対する治療に関する報告はわずかである。今回われわれは,S-1内服中の再発に対してcapecitabine+CDDP(XP)療法が奏効した1例を経験したので報告する。症例は72歳,男性。2010年5月,胃癌に対して幽門側胃切除,D2郭清を施行。S-1による術後補助療法4コース終了後に縦隔リンパ節再発を認めた。CDDP+CPT-11療法を2コース施行したが,治療効果はPDであった。二次治療としてXP療法を行ったところ,2コース後に病変の縮小を認め,5コース後はPRとなった。6コース後,腎機能低下を認めcapecitabine(Cape)単剤投与としたが,術後2年5か月経過しているがADLを落とさずCape単剤による外来化学療法中である。
目次
Summary
S-1 adjuvant chemotherapy following radical surgery has been the standard therapy for the pStageⅡ/Ⅲ gastric cancer in Japan. However, there are few reports regarding treatment for gastric cancer recurrence during S-1 therapy. Here, we present a case of recurrent gastric cancer during S-1 adjuvant therapy that showed partial response to CDDP+capecitabine therapy. A 72-year-old man was diagnosed as having gastric cancer. We performed a distal gastrectomy+D2 dissection, with Roux-en Y reconstruction. The patient was treated with S-1 for adjuvant chemotherapy. Six months after operation, multiple mediastinal lymph node recurrence developed. CDDP+CPT-11 was applied for two courses as first-line treatment for the recurrence. However, the disease progressed with worsening mediastinal lymph node metastases(progressive disease). After two courses of CDDP+capecitabine as second-line chemotherapy, the recurrence site became smaller. After five courses, partial response(PR)had been achieved. Two years and five months after gastrectomy, capecitabine monotherapy was applied as third-line chemotherapy.
要旨
根治術後のpStageⅡ/Ⅲ胃癌に対するS-1の術後補助化学療法が標準治療として行われているが,S-1内服中の再発に対する治療に関する報告はわずかである。今回われわれは,S-1内服中の再発に対してcapecitabine+CDDP(XP)療法が奏効した1例を経験したので報告する。症例は72歳,男性。2010年5月,胃癌に対して幽門側胃切除,D2郭清を施行。S-1による術後補助療法4コース終了後に縦隔リンパ節再発を認めた。CDDP+CPT-11療法を2コース施行したが,治療効果はPDであった。二次治療としてXP療法を行ったところ,2コース後に病変の縮小を認め,5コース後はPRとなった。6コース後,腎機能低下を認めcapecitabine(Cape)単剤投与としたが,術後2年5か月経過しているがADLを落とさずCape単剤による外来化学療法中である。