内容紹介
Eleven Patients with Gastric Cancer Who Received Chemotherapy after Stent Placement for Gastric Outlet Obstruction
Summary
Endoscopic placement of self-expandable metallic stents is reportedly effective for gastric outlet obstructions due to advanced gastric cancer, and is less invasive than gastrojejunostomy. For patients who have good performance status, we administer chemotherapy after stent placement, although the safety and feasibility of this chemotherapy have not yet been discussed in full. Between 2011 and 2015, 15 patients at our institution underwent endoscopic gastroduodenal stent placement for gastric outlet obstruction due to gastric cancer. Eleven of these patients were administered chemotherapy after stent placement. In our case series, we did not observe any specific adverse event caused by stent placement plus chemotherapy. Adverse events after chemotherapy included anemia of CTCAE Grade 3 in 7 patients. Stent-in-stent placement was needed in 2 patients. Neither stent migration nor perforation was observed. Therefore, chemotherapy after stent placement for gastric outlet obstruction due to gastric cancer was considered safe and feasible. Stent placement is useful not only as palliative care for patients with terminal-stage disease, but also as one of the multimodal therapeutic strategies for gastric cancer.
要旨
幽門狭窄を伴う進行胃癌に対し当科では積極的にステント留置を行い,化学療法を行っている。しかし,ステント留置後の化学療法の安全性についてはまとまった報告がない。当科でのステント留置後の化学療法の成績を報告する。2011～2015年までの間に当科で進行胃癌による幽門狭窄に対しステント留置を行った症例は15例で,ステント留置後に化学療法を行ったのは11例であった。化学療法は安全に施行可能であったが,CTCAE Grade 3以上の貧血を7例に認めた。また,再ステント留置を2例に必要とした。ステントの移動や穿孔は認めなかった。ステント留置術は進行胃癌終末期の姑息的治療のみならず,幽門狭窄を伴う切除不能進行胃癌に対する集学的治療の一環になり得ると考えられた。
目次
Summary
Endoscopic placement of self-expandable metallic stents is reportedly effective for gastric outlet obstructions due to advanced gastric cancer, and is less invasive than gastrojejunostomy. For patients who have good performance status, we administer chemotherapy after stent placement, although the safety and feasibility of this chemotherapy have not yet been discussed in full. Between 2011 and 2015, 15 patients at our institution underwent endoscopic gastroduodenal stent placement for gastric outlet obstruction due to gastric cancer. Eleven of these patients were administered chemotherapy after stent placement. In our case series, we did not observe any specific adverse event caused by stent placement plus chemotherapy. Adverse events after chemotherapy included anemia of CTCAE Grade 3 in 7 patients. Stent-in-stent placement was needed in 2 patients. Neither stent migration nor perforation was observed. Therefore, chemotherapy after stent placement for gastric outlet obstruction due to gastric cancer was considered safe and feasible. Stent placement is useful not only as palliative care for patients with terminal-stage disease, but also as one of the multimodal therapeutic strategies for gastric cancer.
要旨
幽門狭窄を伴う進行胃癌に対し当科では積極的にステント留置を行い,化学療法を行っている。しかし,ステント留置後の化学療法の安全性についてはまとまった報告がない。当科でのステント留置後の化学療法の成績を報告する。2011～2015年までの間に当科で進行胃癌による幽門狭窄に対しステント留置を行った症例は15例で,ステント留置後に化学療法を行ったのは11例であった。化学療法は安全に施行可能であったが,CTCAE Grade 3以上の貧血を7例に認めた。また,再ステント留置を2例に必要とした。ステントの移動や穿孔は認めなかった。ステント留置術は進行胃癌終末期の姑息的治療のみならず,幽門狭窄を伴う切除不能進行胃癌に対する集学的治療の一環になり得ると考えられた。