内容紹介
A Case of an Elderly Patient Who Experienced Long-Term Survival after Receiving S-1 for Synchronous Advanced Gallbladder and Stomach Cancer
Summary
The reported patient was a 90-year-old woman with anorexia. She was diagnosed with advanced gallbladder cancer that occurred concurrently with stomach cancer. Subsequent to intestinal bypass surgery, S-1(80 mg/day)was administered for 14 days, followed by 7 days of rest for one course. Tumor marker levels returned to normal after 4 months. Computed tomography results indicated that, in regard to the gallbladder cancer, the patient had stable disease after 8 months. In addition, gastroscopy revealed a complete response of the gastric cancer after a year. The patient was able to continue treatment as an outpatient until she experienced aspiration pneumonia. The administration of S-1 was terminated after 4 years and 4 months. Treatment with S-1 monotherapy is considered safe for elderly patients, and has the additional benefit that it is deliverable as an outpatient treatment.
要旨
症例は90歳,女性。食欲低下と体重減少にて来院。精査のCT検査にて胆嚢癌の十二指腸下行脚および横行結腸浸潤を認めた。上部内視鏡検査では胃前庭部-幽門前庭部に3型胃癌を認めた。根治切除は不能であり,通過障害に対する姑息的バイパス術を施行後にS-1 80 mg/day(2週投与1週休薬)の単独療法を開始した。投与開始4か月後に腫瘍マーカーは正常値化し,8か月後のCTで胆嚢癌はstable disease,12か月後の内視鏡検査で胃癌はcomplete responseを得た。投与開始4年4か月後に誤嚥性肺炎を契機にS-1内服が困難となり,その後,腫瘍マーカー上昇および胆嚢癌の増悪を認め,投与開始4年7か月後に永眠された。切除不能胆嚢癌の予後は不良であり,超高齢者に対する治療法は確立されていない。S-1単独療法は有用な治療法の一つと考えられた。
目次
Summary
The reported patient was a 90-year-old woman with anorexia. She was diagnosed with advanced gallbladder cancer that occurred concurrently with stomach cancer. Subsequent to intestinal bypass surgery, S-1(80 mg/day)was administered for 14 days, followed by 7 days of rest for one course. Tumor marker levels returned to normal after 4 months. Computed tomography results indicated that, in regard to the gallbladder cancer, the patient had stable disease after 8 months. In addition, gastroscopy revealed a complete response of the gastric cancer after a year. The patient was able to continue treatment as an outpatient until she experienced aspiration pneumonia. The administration of S-1 was terminated after 4 years and 4 months. Treatment with S-1 monotherapy is considered safe for elderly patients, and has the additional benefit that it is deliverable as an outpatient treatment.
要旨
症例は90歳,女性。食欲低下と体重減少にて来院。精査のCT検査にて胆嚢癌の十二指腸下行脚および横行結腸浸潤を認めた。上部内視鏡検査では胃前庭部-幽門前庭部に3型胃癌を認めた。根治切除は不能であり,通過障害に対する姑息的バイパス術を施行後にS-1 80 mg/day(2週投与1週休薬)の単独療法を開始した。投与開始4か月後に腫瘍マーカーは正常値化し,8か月後のCTで胆嚢癌はstable disease,12か月後の内視鏡検査で胃癌はcomplete responseを得た。投与開始4年4か月後に誤嚥性肺炎を契機にS-1内服が困難となり,その後,腫瘍マーカー上昇および胆嚢癌の増悪を認め,投与開始4年7か月後に永眠された。切除不能胆嚢癌の予後は不良であり,超高齢者に対する治療法は確立されていない。S-1単独療法は有用な治療法の一つと考えられた。