内容紹介
Summary
A 70-year-old man was diagnosed with advanced gastric cancer based on esophagogastroduodenoscopy(EGD). Abdominal computed tomography(CT)showed swelling of the lymph nodes and invasion to the liver and pancreas. The patient was treated using combined docetaxel, cisplatin, and S-1(DCS)chemotherapy. After 2 courses of treatment, the primary tumor and lymph node metastases continued to grow. The patient was treated using secondary chemotherapy with irinotecan(CPT-11). After 1 course of treatment, the primary tumor and regional lymph nodes reduced in size. We performed curative total gastrectomy with D2 lymph node dissection. There has been no recurrence for 15 months after adjuvant chemotherapy with capecitabine and oxaliplatin(CapeOX). Therefore, CPT-11 therapy is a possible option for the management of advanced gastric cancer after DCS therapy.
要旨
症例は70歳,男性。貧血精査の上部消化管内視鏡検査(EGD)にて胃前庭部癌と診断した。造影CT検査にて周囲リンパ節腫脹,原発巣の肝や膵への浸潤を疑ったため,術前化学療法を施行する方針とした。docetaxel,cisplatin,S-1(DCS)療法を開始し,2コース施行後のCTにて腫瘍は増大し,二次療法にirinotecan(CPT-11)療法を施行した。1コース施行後のCTにて腫瘍は縮小し,肝,膵との境界も保たれたため胃全摘術D2郭清を施行した。術後補助化学療法としてcapecitabine,oxaliplatin(CapeOX)療法を施行し,15か月無再発生存中である。DCS療法で抗腫瘍効果が乏しい場合,二次療法にCPT-11療法は選択肢となると思われた。
目次
A 70-year-old man was diagnosed with advanced gastric cancer based on esophagogastroduodenoscopy(EGD). Abdominal computed tomography(CT)showed swelling of the lymph nodes and invasion to the liver and pancreas. The patient was treated using combined docetaxel, cisplatin, and S-1(DCS)chemotherapy. After 2 courses of treatment, the primary tumor and lymph node metastases continued to grow. The patient was treated using secondary chemotherapy with irinotecan(CPT-11). After 1 course of treatment, the primary tumor and regional lymph nodes reduced in size. We performed curative total gastrectomy with D2 lymph node dissection. There has been no recurrence for 15 months after adjuvant chemotherapy with capecitabine and oxaliplatin(CapeOX). Therefore, CPT-11 therapy is a possible option for the management of advanced gastric cancer after DCS therapy.
要旨
症例は70歳,男性。貧血精査の上部消化管内視鏡検査(EGD)にて胃前庭部癌と診断した。造影CT検査にて周囲リンパ節腫脹,原発巣の肝や膵への浸潤を疑ったため,術前化学療法を施行する方針とした。docetaxel,cisplatin,S-1(DCS)療法を開始し,2コース施行後のCTにて腫瘍は増大し,二次療法にirinotecan(CPT-11)療法を施行した。1コース施行後のCTにて腫瘍は縮小し,肝,膵との境界も保たれたため胃全摘術D2郭清を施行した。術後補助化学療法としてcapecitabine,oxaliplatin(CapeOX)療法を施行し,15か月無再発生存中である。DCS療法で抗腫瘍効果が乏しい場合,二次療法にCPT-11療法は選択肢となると思われた。