内容紹介
Summary
The patient was an 84-year-old male who underwent a total gastrectomy for advanced gastric carcinoma. He received S-1 chemotherapy, but his serum tumor marker(CEA, CA19-9)level increased 6 months post operation. Computed tomography suggested lymph node swelling of the portcaval space(No.12p), and we treated him with chemotherapy that consisted of 4 courses of Tmab plus SOX(trastuzumab plus S-1 plus oxaliplatin). The abdominal CT scan that was performed after 3 courses of chemotherapy and PET-CT that was performed after 4 courses of chemotherapy suggested that the metastatic lesion had disappeared. We therefore assumed that a complete response had been achieved by Tmab plus SOX chemotherapy. A combination of S-1 and cisplatin(SP)has been the standard regimen for advanced gastric cancer, but the combination of S-1 plus oxaliplatin was demonstrated to be non-inferior to SP. We report this case with a review of the literature, because the patient with HER2-positive recurrent gastric cancer achieved a complete response after Tmab plus SOX chemotherapy.
要旨
症例は84歳,男性。進行胃癌にて胃全摘術を施行し,術後S-1補助化学療法を実施していたが,術後約6か月目ごろより腫瘍マーカー(CEA値,CA19-9値)の上昇を認めた。精査にてNo. 12pリンパ節の転移が認められたためtrastuzumab(Tmab)+S-1+oxaliplatin(SOX)療法による化学療法を施行した。3コース施行後の腹部造影CT検査にて転移巣は消失し,4コース施行後のPET-CT検査でも新たな再発巣や転移巣は認められずCRが得られた。進行・再発胃癌に対する一次化学療法はS-1+cisplatin(SP)療法が標準治療であるが,SOX療法も同等の有効性があることが報告されている。今回HER2陽性再発胃癌に対しTmab+SOX療法にて極めて良好な結果が得られたため,文献的考察を加え報告する。
目次
The patient was an 84-year-old male who underwent a total gastrectomy for advanced gastric carcinoma. He received S-1 chemotherapy, but his serum tumor marker(CEA, CA19-9)level increased 6 months post operation. Computed tomography suggested lymph node swelling of the portcaval space(No.12p), and we treated him with chemotherapy that consisted of 4 courses of Tmab plus SOX(trastuzumab plus S-1 plus oxaliplatin). The abdominal CT scan that was performed after 3 courses of chemotherapy and PET-CT that was performed after 4 courses of chemotherapy suggested that the metastatic lesion had disappeared. We therefore assumed that a complete response had been achieved by Tmab plus SOX chemotherapy. A combination of S-1 and cisplatin(SP)has been the standard regimen for advanced gastric cancer, but the combination of S-1 plus oxaliplatin was demonstrated to be non-inferior to SP. We report this case with a review of the literature, because the patient with HER2-positive recurrent gastric cancer achieved a complete response after Tmab plus SOX chemotherapy.
要旨
症例は84歳,男性。進行胃癌にて胃全摘術を施行し,術後S-1補助化学療法を実施していたが,術後約6か月目ごろより腫瘍マーカー(CEA値,CA19-9値)の上昇を認めた。精査にてNo. 12pリンパ節の転移が認められたためtrastuzumab(Tmab)+S-1+oxaliplatin(SOX)療法による化学療法を施行した。3コース施行後の腹部造影CT検査にて転移巣は消失し,4コース施行後のPET-CT検査でも新たな再発巣や転移巣は認められずCRが得られた。進行・再発胃癌に対する一次化学療法はS-1+cisplatin(SP)療法が標準治療であるが,SOX療法も同等の有効性があることが報告されている。今回HER2陽性再発胃癌に対しTmab+SOX療法にて極めて良好な結果が得られたため,文献的考察を加え報告する。