title: [A case of recurrent pleural effusion and positive cytology of advanced gastric cancer treated by TS-1 plus weekly taxane as second-line chemotherapy].
abstract: A second-line chemotherapy for advanced gastric cancer has not been established. We report a case of good response in a 39-year-old woman who had recurrent pleural effusion and positive cytology of type 4 gastric cancer and was treated with TS-1, a DPD inhibitory fluoropyrimidine, in combination with weekly taxane. After a partial response for type 4 gastric cancer from the treatment with 2 courses of TS-1 plus low-dose cisplatinum (CDDP), followed by outpatient chemotherapy with TS-1 alone or TS-1 plus weekly CDDP, left pleural effusion appeared and CA19-9 increased during the 7th course of the chemotherapy. Cytology of the effusion was class IV. The patient was treated with a course of TS-1 (120 mg/day, day 1-21) plus paclitaxel (50 mg/m2, day 1, 8) followed by 2 week washout. In the following courses, paclitaxel was replaced with docetaxel (30 mg/m2, day 1 and 8) and the course was continued in the outpatient setting. After 2 courses, the left pleural effusion disappeared and remained absent after 6 courses. Gastric biopsy showed no cancer cells and abdominal CT showed no recurrence. Serum CA19-9 doubled 1 week after taxane treatment and decreased gradually week by week during the course. This case suggests that a combination of TS-1 and taxane is effective against recurrent pleural effusion of advanced gastric cancer and useful as a second-line chemotherapy.
authors.affiliation: Dept. of Internal Medicine, School of Medicine, Keio University.
authors.forename: Yasutada
authors.initials: Y
authors.lastname: Akiba
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamagishi
authors.forename: Syuka
authors.initials: S
authors.lastname: Mori
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ueda
authors.forename: Junji
authors.initials: J
authors.lastname: Suzuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Hosoe
authors.forename: Mikiko
authors.initials: M
authors.lastname: Izumiya
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Takaishi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nagata
authors.forename: Toshihumi
authors.initials: T
authors.lastname: Hibi
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ishii
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001952:Bridged-Ring Compounds / Q000008:administration & dosage; D018395:CA-19-9 Antigen / Q000097:blood; D000077143:Docetaxel; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006801:Humans; D010094:Oxonic Acid / Q000008:administration & dosage*; D016066:Pleural Effusion, Malignant / Q000188:drug therapy* / Q000473:pathology; D011725:Pyridines / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology; D043823:Taxoids / Q000008:administration & dosage; D005641:Tegafur / Q000008:administration & dosage*
chemical_list: D001952:Bridged-Ring Compounds; D018395:CA-19-9 Antigen; D004338:Drug Combinations; D011725:Pyridines; D043823:Taxoids; C079198:S 1 (combination); D005641:Tegafur; D000077143:Docetaxel; C080625:taxane; D010094:Oxonic Acid