[A case of recurrent gastric cancer with peritoneal dissemination successfully treated with DJ stents against bilateral hydronephrosis and chemotherapy].
A 69-year-old female patient underwent total gastrectomy with a D2 lymph node dissection. Her final findings were of pT2, pN0, sP0, sH0, sM0 and Stage IB. After thirty-five months from the operation, peritoneal recurrence with ascites, bilateral hydronephrosis and stenosis of colon was found. TS-1 (80 mg/day/body) was administered for four weeks followed by a 2-week rest after DJ stents were inserted into bilateral ureters. At the end of two courses of TS-1, ascites disappeared and the decrease of tumor marker was observed. During the seventh course, symptoms such as abdominal fullness and ascites became worse. She underwent a weekly administration of paclitaxel (90 mg/body) as a second-line chemotherapy. This regimen was continued for three weeks followed by a 1-week rest. After four courses of paclitaxel, ascites disappeared and the tumor marker was gradually reduced. However, multiple bone metastases were found during the eighth course, and she died about two years after the recurrence. The toxic events were mucositis (grade 1) in TS-1, and alopecia (grade 2) and leukopenia (grade 1) in paclitaxel. No major adverse effects were observed. Although the prognosis of recurrent gastric cancer with peritoneal dissemination was extremely poor, this case might suggest a possibility that intensive therapies are useful in maintaining the quality of life and improving survival.
Ebisui
Chikara
C
Dept. of Surgery, Hyogo Prefectural Nishinomiya Hospital.
Souma
Itsuro
I
Hayashi
Nobuyasu
N
Fukuchi
Nariaki
N
Izawa
Hikaru
H
Yoshida
Tetsuya
T
Sakita
Isao
I
Hasuike
Yasunori
Y
Fujimoto
Takayoshi
T
D000230:Adenocarcinoma / Q000473:pathology* / Q000628:therapy*; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004338:Drug Combinations; D005260:Female; D005743:Gastrectomy; D006801:Humans; D006869:Hydronephrosis / Q000188:drug therapy* / Q000209:etiology; D008197:Lymph Node Excision; D009364:Neoplasm Recurrence, Local; D010094:Oxonic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects; D010534:Peritoneal Neoplasms / Q000556:secondary* / Q000628:therapy*; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D011725:Pyridines / Q000009:adverse effects / Q000627:therapeutic use*; D015607:Stents; D013274:Stomach Neoplasms / Q000473:pathology* / Q000628:therapy*; D005641:Tegafur / Q000009:adverse effects / Q000627:therapeutic use*
D000964:Antimetabolites, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D017239:Paclitaxel