title: Unresectable gastric cancer with multiple liver metastases effectively treated with combined paclitaxel and doxifluridine chemotherapy.
abstract: We report a 72-year-old man who was diagnosed by gastroscopy as having a type III poorly differentiated adenocarcinoma in the lesser curvature, with the longest diameter being 10 cm. An abdominal computed tomography (CT) scan revealed multiple liver metastases, thickening of the gastric wall, and an enlarged paraaortic lymph node. The serum carcinoembryonic antigen (CEA) level was 60 ng/ml and the carbohydrate antigen (CA) 19-9 level was 1355 U/ml. The patient received combined chemotherapy with doxifluridine (800 mg/body per day) and paclitaxel (one course comprised three weekly infusions at a dose of 70 mg/m(2) followed by 1-week rest). After the completion of three courses, the patient achieved a complete response (CR), with complete disappearance of the primary tumor, the metastatic foci in the liver, and the enlarged abdominal lymph nodes; as well, the tumor markers were normalized. Adverse effects included only mild anorexia that was limited to grade 1. He maintained a CR for 1 year and 2 months. Combination chemotherapy with paclitaxel and doxifluridine can be an effective treatment for unresectable advanced gastric carcinoma.
authors.affiliation: Department of Surgery, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka 543-0035, Japan. shin7216@hotmail.com
authors.forename: Shin
authors.initials: S
authors.lastname: Mizutani
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Oyama
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hatanaka
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Uchikoshi
authors.forename: Katsuhide
authors.initials: K
authors.lastname: Yoshidome
authors.forename: Masayuki
authors.initials: M
authors.lastname: Tori
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ueshima
authors.forename: Masaaki
authors.initials: M
authors.lastname: Nakahara
authors.forename: Kazuyasu
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005467:Floxuridine / Q000008:administration & dosage; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D005467:Floxuridine; D017239:Paclitaxel; C025034:doxifluridine