A case report--The marked response to gemcitabine combined with irinotecan and low-dose cisplatin chemotherapy for advanced gastric cancer with multiple liver metastases.
A 69-year-old man with no sign of symptoms was admitted to our hospital for further examination and treatment of gastric cancer. Endoscopy revealed a Borrmann 3-type tumor in the cardia of the stomach. CT of the abdomen demonstrated a marked thickening of the stomach wall near the esophago-gastric junction, multiple liver metastases in bilateral liver lobes, and regional lymph node swelling around the cardia of the stomach. He consented and received systemic chemotherapy consisting of 0.5 h infusion of cisplatin (25 mg/body) followed by 0.5 h infusion of gemcitabine (800 mg/body) and 2.5 h infusion of irinotecan (60 mg/body) every 14 days as described below. Only the initial 1 course was administered with 5-FU (500 mg/body) as an inpatient, and further courses were performed as an outpatient with no severe adverse events. His tumors responded immediately to the chemotherapy, and restaging abdominal CT after 4-cycles of chemotherapy showed almost complete regression of liver metastases, and partial response to lymphadenopathy. The patient currently undergoes regular chemotherapy and remains in remission more than 6 months after the diagnosis of unresectable gastric cancer with liver metastases. It may be possible that the current chemotherapy will be neoadjuvant chemotherapy, and curative surgical resection can be performed.
Teraishi
Fuminori
F
Dept. of Gastroenterological Surgery, Okayama University Graduate School of Medicine and Dentistry, Japan.
Uno
Futoshi
F
Kagawa
Shunsuke
S
Gochi
Akira
A
Fujiwara
Toshiyoshi
T
Tanaka
Noriaki
N
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D000077146:Irinotecan; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy*; D016896:Treatment Outcome; D000093542:Gemcitabine
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D003841:Deoxycytidine; D000077146:Irinotecan; D002945:Cisplatin; D005472:Fluorouracil; D002166:Camptothecin; D000093542:Gemcitabine