Successful treatment of S-1 + CDDP followed by salvage EMR for a case with metastatic Barrett's esophageal cancer.
A 62-year-old woman with Barrett's esophageal cancer was hospitalized. Abdominal CT confirmed metastases to the liver and lymph nodes, for which surgical excision and radiotherapy were not indicated. We started chemotherapy with a course of daily oral S-1 at a dose of 80 mg/m(2) for 21 days, with a 2-hour drip of cisplatin at 60 mg/m(2) on day 8. Breaks of 14 drug-free days were given between courses. After two courses, a repeat CT confirmed that the liver and lymph node metastases had disappeared; after three courses, another CT confirmed that the metastatic foci were still absent, so we judged the disease to be in complete remission. Endoscopy and upper GI series confirmed that the primary tumor was reduced, and endoscopic mucosal resection performed using the strip biopsy method. The excision specimen was well differentiated adenocarcinoma, and mucosal invasion, and the excision stump was negative. After two more courses of S-1 + cisplatin, chemotherapy has been suspended with the patient's consent, and in the 21 months after endoscopic mucosal resection, no recurrence has been observed. This is a rare case of metastatic Barrett's esophageal cancer in which the metastases were eradicated by S-1 + cisplatin, and the primary tumor successfully excised by endoscopic mucosal resection after downstaging.
Nakatani
K
K
Department of Gastroenterology, Kitasato University East Hospital, School of Medicine, 2-1-1, Asamizodai, Sagamihara, Kanagawa, Japan. dm05021d@st.kitasato-u.ac.jp
Tanabe
S
S
Koizumi
W
W
Nishimura
K
K
Shimoda
T
T
Azuma
M
M
Katada
C
C
Sasaki
T
T
Higuchi
K
K
Saigenji
K
K
D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001471:Barrett Esophagus / Q000473:pathology / Q000628:therapy*; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D004938:Esophageal Neoplasms / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000628:therapy; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009092:Mucous Membrane / Q000601:surgery*; D010094:Oxonic Acid / Q000008:administration & dosage; D016879:Salvage Therapy; D005641:Tegafur / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed
D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin