title: Complete response of a patient with advanced gastric cancer, showing Epstein-Barr virus infection, to preoperative chemotherapy with S-1 and cisplatin.
abstract: Here we report the case of a patient with advanced gastric cancer with esophageal invasion who was treated with chemotherapy using S-1 and cisplatin (CDDP) preoperatively. The patient was a 72-year-old woman who was diagnosed with advanced gastric cancer (T3N2M0) with esophageal invasion. S-1 was orally administered at 80 mg/day (60 mg/m(2) per day) on days 1-14 and CDDP was infused at 80 mg/day (60 mg/m(2) per day) on day 8, followed by a 1-week rest. Marked reductions in the sizes of the primary tumor and metastatic lymph nodes around the stomach were observed after two cycles of the therapy. Adverse reactions occurring during the therapy were only grade 2 gastrointestinal disorder and grade 1 leukocytopenia. Radiological and endoscopic examinations before surgery showed that a partial response (PR) had been achieved. The patient underwent curative surgery consisting of total gastrectomy, D2 lymph node dissection, and splenectomy. Her postoperative course was uneventful, without surgical complications. No gastric cancer cells were detected in the primary lesion or lymph nodes by immunohistochemical staining with cytokeratin, confirming a histological complete response (CR). As Epstein-Barr virus-encoded small RNA (EBER) had been detected by in-situ hybridization in the gastric cancer cells of a biopsy specimen, this tumor was diagnosed as an Epstein-Barr virus (EBV)-associated gastric carcinoma (EBVaGC), which was effectively treated with S-1 and cisplatin chemotherapy.
authors: Department of Surgery, Chiba-Hokusoh Hospital, Nippon Medical School, Inbamura, Chiba, Japan. seya@nms.ac.jp
authors: Tomoko
authors: T
authors: Seya
authors: Noritake
authors: N
authors: Tanaka
authors: Kimiyoshi
authors: K
authors: Yokoi
authors: Noriyuki
authors: N
authors: Ishikawa
authors: Koji
authors: K
authors: Horiba
authors: Yoshikazu
authors: Y
authors: Kanazawa
authors: Takeshi
authors: T
authors: Yamada
authors: Michihiro
authors: M
authors: Koizumi
authors: Seiichi
authors: S
authors: Shinji
authors: Hirotake
authors: H
authors: Okazaki
authors: Yoshiharu
authors: Y
authors: Ohaki
authors: Toshiyuki
authors: T
authors: Ishiwata
authors: Zenya
authors: Z
authors: Naito
authors: Takashi
authors: T
authors: Tajiri
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage; D004338:Drug Combinations; D020031:Epstein-Barr Virus Infections / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D005743:Gastrectomy; D006564:Herpesviridae / Q000302:isolation & purification*; D006801:Humans; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage; D012367:RNA, Viral; D012074:Remission Induction; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery / Q000821:virology*; D005641:Tegafur / Q000008:administration & dosage
chemical_list: D004338:Drug Combinations; D012367:RNA, Viral; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin