title: [Complete recovery obtained with combined S-1 + CDDP therapy in a patient with multiple lung metastases from esophageal cancer].
abstract: OBJECTIVE
  There are numerous reports on the subject of effectiveness in radio-chemotherapy with regard to esophageal cancer, suggesting especially the combination therapy of 5-FU + CDDP aimed for recovery. Treatment becomes difficult when distal metastases appear during an adjuvant therapy followed by surgery. Our report here is a case in which a complete recovery was obtained after changing to S-1, a prodrug of 5-FU, in response to multiple lung metastases which appeared during the combined 5-FU + CDDP therapy followed by surgery for esophageal cancer.
  
  
  METHODS
  The patient was a 71-year-old male. Endoscopy during a physical examination showed a Type 1 tumor 27-30 cm from the anterior teeth. Detailed tests provided a preoperative diagnosis of esophageal cancer: Ut Type 1, T2-T3, N2, MO, IMO. A right thoracolaparotomic subtotal esophagectomy and retrosternal reconstruction were performed. Pathological findings showed well-differentiated squamous cell carcinoma, pT1b (sm), pN1 (106-rec R), pStage II. Postoperative combination of 5-FU + CDDP (day 1-5, 5-FU 500 mg; CDDP 10 mg/body) was started. Because of the appearance of multiple lung metastases after the completion of 3 courses, 2 courses of S-1 + CDDP (S-1 120 mg/body day 1-14; CDDP 5 mg/body day 1-5, day 8-12) were performed. After completing the chemotherapy, CT revealed the resolution of the lung metastases and complete recovery was diagnosed. Following this, a treatment with S-1 alone was continued until the appearance of bone metastases at which time radiotherapy was performed. The treatment is currently ongoing and no recurrence of the lung metastases has been shown.
  
  
  CONCLUSIONS
  There have been numerous reports of the combination of S-1 + CDDP in esophageal cancer for NAC or in inoperable cases. However, our report suggests that this method may be effective in cases of recurrence or distal metastases.
authors.affiliation: Nikko Memorial Hospital Digestive Disease Center.
authors.forename: Joji
authors.initials: J
authors.lastname: Takada
authors.forename: Koji
authors.initials: K
authors.lastname: Okuda
authors.forename: Chikayoshi
authors.initials: C
authors.lastname: Tani
authors.forename: Sachiko
authors.initials: S
authors.lastname: Kenno
authors.forename: Seiji
authors.initials: S
authors.lastname: Oguro
authors.forename: Tatsushi
authors.initials: T
authors.lastname: Shimokuni
authors.forename: Takanori
authors.initials: T
authors.lastname: Aoki
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nagaoka
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Uno
authors.forename: Hiromi
authors.initials: H
authors.lastname: Hamada
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002945:Cisplatin / Q000627:therapeutic use*; D004338:Drug Combinations; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary*; D008297:Male; D010094:Oxonic Acid / Q000627:therapeutic use*; D011379:Prognosis; D005641:Tegafur / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin