[A case of advanced gastric cancer effectively treated with combination of weekly paclitaxel and hepatic arterial infusion of 5-FU/LV].
The patient was a 66-year-old woman who underwent upper gastrointestinal endoscopy as part of a detailed examination because of loss of appetite and anemia, and type 2 gastric cancer was detected on the greater curvature in the pyloric area. Abdominal ultrasonography and CT revealed lymph node enlargement around the pyloric area and multiple liver metastases in both lobes of the liver. Curative resection was judged to be impossible, and oral S-1 therapy was started. However, no efficacy was observed even after the completion of three courses, and especially because of the rapid increase in the size of the liver metastases, treatment was switched to combination therapy consisting of a continuous hepatic artery infusion of 5-FU+Leucovorin (day 1-7) and weekly PTX for 3 consecutive weeks (day 8, 15, 22) followed by a 1-week rest. The tumor marker levels decreased rapidly, and at the end of 4 courses marked regression of the primary tumor and lymph node metastases as well as of the metastatic foci in the liver was observed. Adverse events have been mild, and at present, 6 months after the switch in treatment, good QOL has been maintained, and treatment is continuing. This method appears to be an effective treatment strategy for unresectable advanced gastric cancer complicated by liver metastasis.
Oida
Yasuhisa
Y
Dept. of Surgery, Tokai University Hachioji Hospital.
Motojuku
Megumi
M
Morikawa
Goryu
G
Mukai
Masaya
M
Imaizumi
Toshihide
T
Makuuchi
Hiroyasu
H
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000097:blood; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000627:therapeutic use*; D005773:Gastroscopy; D006801:Humans; D007261:Infusions, Intra-Arterial; D002955:Leucovorin / Q000008:administration & dosage / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000097:blood / Q000098:blood supply* / Q000188:drug therapy* / Q000556:secondary; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use*; D013274:Stomach Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D013997:Time Factors; D014057:Tomography, X-Ray Computed
D014408:Biomarkers, Tumor; D017239:Paclitaxel; D002955:Leucovorin; D005472:Fluorouracil