title: [A case of effective treatment with chemosensitivity test-guided chemotherapy for advanced pancreatic and gastric cancer with peritoneal metastasis].
abstract: A 63-year-old man with abdominal pain was diagnosed as locally advanced pancreatic tail cancer and gastric cancer with peritoneal metastasis based on computed tomography (CT) and gastrointestinal series. Preoperative serum CA19- 9 was 1,357 U/mL. During laparotomy, peritoneal dissemination was observed and confirmed pathologically. An ileoileostomy was performed and peritoneal tissue was submitted to a chemosensitivity test. Based on the chemosensitivity test, CPT-11 (50 mg/body), 5-FU (750 mg/body), and Leucovorin (375 mg/body) were administered intravenously once a week for 3 weeks with a 1-week rest as 1 course. The patient received 9 courses of chemotherapy until progressive disease. Stable disease in tumor size was observed and serum CA19-9 level dropped to 81 U/mL. He remained well without any symptoms and pursued normal activity for 15 months. He died of peritoneal dissemination 26 months after diagnosis. Chemosensitivity test-guided chemotherapy seems to be an effective regimen as individualized chemotherapy for advanced pancreatic and gastric cancer.
authors.affiliation: Dept. of Surgical Oncology and Digestive Surgery, Kagoshima University Graduate School of Medical and Dental Sciences.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shinchi
authors.forename: Kosei
authors.initials: K
authors.lastname: Maemura
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Noma
authors.forename: Yukou
authors.initials: Y
authors.lastname: Mataki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kurahara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Maeda
authors.forename: Masaki
authors.initials: M
authors.lastname: Kitazono
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakashima
authors.forename: Shigeho
authors.initials: S
authors.lastname: Maenohara
authors.forename: Shoji
authors.initials: S
authors.lastname: Natsugoe
authors.forename: Sonshin
authors.initials: S
authors.lastname: Takao
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D010534:Peritoneal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000556:secondary* / Q000601:surgery; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure