[Report of a case successfully treated with chemo-radiation against local recurrence after gastric cancer surgery].
A 68-year-old male was diagnosed as type 2 gastric cancer in the upper part of the stomach, then diagnosed as cT2 (MP) N0M0H0P0, cStage I B. Total gastrectomy and splenectomy with D2 lymph node dissection were performed. Final diagnosis including pathology was pT1 (SM) N1M0H0P0, pStage I B, and with his informed consent, an anticancer drug, UFT, was given as postoperative adjuvant therapy. Four months after the surgery, a 35-mm sized tumor recurring around the distal region of pancreas was detected by abdominal computed tomography (ACT). Then, combination chemo-radiotherapy using S-1, cisplatin and radiation (50 Gy) was performed. One year after the initial surgery, ACT showed a complete response (CR) of the recurred tumor, while outpatient chemotherapy with S-1 +CPT-11 and S-1 +paclitaxel was continuously performed, because of elevated CEA. Two years after initial surgery, the CEA value was elevated to 28.4 ng/mL, and so S-1 +docetaxel was applied. The patient is still alive with no sign of lesion recurrence by CT 3 years after initial surgery. Outpatient chemotherapy helped the patient maintain good quality of life. In addition, initial therapy for the recurred tumor including radiation proved to be a powerful way to control local growth of gastric cancer, even if hematogenous/lymphatic spreading of gastric cancer cells might be difficult to suppress with such chemo-radiotherapy.
Igarashi
Takahiro
T
Dept. of Surgery, School of Medicine, Keio University.
Saikawa
Yoshiro
Y
Kumagai
Koshi
K
Nakamura
Rieko
R
Takahashi
Tsunehiro
T
Takeuchi
Yuya
Y
Kitagawa
Yuko
Y
D000368:Aged; D000553:Ambulatory Care; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D006801:Humans; D000077146:Irinotecan; D008197:Lymph Node Excision; D008297:Male; D009364:Neoplasm Recurrence, Local; D017239:Paclitaxel / Q000008:administration & dosage; D013156:Splenectomy; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D005641:Tegafur / Q000008:administration & dosage
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D005641:Tegafur; D000077146:Irinotecan; D017239:Paclitaxel; D002945:Cisplatin; D002166:Camptothecin