title: [Synchronous double cancer of the gallbladder and rectum successfully treated with S-1 as second-line chemotherapy- a case report].
abstract: A 66-year-old man was referred to our hospital with obstructive jaundice. Computed tomography(CT)scan showed thickening of the gallbladder wall, invasion into the liver bed, and thickening of the rectal wall. Colonoscopy revealed a type 2 rectal cancer, in which adenocarcinoma was identified by endoscopic biopsy. He was diagnosed with double-cancer of the gallbladder and rectum. Because his gallbladder cancer was more life threatening than his rectal cancer, gemcitabine was administered at 1, 000 mg/m2 on days 1, 8, and 15 of a 28-day course. After 3 courses of gemcitabine, the CT scan showed that the lymph nodes in the hepatoduodenal ligament had been enlarged, and duodenal stenosis had occurred as a result of gallbladder cancer invasion. S-1 was administered orally at doses of 120 mg/day twice daily on days 1-28 of a 42-day course. Partial response was confirmed by CT scan. After 8 courses of S-1, the gallbladder cancer had progressed and liver metastases had appeared. He subsequently died of disease progression. He survived for 17 months after the first course of chemotherapy, and the progression-free survival with S-1 was 10 months. Therefore, S-1 could be an effective agent for synchronous double cancer of the gallbladder and rectum.
authors.affiliation: Dept. of Gastroenterology and Hepatology, Osaka National Hospital, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Araki
authors.forename: Shoichi
authors.initials: S
authors.lastname: Nakazuru
authors.forename: Mari
authors.initials: M
authors.lastname: Itoh
authors.forename: Shigeki
authors.initials: S
authors.lastname: Suemura
authors.forename: Chiaki
authors.initials: C
authors.lastname: Mitsuta
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sueyoshi
authors.forename: Makiyo
authors.initials: M
authors.lastname: Ota
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohta
authors.forename: Hiroko
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Kaori
authors.initials: K
authors.lastname: Tatsumi
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Yoshio
authors.forename: Takashi
authors.initials: T
authors.lastname: Toyama
authors.forename: Noriyoshi
authors.initials: N
authors.lastname: Kuzushita
authors.forename: Eiji
authors.initials: E
authors.lastname: Mita
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004338:Drug Combinations; D017809:Fatal Outcome; D005706:Gallbladder Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D010094:Oxonic Acid / Q000627:therapeutic use*; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016879:Salvage Therapy; D005641:Tegafur / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid