[A case of unresectable gastric cancer with pyloric stenosis which was resectable by chemotherapy after gastrojejunostomy].
A man in his fifties was referred to our hospital for anorexia and vomiting. Upper gastrointestinal endoscopy showed a gastric cancer (Borrmann Type 3) with pyloric stenosis. We performed gastrojejunostomy to allow oral intake for a tumor invading the pancreas head (cT4bN1H0P0CY1, Stage IV). After the operation, systemic chemotherapy with S-1 (120 mg/m²) was administered from July 2007, which caused grade 3 mucositis oral and drug rash after one week. Then, bi- weekly administration of CPT-11 (60 mg/m²) and CDDP (30 mg/m²) was started from August 2007 as second-line chemotherapy. The treatment was repeated for 14 courses till an allergic reaction happened. A weekly paclitaxel (PTX) therapy (80 mg/m²) was started from January 2009 as third-line. After 6 courses, CT showed that direct invasion to the pancreas was not clear any more, so a distal gastrectomy with D1 lymphadenectomy was performed on August 2009 (ypT3N- 1P0CY0, Stage IIB). The patient received 9 courses of weekly PTX therapy and after that the treatment has been discontinued. Recurrence was not observed for 48 months after an initial treatment.
Dept. of Surgery, Minoh City Hospital.
Masaaki
M
Miyo
Shohei
S
Iijima
Yoichi
Y
Makari
Aya
A
Kato
Takuya
T
Sakamoto
Takashi
T
Doi
Minako
M
Hoshi
Yasuhiro
Y
Miyake
Satoshi
S
Oshima
Takeshi
T
Kato
Eiji
E
Kurokawa
Nobuteru
N
Kikkawa
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D011707:Pyloric Stenosis / Q000209:etiology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery*; D014057:Tomography, X-Ray Computed