title: [A case of paraaortic lymph node metastasis of gastric cancer resistant to chemotherapy successfully treated with chemoradiation therapy].
abstract: We report a case of recurrent gastric cancer with paraaortic lymph nodes (No.16LNs) that was effectively controlled with chemoradiation therapy. A 63-year-old man underwent distal gastrectomy, cholecystectomy, and D2 dissection in July 2004 for advanced gastric cancer in the lower third area that was diagnosed as moderately differentiated stage II adenocarcinoma [T1(SM), N2, H0, P0, CY0, M0]. He suffered from No.16LNs metastasis with serum CEA elevation in October 2007, and therefore, 4 courses of S-1, followed by 3 courses of CPT-11 as second-line treatment, 14 courses of docetaxel as third-line treatment, and 15 courses of paclitaxel+cisplatin as fourth-line chemotherapy, were administrated. Enlargement of No.16LNs with serum CEA elevation was observed in October 2010. Other metastases were not observed, and hence, chemoradiotherapy (CRT; S-1: 80 mg/body+total of 65 Gy per 26 Fr) for No.16LNs was performed. A partial response and reduction of serum CEA level were noted, and the patient is alive with no sign of progression 18 months after CRT. Grade 1 adverse events including anemia, fatigue, and anorexia were recognized. It is thought that chemoradiation therapy is an effective treatment for localized LN metastasis originating from gastric cancer resistant to chemotherapy.
authors.affiliation: Dept. of Surgery, NTT West Osaka Hospital, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kimura
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Taniguchi
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Fujita
authors.forename: Chiwan
authors.initials: C
authors.lastname: Kim
authors.forename: Katsuki
authors.initials: K
authors.lastname: Danno
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kanoh
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yoshida
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ohnishi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tono
authors.forename: Yuji
authors.initials: Y
authors.lastname: Yamada
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Kagawa
authors.forename: Takushi
authors.initials: T
authors.lastname: Monden
authors.forename: Shingi
authors.initials: S
authors.lastname: Imaoka
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001011:Aorta / Q000473:pathology; D059248:Chemoradiotherapy; D004338:Drug Combinations; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000627:therapeutic use*; D016879:Salvage Therapy; D013274:Stomach Neoplasms / Q000473:pathology / Q000628:therapy*; D005641:Tegafur / Q000627:therapeutic use*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid