title: [A case report of complete response by weekly paclitaxel and 5'-DFUR combination chemotherapy for recurrenced gastric cancer with peritoneal dissemination].
abstract: A 77-year-old man complained chiefly of chest pain and heartburn. He had type 3 gastric cancer on the posterior wall of vestibular part. Distal partial gastrectomy and D2 lymph node dissection were performed. The pathological findings were as follows: partially poor tub2, pT2 (SS), ly2, v0, pN1, H0, P0, CY0, M0, pStage II,and Cur A. S-1 was administered orally as an adjuvant therapy. Carbohydrate antigen(CA) 19-9 levels were elevated 16 months after the operation. Computed tomography revealed a small amount of ascitic fluid with no other significant findings. Endoscopy revealed an erythrogenic protruding lesion 20 cm from the anal verge. In the biopsy, the lesion was classified as Group V, indicating metastasis of gastric cancer. It was judged that the S-1 therapy had led to the recurrence of peritoneal dissemination. Weekly paclitaxel (PTX; 3-week administration followed by 1-week withdrawal) was used together with doxifluridine(5'-DFUR; daily oral administration). CA19-9 levels decreased gradually, becoming normal in 3 months. Most of the ascitic fluid disappeared in 4 months. In the endoscopy performed after 9 months, the lesion was classified as Group I, revealing a histological complete response (CR). No serious side effects were observed, although epilation occurred as an adverse event. Currently, 21 months after the start of treatment, the CR has persisted. These results suggest that despite a few side effects, concomitant therapy with weekly PTX and 5'-DFUR can be continued as ambulatory care, and it may be effective in patients treated previously with S-1 who exhibit recurrence of peritoneal dissemination of gastric cancer.
authors.affiliation: Dept. of Surgery, Shakaihoken Shimonoseki Kosei Hospital, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Nakamura
authors.forename: Koichiro
authors.initials: K
authors.lastname: Sakata
authors.forename: Junya
authors.initials: J
authors.lastname: Kondo
authors.forename: Taku
authors.initials: T
authors.lastname: Nishimura
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nagashima
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Okada
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005467:Floxuridine / Q000008:administration & dosage; D005743:Gastrectomy; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D012008:Recurrence; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery
chemical_list: D005467:Floxuridine; D017239:Paclitaxel; C025034:doxifluridine