title: [A case of gastric cancer with peritoneal metastasis successfully treated with multidisciplinary therapy].
abstract: A 56-year-old woman with advanced gastric cancer with peritoneal metastasis was successfully treated with multidisciplinary therapy. Gastrectomy and total resection of the peritoneal metastasis were performed initially. Subsequently, combined chemotherapy with S-1/polysaccharide-Kureha( PSK) and intraperitoneal infusion( IP) of docetaxel( TXT) was continued for 9 months. Because of the appearance of hepatic metastasis, the anti -cancer drug was changed to irinotecan (CPT-11) that was administered by dropping intravenously( DIV therapy) and continued for 10 months. Despite the reduction of the hepatic metastasis, ascites was increased. All metastatic lesions disappeared after 3-months of paclitaxel (TXL) DIV therapy. Five years after the operation, the peritoneal metastasis recurred. Combined DIV and IP TXL therapy was administered for 2 months. The peritoneal metastasis was reduced and the TXL DIV therapy was continued for 6 months. Due to increased levels of tumor markers, capecitabine( Xeloda)/cisplatin( CDDP) was introduced; however, it could not be continued because of the side effects. Subsequent TXT DIV therapy was not effective; chemotherapy was switched to CPT-11 DIV therapy, which was effective for 14 months. S-1 and TXL IP therapy was initiated because of the appearance of a new peritoneal tumor. This therapy effectively controlled the disease until today. The patient is in good health at 8 years after the start of therapy.
authors.affiliation: Dept. of Gastroenterological Surgery, Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University.
authors.forename: Miki
authors.initials: M
authors.lastname: Matoba
authors.forename: Sachio
authors.initials: S
authors.lastname: Fushida
authors.forename: Katsunobu
authors.initials: K
authors.lastname: Oyama
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Watanabe
authors.forename: Tomoya
authors.initials: T
authors.lastname: Tsukada
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamoto
authors.forename: Jun
authors.initials: J
authors.lastname: Kinoshita
authors.forename: Keishi
authors.initials: K
authors.lastname: Nakamura
authors.forename: Masafumi
authors.initials: M
authors.lastname: Inokuchi
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Nakagawara
authors.forename: Tomoharu
authors.initials: T
authors.lastname: Miyashita
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Tajima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takamura
authors.forename: Itasu
authors.initials: I
authors.lastname: Ninomiya
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kitagawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ohta
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome