title: [An effective treatment by chemotherapy with CDDP+CPT-11 for recurrent gastric cancer which S-1 cannot be used owing to adverse effects].
abstract: We report a case of a 64-year-old man with multiple lung metastases after gastric cancer surgery. This patient was initially treated with S-1. However, he experienced adverse effects, and subsequently, he was effectively treated with cisplatin (CDDP) and irinotecan (CPT-11). In July 2010, the patient experienced a decrease in appetite and underwent a detailed examination. He also underwent distal gastrectomy in the same month. The postoperative diagnosis was T4a( SE), N2, M0, Stage IIIB. In November 2010, adjuvant chemotherapy with S-1 was initiated. In February 2011, the patient developed a skin disorder( grade 3) and generalized edema along with walking difficulty, which were identified as adverse effects of S-1. Evidently, S-1 was contraindicated for this patient, and adjuvant therapy was discontinued. In September 2011, contrast -enhanced thoracoabdominal computed tomography( CT) was performed and para-aortic lymph node metastasis and multiple lung metastases were detected. CDDP+CPT-11 therapy was initiated. By June 2012, 8 courses had been administered, and the patient had a good partial response. With regard to chemotherapy for advanced or recurrent gastric cancer, there is no consensus on a treatment policy for cases in which S-1 cannot be used owing to adverse effects. CDDP+CPT-11 therapy is considered a safe and effective choice.
authors.affiliation: Dept. of Surgery, Hasuda Hospital.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Matsui
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Aoyagi
authors.forename: Jun
authors.initials: J
authors.lastname: Kaneko
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Kumi
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Jun
authors.initials: J
authors.lastname: Isogai
authors.forename: Shizuaki
authors.initials: S
authors.lastname: Maejima
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D002945:Cisplatin / Q000008:administration & dosage; D000075202:Contraindications; D004338:Drug Combinations; D006801:Humans; D000077146:Irinotecan; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D010094:Oxonic Acid / Q000009:adverse effects; D012008:Recurrence; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D005641:Tegafur / Q000009:adverse effects
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D000077146:Irinotecan; D002945:Cisplatin; D002166:Camptothecin