[A case of locoregional recurrence after gastric cancer surgery, which was treated with XPT regimen chemotherapy].
Based on the results of the trastuzumab for gastric cancer (ToGA) trial, the regimen of Xeloda/5-FU+CDDP+trastuzu- mab (XPT/FPT) has become the standard of care for treatment of HER2-positive unresectable or recurrent gastric cancers. In our hospital, the percentage of HER2-positive gastric cancer patients is 16.7%; we present a case of recurrence 26 months after gastric cancer surgery. A 67-year-old man presented with locoregional lymph node recurrence, with swelling in a paraaortic lymph node. ¹⁸F-fluorodeoxy glucose positron emission tomography (FDG-PET) examination revealed abnormal accumulation in these lymph nodes. He was treated with a regimen of XPT chemotherapy because of the HER2-positive status of his gastric cancer. After 8 courses, the lymph nodes had shrunk and FDG-PET examination revealed no abnormal accumulation. Imaging revealed the presence of interstitial pneumonia, and the adverse events of venous thromboembolism, and grade 3 hand-foot syndrome were detected; as a result, chemotherapy was suspended. The XPT regimen may be an effective treatment for HER2-positive unresectable or recurrent gastric cancers. HER2 status should be the key determinant in the strategy for the treatment of unresectable and recurrent gastric cancers in the future.
Dept. of Surgery, Nishinomiya Municipal Central Hospital.
Yoshio
Y
Oka
Kaoru
K
Okada
Hisashi
H
Uemura
Shigeru
S
Nakane
Yasuhiro
Y
Miyake
Naozumi
N
Higaki
Masakazu
M
Murakami
Hirohito
H
Hayashida
Riichiro
R
Nezu
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D012008:Recurrence; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology / Q000601:surgery
D018719:Erb-b2 Receptor Tyrosine Kinases