title: [A Case of Pulmonary Embolism Developed during Combination Chemotherapy with S-1 and Cisplatin in a Young Female Patient with Type 4Gastric Cancer].
abstract: We report a case of a 23-year-old womanwho developed pulmonary embolism(PE)during chemotherapy for advanced gastric cancer following total gastrectomy(R1). She presented with type 4 gastric cancer with peritoneal dissemination and positive washing cytology. Palliative total gastrectomy was performed(R1)and first-line chemotherapy with S-1(80mg/m2, days 1 to 21) plus CDDP(60mg/m2, day 8)(SP; every 35 days)was administered. PE occurred on day 15 of the 3rd courses of SP. Computed tomography(CT)revealed massive PE in both the pulmonary arteries, and ultrasonography indicated an increase in right-sided pressure. Thrombolysis using urokinase and heparin was performed immediately, and she recovered after 10 days in intensive care. Dehydration caused by the adverse event, as well as nausea and the anticancer drug itself, are risk factors for DVT and PE. Risk stratification, prevention, and early treatment are very important for PE.
authors.affiliation: Dept. of Surgery, National Hospital Organization, Osaka National Hospital.
authors.forename: Noboru
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Hagihara
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nishikawa
authors.forename: Motohiro
authors.initials: M
authors.lastname: Hirao
authors.forename: Sakae
authors.initials: S
authors.lastname: Maeda
authors.forename: Mamoru
authors.initials: M
authors.lastname: Uemura
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyake
authors.forename: Naoki
authors.initials: N
authors.lastname: Hama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Miyamoto
authors.forename: Michihiko
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Masataka
authors.initials: M
authors.lastname: Ikeda
authors.forename: Shoji
authors.initials: S
authors.lastname: Nakamori
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D004338:Drug Combinations; D005260:Female; D005743:Gastrectomy; D006801:Humans; D010094:Oxonic Acid / Q000008:administration & dosage / Q000009:adverse effects; D011655:Pulmonary Embolism / Q000209:etiology*; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000601:surgery; D005641:Tegafur / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid; D002945:Cisplatin