[Report of a case successfully treated with chemo-radiation against local recurrence after gastric cancer surgery]

Gan To Kagaku Ryoho. 2009 Aug;36(8):1363-6.
[Article in Japanese]

Abstract

A 68-year-old male was diagnosed as type 2 gastric cancer in the upper part of the stomach, then diagnosed as cT2 (MP) N0M0H0P0, cStage I B. Total gastrectomy and splenectomy with D2 lymph node dissection were performed. Final diagnosis including pathology was pT1 (SM) N1M0H0P0, pStage I B, and with his informed consent, an anticancer drug, UFT, was given as postoperative adjuvant therapy. Four months after the surgery, a 35-mm sized tumor recurring around the distal region of pancreas was detected by abdominal computed tomography (ACT). Then, combination chemo-radiotherapy using S-1, cisplatin and radiation (50 Gy) was performed. One year after the initial surgery, ACT showed a complete response (CR) of the recurred tumor, while outpatient chemotherapy with S-1 +CPT-11 and S-1 +paclitaxel was continuously performed, because of elevated CEA. Two years after initial surgery, the CEA value was elevated to 28.4 ng/mL, and so S-1 +docetaxel was applied. The patient is still alive with no sign of lesion recurrence by CT 3 years after initial surgery. Outpatient chemotherapy helped the patient maintain good quality of life. In addition, initial therapy for the recurred tumor including radiation proved to be a powerful way to control local growth of gastric cancer, even if hematogenous/lymphatic spreading of gastric cancer cells might be difficult to suppress with such chemo-radiotherapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Ambulatory Care
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Cisplatin / administration & dosage
  • Combined Modality Therapy
  • Humans
  • Irinotecan
  • Lymph Node Excision
  • Male
  • Neoplasm Recurrence, Local*
  • Paclitaxel / administration & dosage
  • Splenectomy
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / radiotherapy
  • Stomach Neoplasms / surgery
  • Stomach Neoplasms / therapy*
  • Tegafur / administration & dosage

Substances

  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents
  • Antineoplastic Agents, Phytogenic
  • Tegafur
  • Irinotecan
  • Paclitaxel
  • Cisplatin
  • Camptothecin