Second-lineにpaclitaxelの併用で長期のS-1投与が有用であった胃癌腹膜転移の1例

われわれはS-1の反応が悪くなった胃癌腹膜転移の1例に2nd-line chemotherapyとしてpaclitaxelを併用して有効であったことを報告する.投与方法はS-1 80mg/日3週連日経口投与+paclitaxel 40mg/m^2をday 1, 8, 15に点滴静脈注射し, 2週休薬する5週間1コースの併用である.主に外来化学療法として行った.症例の腹膜転移を有する4型胃癌に対し,胃全摘+脾合併切除術, D2郭清を施行した.術後S-1を12コース投与した. CTで右横隔膜下に腹膜転移の増強と肝門部に再発の増大を認めたため, paclitaxelを併用した.併用11コース後,肝門部再発が徐々に軽度増大したが,腹膜転移は不変で,長期間にわたって全身状態は良好であった.腹膜転移診断後3年7ヵ月でご永眠された. S-1の反応が悪くなった胃癌腹膜転移例に2nd-line chemotherapyとしてpaclitaxelを併用して生存期間をさらに延長したと考えられる.この化学療法は重症な副作用がなく,外来で頻用できる有効な治療である.We describe a patient with peritoneal metastasis from gastric cancer treated with S-1 (TS-1^) in whom survival was further prolonged by concomitant treatment with paclitaxel (Taxol^), given as second-line chemotherapy. S-1 (80mg/day) was given orally for 21 days, and paclitaxel (40mg/m^2) was given by intravenous infusion on days 1, 8, and 15 of a 5-week cycle, administered primarily on an outpatient basis. A 61-year-old man presented with body weight loss. Type 4 gastric cancer was diagnosed on endoscopic examination. The patient underwent total gastrectomy for gastric cancer with peritoneal metastasis. Twelve cycles of S-1 were given postoperatively. A computed tomographic scan revealed increased peritoneal metastasis and disease recurrence. Paclitaxel was therefore given concomitantly with S-1. After 11 cycles of combination chemotherapy, peritoneal metastasis remained unchanged. The patient died 3 years 7 months after the diagnosis of peritoneal metastasis. In the patient with gastric cancer and peritoneal metastasis relatively refractory to S-1 therapy, the combination of a low weekly dose of paclitaxel and S-1 prolonged survival further without severe toxicity. We conclude that this regimen can be given for many cycles on an outpatient basis and prolong survival

Second-lineにpaclitaxelの併用で長期のS-1投与が有用であった胃癌腹膜転移の1例

われわれはS-1の反応が悪くなった胃癌腹膜転移の1例に2nd-line chemotherapyとしてpaclitaxelを併用して有効であったことを報告する.投与方法はS-1 80mg/日3週連日経口投与+paclitaxel 40mg/m^2をday 1, 8, 15に点滴静脈注射し, 2週休薬する5週間1コースの併用である.主に外来化学療法として行った.症例の腹膜転移を有する4型胃癌に対し,胃全摘+脾合併切除術, D2郭清を施行した.術後S-1を12コース投与した. CTで右横隔膜下に腹膜転移の増強と肝門部に再発の増大を認めたため, paclitaxelを併用した.併用11コース後,肝門部再発が徐々に軽度増大したが,腹膜転移は不変で,長期間にわたって全身状態は良好であった.腹膜転移診断後3年7ヵ月でご永眠された. S-1の反応が悪くなった胃癌腹膜転移例に2nd-line chemotherapyとしてpaclitaxelを併用して生存期間をさらに延長したと考えられる.この化学療法は重症な副作用がなく,外来で頻用できる有効な治療である.We describe a patient with peritoneal metastasis from gastric cancer treated with S-1 (TS-1^<[○!R]>) in whom survival was further prolonged by concomitant treatment with paclitaxel (Taxol^<[○!R]>), given as second-line chemotherapy. S-1 (80mg/day) was given orally for 21 days, and paclitaxel (40mg/m^2) was given by intravenous infusion on days 1, 8, and 15 of a 5-week cycle, administered primarily on an outpatient basis. A 61-year-old man presented with body weight loss. Type 4 gastric cancer was diagnosed on endoscopic examination. The patient underwent total gastrectomy for gastric cancer with peritoneal metastasis. Twelve cycles of S-1 were given postoperatively. A computed tomographic scan revealed increased peritoneal metastasis and disease recurrence. Paclitaxel was therefore given concomitantly with S-1. After 11 cycles of combination chemotherapy, peritoneal metastasis remained unchanged. The patient died 3 years 7 months after the diagnosis of peritoneal metastasis. In the patient with gastric cancer and peritoneal metastasis relatively refractory to S-1 therapy, the combination of a low weekly dose of paclitaxel and S-1 prolonged survival further without severe toxicity. We conclude that this regimen can be given for many cycles on an outpatient basis and prolong survival