Effective treatment of unresectable advanced gastric cancer by TS-1-based chemotherapy with a sequential combination of cisplatin (CDDP) and paclitaxel (PTX)

摘要

The patient was a 66-year-old female with Borrmann's type 4 gastric cancer complicated by metastasis to the liver and invasion of the head of the pancreas. Radical resection was not indicated, and only gastrojejunostomy was performed to bypass an existing pyloric obstruction. One course of chemotherapy was defined as 3 weeks of drug administration(TS-1 100 mg/body/day po for 21 days + CDDP 9 0 mg/body/day by iv drip on day 8), followed by a 2-week rest period. Chemotherapy was started 13 days after the operation, and it was possible to continue it for 7 courses. TS-1/CDDP therapy improved the patient's general condition. The tumor marker levels were also decreased. However, the efficacy of treatment began to decline,and ascites gradually developed during the fourth course of therapy. The treatment regimen was then switched to TS-1 100 mg/body/day po for 14 days, followed by a 14-day rest period, combined with PTX 9 0 mg/body/day iv drip on day 1 and day 15, while the ascites was being controlled. The ascites decreased significantly after the change in regimen, and the new regimen was continued for 6 courses. However, PTX was switched to CPT-11 because of gradual progression of peripheral neuropathy as a side effect of chemotherapy, and the patient subsequently died without any improvement in symptoms. This report describes a case of advanced gastric cancer treated by combination chemotherapy with TS-1 as a key drug, which resulted in a long survival (1 year and 5 months)and improvement in quality of life.