A case of unresectable gastric cancer with pyloric stenosis which was resectable by chemotherapy after gastrojejunostomy
Miyo, M.; Iijima, S.; Makari, Y.; Kato, A.; Sakamoto, T.; Doi, T.; Hoshi, M.; Miyake, Y.; Oshima, S.; Kato, T.; Kurokawa, E.; Kikkawa, N.
Gan to Kagaku Ryoho. Cancer and ChemoTherapy 38(12): 2336-2338
2011
ISSN/ISBN: 0385-0684 PMID: 22202374 Document Number: 655640
A man in his fifties was referred to our hospital for anorexia and vomiting. Upper gastrointestinal endoscopy showed a gastric cancer (Borrmann Type 3) with pyloric stenosis. We performed gastrojejunostomy to allow oral intake for a tumor invading the pancreas head (cT4bN1H0P0CY1, Stage IV). After the operation, systemic chemotherapy with S-1 (120 mg/m²) was administered from July 2007, which caused grade 3 mucositis oral and drug rash after one week. Then, bi- weekly administration of CPT-11 (60 mg/m²) and CDDP (30 mg/m²) was started from August 2007 as second-line chemotherapy. The treatment was repeated for 14 courses till an allergic reaction happened. A weekly paclitaxel (PTX) therapy (80 mg/m²) was started from January 2009 as third-line. After 6 courses, CT showed that direct invasion to the pancreas was not clear any more, so a distal gastrectomy with D1 lymphadenectomy was performed on August 2009 (ypT3N- 1P0CY0, Stage IIB). The patient received 9 courses of weekly PTX therapy and after that the treatment has been discontinued. Recurrence was not observed for 48 months after an initial treatment.