ABSTRACT
We report a case of advanced gastric cancer resected after successful treatment with the novel oral anticancer drug TS-1. The patient was a 52-year-old male. Gastrointestinal fiberscopy showed advanced gastric cancer. Examinations by computed tomography revealed gastric cancer invasion of the pancreas and swollen para-aortic lymph nodes. This patient was treated by preoperative chemotherapy with oral administration of TS-1 (120 mg per day). After 3 courses of treatment of TS-1, the primary lesion and swollen lymph nodes were remarkably reduced. This chemotherapy enabled total gastrectomy in curative resection. The pathological effectiveness of chemotherapy was Grade 1b in the primary lesion and Grade 2 or 3 in the lymph nodes. The patient sustained few side effects. This preoperative chemotherapy regimen seems to be an effective and promising therapy for patients with advanced gastric cancer.
Subject(s)
Adenocarcinoma/drug therapy , Antimetabolites, Antineoplastic/administration & dosage , Gastrectomy , Oxonic Acid/administration & dosage , Pyridines/administration & dosage , Stomach Neoplasms/drug therapy , Tegafur/administration & dosage , Adenocarcinoma/secondary , Adenocarcinoma/surgery , Administration, Oral , Drug Administration Schedule , Drug Combinations , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Staging , Stomach Neoplasms/pathology , Stomach Neoplasms/surgeryABSTRACT
We treated a patient with unresectable rectal cancer with multiple liver, pulmonary and lymph node metastases that responded remarkably to pharmacokinetic modulating chemotherapy (PMC). The patient was a 63-year-old male. Colonoscopy showed a type 3 advanced lower rectal cancer. Examinations by computed tomography and chest X-ray revealed unresectable rectal cancer invading the sacrum and bladder with multiple liver and pulmonary metastases and swollen para-aortic lymph nodes. The patient was treated by colostomy and postoperative PMC. UFT (400 mg/day) was orally administered daily and a continuous infusion of 5-FU (1,000 mg/24 h) was given once a week. After 10 courses of treatment with PMC, the primary lesion was remarkably reduced. This chemotherapy also produced partial responses in the pulmonary metastases and para-aortic lymph node swelling. The patient experienced few side effects and had good QOL in the terminal stage. This chemotherapy regimen appears to be an effective and promising therapy with few side effects, even for patients with unresectable advanced colorectal cancer.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Liver Neoplasms/secondary , Lung Neoplasms/secondary , Rectal Neoplasms/drug therapy , Adenocarcinoma/secondary , Administration, Oral , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Drug Administration Schedule , Fluorouracil/administration & dosage , Humans , Infusion Pumps, Implantable , Male , Middle Aged , Quality of Life , Rectal Neoplasms/pathology , Tegafur/administration & dosage , Uracil/administration & dosageABSTRACT
Eighteen patients with far advanced and recurrent gastric cancer with peritoneal dissemination were treated with a novel oral anticancer drug, TS-1, and assessed according to clinical effect. TS-1 was administered at a dose of 80-120 mg/day. One course consisted of consecutive administration of TS-1 for 28 days followed by 14 days rest. The 1- and 2-year survival rates and median survival time after administration of TS-1 were 63.2%, 23.7% and 437 days, respectively. Eight patients (44.4%) survived for 1 year or more. Adverse reactions consisted of reduction in hemoglobin level and hyperbilirubinemia at grades 3 and 4, which were observed in 3 patients and 1 patient, respectively. TS-1 is a promising drug for gastric cancer with peritoneal dissemination.