ABSTRACT
A 71-year-old male complaining of jaundice was referred to our hospital. He had undergone cholecystectomy for gall bladder cancer. Computed tomography showed the biliary duct was obstructed by recurrent gall bladder cancer at the hepatic hilum. After endoscopic metallic biliary stent implantation, gemcitabine(700 mg/m(2) day)was administered once a week for two weeks followed by a week of no treatment. After three courses of the chemotherapy, computed tomography showed that the tumor at the hepatic hilum was no longer visible and that the serum CA19-9 level was reduced to normal. Grade 2 appetite loss and grade 3 neutropenia were observed as adverse reactions to the treatment. Gemcitabine therapy after endoscopic intervention was safe and effective in this case of recurrent gall bladder cancer with obstructive jaundice.
Subject(s)
Deoxycytidine/analogs & derivatives , Gallbladder Neoplasms/drug therapy , Gallbladder Neoplasms/surgery , Liver Neoplasms/drug therapy , Metals , Stents , Aged , Deoxycytidine/therapeutic use , Endoscopes , Gallbladder Neoplasms/diagnostic imaging , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/secondary , Male , Recurrence , Tomography, X-Ray Computed , GemcitabineABSTRACT
A 65-year-old female who complained of appetite loss and upper abdominal pain was diagnosed as unresectable advanced gastric cancer with pyloric stenosis and obstructive jaundice by peritoneal and lymph node metastases. After endoscopic balloon dilatation and endoscopic biliary drainage, S-1(80 mg/m(2)/day, days 1-14 with 1 week rest)/pacli- taxel(PTX)(50 mg/m(2)/day, day 1, day 8)combination therapy was done. After one course of the chemotherapy, subjective symptoms were relieved and oral intake was increased. Computed tomography showed that the volume of gastric wall, the size of paraaortic lymph node, and the amount of pleural effusion and ascites were decreased. Grade 1 alopecia, vasculitis and grade 2 neutropenia were observed as adverse reactions to the treatment. S-1/PTX combination therapy after endoscopic intervention was effective in this case of advanced gastric cancer with pyloric stenosis and obstructive jaundice.
