胃と腸40巻7号

2005年06月発行

今月の主題 胃癌化学療法の進歩と課題 主題症例

集学的治療により長期生存を得た腹膜播種を伴う4型胃癌の1例

著者： 才川義朗¹ 大谷吉秀¹ 久保田哲朗¹ 中村理恵子¹ 吉田昌¹ 熊井浩一郎¹ 北島政樹¹

所属機関： ¹慶應義塾大学医学部外科

ページ範囲：P.1027 - P.1030

要旨　症例は40歳男性で，腹部膨満・胃痛を訴え，精査にて腹水を伴う4型胃癌〔T2（SS）以上 N1M0H0P1，cStage IV〕と診断された．初回治療としてS-1/low dose cisplatin（TSLD）＋放射線療法を施行し，さらに外来にて1cycle追加した．腹水消失，原発巣の改善，肝転移巣（S4）出現にてCPT-11/S-1外来投与に変更し，その後肝転移巣は消失した．治療開始11か月後，肝・腹膜転移巣の増悪なく，本人の希望にて根治切除（胃全摘，リンパ節郭清術）が行われた．術後合併症はなく早期に退院した．病理組織学的にpT3（SE）N0M0P0，pStage IIと診断された．現在治療開始1年5か月後，再発の徴候はない．

参考文献

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