A case of paraaortic lymph node metastasis of gastric cancer resistant to chemotherapy successfully treated with chemoradiation therapy

We report a case of recurrent gastric cancer with paraaortic lymph nodes (No.16LNs) that was effectively controlled with chemoradiation therapy. A 63-year-old man underwent distal gastrectomy, cholecystectomy, and D2 dissection in July 2004 for advanced gastric cancer in the lower third area that wa...

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Bibliographic Details
Published inGan to kagaku ryoho Vol. 39; no. 12; p. 2324
Main Authors Kimura, Yutaka, Taniguchi, Hirokazu, Fujita, Shoichiro, Kim, Chiwan, Danno, Katsuki, Kanoh, Toshiyuki, Yoshida, Tetsuya, Ohnishi, Tadashi, Tono, Takeshi, Yamada, Yuji, Kagawa, Kazufumi, Monden, Takushi, Imaoka, Shingi
Format Journal Article
LanguageJapanese
Published Japan 01.11.2012
Subjects
Antimetabolites, Antineoplastic - therapeutic use
Aorta - pathology
Chemoradiotherapy
Drug Combinations
Humans
Lymphatic Metastasis
Male
Middle Aged
Neoplasm Staging
Oxonic Acid - therapeutic use
Salvage Therapy
Stomach Neoplasms - pathology
Stomach Neoplasms - therapy
Tegafur - therapeutic use
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Summary:We report a case of recurrent gastric cancer with paraaortic lymph nodes (No.16LNs) that was effectively controlled with chemoradiation therapy. A 63-year-old man underwent distal gastrectomy, cholecystectomy, and D2 dissection in July 2004 for advanced gastric cancer in the lower third area that was diagnosed as moderately differentiated stage II adenocarcinoma [T1(SM), N2, H0, P0, CY0, M0]. He suffered from No.16LNs metastasis with serum CEA elevation in October 2007, and therefore, 4 courses of S-1, followed by 3 courses of CPT-11 as second-line treatment, 14 courses of docetaxel as third-line treatment, and 15 courses of paclitaxel+cisplatin as fourth-line chemotherapy, were administrated. Enlargement of No.16LNs with serum CEA elevation was observed in October 2010. Other metastases were not observed, and hence, chemoradiotherapy (CRT; S-1: 80 mg/body+total of 65 Gy per 26 Fr) for No.16LNs was performed. A partial response and reduction of serum CEA level were noted, and the patient is alive with no sign of progression 18 months after CRT. Grade 1 adverse events including anemia, fatigue, and anorexia were recognized. It is thought that chemoradiation therapy is an effective treatment for localized LN metastasis originating from gastric cancer resistant to chemotherapy.
ISSN:0385-0684