s-1-(combination) and Ovarian-Neoplasms

Primary ovarian signet-ring cell carcinoma is extremely rare, with only five recent case reports. Almost all reported cases of ovarian signet-ring cell carcinoma have been treated with TC therapy and none have reported regarding the use of S-1/CDDP therapy. We report a case of primary ovarian signet-ring cell carcinoma treated postoperatively with S-1/CDDP therapy.. We describe a 55-year-old woman diagnosed with stage IB primary ovarian signet-ring cell carcinoma that was treated with S-1/CDDP therapy. Preoperative transvaginal ultrasonography and contrast-enhanced computed tomography (CT) revealed a solid tumor measuring 10 cm in diameter in the pelvis. The tumor marker levels were as follows: CA125, 41.6 U/mL; CA19-9, < 2.0 U/mL; and CEA, 2.2 ng/mL. Ovarian cancer was suspected, and total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. The left ovary was enlarged to greater than fist-sized, and there was a small amount of clear yellow ascites. Histological examination of the left ovary led to the diagnosis of signet-ring cell carcinoma. Histological examination of the right ovary also showed the presence of a signet-ring cell carcinoma. After surgery, upper and lower gastrointestinal endoscopy and positron-emission tomography-CT were performed to search for a possible primary lesion, but none was found. The patient was diagnosed with primary ovarian signet-ring cell carcinoma with FIGO Stage IB (PT1b, NX, M0). As postoperative adjuvant chemotherapy, S-1/CDDP therapy (S-1120 mg/day/body × 14 days, CDDP 50 mg/m. We considered S-1/CDDP therapy was effective for primary ovarian signet-ring cell carcinoma. This is the first case report of primary ovarian signet-ring cell carcinoma treated with S-1/CDDP therapy in the world.

Topics: Antimetabolites, Antineoplastic; Biomarkers, Tumor; Biopsy; Carcinoma, Signet Ring Cell; Drug Combinations; Female; Humans; Immunohistochemistry; Middle Aged; Ovarian Neoplasms; Oxonic Acid; Tegafur; Tomography, X-Ray Computed; Treatment Outcome; Ultrasonography

A 55-year-woman presented with abdominal fullness. An abdominal MRI disclosed ovarian and uterine tumors. Under the pathological diagnosis of Kruckenberg tumor, total hysterectomy and bilateral adenexectomy were performed. Gastrointestinal endoscopy disclosed type 3 on the greater curvature and anterior wall of the middle gastric body. The gastric cancer had a similar histology, which suggested the tumor origin and led to the diagnosis of c-stage IV. She received 6 courses of SOX chemotherapy. Staging laparoscopy revealed no peritoneal metastasis and negative cytodiagnosis of ascites. She underwent total gastrectomy with D2 lymphadenectomy. In May 2017, after S-1 chemotherapy, no metastasis to other organs was observed.

Topics: Antineoplastic Combined Chemotherapy Protocols; Drug Combinations; Female; Humans; Hysterectomy; Krukenberg Tumor; Middle Aged; Organoplatinum Compounds; Ovarian Neoplasms; Oxaliplatin; Oxonic Acid; Stomach Neoplasms; Tegafur; Time Factors

A 61-year-old woman with an abnormal radiograph shadow in her anterior mediastinum was admitted to our hospital and underwent an extended thymectomy. The pathological diagnosis of the tumor was a non-papillary adenocarcinoma of the thymus in pathological stage IV b using the Masaoka classification owing to mediastinal lymph node metastasis. We found parasternal lymph node metastases 5 months after her first operation, and subsequently, she underwent surgery and adjuvant radiotherapy. We found systemic lymph node metastases and metastatic lesions in distant organs, including her lungs, brain, and kidney 27 months after her first operation. Systemic chemotherapy, such as carboplatin plus paclitaxel and an ADOC regimen were not very effective, so we performed immunohistochemical staining of the primary thymic adenocarcinoma. The levels of both thymidylate synthase and dihydropyrimidine dehydrogenase were low; therefore, we started S-1 100mg/body (2 weeks of administration, 1 week of withdrawal)31 months after her first operation. She entered complete remission 6 months after the initiation of S-1. We surgically resected her solitary lung metastasis 13 months after initiation of S-1, and then continued the S-1 treatment. There was no recurrence for more than 2 years after the lung surgery. We believe that when the expression levels of thymidylate synthase or dihydropyrimidine dehydrogenase are low in cases of recurrent thymic adenocarcinoma, S-1 may be able to induce an effective response.

Topics: Adenocarcinoma; Antimetabolites, Antineoplastic; Drug Combinations; Female; Humans; Middle Aged; Ovarian Neoplasms; Oxonic Acid; Recurrence; Tegafur; Thymus Neoplasms; Time Factors

Previous studies have suggested that the novel BH3 mimetic S1 could induce apoptosis in diverse tumor cell lines through endoplasmic reticulum (ER) stress or mitochondrial cell death pathways. The activation of c-Jun N-terminal kinase (JNK) through inositol requiring enzyme-1 (IRE1) is closely connected to ER stress-induced apoptosis. However, the role of JNK is complex, as there are different JNK subtypes and the function of each subtype is still not entirely clear. Here we found that the mRNA expression of JNK3 was continuously high in S1-treated human ovarian cancer SKOV3/DDP cells using a human unfolded protein response (UPR) pathway PCR array. Pharmacological inhibition of JNK3 increased cell sensitivity to apoptosis induced by S1. Furthermore, inhibition of JNK3 induced accumulation of both acidic compartment and p62, and upregulated ROS production. Our results suggest that JNK3 plays a pro-survival role during ER stress through preventing the block of autophagic flux and reducing oxidative stress in SKOV3/DDP cells. Inhibition of JNK3 may be a potential method to enhance the killing effect of the Bcl-2 inhibitor S1.

Topics: Antineoplastic Agents; Apoptosis; BH3 Interacting Domain Death Agonist Protein; Biomimetic Materials; Cell Line, Tumor; Drug Combinations; Drug Resistance, Neoplasm; Female; Humans; Mitogen-Activated Protein Kinase 10; Molecular Mimicry; Ovarian Neoplasms; Oxonic Acid; Proto-Oncogene Proteins c-bcl-2; Tegafur

The patient was a 57-year-old woman. In October 2011, she underwent distal gastrectomy, D2 lymphadenectomy, and Roux-en-Y reconstruction for gastric cancer (pT4a, pN3b, Stage ⅢC [JCGC 14th Edition]). She then received S-1 plus CDDP combination therapy and S-1 monotherapy as postoperative adjuvant chemotherapies for 1 year, and was followed up as an outpatient. In April 2013, a significant increase in the CA19-9 level was noted, and CT indicated a right ovarian tumor. Ovarian metastasis from the gastric cancer was diagnosed, and the response to 3 courses of weekly PTX was stable disease. No findings indicated metastasis to other organs. In July 2013, a salpingo-oophorectomy was performed, after which her CA19-9 level returned to the normal range. Follow-up was adopted as the postoperative strategy in part due to the desires of the patient. Presently, 3 years and 6 months after the initial surgery and 1 year and 9 months after the last surgery, no recurrence has been detected. Generally, ovarian metastasis from gastric cancer is considered to be associated with a poor prognosis. However, our patient showed long-term survival after surgeries for gastric cancer and asynchronous ovarian metastasis. Here, we report the details of our case and review the relevant literature.

Topics: Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Drug Combinations; Female; Gastrectomy; Humans; Middle Aged; Ovarian Neoplasms; Ovariectomy; Oxonic Acid; Paclitaxel; Stomach Neoplasms; Tegafur; Time Factors

Peritoneal metastasis of gastric cancer has extremely poor clinical outcomes. Recently, we developed a combination chemotherapy that used intraperitoneal (IP) paclitaxel (PTX) and produced excellent antitumor effects against peritoneal lesions. However, no information is available about the benefit of gastrectomy in cases with malignant ascites.. A total of 64 patients with severe peritoneal metastasis and ascites received IP PTX at 20 mg/m(2) via implanted subcutaneous peritoneal access ports as well as intravenous (IV) PTX at 50 mg/m(2) on days 1 and 8. S-1 was administered at 80 mg/m(2) day for 14 consecutive days, followed by 7 days of rest. In all patients, investigative laparoscopy was performed around the combination chemotherapy, and gastrectomy was performed on patients who showed apparent shrinkage of their peritoneal nodules as well as negative peritoneal cytology at the second laparoscopy.. Gastrectomy was performed in 34 patients. The median course of chemotherapy before surgery was 5 courses (range 2-16). R0 operation was achieved in 22 patients (65%), and grade 2 and 3 histological responses were obtained in 7 (21%) and 1 (3%) patient(s), respectively. The median survival time and 1-year overall survival of the gastrectomized patients were 26.4 months and 82%, and those of the 30 patients who did not receive gastrectomy were 12.1 months and 26%, respectively. Morbidity was minimal, and there was no mortality.. Salvage gastrectomy after chemotherapy of S-1 with IV and IP PTX is promising, even for patients with highly advanced gastric cancer and severe peritoneal metastasis and malignant ascites.

Topics: Administration, Oral; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Ascites; Combined Modality Therapy; Drug Combinations; Female; Follow-Up Studies; Humans; Injections, Intraperitoneal; Lymphatic Metastasis; Male; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Oxonic Acid; Paclitaxel; Peritoneal Neoplasms; Prognosis; Salvage Therapy; Stomach Neoplasms; Survival Rate; Tegafur

Stage IV gastric cancer has poor prognosis, and median survival time (MST) is reported to range from 6 to 13 months. We report a case of long-term survival in a Stage IV gastric cancer patient who was successfully treated with multi combination chemotherapy with S-1. A 73-year-old woman presenting with gastric cancer with pyloric stenosis and peritoneal dissemination at the sigmoid colon underwent distal gastrectomy with D2 lymphadenectomy and sigmoidectomy. She received adjuvant chemotherapy with S-1 and CDDP after surgery. During the twelfth administration of S-1 and CDDP, she developed an anaphylactic reaction against CDDP; therefore, only S-1 was administered for the next 6 courses. Thirty one months postgastrectomy, a left ovarian metastasis (about 4 cm) was detected by computed tomography. Two courses of S-1 and CPT-11 were administered; however, the ovarian metastasis grew to twice its initial size. She underwent hysterectomy and bilateral ovariectomy. The pathological diagnosis was metastatic tumors in the uterus and ovary(Krukenberg tumor). After the second surgery, S-1 and docetaxel therapy was initiated. A metastasis (S2, 5mm diameter) appeared in the right lung around 65 months after the gastrectomy. The patient received a total of 28 courses, up until 69 months post-gastrectomy. At present, she hopes to finish the chemotherapy and is consulting a palliative care facility. At 80 months post-gastrectomy, she has no symptoms because the lung metastasis exhibits slow growth (15 mm diameter), and is maintaining her quality of life (QOL).

Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Drug Combinations; Female; Gastrectomy; Humans; Lung Neoplasms; Neoplasm Staging; Ovarian Neoplasms; Oxonic Acid; Stomach Neoplasms; Tegafur

A 46-year-old female underwent total gastrectomy with a combined resection of the pancreatic tail, spleen, and lateral segment of the liver surgery after conservative medical management for a perforated advanced gastric cancer. The histological findings showed poorly differentiated adenocarcinoma, and the tumor was Stage IIIC. S-1 and "Kampo-Juzen-taiho-to" were administered as postoperative adjuvant chemo-immunotherapy. A Krukenberg tumor was identified 4 years later. The histological findings strongly suggested the presence of peritoneal dissemination, and S-1-based combined chemotherapies using key drugs such as CDDP, CPT-11, and taxane with the biochemical response modifier "Lentinan" was administered. However, the Krukenberg tumor rapidly increased in size after 4 years and she complained of abdominal distension. Therefore, it was removed with neither difficulties nor apparent recurrent disease, which was thought to be due to the S-1-based combined chemotherapy and the immunological agents are likely to have contributed to her long survival and good quality of life.

Topics: Adenocarcinoma; Antineoplastic Combined Chemotherapy Protocols; Chemotherapy, Adjuvant; Combined Modality Therapy; Drug Combinations; Drugs, Chinese Herbal; Female; Gastrectomy; Humans; Immunotherapy; Krukenberg Tumor; Middle Aged; Ovarian Neoplasms; Ovariectomy; Oxonic Acid; Phytotherapy; Postoperative Care; Stomach Neoplasms; Tegafur; Treatment Outcome

A 35-year-old female with scirrhous stomach cancer (stage IV) was treated with a combination of 5-aminolevulinic acid (ALA), sodium dichloroacetate (DCA), hyperthermotherapy, and immunotherapy as terminal care. The patient survived for one year and seven months, during which her quality of life was markedly improved and she returned to work. The patient was diagnosed with poorly-differentiated adenocarcinoma and progressive signet-ring cell carcinoma, accompanied by left ovarian metastasis, peritoneal dissemination, and right hydronephrosis stage IV, and treated with combination chemotherapy with tegafur-gimeracil-oteracil potassium (TS-1) and docetaxel. Oral ALA and DCA were concomitantly administered at 50 mg each three times a day (150 mg/day, respectively). In addition, hyperthermotherapy using thermotron was concomitantly performed at 2- to 3-week intervals. Cellular immunotherapy with αβ T- and immature dendritic cells was also performed. The disease did not progress for 11 months, her quality of life was markedly improved, and she was able to return to work. However, the signs of enlargement of the ovarian metastatic lesion were noted later, for which chemotherapy with four cycles of second-line paclitaxel and a half dose of irinotecan and cisplatin as third-line treatment were performed. Combination of ALA/DCA, hyperthermotherapy, and cellular immunotherapy may be a low-invasive palliative therapy superior in maintaining quality of life of tumor-bearing terminally ill individuals.

Topics: Adenocarcinoma, Scirrhous; Adult; Aminolevulinic Acid; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Carcinoma, Signet Ring Cell; Cisplatin; Combined Modality Therapy; Dichloroacetic Acid; Docetaxel; Drug Combinations; Drug Therapy, Combination; Female; Humans; Hyperthermia, Induced; Irinotecan; Ovarian Neoplasms; Oxonic Acid; Paclitaxel; Peritoneal Neoplasms; Photosensitizing Agents; Prognosis; Silicates; Stomach Neoplasms; Taxoids; Tegafur; Titanium

We encountered a case of delayed subcutaneous metastases of gastric carcinoma. The patient underwent distal gastrectomy for advanced gastric carcinoma 11 years ago. Postoperative pathological diagnosis indicated stage IIIB disease, poorly differentiated adenocarcinoma (scirrhous, T4a, ly2, v2, N2, H0, P0). Three courses of adjuvant chemotherapy with 5-fluorouracil (5-FU)+cisplatin (CDDP) were administered; however, the patient discontinued the treatment. No signs of recurrence were observed for 11 years after the treatment. However, subcutaneous metastases in the front portion of the head and the back and an ovarian tumor were detected after the remission period. The specimen from the resected subcutaneous tumor from the back indicated signet-ring cell carcinoma, and delayed subcutaneous and ovarian metastases of the gastric carcinoma was diagnosed. Therefore, 8 courses of the S-1+CDDP combination therapy were administered. The cutaneous metastases disappeared, but the ovarian tumor progressed and was therefore resected. Analysis of the resected ovarian tumor also indicated signet-ring cell carcinoma. We report a case of delayed recurrence of gastric carcinoma that was effectively treated with chemotherapy.

Topics: Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Signet Ring Cell; Cisplatin; Drug Combinations; Female; Humans; Lymphatic Metastasis; Middle Aged; Ovarian Neoplasms; Oxonic Acid; Skin Neoplasms; Stomach Neoplasms; Tegafur; Time Factors

A 79-year-old woman was referred to our hospital with complaints of dyspnea. She was diagnosed with massive pleural effusion and cytology demonstrated the presence of adenocarcinoma, but no solid tumors were found in the systemic examination. Her serum CYFRA and CA125 level were increased. She was diagnosed with an effusion type of lung cancer or a cancer of unknown origin. S-1/CDDP was the chemotherapy of choice. After 2 courses of the treatment, her serum CYFRA level and CA125 level were normalized, and a chest CT detected no pleural effusion. Two years and 3 months after the first treatment, her CA125 level was increased. We found an FDG accumulation in her pelvic lesion by PET examination. To identify the FDG accumulated lesion in her pelvis, an operation was performed. Histopathological examination of the right ovary demonstrated the presence of an adenocarcinoma. Postoperatively, we administered 2 courses of paclitaxel/carboplatin combination treatment, considering the right ovarian tumor was the primary lesion. The patient remained alive and in good condition without any signs of recurrence 2 years after second treatment. This case suggests that S-1 therapy may be effective for patients with mullerian cancer.

Topics: Aged; Antimetabolites, Antineoplastic; Diagnosis, Differential; Drug Combinations; Female; Humans; Ovarian Neoplasms; Oxonic Acid; Remission Induction; Tegafur; Tomography, X-Ray Computed

We report a long-term survival case treated by chemotherapy with new anticancer drugs such as S-1, CPT-11 and docetaxel after bilateral overiectomy for bilateral ovarian metastases of progressive gastric cancer. A 68-year-old female, who had undergone total gastrectomy with D2 lymphadenectomy for scirrhous gastric cancer of Stage IIIA, was admitted because of ovarian metastasis. Laparoscopic bilateral ovariectomy was performed for ovarian metastases of the gastric cancer (Krukenberg tumor) 6 months after gastrectomy. Seven months after gastrectomy, 11-course of S-1 treatment (80 mg/m2) for bilateral ovarian metastases of the gastric cancer was administered. CT scan revealed mediastinal lymphadenopathy 2 years and 5 months after gastrectomy. Then, the drug was changed to docetaxel (60 mg/m2). After 9-course of docetaxel treatment, the mediastinal lymphadenopathy disappeared. For a treatment of grade 3 neuropathy, a 12-course CPT-11 was started after gastrectomy 3 years and 6 months ago. CT scan and PET-CT showed no new metastasis in 4 years and 10 months after gastrectomy.

Topics: Adenocarcinoma, Scirrhous; Aged; Antimetabolites, Antineoplastic; Antineoplastic Agents; Antineoplastic Agents, Phytogenic; Camptothecin; Docetaxel; Drug Combinations; Female; Gastrectomy; Humans; Irinotecan; Krukenberg Tumor; Ovarian Neoplasms; Ovariectomy; Oxonic Acid; Stomach Neoplasms; Taxoids; Tegafur

The patient was a 51-year-old female, who underwent radical surgery for cancer of remnant stomach in May 2006 (f-T4N0M0P0H0CY0, por 2, Stage IIIA, Cur B). Bilateral ovarian resection was performed in March 2009 for bilateral ovarian metastasis, so called "Krukenberg tumor" with peritoneal dissemination detected with CT scan after one-year adjuvant chemotherapy with S-1 (80 mg/m2, 4 weeks on and 2 weeks off). As of June 2010, she is alive and maintain her status quo after 6 courses of S-1 plus CDDP combination therapy (S-1 80 mg/m2, 3 weeks on, CDDP 60 mg/m2, started at day 8, ended 35 days later) followed by S-1 for residual peritoneal dissemination detected at operation. In ovary metastasis of gastric cancer, even if accompanied by peritoneum metastasis, ovarian resection as a reduction surgery followed by chemotherapy may improve survival.

Topics: Antimetabolites, Antineoplastic; Antineoplastic Agents; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Combined Modality Therapy; Drug Combinations; Female; Gastrectomy; Humans; Krukenberg Tumor; Middle Aged; Ovarian Neoplasms; Ovariectomy; Oxonic Acid; Stomach Neoplasms; Tegafur

An 80-year-old female patient was undergone sigmoidectomy with D2 lymph node dissection for type 2 sigmoid colon cancer in February 2007. A post operative pathological finding of cancer was SS, N0, P0, H0, M0 (Stage II), curative A. Twelve months after the operation, elevated CEA level was observed. CT scan and MRI revealed a mass of 10 cm in diameter with multiple cysts in the pelvic cavity, which was diagnosed a malignant ovarian tumor. In May 2008, total hysterectomy, bilateral oophorectomy, and partial omentectomy were performed and its pathological finding was metastatic ovarian tumor originating from colon cancer. Adjuvant chemotherapy was administered, as cancer cells were detected in the ascites. The patient has been in good health without recurrence for 25 months after the second operation.

Topics: Adenocarcinoma; Aged, 80 and over; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Combined Modality Therapy; Drug Combinations; Female; Humans; Hysterectomy; Krukenberg Tumor; Ovarian Neoplasms; Ovariectomy; Oxonic Acid; Sigmoid Neoplasms; Tegafur; Uracil

This is an account of a case of primary adenocarcinoma of the small intestine with peritoneal dissemination successfully treated with chemotherapy. A 64-year-old woman was admitted with a complaint of severe abdominal distension. Abdominal computerized tomography revealed a bowel obstruction with tumor and the remarkable small bowel dilation of oral side of tumor. The tumor was found at surgery to be at the ileum 15 cm proximal from the ileocecal region. Peritoneal dissemination was recognized around the ileocecal region, so ileum partial resection was performed for the primary cancer lesion and dissemination region. Pathological diagnosis of the resected specimen was adenocarcinoma with lymph nodes metastasis. The peritoneal dissemination consisted of metastatic adenocarcinoma from small intestine. After an operation, internal use of S-1 was performed as adjuvant chemotherapy. But a recurrent lesion at the ovarium was detected 6 months after surgery. The patient was subsequently treated with resection of the ovarium. For lung metastasis, the combination chemotherapy with mFOLFOX6 + bevacizumab was administered. Primary small intestinal adenocarcinoma is a rare disease, and it is often diagnosed as advanced cancer because of few characteristic symptoms. So carcinoma of the small intestine usually has a poor prognosis.

Topics: Adenocarcinoma; Angiogenesis Inhibitors; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antimetabolites, Antineoplastic; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Combined Modality Therapy; Drug Combinations; Female; Fluorouracil; Humans; Ileal Neoplasms; Intestinal Neoplasms; Leucovorin; Lymphatic Metastasis; Middle Aged; Organoplatinum Compounds; Ovarian Neoplasms; Oxonic Acid; Tegafur

We report a patient with multiple hepatic metastases and ovarian metastases of transverse colon cancer treated by combination of S-1 and CPT-11. The patient was a 51-year-old woman with cancer of the transverse colon and multiple hepatic metastases. She had undergone surgery. Resection of the transverse colon and left ovary was performed because left ovarian metastases were found during the operation. After the operation, the patient was given chemotherapy with S-1 (120 mg/body on days 1-14) and CPT-11 (150 mg/body on day 1). After completion of 11 courses of chemotherapy, abdominal CT scans revealed that the LDAs of the liver had disappeared, so the patient was judged to have achieved CR. No adverse event was observed. This case suggests that the combination of S-1 and CPT-11 may be an effective regimen for advanced colon cancer with multiple hepatic metastases.

Topics: Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Colonic Neoplasms; Drug Combinations; Female; Humans; Irinotecan; Liver Neoplasms; Middle Aged; Ovarian Neoplasms; Oxonic Acid; Tegafur; Tomography, X-Ray Computed

We report a case in which combination chemotherapy of TS-1 and paclitaxel was effective for gastric cancer with malignant ascites, metastatic ovarian cancer and hydronephrosis. Judging from the above issue, the stage was IV and the type was Borrmann 4. The chemotherapy schedule was adjusted at the patient' s request without hindering her activities of daily living. The patient was a 53-year-old woman who suffered from gastric cancer as having malignant ascites and metastatic ovarian tumor. As an outpatient, she was treated with combination chemotherapy of TS-1 and paclitaxel for 2 cycles. The ascites had remarkably disappeared after 2 cycles. The adverse event was alopecia (grade 2), but she could continue the chemotherapy as an outpatient treatment. After completing 5 cycles of chemotherapy, we recognized the primary tumor as an endoscopic complete response.

Topics: Alopecia; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Signet Ring Cell; Drug Administration Schedule; Drug Combinations; Female; Humans; Middle Aged; Ovarian Neoplasms; Oxonic Acid; Paclitaxel; Quality of Life; Remission Induction; Stomach Neoplasms; Tegafur

We encountered a resected case of advanced gastric cancer after successful chemotherapy. The patient remained alive in good condition without any signs of recurrence at 2 years and 8 months after surgery. The 40-year-old woman initially complained of low abdominal pain, which was diagnosed as gastric cancer with metastasis of ovaries and carcinomatous ascites. We administered TS-1 (100 mg/body/day) for 3 weeks followed by 2-week rest and CDDP (60 mg/body) on the 8th day of one cycle. After 3 cycles of treatment, carcinomatous ascites disappeared and the ovarian lesion was reduced. The patient underwent total gastrectomy, ileocecal resection, cholecystectomy and radical hysterectomy. The antitumor efficacy of the treatment was histologically Grade 2. We administered 17 cycles of TS-1 treatment, and the patient is alive in good condition at this writing. This shows that TS-1 and CDDP may have potent therapeutic efficacy in advanced gastric cancer patients. For the future, the safety and efficacious administration of TS-1 and CDDP should be examined further.

Topics: Adult; Antineoplastic Combined Chemotherapy Protocols; Ascites; Cholecystectomy; Cisplatin; Combined Modality Therapy; Drug Administration Schedule; Drug Combinations; Female; Gastrectomy; Humans; Hysterectomy; Ileum; Ovarian Neoplasms; Oxonic Acid; Remission Induction; Stomach Neoplasms; Tegafur

Chemotherapies for recurrent gastric cancer have not yet been established. Here we report a case of type 4 gastric cancer associated with lymphangitis carcinomatosis which became refractory to the previous chemotherapies. The case was a 40-year-old woman. She had been diagnosed with gastric cancer after a Krukenberg tumor operation. Chemotherapies (TS-1 plus CDDP as first-line, and TS-1 plus taxanes as second-line) were performed, and a partial response was achieved. Disease activity has been well controlled until this time. Since recurrence of left pleural effusion and lymphangitis carcinomatosis was recognized, we changed the chemotherapy TS-1 plus CPT-11. Pleural effusion decreased and lymphangitis carcinomatosis improved. The serum CA 19-9 level rose transiently after CPT-11 administration, and tended to fall at the second week of chemotherapy. However, the patient died 2 years 4 months after the onset. TS-1 plus CPT-11 combination chemotherapy would be effective for lymphangitis carcinomatosis and also useful as third-line chemotherapy for recurrent gastric cancer.

Topics: Adult; Antimetabolites, Antineoplastic; Antineoplastic Agents, Phytogenic; Antineoplastic Combined Chemotherapy Protocols; Camptothecin; Drug Combinations; Female; Humans; Irinotecan; Krukenberg Tumor; Lymphangitis; Ovarian Neoplasms; Oxonic Acid; Pyridines; Stomach Neoplasms; Tegafur

Survival of patients with advanced gastric cancer with Krukenberg's tumor is poor. We report the case of a good response in a 37-year-old woman who had type 4 gastric cancer, diagnosed after the operation of Krukenberg's tumor, and then was treated with TS-1, a DPD inhibitory fluoropyrimidine, in combination with a low-dose cisplatinum (CDDP). Endoscopic gastric biopsy showed signet-ring cell adenocarcinoma and moderately differentiated tubular adenocarcinoma, and computed tomography (CT) showed the para-aortic lymph node metastasis before the chemotherapy. The patient was treated with two courses of TS-1 (100 mg/day, day 1-21) plus CDDP (10 mg/m2, day 1-5, 8-12, 15-19) with two-week interval. After the first course, gastric biopsy did not show any cancer cells and lymph node metastasis had disappeared. Serum CA19-9 decreased gradually week by week during the chemotherapy, even during the washout period after the first course, and was normalized after two courses. This case suggests that the combination of TS-1 and low-dose CDDP is effective against type 4 advanced gastric cancer.

Topics: Adenocarcinoma; Adult; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Signet Ring Cell; Cisplatin; Drug Administration Schedule; Drug Combinations; Female; Humans; Infusions, Intravenous; Krukenberg Tumor; Lentinan; Neoplasms, Multiple Primary; Ondansetron; Ovarian Neoplasms; Oxonic Acid; Pyridines; Stomach Neoplasms; Tegafur

A patient with recurrent gastric cancer which infiltrated the pelvic muscle after the treatment of paraaortic lymph node and ovarian metastases was successfully managed by a novel oral anticancer drug, TS-1. TS-1 was administered at a dose of 80 mg/day. One course consisted of two repetitions of consecutive administration of TS-1 for 14 days and withdrawal of TS-1 for 14 days. Adverse reactions were mild and the patient did not request hospitalization after two courses had been completed. Subjective symptoms such as difficulty in walking improved after one week and a partial response was obtained after 2 weeks of treatment. At the end of 4 courses we could remove an indwelling pyelocatheter for the ureter stricture. As of 14 months after the beginning of administration of TS-1, the patient is being treated as an outpatient and has attained a better QOL than before.

Topics: Aged; Antimetabolites, Antineoplastic; Drug Administration Schedule; Drug Combinations; Female; Humans; Lymph Nodes; Lymphatic Metastasis; Muscle Neoplasms; Ovarian Neoplasms; Oxonic Acid; Pyridines; Stomach Neoplasms; Tegafur