Highly advanced gastric cancer that responded to neoadjuvant combination chemotherapy with docetaxel/CDDP/S-1 (DCS)

Tomohisa Egawa, Takeshi Kenmochi, Masaki Ohashi, Tomoyuki Irino, Koki Mihara, Akihiko Okamura, Yusaku Inaba, Yasuhiro Ito, Shinobu Hayashi, Atsushi Nagashima

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Abstract

A 60-year-old male was found to have advanced gastric cancer and multiple lymph node metastases. Since curative surgery was concluded to be unfeasible, we tried neoadjuvant chemotherapy with the aim of controlling the lymph node metastasis. S-1 (80 mg/m2) was administered orally for two weeks then followed by 2-week rest period. CDDP (60 mg/ m2) and docetaxel (40 mg/m2) were simultaneously administered on day 1. Two courses of treatment resulted in marked shrinkage of the primary lesion and a reduction in size of the lymph nodes. The results were evaluated as a clinical PR based on RECIST, and radical resection was considered possible. The patient experienced a grade 3 leukocytopenia and neutropenia as adverse events of the chemotherapy. Total gastrectomy, splenectomy, and D2 lymph node dissection were performed with curative intent, and the postoperative course was uneventful. Histological examination of the surgical specimens revealed almost complete disappearance of cancer cells in the primary lesion in the stomach and complete disappearance in the lymph nodes. Pathological efficacy was Grade 2. The patient experienced a grade 3 appetite loss, and the adjuvant chemotherapy (S-1 regimen) was discontinued. The patient died of peritoneal dissemination eight months after the operation. We concluded that DCS as neoadjuvant chemotherapy was a promising strategy for patients with highly advanced gastric cancer because of its rapid antitumor effect.

Original languageEnglish
Pages (from-to)2470-2472
Number of pages3
JournalJapanese Journal of Cancer and Chemotherapy
Volume37
Issue number12
Publication statusPublished - 2010 Nov
Externally publishedYes

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Keywords

  • Gastric cancer
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Egawa, T., Kenmochi, T., Ohashi, M., Irino, T., Mihara, K., Okamura, A., Inaba, Y., Ito, Y., Hayashi, S., & Nagashima, A. (2010). Highly advanced gastric cancer that responded to neoadjuvant combination chemotherapy with docetaxel/CDDP/S-1 (DCS). Japanese Journal of Cancer and Chemotherapy, 37(12), 2470-2472.