A case of advanced gastric cancer with liver and intra-abdominal lymph node metastasis treated by hypertensive selective chemotherapy with pharmacokinetic modulating chemotherapy

There have been few effective chemotherapeutic regimens for advanced gastric cancer with liver and intra-abdominal lymph node metastasis. A 78-year-old male patient was admitted to our hospital because of anorexia and abdominal discomfort. Gastroendoscopy showed a type 4 advanced gastric cancer in t...

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Bibliographic Details
Published in:	Gan to kagaku ryoho Vol. 30; no. 8; p. 1151
Main Authors:	Ishikawa, Toru, Nomura, Kunihiro, Baba, Yasuyuki, Hayashi, Syun-ichi, Oota, Hironobu, Yoshida, Toshiaki, Kamimura, Tomoteru
Format:	Journal Article
Language:	Japanese
Published:	Japan 01-08-2003
Subjects:	Adenocarcinoma - pathology Aged Angiotensin II - administration & dosage Antineoplastic Combined Chemotherapy Protocols - administration & dosage Fluorouracil - administration & dosage Humans Liver Neoplasms - drug therapy Liver Neoplasms - secondary Lymphatic Metastasis Male Methotrexate - administration & dosage Pancreatic Neoplasms - drug therapy Pancreatic Neoplasms - secondary Stomach Neoplasms - blood supply Stomach Neoplasms - drug therapy Stomach Neoplasms - pathology Tegafur - administration & dosage
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Summary:	There have been few effective chemotherapeutic regimens for advanced gastric cancer with liver and intra-abdominal lymph node metastasis. A 78-year-old male patient was admitted to our hospital because of anorexia and abdominal discomfort. Gastroendoscopy showed a type 4 advanced gastric cancer in the antrum of the stomach. Histological study of biopsy specimens from the tumor revealed poorly differentiated adenocarcinoma. Examination by computed tomography and ultrasonography showed swollen paraaortic lymph nodes and liver metastasis. He was diagnosed as having advanced gastric cancer with liver and lymph node metastasis. This patient was treated weekly with an intraarterial 5-FU (500 mg) and MTX (100 mg) including AT-II by subcutaneously implanted port system placed into the celiac artery. Furthermore, he was administered tegafur/uracil (400 mg/day) 5 days weekly as pharmacokinetic modulating chemotherapy (PMC). After ten courses of treatment with PMC, the liver and lymph node metastases were reduced in size. This therapy was considered to be an effective treatment for advanced gastric cancer with liver and lymph node metastasis. The theoretical purpose of hypertensive chemotherapy used together with injection of angiotensin-II is to increase the delivery of anticancer drug to the target tumor tissue by increasing the blood flow in the tumor. We conclude that this chemotherapy is effective in cases of advanced gastric cancer with liver and lymph node metastasis from the viewpoints of toxicities, antitumor effect and QOL of the patient.
ISSN:	0385-0684