Neoadjuvant chemoradiotherapy for locally advanced gastric cancer with bulky lymph node metastasis:Five case reports  

作　　者：Eiji Nomura Hajime Kayano Takashi Machida Hideki Izumi Soichiro Yamamoto Akitomo Sugawara Masaya Mukai Terumitsu Hasebe 

机构地区：[1]Department of Gastroenterological and General Surgery,Tokai University Hachioji Hospital,Hachioji 192-0032,Tokyo,Japan [2]Department of Radiology,Tokai University Hachioji Hospital,Hachioji 192-0032,Tokyo,Japan

出　　处：《World Journal of Clinical Cases》2020年第18期4177-4185,共9页世界临床病例杂志

摘　　要：BACKGROUND Neoadjuvant chemoradiotherapy(NACRT)has not been accepted as a general therapy for gastric cancer because of its localized effect and toxicity for radiosensitive organs.However,if radiation therapy could compensate for the limited or inadequate treatment choices available for elderly patients and/or those at high risk,the available therapeutic options for advanced gastric cancer might increase.From this perspective,we present our experiences of five patients with advanced gastric cancer in whom we used NACRT therapy with interesting results.CASE SUMMARY We admitted five patients with clinical Stage III gastric cancer and bulky lymph node metastasis or adjacent organ invasion at the time of diagnosis.A total of 50 Gy of preoperative intensity modulated radiation therapy was delivered to the patients in doses of 2.0 Gy/d,together with a regimen of concomitant chemotherapy comprising two courses of oral tegafur/gimeracil/oteracil(S-1;65 mg/m2 per day)for three consecutive weeks followed by two weeks of rest,starting at the same time as radiotherapy.All patients underwent no residual tumor resection and a pathological complete response of the primary tumors was achieved in two patients.The incidence of hematological toxicity was low,although the digestive toxicities of anorexia and diarrhea developed in three of the five patients,necessitating termination of radiation therapy at 30 Gy and S-1 at three weeks.However,even 30 Gy of irradiation and half the dose of S-1 resulted in sufficient downstaging,indicating that even a reduced amount of NACRT could confer considerable effects.CONCLUSION Slightly reduced NACRT might be useful and safe for patients with locally advanced gastric cancer.

关 键 词：Advanced gastric cancer Neoadjuvant chemoradiotherapy Intensity modulated radiation therapy Tegafur/gimeracil/oteracil Curative resection Case report GASTRECTOMY 

分 类 号：R735.2[医药卫生—肿瘤]