A Case of Gastric Cancer Responded Dramatically to Docetaxel for Chemotherapy

Tetsuya Okino¹⁾, Hiroyuki Kiuchi²⁾, Yoshio Ogawa²⁾, Yoshiyuki Takahashi²⁾, Yonho Ri²⁾, Atsushi Hirakata²⁾, Yoshie Terada²⁾, Takao Takizawa¹⁾ and Takashi Tajiri³⁾

Department of Gastroenterology¹⁾ and Department of Surgery²⁾, Kitamurayama Public Hospital, Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Mediciney³⁾

We report a case of stage IV gastric cancer resected after successful treatment with docetaxel as chemotherapy. A 70-year-old man was admitted to hospital because of progressive appetite loss. Endoscopic examination revealed type 3 advanced gastric cancer at the upper body of the stomach. Computed tomography (CT) showed pancreas and lymph node invasion at the splenic hilum. The preoperative diagnosis was stageIV gastric cancer. Since a curative operation was deemed impossible, we started the chemotherapy using TS-1 for downstaging. TS-1 (100 mg/day) was orally administered for 4 weeks followed by a drug-free 2-week period as 1 course. At the completion of 1 course, the tumors were assessed, showing disease progression (DP). Therefore, for the second regimen, CPT-11 was administered at a dose of 100 mg/body intravenous infusion once a week for three weeks followed by a drug-free 2-week period as 1 course. After 2 courses, the primary lesion was assessed, showing DP. Next Docetaxel was administered at an intravenous dose of 80 mg with dose free intervals of 3 weeks. After 4 courses, the primary lesion was reduced in size, so this therapy had induced a partial response (PR). Subsequently, the patient underwent curative total gastrectomy with pancreatectomy and splenectomy and cholecystectomy together with D3 lymph node dissection. Histological examination of the primary lesion revealed a small amount of residual cancer cells. This case suggests that docetaxel therapy is effective against advanced gastric cancer.

Key words
gastric cancer, docetaxel, chemotherapy

Reprint requests
Tetsuya Okino Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine
1-1-5 Sendagi, Bunkyo-ku, 113-8603 JAPAN

Accepted
June 22, 2005

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