Two Cases of Complete Response of Recurrent Gastric Cancer treated with Paclitaxel as Second Line Chemotherapy

Yasuhiko Midorikawa, Kumiko Suzuki, Takeshi Nakachi and Teruhiko Kasuga

Department of Surgery, Kureha General Hospital

Case 1. A 72-year-old man who had undergone distal gastrectomy for gastric cancer 1 year and 2 months earlier and suffered from jaundice was found in enhanced Computed Tomography (CT) of the abdomen to have lymph node swelling of the hepatic hilus and paraaorta. Treatment with low-dose FP chemotherapy and oral administration of TS-1 at 80 mg/day proved ineffective. We then Paclitaxel administered at a dose of 60 mg/body intravenous infusion once a week for three weeks followed by a drug-free-one week period as a single course. Five months later, this therapy induced CR. We then administered Paclitaxel for 6 months, but he died due to rapid growth of multiple liver metastases appearing 4 months after Paclitaxel was stopped. Case 2. A 67-year-old man who had undergone total gastrectomy, distal pancreatectomy, and splenectomy and treated with 80 mg/day of oral TS-1 and CDDP of 10 mg/week was found in enhanced abdominal CT to have multiple liver metastases and paraaortic lymph node swelling. Paclitaxel was administered at a dose of 60 mg/body intravenous infusion once a week for three weeks followed by a drug-free-one week period as a single course. Nine months later, this therapy had induced CR, which has continued for two years and seven months in biweekly administration, maintained for more than 3 years as of this writing. The result of case 1 suggested some break in immunological surveillance after Paclitaxel was stopped. Despite CR, we have concluded that it is better to use continuous chemotherapy against metastasis for at least one year.

Key words
gastric cancer, Paclitaxel, complete response

Reprint requests
Yasuhiko Midorikawa Department of Surgery, Kureha General Hospital
1-1 Ochiai, Nishiki-cho, Iwaki, 974-8232 JAPAN

Accepted
January 31, 2007

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