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胃原発小細胞癌に対して全身化学療法を行った1例

■巻ページ:高知市医師会医学雑誌第17巻第1号  208~212頁 2012年
■表題:胃原発小細胞癌に対して全身化学療法を行った1例
■著者:板垣達三
■共著者:岸久美子、友兼毅、井上修志

■要旨(はじめに)
症例は64歳男性。上部内視鏡検査でスキルス胃癌が疑われたが,生検病理結果は胃原発としては稀な小細胞癌であった。初診時CTで癌性腹膜炎,全身リンパ節転移を指摘された。治療は通常の胃腺癌に準じてTS-1+CDDP療法を施行。1クール終了後で腫瘍の縮小効果が認められ,症状も改善された。しかし,同時期に副作用等で全身化学療法は継続不可能となり,その後は急速に病状が進行し,初診から6か月後に死亡した。胃原発小細胞癌は一般に進行が早く,また抗がん剤の奏効率も低く,その予後は不良とされる。今回の症例は胃原発小細胞癌の症例として示唆に富むものと思われ,若干の文献的考察を含めて報告する。

■Key words:胃小細胞癌、化学療法、予後
■備考:いたがき たつぞう 独立行政法人国立病院機構高知病院 検査科

■title:A case of gastric small cell carcinoma responding to systemic chemotherapy with TS1/CDDP regimen
■the author:Tatsuzo Itagaki
■Abstract:The subject was a 64-year old male. Although scirrhous gastric
cancer was suspected in an upper endoscopic examination, in a pathologic
biopsy he was found to be affected with small cell carcinoma, which is a rare
type of primar y gastric cancer. In a CT at the initial visit, peritonitis
carcinomatosa and systemic multiple lymph node metastases were detected. As
treatment, TS-1 plus CDDP therapy was performed in the same manner as
ordinary gastric adenocarcinoma.
At the completion of the first course, objective
tumor response was observed and the symptoms were alleviated. Around the
same time, however, side effects and other reasons made it impossible to
continue systemic chemotherapy, since which time his disease conditions
rapidly got worse and the subject died six months after the initial visit.
Generally, gastric small cell carcinoma advances rapidly and response rates of
anticancer drugs are low, and is said to carry a poor prognosis. This case would
be suggestive as a case of gastric small cell carcinoma, and thus is reported
along with consideration of certain literature.
■Key words:gastric small cell carcinoma, chemotherapy, prognosis