Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024623 (gastric cancer)
 36,219 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
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PMID:[A case of advanced gastric cancer with liver and intra-abdominal lymph node metastasis treated by hypertensive selective chemotherapy with pharmacokinetic modulating chemotherapy]. 1293 72

We report a case of advanced gastric cancer that responded to docetaxel with low-dose 5-FU and cisplatin combination chemotherapy after becoming chemoresistant to M-FLP. A 52-year-old male was diagnosed with type 3 gastric cancer of angulus (poorly differentiated adenocarcinoma) with left neck, Virchow, mediastinal and abdominal lymph nodes metastases. The patient was treated with 5 courses of M-FLP (MTX + 5-FU + LV + CDDP), and the effect of this therapy was PR, but the tumor was chemoresistant to the sixth course of this therapy. After 7 courses of M-FLP, docetaxel (TXT) with low-dose FP (5-FU + CDDP) was administered to the patient as second-line chemotherapy. After 2 courses of TXT with low-dose FP, the gastric cancer and metastatic lymph nodes were remarkably reduced and the effect of this therapy was PR. The toxic events were anemia (grade 2) and leukopenia (grade 3), which were treated with G-CSF. CDDP and 5-FU based regimens are considered as the first-line chemotherapy for metastatic advanced gastric cancer in Japan; however, a second-line chemotherapy has not been established. As in this case, a TXT based regimen is effective and well tolerated therapy as a second-line chemotherapy for metastatic gastric cancer after prior exposure to CDDP and 5-FU.
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PMID:[A case of advanced gastric cancer that responded to docetaxel with low-dose 5-FU and cisplatin combination chemotherapy after becoming chemoresistant to M-FLP]. 1465 Sep 69

A 75-year-old man was admitted to our hospital complaining of gastric fatigue. Endoscope and CT scan revealed type 3 gastric cancer with paraaortic lymph nodal metastasis. Histological examination of the endoscopic biopsy revealed poorly differentiated adenocarcinoma. A blood examination and bone marrow biopsy revealed DIC causing bone marrow carcinosis. Chemotherapy with sequential therapy consisting of MTX and 5-FU was performed. Stretch of the fold and flatness of the ulcer were obtained against the gastric primary lesion observed endoscopically. Complete response was obtained against the lymph node around the abdominal aorta. Reduction of low back pain and DIC were observed. He was thus able to be discharged and sequential therapy was performed again over 2 months in outpatient care.
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PMID:[A case of advanced gastric cancer with DIC treated by sequential MTX and 5-FU]. 1504 48

Peritoneal dissemination is a major event in the development of gastric cancer. However, most patients with it have been excluded from clinical studies because they rarely have measurable lesions. We conducted an analysis to evaluate the efficacy and feasibility of modified pharmacokinetic modulating chemotherapy, for gastric cancer patients with peritoneal dissemination. Between May 2002 and April 2004, 10 patients were treated by modified pharmacokinetic modulating chemotherapy. This analysis was based on 10 consecutive chemotherapy-naive patients with confirmed peritoneal dissemination. This therapy regimen was repeated with a weekly schedule of MTX 100 mg/body, given as intraarterial infusion 1 h prior to a 24-hr infusion of 5-FU 500 mg/body. Simultaneously, enteric-coated tegafur/uracil (400 mg) was administered every day. The one-year overall survival rate was 50. 0%. The median survival time was 311 days. Grade 1 stomatitis and Grade 1/2 oral dryness were involved in 40% of the cases. No patient had to discontinue this therapy because of complications. Objective improvement of ascites was seen in all patients, and all patients could be treated at outpatient clinics. This regimen may be well-tolerated and of clinical benefit for patients with peritoneal dissemination of gastric cancer.
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PMID:[Modified pharmacokinetic modulating chemotherapy for progressive gastric cancer accompanied by peritoneal dissemination]. 1585 12

We report a 47-year-old female patient who was suffering from severe DIC due to multiple bone metastases. This patient was treated weekly with an intraarterial 5-FU (500 mg) and MTX (100 mg) including AT-II by a subcutaneously implanted port system placed into her abdominal aorta. Furthermore, she was administered tegafur/uracil (400 mg/day) 5 days weekly for pharmacokinetic modulating chemotherapy (PMC). After three courses of PMC treatment, DIC was resolved and the tumor marker was reduced. However, after 22 courses of this regimen, DIC suddenly recurred. As second line chemotherapy, we then administered paclitaxel (80 mg) in place of CDDP. After five courses of this second line chemotherapy, DIC recovered and the tumor marker was again decreased. We concluded that this chemotherapy is effective for advanced gastric cancer complicated with bone metastasis and DIC from the standpoint of toxicities, antitumor effect and QOL of the patient.
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PMID:[A case of advanced gastric cancer with bone metastasis and severe DIC responding to hypertensive subselective chemotherapy with pharmacokinetic modulating chemotherapy]. 1585 21

Gastric cancer is most chemosensitive among gastrointestinal tumors. However, the role of chemotherapy in advanced disease and its advantage over best supportive care has been adequately addressed only in the last decade. First generation regimens, such as 5-Fluorouracil (5-FU), Doxorubicin, Mitomycin C (FAM) have been used until early 90's, when evidence from randomized studies came up in favour of second generation regimens, such as 5-FU, Doxorubicin, high-dose Methotrexate (FAMTX), which in turn was proven less active than a third generation regimen, such as epirubicin, cisplatin, continuous infusion 5-FU (ECF) in a randomized study. Newer treatment options came up over last years. The Swiss Group for Clinical Cancer Research has carried out a randomized three-arm phase II study with ECF or docetaxel, cisplatin (TC), or docetaxel, cisplatin, 5-FU (TCF) in advanced gastric cancer. TCF has been selected as the combination to be further evaluated in a formal comparison with ECF. Oxaliplatin is being tested in advanced gastric cancer. Two recently published phase II studies of biweekly infusional 5-FU, folinic acid, and oxaliplatin have shown a considerable therapeutic activity. Irinotecan is another drug under investigation in advanced gastric cancer, both as single agent and in combination. A randomized phase II-III study of irinotecan plus cisplatin or irinotecan plus folinic acid/5-FU has recently been completed; the latter arm was proven worth undergoing a formal comparison with a standard CF regimen. Oral fluoropyrimidines represent a suitable therapeutic option in selected groups of patients. Marimastat is a matrix metalloproteinase inhibitor, whose main toxicity is musculoskeletal. A randomized phase III study of marimastat versus placebo as maintenance therapy in advanced gastric cancer has shown a significant survival advantage for the marimastat arm, both in the total patient population and in the subgroup of patients who had previously received chemotherapy. Since a clear gold standard for advanced gastric cancer does not yet exist, the inclusion of patients in well designed clinical trials is to be considered the best treatment option.
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PMID:Gastric cancer. Treatment of advanced disease and new drugs. 1597 May 66

A 62-year-old male patient with paraaortic lymph node metastasis of type 2 gastric cancer underwent distal gastrectomy with partial resection of transverse colon. MTX/5-FU sequential therapy was performed 5 times as adjuvant chemotherapy. After that TS-1 was administered on a 4-week dosing regimen with a 2-week interval between sessions. The patient regimen was discontinued temporarily because of thrombocytopenia. Therefore the schedule was changed to a 2-week dosing regimen with a 1-week interval between sessions at 2 years after operation. Paraaortic lymph node size was then checked by abdominal CT one or two times a year. The size showed no change for 3 years after operation. Then, 3 years and 3.5 years later, CT follow-up did not show paraaortic lymph node or other organ metastasis. We judged the effect of TS-1 was CR. Now the patient is disease-free at 4 years after operation.
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PMID:[A case of advanced gastric cancer with paraaortic lymph node metastasis reaching long-term survival by TS-1 treatment]. 1618 35

Curative resection is considered to be a standard therapy for gastric cancer with localized peritoneal metastases. For tumors with diffuse dissemination, chemotherapy may play a major role, however, the benefits of reduction surgery and standard chemotherapy have not yet been clarified. Median survival time after reduction surgery was reported to be 4-13 months for patients diagnosed by surgery and/or CT and 5-6 months for chemotherapy for those diagnosed by CT alone. Reduction surgery has a high risk, with a morbidity of 12-44% and a mortality of 3-14%. Palliative surgery should be indicated for stenosis or bleeding due to primary tumors. 5-FU, MTX-5-FU, TS-1, paclitaxel, and their combination are candidates for practice and clinical trials. It is important to evaluate the severity of peritoneal dissemination by diagnostic laparoscopy or laparotomy for decision making.
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PMID:[Treatment strategy for primary gastric cancer with peritoneal dissemination]. 1622 37

A 71 year-old woman underwent total gastrectomy for advanced gastric cancer of p stage IV (pathological findings: por1 type 3 pT3, pN3 (12p: 1/1, 16b1 int: 3/3, 16b1 lat: 2/2), P1, CY1, H0) in March 2002. She was treated with the double modulation therapy of MTX/CDDP/5-FU intraperitoneally after the surgery. After leaving the hospital, she was carrying out the chemotherapy with MTX/5-FU continually. In August 2002, she became hospitalized once again because an appetite decrease and diarrhea appeared. CT of abdomen showed that malignant ascites had obviously accumulated, and she was admitted. Because it was conceivable in all cases of an inflammation by the chemical stimulation that originated in an anticancer drug, we suspended the intraperitoneal chemotherapy. Paclitaxel 90 mg/body administration was started intravenously on a weekly basis from the end of the same month. Those symptoms improved and she was discharged from the hospital, and was continued the paclitaxel administration. In CT of the abdomen that was taken in November in 2002, malignant ascites had obviously been decreasing and disappeared completely after that.
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PMID:[An effective weekly paclitaxel administration for gastric cancer with malignant ascites--a case report]. 1631 30

The patient was a 63-year-old woman who presented with upper abdominal discomfort. Type 3 gastric cancer in the midgastric region was diagnosed, and the patient underwent surgery. Because peritoneal metastasis and periaortic lymph node metastasis were confirmed, paraaortic lymph node metastasis, total gastrectomy and D 1 lymph node dissection were performed. Surgical and pathological findings were pType 3, pT 3(SE), sN 3, pP 1, sH 0, CY 1, Stage IV, and Cur C. After surgery, she was treated with five regimens of MTX/5-FU, TS-1 or DOC, but because progressive disease was confirmed, weekly paclitaxel and 5'-DFUR combination therapy was initiated as salvage therapy. Five months after the start of combination therapy, complete response was achieved, and combination therapy was continued for 19 more months. Since no recurrence was observed, therapy was terminated. No severe adverse reactions were observed. The patient has been recurrence-free for 25 months and remains alive as of 68 months after surgery. The present therapy may thus be effective in the treatment of previously treated Cur C advanced gastric cancer.
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PMID:[A long-term survivor with stage IV gastric cancer due to postoperative weekly paclitaxel and 5'-DFUR combination therapy]. 1648 63


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