摘要
本文介绍1例胃癌伴腹膜种植转移患者的诊治过程。患者入院时经胃镜和病理证实为胃窦低分化腺癌。随后腹部CT及腹腔镜探查确诊为腹膜种植转移(腹腔积液伴腹膜大网膜结节),已无手术指征。经消化道肿瘤多学科专家小组(multidisciplinary team,MDT)讨论后给予NIPS方案[替吉奥(S-1)/紫杉醇(paclitaxel,PTX)全身化疗+顺铂(cisplatin,DDP)腹腔化疗]治疗3个周期后再次评估显示,肿瘤退缩明显,腹腔积液及腹膜大网膜转移结节消失。再次经MDT讨论后行手术治疗,术后给予3个周期S-1/PTX全身化疗。现患者无瘤生存期已达3年,生活质量较高。此例患者治疗过程中充分体现转化治疗模式的可观前景,对于延长晚期胃癌生存期和提高其生活质量发挥重要作用。
The process of conversion treatment of a case of gastric cancer patient with peritoneal metastasis was described.The patient was diagnosed with poorly differentiated gastric adenocarcinoma by endoscopy and pathology at initial diagnosis.Subsequently,peritoneal metastasis（ malignant ascites with peritoneum nodules） was further confirmed in the patient by abdominal CT and laparoscopic exploration.No surgery indication was suggested.After multidisciplinary team（ MDT） discussion,the patient was treated with NIPS regimen [S-1/paclitaxel（ PTX） systemic therapy plus cisplatin（ DDP） intra-peritoneal chemotherapy]for 3 cycles.Afterwards,the primary tumor showed significant recession.Peritoneal fluid retention and peritoneum nodules were also largely disappeared.The subsequent treatment was presented to MDT again,which suggested performing a radical surgery.After surgery,the patient received 3 cycles of S-1/PTX systemic therapy.Until now,the patient already had 3-year disease-free survival and is having a high quality of life.The treatment process of this case showed the clinical value of conversion therapy.Conversion therapy plays an important role in extending the overall survival and enhancing the quality of life in patients with advanced gastric cancer.
出处
《实用肿瘤杂志》
CAS
2017年第6期494-498,共5页
Journal of Practical Oncology
基金
国家自然科学基金(81573953)
浙江省重大科技专项重点社会发展项目(2013C03044-4)
浙江省医药卫生科技计划项目(2016KYB220
2013KYA029)
关键词
胃肿瘤/药物疗法
腹膜转移
转化治疗
stomach neoplasms/drug therapy
peritoneal metastasis
conversion therapy
