化学療法が奏効し，10年以上無再発が継続しているStage IV胃癌の2例

Two Patients with Inoperable Gastric Cancer Who Survived More Than 10 Years after Successful Chemotherapy

要旨　〔症例1〕は58歳，男性．食欲低下で発症．胃X線と内視鏡で胃体下部小彎に1型病変を認めた．CTで腹部・頸部リンパ節転移を認めた．EAP施行し，原発巣PR，リンパ節CRの判定で手術を施行したが組織学的CRであった．〔症例2〕は53歳，男性．食欲低下で発症．胃X線と内視鏡で胃体上部小彎に3型病変を認めた．CTで傍大動脈リンパ節転移を認めた．EAP施行し，原発巣PR，リンパ節CRの判定で手術を施行したが組織学的CRであった．1年後脳転移が出現し照射で消失した．2例ともに再発なく生存中である．リンパ節転移のみの症例は長期生存の可能性があり，積極的に化学療法を行うべきであると考えられた．

　We report the case of two patients with advanced gastric cancer who were treated successfully and survived longer than 10 years. The first patient was a 58-year-old male, who was referred for evaluation of anorexia and cervical lymphadenopathy. Given a diagnosis of gastric cancer with cervical- and abdominal-node metastases, he was treated with etoposide, doxorubicin, and cisplatin (EAP). Because the overall response was good PR, the laparotomy performed revealed a pathological CR. The second patient was a 53-year-old male, who was referred for evaluation of anorexia. Given a diagnosis of gastric cancer with abdominal-node metastases, he was treated with 6 courses of EAP, which resulted in a good PR. Partial gastrectomy to remove the remaining lesion was performed. Histologic examination revealed a pathological CR. One year later, he was found to have brain metastases and was treated with irradiation successfully. Both patients are still alive with no evidence of disease. Patients with node-positive gastric cancer are good candidates for intensive chemotherapy because they have some chance to achieve a pathological CR and subsequent long survival.