②化学療法で著効をみた老人のⅡa型早期胃癌例

A Case of Early Gastric Cancer (Type Ⅱa) Disappeared During Anti-Cancer Chemotherapy

患者　阿○隆　72歳　男

　1975年4月14日より5月17日まで慢性気管支炎で当院に入院した際，ルーチンの検査で癌がみつかった．消化器症状は全くなかった．

　治療前の胃X線所見（Fig. 1）：立位圧迫像で前庭部後壁に13×12mm（フィルム計測上）の不整な透亮像を認め，背臥位二重造影像では辺縁不整な表面に凹凸のある隆起陰影を認めた．

　The patient is 72 years-old-male in our hospital with chronic bronchitis from April 14 to May 17, 1975. During admission, he had a barium meal study done, and was found to have an irregular-shaped poiypoid lesion on the posterior wall of the antrum, measuring 13×12 mm in diameter. The polypoid lesion was diagnosed as being Type Ⅱa early gastric cancer, and the biopsy specimen were reported as Group Ⅳ (well differ. tub. adenoca.)

　He was advised to have an operation done, but he refused. He started to take oral administration of dry syrup 300 mg/day on October 8, 1975. On November, 1975, follow-up x-ray and gastroscopy were performed, and both of them showed slight flattening of the elevation. After he felt the sense of epigastric fullness, anorexia and belching, he discontinued with anti-cancer chemotherapy, against our advise on November 31, 1975. Therefore, it showed that the elevated lesion again grew up, to what it was before anti-cancer chemotherapy, by gastroscopy. He was advised to have gastrectomy done, but again he refused. Anti-cancer chemotherapy with 5-FU dry syrup 300 mg/day was restarted again on April 24, 1976. A repeated barium meal study on July 23, 1976 failed to visualize the polypoid lesion, and also the Type Ⅱa early gastric cancer could not be found at gastroscopy. Gastric biopsy was reported as showing Group Ⅱ (intestinal metaplasia). Until, April 24, 1978, he stayed on 5-FU dry syrup with a total dose of 165.2g. He also took P-SK between June 15, 1977 and April 23, 1978 with a total dose of 919 g. On September 1, 1979, gastroscopy was repeated, but the polypoid lesion could not be found.

So, it is concluded by 5-FU dry syrup, type Ⅱa early gastric cancer was completely disappeared.