③化学療法により著効のみられたBarrmann2型胃癌

Improvement of Radiologic and Endoscopic Appearances of Gastric Cancer (Borrmann's type 2) by Anti-cancer Chemotherapy

　現在，胃癌に対する最良の対策は早期診断に基づく外科的切除である．しかし，胃癌が切除可能な段階で発見されても，合併症のために手術を行えないこともある．最近，われわれは狭心症のために手術が受けられなかった胃癌患者に化学療法を行い，極めて良好な結果を得たので報告する．

　The best management of gastric cancer at present is early diagnosis followed by surgical removal. Risky complications, however, may prevent cancer patients from undergoing surgery. In such a case, chemotherapy may be another treatment of choice. In this paper, a ease of gastric cancer is reported, in which chemotherapy showed remarkable effects and the responses were clearly documented radiologically and endoscopically.

　A 71 year-old man has been under a cardiologists care for the past two years because of angina pectoris. He noticed epigastric pain in October, 1978. X-ray and endoscopic examinations revealed advanced gastric cancer (Borrmann's type 2) on the posterior wall of the upper part of the stomach. Gastric biopsy showed moderately differentiated adenocarcinoma. According to the cardiologist's advice, treatment with anti-cancer drug instead of surgery was planned and the patient was admitted to the hospital. On December 12, 1978, oral administration of N-(2-telrahydrofuryl)-5-fluo rouracil (ftorafur) was started at a dose of 800 mg per day. Radiologic and endoscopic examinations at the end of January,1979, disclosed only a slight improvement. Intravenous administration of Mitomycin C (MMC) was then added. The administration was continued until March 22, 1979, when the total dose of MMC amounted to 42 mg. At the end of March X-ray and endoscopic examinations revealed a remarkable improvement, showing appearances similar to benign ulcer. The dose of ftorafur was decreased to 600 mg per day. The patient was discharged on April 12. Since then he has been treated on an ambulatory basis. Finally the lesion took the appearances similar to benign ulcer scar. Gastric biopsy changed to negative on May 9, 1979. As far as the stomach is concerned, the patient is asymptomatic at this writing.