⑦化学療法を施行した噴門部進行癌の1例

A Case of Administration of Chemotherapy against Advanced Gastric Cancer

　胃生検により確診され，胃X線および内視鏡検査で噴門部のBorrmann3型進行癌と診断された症例に化学療法（免疫療法を含む）を行い，最終的に手術を施行した例を提示する．

患　者：U. K.　49歳　男性

主　訴：嚥下障害

現病歴：約3カ月前より嚥下障害，空腹時の心窩部痛を時々訴えていた．その後，次第に自覚症状の増強とともに全身倦怠感を伴うようになってきた．

　The patient, a 49 year-old man, came to us for consulting with his chief complaint of dysphagia. His hunger pain in the epigastrium started about three months before and due to the acuteness of his symptom he came to our hospital.

　Through his first gastric X-ray and endoscopic examinations he was diagnosed as having cancer of the cardia (Borr. 3), The gastric biopsy test carried out at the same time proved also to be cancer.

　Since the patient refused to have an operation, he was given FAMT therapy (5-FU, Cyclophosphamide, MMC, Chromomycin A₃) and also was administered OK-432 together with Ft-207). He became less aware of subjective symptom and both stomach X-ray test and endoscopic examination seven months later showed that cancer was reducing its size. But, while his subjective symptom was appearing again, the same test results as his initial ones (Borr. 3) were recognized, for which he was re-admitted to our hospital. An operation was performed ten months later. Histopathological findings of the excised stomach showed poorly differentiated adenocarcinoma with a Borr. 3 lesion, measuring 80×75 mm and the degree of infiltration was Se.