⑧Mitomycin Cと5-Fluorouracilの併用が有効であった残胃癌の症例

A Case of Cancer of the Remnant Stomach Treated Effectively with the Combination of Mitomycin C and 5-Fluorouracil.

患　者：阿○波○則　45歳　男

主　訴：上腹痛，黄疸

家族歴：母，腹部腫瘍で死亡

既往歴：22歳の時，十二指腸潰瘍の手術をうけ2週間入院，1978年5月，虫垂炎手術．

現病歴：1978年5月，虫垂炎の手術後，全身倦怠感，食思不振あり，自宅療養をしていた．6月22日より出勤し，8月末までは特別変わりはなかった．9月4日頃より腹部膨満感と上腹痛が起こり次第に増強した．9月9日当科を受診し即日入院した．

　A 45-year-old man with cancer of the remnant stomach has a history of gastrectomy 22 years before because of duodenal ulcer. On Sept. 9, 1978, he visited our hospital with the complaints of abdominal pain and jaundice, and was admitted on that day. Fluoroscopic examination revealed aremnant stomach cancer. Liver function tests indicated that jaundice was attributable to the obstruction because the elevated serum bilirubin level (4.7mg/dl) was associated with the increased serum Al-P (48.2 KAU) and γ-GTP (624 U). On Sept. 26, the patient suddenly had complication of the ileus because of the Schnitzler's metastasis. Intravenous administration of both Mitomycin C (4mg) and (500mg) was started on Sept. 27, twice a week. On Oct. 9, ileus signs disappeared. jaundice was also improved remarkably (serum bilirubin 1.0mg/dl). Since Oct. 26, the patient was treated with oral use of 300～500mg of UFT (combination of uracil and ftorafur) per day, and 6mg of Mitomycin C i. v. per week. On Dec. 19, he was discharged in good health. However, this patient soon had recurrence. He had lived 4.5 months long after initiation of the therapy.

　In general, it is considered that the combination of oral use of UFT with Mitomycin C (i.v.) per week is recommended as a treatment for gastric cancer from the view-point of the mode of action of 5-FU analogues and Mitomycin C.