A CASE REPORT OF UNRESECTABLE GASTRIC CANCER HAVING A LONG TERM PARTIAL RESPONSE AND FINALLY UNDERGOING RADICAL OPERATION FOLLOWIN FAM THERAPY AND ADMINISTRATION OF 5'-DFUR

A case of advanced gastric carcinoma (type 3) diagnosed as unresectable, successfully underwent a radical operation after two courses of the combination chemotherapy with 5-FU, MMC and ADM followed by oral administration of 5'-DFUR. The gastric lesion was proven Stage IVb [AM, 3T4 (SI), N3, P1, H0, M0] and pathologically well to moderately differentiated adenocarcinoma at the first operation. Since the 8th postoperative day, two courses of FAM therapy (300mg/m2 of 5-FU I. V. on day 1, 8, 29, 36, 13mg/m2 of ADM I. V. on day 1, 29, 6.5mg/m2 of MMC I. V. on day 1) has been applied. Within three months, the abdominal mass disappeared, passage of the stomach and vomiting improved, and the serum CEA level returned to a normal range. Endoscopically, the main gastric tumor was remarkably diminished. The general condition improved and body weight increased. After discharge, the administration of 600mg 5'-DFUR p.o./day was started. From the 40th month, severe anemia continued and became uncontrollable. In the 44th month from the first chemotherapy, a subtotal gastrectomy was performed with regional lymph nodes dissection. Histological findings of the specimen including regional lymph nodes revealed a mardked effect of anticancer agents, and proved the operative radicality.