[A surgical case of recurrent gastric cancer successfully treated by TS-1 plus low-dose consecutive administration of CDDP following TS-1 monotherapy].

: The patient was a 65-year-old woman who was discovered to have recurrent gastric cancer involving para-aortic lymph nodes 21 months after postoperative low-dose FP therapy for gastric cancer. The recurrent cancer was judged to be unresectable, and TS-1 chemotherapy (one course consisting of 4-week administration of 100 mg/day and a 2-week withdrawal period) was performed. Although a complete response occurred in the para-aortic lymph nodes and a partial response in the residual stomach (i.e., only a shallow erosion remained) after the end of course 2, histological examination showed "no change". The following regimen was therefore used in courses 3 and 4: 6-day administration of CDDP at a dose of 15 mg/body (10 mg/m2)/day the first week, concomitant administration of 90 mg/body (60 mg/m2) of CDDP plus 100 mg/day of TS-1 the next three weeks, and two-week withdrawal of chemotherapy. Since down-staging was observed at the completion of course 4, total gastrectomy of the residual stomach was performed. No noteworthy adverse reactions to chemotherapy were observed, and good patient QOL (e.g., appetite) was achieved. Based on these findings, this chemotherapy regimen appears to be an effective treatment modality for far advanced gastric cancer, particularly involving the abdominal para-aortic lymph nodes.