S-1 + CPT-11 combination therapy with continuing 30-month CR in a recurrent gastric cancer with para-aortic lymph node metastasis in adjuvant chemotherapy with S-1--a case report

The patient is a 62-year-old male who was treated for macroscopic-type 3 gastric cancer by total gastrectomy (D2) and splenectomy. His disease was recorded as pT3, pN2, Stage IIIB, curability B, and S-1 was started as postoperative adjuvant chemotherapy. One year later, during the adjuvant chemotherapy, CT revealed para-aortic lymph node enlargement. Recurrence was diagnosed, and S-1 (100mg/body, days 1-28) + CPT-11 (80 mg/body, days 1, 8, 15, and 22) combination therapy was started. After 4 courses, the lymph node had markedly regressed (regression rate: 72. 2%), and CPT-11 administration was changed to biweekly (days 1, 15, 28). A total of 9 courses were administered, and during the 9th course it disappeared. Adverse events during the 9 courses consisted of only grade 1 alopecia and grade 2 diarrhea and leukopenia, and none of them were serious. At the patient's request, only oral S-1 was continued thereafter, however, CR has been maintained for 30 months. S-1+CPT-11 combination therapy can be conducted safely on an outpatient basis, and it has been superior in terms of continuity of treatment.