基础医学与临床 ›› 2021, Vol. 41 ›› Issue (7): 1043-1046.

• 疑难病例 • 上一篇    下一篇

综合治疗79岁进展期胃癌1例

苏鹏飞,蒋林,章盈婧,郭博,马志强,周炜洵,于健春   

  1. 中国医学科学院 北京协和医学院 北京协和医院
  • 收稿日期:2020-12-07 修回日期:2021-04-27 出版日期:2021-07-05 发布日期:2021-06-17
  • 通讯作者: 于健春 E-mail:yu-jch@163.com
  • 基金资助:
    北京市科委基金

A 79-year-old patient with advanced gastric cancer who received comprehensive therapy

  • Received:2020-12-07 Revised:2021-04-27 Online:2021-07-05 Published:2021-06-17
  • Contact: Jian-chun -YU E-mail:yu-jch@163.com
  • Supported by:
    Beijing Ministry of Science and Technology

摘要: 目的 探讨进展期胃癌老龄患者的治疗现状与难题,为寻求理想治疗模式提供参考。方法 收集1例进展期胃癌老龄患者的诊疗资料并结合相关文献进行探讨。结果 本例患者为一例79岁老龄男性,结合胃镜、影像学和病理学检查结果临床诊断为胃底腺癌(cT4a-bN2Mx)。患者首先行新辅助同步放射治疗和化学治疗,3程治疗结束后行术前评估显示肿瘤发生临床降期(cT3-4N1Mx),遂予实施胃癌根治手术,术后替吉奥(S1)单药口服化学治疗。营养治疗贯穿全程管理,患者术后至今2年半规律门诊随访,未见肿瘤复发、转移,一般状况良好。结论 包括新辅助放射治疗、化学治疗、手术治疗和营养治疗等在内的序贯性综合疗法对于进展期胃癌老龄患者的治疗展现出长远意义和潜力,值得在临床上进一步验证和推广。

关键词: 进展期胃癌, 老龄患者, 综合治疗, 病例报告

Abstract: Objective To discuss the current situation and challenge of the therapy on elderly patients with advanced gastric cancer and provide reference for the exploration of ideal treatment methods. Methods Collect the clinical material of an elderly patient with advanced gastric cancer, and the relevant literatures were reviewed. Results A 79-year-old man was clinically diagnosed with adenocarcinoma on the fundus of stomach (cT4a-bN2Mx). After the third course of neo-adjuvant concurrent chemo-radiotherapy, a remarkable reduction and down-staging was achieved (cT3-4N1Mx), then followed by radical gastrectomy for gastric cancer. S-1 was used alone for the postoperative chemotherapy. The patient received nutritional therapy in the full treatment course, and the physical condition was satisfactory without tumor metastasis and relapse two years and a half after the surgery. Conclusions The sequentially comprehensive therapy shows a potency for the therapy on elderly patients with advanced gastric cancer, and deserves further verification and promotion clinically.

Key words: advanced gastric carcinoma, elderly patients, comprehensive therapy, case report

中图分类号: