[A Case of Unresectable Gastric Cancer Who Underwent Conversion Surgery after SP Therapy and Achieved Long-Term Survival].

The case was a man in his 60s. With a complaint of loss of appetite, a peripheral type 3 lesion was found from the lower body of the stomach to the vestibule, and a biopsy revealed poorly differentiated adenocarcinoma. CT examination revealed that the tumor had invaded the left lobe of the liver and the transverse colon, and that the para-aortic lymph nodes were swollen and multiple nodules of the gastrocolonic mesentery were found. After 6 courses of S-1 plus cisplatin(SP)therapy were performed, the tumor shrank and lymph node swelling and nodule disappearance were observed. Laparotomy and pyloric gastrectomy, partial liver resection, D2 dissection, and Roux-en-Y reconstruction were performed. As a result of histopathological examination, R0 was resected. After the operation, S-1 was taken orally for 1 year, and no recurrence or metastasis has been observed 6 and a half years after the operation. This time, we report a valuable case in which SP therapy was successful for unresectable gastric cancer and long-term survival was obtained by conversion surgery.

Detection and treatment of akathisia in advanced cancer patients during adjuvant analgesic therapy with tricyclic antidepressants: case reports and review of the literature.

OBJECTIVE: There is substantial evidence that tricyclic antidepressants are effective in the management of chronic pain, including cancer pain. In oncological settings, these agents are used as adjuvant analgesic drugs. However, cases of akathisia due to tricyclic antidepressants used as adjuvant analgesic therapy have not previously been reported. CASE REPORTS: Two cancer patients experiencing chronic pain who were refractory to nonsteroidal anti-inflammatory drugs and opioids were prescribed amoxapine as an adjuvant analgesic therapy for neuropathic pain. These patients developed inner restlessness and restless physical movements after amoxapine was prescribed. Although symptoms were atypical, akathisia was suspected and discontinuation of amoxapine resolved the symptoms. RESULTS AND SIGNIFICANCE OF RESULTS: Akathisia should be considered in patients receiving adjuvant analgesic therapy with tricyclic antidepressants. Early detection and appropriate treatment will relieve this distressing symptom. Restless movements involving parts of the body other than the legs may be the clue to the diagnosis.