[A Case of CR Achieved by Chemotherapy for Distant Metastatic Lymph Nodes after Surgery for HER2 Positive Early Gastric Cancer].

ABSTRACT

The patient was a 72-year-old man who exhibited an abnormal shadow in the stomach in a series of medical check-ups of the upper gastrointestinal in August 20XX. It was diagnosed as gastric cancer(type 1)of the greater curvature of the MU region. Total gastrectomy, D2-11p dissection, and Roux-en-Y reconstruction were performed in October 20XX. The tumor was p-T1bN3aM0, Stage ⅡB, Pap, Ly1c, V1a, 90×70mm, HER2 score 3. Six courses of S-1/CDDP were administered as adjuvant chemotherapy after consultation. Two years and 8 months after the surgery, PET-CT scan showed distant lymph node metastasis(left axilla, para-aortic)and left lung metastasis. Three courses of XP-Her after 2 years and 11 months, 19 courses of X-Her after 3 years and 2 months, and 7 courses of trastuzumab alone after 4 years and 4 months to 4 years and 9 months were canceled. Three years and 4 months after the surgery, the tumor showed PR, and it showed CR, 3 years and 8 months after the surgery. Eight years and 3 months after the surgery, the tumor continued to show CR. The adverse events were blood toxicity, WBC reduction Grade 1, neutropenia Grade 3, and anemia Grade 2. There have only been a few reports on CR after chemotherapy with XP-Her for lung metastasis of gastric cancer, with a review of the literature.