S-1 has been developed as a new oral anticancer
drug, based on the
biological modulation of
5-fluorouracil. We report a patient with highly advanced gastric
carcinoma who was treated successfully with a new combination
chemoradiotherapy using S-1 and
cisplatin (CDDP). The patient was a 37-year-old man who was diagnosed with advanced gastric
carcinoma (T4N3M0) that had invaded the diaphragm and the paraaortic tissues. Remarkable
tumor reduction was observed in the primary
tumor and metastatic lymph nodes around the stomach after three cycles of the
therapy. Radiological examination before surgery determined that a partial response (PR) had been achieved by the initial
therapy. Adverse effects included only a
gastrointestinal disorder that was limited to grade 2 when low-dose CDDP was utilized in the regimen, while an initial high dose of CDDP resulted in grade 3 toxicity, due to myelosuppression. The patient underwent curative surgery, including total
gastrectomy, D2
lymph node dissection, and
splenectomy, after completion of the
radiochemotherapy regimen. No surgical complication was observed. No
tumor cells were detected by pathological evaluation of the resected stomach and all the regional lymph nodes, confirming a pathological complete response (CR; grade 3). This regimen is a potent treatment for advanced gastric
carcinoma, especially when used as preoperative
chemotherapy to control
cancer cells.