Neoadjuvant chemotherapy with a combination of irinotecan and cisplatin inadvanced gastric cancer - A case report

We report a case of advanced gastric carcinoma successfully treated with a combination of irinotecan and cisplatin as neoadjuvant chemotherapy. The pa tient, a 78-year-old man, had type 2 gastric cancer, which had metastasized to the paraaortic lymph nodes. He was treated with irinotecan, 70mg on day 1 and day 15, and cisplatin, 80mg on day 1. The course was repeated every 4 weeks. Two courses of treatment resulted in a marked reduction of both th e primary tumor and lymph nodes. Subsequently, the patient underwent curati ve surgery consisting of total gastrectomy, splenectomy, and D3 lymph node dissection. No surgical complications were observed. On microscopic examina tion, only a few tumor cells were detected in the granulation tissues of th e resected stomach and in the lymph nodes. This would be the first case to demonstrate the effectiveness and the safety of irinotecan and cisplatin us ed in the neoadjuvant setting for treatment of advanced gastric carcinoma.