[A Long-Surviving Patient with Unresectable Gastric Cancer Treated with Multiple Rounds of Chemotherapyafter Gastrojejunostomyand Ileocolonostomy].

We report a long-surviving patient with unresectable gastric cancer treated with multiple rounds of chemotherapy after gastrojejunostomy and ileocolonostomy. The patient was a 79-year-old man. Endoscopic examination revealed a type 3 gastric cancer in the antrum and showed pyloric stenosis. We observed that the gastric tumor had invaded the transverse colon, pancreas, and duodenum, and was associated with peritoneal metastasis on the surface of the hepatoduodenal ligament and the posterior leaf of the transverse mesocolon. We performed gastrojejunostomy and ileocolonostomy to allow oral intake and to prevent ileus. The final diagnosis was fT4b(SI), N2, H0, P1, M0, CY0, Stage IV . The patient's oral intake was not sufficient following the operation, and therefore, he was treated with 8 courses of 5-FU plus PTX intravenously until disease progression was observed. Bi-weekly administration of CPT-11 and CDDP was chosen as the second-line chemotherapy. Grade 2 renal dysfunction was observed after 13 courses of this therapy, and therefore, we changed the regimen to CPT-11 monotherapy, repeating 18 courses until disease progression was observed. The patient was treated with 18 courses of S-1 monotherapy as the fourth-line chemotherapy, and then 2 courses of S-1 plus DTX. The patient died of progressive disease 4 years and 5 months after surgery. During chemotherapy, he maintained a good performance status and could be treated as an outpatient.