[A case of advanced non-small-cell lung cancer successfully treated with S-1 plus CBDCA after multiple chemotherapy]

A 51-year-old man consulted our hospital with complaints of a headache and spasm of the left upper limbs in January 2007. He was diagnosed as left lung adenocarcinoma (c-T2N0M1, stage IV). His serum CEA level was 104.1 ng/mL. After the brain tumor extraction, CDDP (80 mg/m2) + GEM (1,000 mg/m2) were administered as first-line treatment, and the tumor response was PR (33.3% reduction rate), impaired liver function served to interrupt this regimen. Other chemotherapy was then conducted in the order of GEM (1,000 mg/m2) + VNR (25 mg/m2), and CBDCA (AUC=5) + DOC(60 mg/m2), and the tumor response was NC. As fourth-line treatment, S-1 (75 mg/m2, day 1-28, every 6 weeks) + CBDCA (AUC=5, day 8, every 6 weeks) was chosen. After 3 courses of the treatment, the serum CEA level normalized, a chest CT detected the left lung tumor size reduction (66.7% reduction rate), and an abdominal CT detected disappearance of the left adrenal gland tumor. In January 2008, left upper lobectomy and lymph node resection (ND2a) were performed. Histopathological examination of the lung tumor showed viable adenocarcinoma cells. Postoperatively, S-1+CBDCA also was administered in a 3-course treatment. This patient is currently continuing treatment with S-1 monotherapy with no recurrence. This case suggests that S-1+CBDCA may be an effective treatment in patients with advanced non-small-cell lung cancer even after multiple chemotherapy.