PMC9400896_01
The CT images of the cardiac cancer and hepatic metastases before and after first-line chemotherapy. The cardiac tumor with multiple hepatic metastases were indicated on 15 August 2017. After two cycles of first-line chemotherapy with oxaliplatin and S-1, the cardiac and hepatic lesions showed stable disease (SD) on 8 November 2017. Five months after first-line treatment, the cardiac and liver masses were progressed on 17 December 2018.
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F1
Five months after first-line treatment, the gastric and liver masses progressed on 17 December 2018 (Figure 1).
The CT images of the cardiac cancer and hepatic metastases during second-line treatment with apatinib and paclitaxel. Before second-line treatment, the CT showed markedly enlarged cardiac tumor and multiple hepatic metastases with abundant blood supply. The average CT ratio (the density of the liver metastases/the density of abdominal aorta) during arterial phase on CT imaging was 79/210. After two cycles of second-line therapy, the cardiac tumor and hepatic metastases showed a response of partial response (PR), and the ratio was 38/281 with an obviously decreasing of the degree of enhancement. Four cycles later, the efficacy remained PR. The recent CT examination was on 20 November 2021, which showed the disease remained an efficacy of PR.
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F2
That average CT ratio was 38/281 with an obviously decreasing of the degree of enhancement (Figure 2).
Timeline of management of this patient with metastatic gastric adenocarcinoma.
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F3
From 10 March 2021, the patient received apatinib (250 mg/d) alone for maintaining therapy (Figure 3).