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ABSTRACT: A 68-year-old man underwent total gastrectomy for gastric cancer(Stage II). Adjuvant chemotherapy with S-1 was administered. At 21 months after the operation, he received a nephron catheter because of hydronephrosis caused by para-aortic lymph node metastases. Then, weekly paclitaxel was given as a second-line treatment. However, his tumor marker level increased and he therefore received CPT-11 (160 mg/m2) as a third-line treatment at 28 months after the operation. At 7 days after the first CPT-11 administration, he was hospitalized because of a severe adverse event involving nausea and general fatigue, which caused a continuous fever of 39°C and renal failure at 14 days after administration. However, hydration enabled him to recover several days later. Computed tomography scan revealed the lymph node metastases to be partial remission.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2336-8.
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ABSTRACT: An 80-year-old woman visited our department with the complaint of icterus and brown urine. After detailed examination, she was diagnosed with cT4N0M (-), cStage IVa, hilar cholangiocarcinoma. We believed that she could be cured with surgery, but she and her family did not agree to the surgical procedure. Chemotherapy was scheduled, and gemcitabine (GEM) therapy was started in April 2011. GEM therapy reduced significantly the level of the CA 19-9 tumor marker, and diagnostic imaging allowed a judgment of partial response or stable disease after 18 months. In the present report, we describe a case of a patient with hilar cholangiocarcinoma who achieved long-term survival with GEM therapy. We also include a brief literature review.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2116-8.
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ABSTRACT: There are a growing number of reports of unresectable, advanced colorectal cancer and multiorgan invasive colorectal cancer for which extended surgery was avoided or a radical operation was performed after down-staging, or tumor size reduction, was achieved by chemotherapy. Here we describe a case of sigmoid colon cancer (cStage IV) for which preoperative chemotherapy improved the outcome of surgery. The patient was a 57-year-old man with sigmoid colon cancer of sufficient size to block the passage of the endoscope. The cancer was found to be widely infiltrated and adherent to the peritoneum over the bladder, with effusion around the tumor that made peritoneal disseminated metastasis a strong possibility. Moreover, many regional and periaortic lymph nodes were swollen. Sigmoid colon cancer at Stage IV was diagnosed. After preoperative chemotherapy [mFOLFOX6+bevacizumab (Bev)] was administered, tumor size decreased sufficiently to allow the endoscope to pass through. The effusion around the tumor disappeared, and lymph node swellings were reduced. The surgical findings revealed no evidence of peritoneal metastasis, and tumor adhesion to the peritoneum over the bladder was small, which limited the extent of combined peritonectomy. Ultimately, the histopathological diagnosis was Stage II,and histological evaluation of the drug therapy effects was that the tumor was then Grade 1b. Although clinical studies are currently conducted on preoperative chemotherapy for locally advanced colorectal cancer, preoperative chemotherapy is not established as standard treatment due to lack of clear evidence. The evaluation of the usefulness of preoperative chemotherapy is warrants future clinical studies.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2204-6.
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Haruhiko Aoyagi,
Jun Kaneko,
Ayako Kamiya,
Jun Isogai,
Noriko Iwata,
Eriko Katsuta,
Taro Takahata, Kumi Hasegawa,
Kenji Teduka,
Tetsuro Higuchi,
Shizuaki Maejima
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ABSTRACT: In August 2008, a 52-year-old woman presented to our hospital with a complaint of bleeding upon defecation. The patient underwent lower gastrointestinal endoscopy with biopsy. PRb indicated a type 2 lesion in one-third of the circumference. The patient was diagnosed with squamous cell carcinoma by biopsy. Imaging did not reveal any metastasis to other organs. In September, she underwent an abdominoperineal resection of the rectum. Postoperative histopathological findings were PRb, type 2, A, N3, H0, P0, M0, and Stage III b. Adjuvant chemotherapy of oral S-1 was started. In January 2009, contrast-enhanced abdominal CT revealed a pelvic recurrence, and the patient underwent chemoradiotherapy. In October, chest CT showed a 5-mm solitary pulmonary metastasis in the right apex of the lung. In March 2010, chest CT showed a slight enlargement of the tumor in the right apex, but no other metastatic lesion was observed. In April, the patient underwent a thoracoscopic partial pneumonectomy. It has been 16 months postoperatively, and no recurrence has been observed. In the present report, we describe a case of squamous cell carcinoma of the anal canal that underwent multidisciplinary treatment including pneumonectomy. We also include a brief literature review.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2277-9.
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ABSTRACT: A 55-year-old woman who had a chief complaint of left abdominal and back pain. She was diagnosed with pancreatic cancer associated with splenic metastasis (Stage IVb) by CT and MRI study and was treated with chemotherapy of gemcitabine (GEM). Chemotherapy was discontinued due to adverse event (grade 3). CT study at this point reveals the effectiveness of GEM. The tumor was localized, and an operation was performed. The tumor was diagnosed as primary malignant lymphoma (diffuse large B-cell lymphoma) of the spleen. The splentic tumor is extremely rare, so a surgical treatment was indicated for making a correct diagnosis. This was an interesting case of malignant lymphoma that GEM revealed a cytoreductive result.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2020-2.
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ABSTRACT: A 59-year-old man visited our department with the complaint of an abdominal mass. After detailed examination, he was diagnosed with cT3 (SE) N2M0, cStage III C gastric cancer and underwent a 3 course preoperative S-1/CDDP combination chemotherapy. After tumor down-staging was achieved after the 3 course combination chemotherapy, a surgery was scheduled. The patient underwent distal gastrectomy with D2 lymph node dissection. Histopathological diagnosis was M, type 1, 75 × 35 mm, papillary>moderately-differentiated tubular adenocarcinoma [pT2 (MP), ly3, v0, pN2, Stage IIB]. The patient is now treated with oral S-1 as postoperative adjuvant chemotherapy on an outpatient basis, and there are no signs of recurrence as of 1 year after the surgery. Preoperative chemotherapy appears to be a promising treatment option for gastric cancer with extensive lymph node metastasis.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2334-5.
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ABSTRACT: A 64-year-old female with a primary complaint of abdominal and back pain was diagnosed as locoregionally advanced pancreas cancer. She underwent distal pancreatectomy and received postoperative adjuvant chemotherapy of gemcitabine (GEM). Abdominal CT after 14 months showed a local recurrence without far organ metastasis. She was treated with radiation and the chemotherapy of S-1, which resulted in a stable control by a follow up CT. Then she is undergoing the combination chemotherapy of GEM and S-1. The patient is alive for 26 months after the operation.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2152-4.
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ABSTRACT: In a patient with multiple liver metastases of colorectal cancer in whom tumor response had been achieved by 5-FU hepatic arterial infusion, the catheter for arterial infusion chemotherapy was occluded resulting in re-elevation of tumor marker levels. Second-line IRIS therapy using S-1 and CPT-11 was started. IRIS therapy reduced tumor marker levels to a degree greater than that previously achieved with 5-FU hepatic arterial infusion, and diagnostic imaging allowed a judgment of partial response. But tumor marker levels increased gradually. After all, diagnostic imaging allowed a judgment of progressive disease and an eminent elevation of tumor marker levels in one year. Third-line panitumumab therapy was started. Panitumumab therapy reduced tumor marker levels to a degree greater than that previously achieved with 5-FU hepatic arterial infusion and IRIS therapy, and diagnostic imaging allowed a judgment of partial response. We report herein a successful case. Hepatic arterial infusion therapy is one of the treatment methods characterized by a lower incidence of adverse reactions, relatively low cost, and expectation of high anti-tumor efficacy as compared to chemotherapy such as FOLFIRI. IRIS therapy does not require a port insertion and pump carrying, and its cost is about half of FOLFIRI therapy. When used as second-line therapy for unresectable colorectal cancer, non-inferiority of IRIS therapy to FOLFIRI therapy has been demonstrated in a phase II/III clinica (l FIRIS) study. We may say that IRIS therapy is promising as an equivalent to hepatic arterial infusion therapy in the treatment of liver metastases of colorectal cancer. In addition, we may say that panitumumab therapy is promising as an equivalent to hepatic arterial infusion therapy and IRIS therapy.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2247-9.
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ABSTRACT: A 60-year-old man underwent total pelvic exenteration for rectal cancer and urinary bladder invasion.He received adjuvant chemotherapy with S-1 and PSK.Because of local recurrence in the 4th postoperative month, he underwent FOLFIRI therapy followed by mFOLFOX6 therapy.After an adverse reaction occurred for OHP, CPT-11 therapy was performed.After 1 course of CPT-11 therapy, he complained of dyspnea and chest pain.We suspected drug-induced interstitial pneumonia, and stopped chemotherapy.He still complained dyspnea, and was treated with PSL.Once dyspnea improved, he gradually deteriorated and was admitted to the hospital.He was given oxygen and steroid pulse therapy, but died of respiratory failure.
Gan to kagaku ryoho. Cancer & chemotherapy 07/2011; 38(7):1225-7.
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Haruhiko Aoyagi,
Jun Kaneko,
Hiroaki Ono,
Jun Isogai,
Masafumi Yoshida,
Yasunori Someno,
Eriko Katsuta,
Morihito Saguchi,
Taro Takahata, Kumi Hasegawa,
Setsuo Hamada,
Tetsuro Higuchi,
Kenichi Sugihara,
Shizuaki Maejima
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ABSTRACT: The patient was a 59-year-old man who was hospitalized at our department for intestinal obstruction. Contrast enhanced abdominal CT showed a rectosigmoid tumor invading the left pelvic wall and multiple metastatic hepatic tumors. Colonoscopy showed a type-2 cancer in the rectosigmoid region. The patient underwent sigmoid colostomy 3 days after admission. Postoperative upper gastrointestinal endoscopy showed a type 3 cancer in the fornix. From the above findings, the patient was diagnosed with unresectable gastric and rectosigmoid cancers with multiple hepatic metastases, and systemic chemotherapy was initiated. The first line treatment was two courses of S-1, but it was discontinued due to PD. FOLFIRI was begun as the second line treatment. After 5 courses of FOLFIRI, upper gastrointestinal endoscopy showed a marked reduction in tumor size. Twelve courses of FOLFIRI chemotherapy were performed in total. Subsequently, 11 courses of mFOLFOX6 and 1 course of RPMI were performed, but the patient died from carcinomatous peritonitis. However, the gastric lesion had been controlled well after the second line treatment. The findings of the present study suggested that FOLFIRI could be an effective treatment for unresectable multiple advanced cancers of the stomach and colorectal cancer.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2433-5.
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ABSTRACT: In a patient with multiple liver metastases of colorectal cancer whose tumor response had been achieved by 5-FU hepatic arterial infusion, a catheter for arterial infusion chemotherapy was occluded resulting in re-elevation of tumor marker levels. For this reason, a second-line IRIS therapy using S-1 and CPT-11 was started. IRIS therapy reduced tumor marker levels to a degree greater than that of previously achieved with 5-FU hepatic arterial infusion, and a diagnostic imaging allowed a judgment of partial response. Although a ratio of liver tumor volume to liver volume was 57% on admission of this patient, the ratio was reduced to 16% by the 14th course of 5-FU hepatic arterial infusion immediately before the catheter was occluded. The ratio was 18% after the 7th course of IRIS therapy, and the diagnostic imaging showed a partial response. Hepatic arterial infusion therapy is one of the treatment methods characterized by a lower incidence of adverse reactions, relatively low cost, and expectation of high anti-tumor efficacy as compared to chemotherapy such as FOLFIRI. IRIS therapy does not require a port insertion and it costs about a half of FOLFIRI therapy. When used as a second-line therapy for unresectable colorectal cancer, IRIS therapy has demonstrated non-inferiority compared to FOLFIRI in a phase III clinica (l FIRIS) study.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2576-8.
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ABSTRACT: The case was a 70-year-old woman. In 1997, the patient underwent pectoral muscle-preserving mastectomy and axillary/subclavicular lymph node dissection for the treatment of right breast cancer. Histological diagnosis was invasive ductal carcinoma (T2, N2, M0, Stage IIIA). She received a combination therapy with TAM and UFT for 5 years postoperatively. Because tumor recurrence occurred in right axillary lymph nodes in the 9th postoperative year, the patient underwent resection of these lymph nodes followed by 6 cycles of AC-based chemotherapy. Multiple lung metastases occurred in the 10th postoperative year, and then, the patient received 8 cycles of DOC-based chemotherapy. In the 11th postoperative year, a mass appeared again in the right axilla, and 6 cycles of capecitabine-based chemotherapy was administered. In the 12th postoperative year, pulmonary metastasis was in progression and an increased right axillary mass were noted. Thus, the specimen extirpated in 2006 was examined again, revealing negative ER, negative PgR and positive HER2. Six cycles of combined trastuzumab+PTX therapy were administered. Lung metastasis decreased in size, allowing a judgment of partial response. Because the right axillary mass had grown to 10 cm, and the patient's QOL was reduced, it was extirpated. The patient is scheduled to receive a postoperative radiotherapy, followed by resumption of chemotherapy.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2010; 37(12):2760-2.
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ABSTRACT: We examined efficacy and safety of bevacizumab (BV)+modified FOLFOX6 (mFOLFOX6) regimen for unresectable colorectal cancer. We had 16 patients: liver metastases 8, lung metastases 4, local recurrences 2, and lymph node metastases 2, as for evaluable lesions. The response rate was 46.6%, and disease control rate was 86.6%. Hepatic metastatectomy was done in two cases after PR response. There was 1 infusion related reaction case, 1 tumor bleeding and 1 anal fistula as the adverse events. In conclusion, the BV+mFOLFOX6 is one of the effective and feasible regimens for unresectable colorectal cancer.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2207-9.
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ABSTRACT: The patient was a 64-year-old male diagnosed as advanced sigmoid colon cancer accompanied with hydronephrosis caused by peritoneal dissemination and para-aortic lymph node metastases. We performed transverse colostomy in the end of June 2008. Though he got renal failure, he was recovered by dialysis and diuretic. He received chemotherapy with LV+5-FU in the middle of August, continuously with bevacizumab (BV)+mFOLFOX6 in the end of October. In December, an elevated CEA marker was decreased after these treatments. Sigmoidectomy was done in the beginning of February 2009, dissemination disappeared completely. Histologically, most mucinous carcinoma cells disappeared or denatured, with viable tumor cells slightly remained.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2213-6.
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ABSTRACT: We investigated the incidence of free cancer cells in the peritoneal washings of 278 patients who had undergone surgery for colorectal cancer to evaluate its influence as a prognostic factor of the disease. Twenty-two cases (7.9%) were found to have malignant positive cytology (CY(+)). The rate of CY(+) in the cases with peritoneal dissemination (P(+)) was significantly higher than that in P(-) (66.7% vs 3.8%). In 244 cases, those who had tumors exposing to the peritoneum, both CY(+) and P(+) were observed highly in poorly differentiated adenocarcinoma. Among 18 P(+) cases, the rates of CY(+) were higher in both P3 and cur C than in P1, 2 and cur B. When restricted to 260 P(-) cases, CY(+) was observed more often in stage IV cases (14.3% vs 1.8%). Rate was significantly high in M+ (66.7%). Prognosis of 4 P(-) CY(+) cur A cases was as follows; 2 survived for a long time with no recurrence (20 and 60 months), 1 had curable liver metastases after half a year and obtained a 2 year disease free period after surgery, and another one died with brain, liver, and peritoneal recurrence one year later. The incidence of CY(+) is correlated with P(+); CY(+) increased when P(+) is extended more highly and incurable. CY(+) alone doesn't become a prognostic factor for peritoneal recurrences, because CY(+) is found rarely in curable P(-) cases. However, CY(+) is also associated with far advanced cancer with remote metastases, therefore we should consider the risk of such metastases for CY(+) cases with curable colorectal cancer.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2005; 32(11):1701-6.
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Shoji Maruyama,
Michio Maruyama,
Hideaki Tanami,
Masakazu Ebuchi,
Itaru Takashima, Kumi Hasegawa,
Ayaki Koide,
Nobuko Tamura,
Yutaka Miyawaki,
Masahide Ohbu,
Takeshi Nagahama
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ABSTRACT: Docetaxel is an increasingly important drug for the treatment of esophageal cancer. The docetaxel radiosensitization has been established in cancer cell lines. The therapeutic response and toxicity of a weekly docetaxel in combination with radiotherapy for unresectable esophageal cancer were examined.
Ten patients with locally advanced or metastatic squamous cell esophageal cancer were recruited in the following protocol. The median age was 65.7 years. Patients received radiation in 2 Gy single daily fractions to a total dose of 60 Gy. Docetaxel (10 mg/m2) was administered weekly for 6 consecutive weeks.
One patient could not be evaluated. The overall response rate was 77% with 11% CR and 66% PRs. Mild grade 2 leukocytes toxicity was observed in 2/10 patients, which enforced the treatment absence for 7-14 days. Grade 2 stomatitis was noted in one patient. No severe grade 3 adverse effects were observed.
It is concluded that low dose docetaxel with radiotherapy is feasible and, a high response rate can be expected. Toxicity is modest, and this protocol may be useful for the outpatients or neoadjuvant chemotherapy.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2005; 32(11):1724-6.
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ABSTRACT: This study was designed to evaluate the pharmacokinetics and toxicity of paclitaxel, administered via an intraperitoneal route for a gastric cancer patient with renal dysfunction. The patient was a woman in her 50's, who had been diagnosed with severe renal dysfunction but no treatment history was known. She complained of dyspnea for a large quantity of ascites and was urgently hospitalized. It was diagnosed as gastric cancer with peritoneal dissemination. At this hospital, PTX was administered weekly intraperitoneally through an infusion port without complication. This result suggested that intraperitoneal PTX chemotherapy for a patient with renal dysfunction was a safe treatment.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2005; 32(11):1745-7.
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ABSTRACT: A 71 year-old woman underwent total gastrectomy for advanced gastric cancer of p stage IV (pathological findings: por1 type 3 pT3, pN3 (12p: 1/1, 16b1 int: 3/3, 16b1 lat: 2/2), P1, CY1, H0) in March 2002. She was treated with the double modulation therapy of MTX/CDDP/5-FU intraperitoneally after the surgery. After leaving the hospital, she was carrying out the chemotherapy with MTX/5-FU continually. In August 2002, she became hospitalized once again because an appetite decrease and diarrhea appeared. CT of abdomen showed that malignant ascites had obviously accumulated, and she was admitted. Because it was conceivable in all cases of an inflammation by the chemical stimulation that originated in an anticancer drug, we suspended the intraperitoneal chemotherapy. Paclitaxel 90 mg/body administration was started intravenously on a weekly basis from the end of the same month. Those symptoms improved and she was discharged from the hospital, and was continued the paclitaxel administration. In CT of the abdomen that was taken in November in 2002, malignant ascites had obviously been decreasing and disappeared completely after that.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2005; 32(11):1752-4.
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ABSTRACT: This was an extraordinary liver metastasis case with complication when the patient, a 70-year-old male, was diagnosed with stomach cancer for the first time. However, the patient has been in remission and is a long-term survivor due to an active chemotherapy after the operation. His chief complaints were stomachache and a loss of weight. He was diagnosed with stomach cancer by endoscopy. During the surgery, the mass was found to be 3 QFB palpable caused from hepatomegaly. The liver dysfunction was revealed in the blood biochemistry inspection. The abdominal CT revealed that the stomach cancer had spread to the whole liver. Distal gastrectomy was performed on May 22, 1997. In pathological findings, the tumor was diagnosed as a well-differentiated adenocarcinoma. Final findings: M, type3, T3 (SE), N2, H3, P0, CY0, and Stage IVb. The 5-FU based chemotherapy was performed and a complete response was temporarily obtained. However, it has recurred one year later and two or more kinds of chemotherapy have continued. He is alive for more than 7 years and comes to our hospital as an outpatient.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2004; 31(11):1682-4.
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ABSTRACT: We studied the efficacy of MTX/CDDP/5-FU intra-peritoneal chemotherapy for advanced and metastatic gastric cancer (n=24), and compared the results with intra-aortic (n=26) and intra-venous (n=21) routes of MTX-CDDP-5-FU double modulation therapy. I.p. administration was more efficient for reduction of malignant acites (p=0.049). However, median survival duration of malignant acites cases showed no difference between the i.p. group and i.a., i.v. groups (p=0.103). Survival rate of the i.p. group was no different with those of i.a. and i.v. groups (p=0.36). Frequency of side effects is much lower in the i.p. group.
Gan to kagaku ryoho. Cancer & chemotherapy 11/2004; 31(11):1714-6.
