[Show abstract][Hide abstract] ABSTRACT: We report an investigation of the therapeutic efficacy and safety of combination chemotherapy with docetaxel (DOC) and doxifluridine (5'-DFUR) administered as second-line or third-line chemotherapy in 23 cases of unresectable and/or advanced gastric cancer. Treatment consisted of intravenous DOC (40mg/m/2) on day 1 and 15, and oral 5'-DFUR (600mg/body) on days 1 to 28 every 4 weeks. The response rate for its antitumor efficacy was 17.4 %, with partial response in 4 cases, no change in 6 cases, progressive disease in 12 cases, and one case not evaluable. By site, the response rate was 11. 8% for primary tumors (2/17), 33.3% for lymph nodes (3/9) , and 26.9% for liver metastasis (1/7). Median time to treatment failure was 2.6 months, median overall survival was 4.6 months. The one-year survival rate was 26.1 %, and the two-year survival rate was 13.0%. The most common grade 3 to 4 toxicities were neutropenia( 4.3%), fatigue (8.7%), stomatitis (8.7%), anorexia(4.3% ), and rash (4.3%). Our data suggest that the combination of docetaxel and 5'-DFUR has a promising therapeutic index in patients with unresectable advanced gastric cancer as second-line or third-line chemotherapy.
No preview · Article · Sep 2010 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: The patient was a 53-year-old male who was admitted on an emergency basis with obstructive jaundice. He was diagnosed as having advanced ampullary carcinoma(T4 N0 H1, Stage IV b). To reduce the degree of obstructive jaundice, a self-expandable metallic stent was placed in the area of the biliary obstruction. Immediately after relief from obstructive jaundice, combination chemotherapy of S-1 and gemcitabine was given. Subsequently, CA19-9, the tumormarker level was reduced, the metastatic liver tumor disappeared, and the size of the primary lesion was remarkably reduced. Therefore, a curative surgical resection was done. This is a very instructive case for developing effective chemotherapy options to treat biliary tract cancers involving ampullary carcinoma.
No preview · Article · Jul 2009 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: Aim: In chronic hepatitis C virus (HCV) infection, it is thought that both chronic persistent inflammation and oxidative stress contribute to the development of hepatocellular carcinoma (HCC), and it has been reported that long-term oral supplementation with branched-chain amino acid (BCAA) granules could inhibit liver carcinogenesis. However, the extent of the involvement of these factors remains obscure.
Methods: To clarify the involvement of inflammation and oxidative stress in the inhibition of liver carcinogenesis, we evaluated the effect of oral administration of BCAA granules on oxidative stress and inflammation in HCV-positive patients with liver cirrhosis.
Results: Twenty-seven patients were enrolled in the study: 18 of the patients were treated with BCAA granules (administered group) and nine were observed without BCAA granules (non-administered group). In the non-administered group, the production of oxidative stress, as indicated by urine 8-hydroxydeoxyguanosine (8-OHdG) and 15-F2t-Isoprostane (8-IsoPs), significantly increased with time, while in the administered group the levels of ferritin and 8-OHdG decreased significantly. Comparison of the two groups demonstrated that highly sensitive CRP, ferritin, 8-OHdG and 8-IsoPs were significantly reduced by taking BCAA granules. The time-course analysis showed that ferritin and highly sensitive CRP seemed to decrease first, followed by a decrease of 8-OHdG and 8-IsoPs.
Conclusion: These findings indicated that the administration of BCAA granules influenced microinflammation and the metabolism of iron in HCV-positive patients with liver cirrhosis, and subsequently seemed to reduce the production of oxidative stress, possibly leading to a decrease in the occurrence of HCC.
No preview · Article · Mar 2008 · Hepatology Research
[Show abstract][Hide abstract] ABSTRACT: The recurrence rate of HCV-related hepatocellular carcinoma (HCC) is very high even after potentially curative therapies. Such high recurrence rate has been explained by intrahepatic metastasis or multicentric carcinogenesis. Interferon (IFN) therapy is known to reduce the incidence of HCC and also to be very effective when combined with chemotherapy against advanced HCC. Therefore we evaluated how effective IFN was to prevent the recurrence of HCC in consecutive eight patients who was treated with IFN after curative treatment of HCC. Four patients achieved sustained virological response while the remaining four could not eradicate HCV. Prognosis of the 4 responders was very satisfactory (no recurrence of HCC, or a relapsed HCC could be curatively treated), whereas HCC recurred again and again in all of the non-responders. These data indicated that for the suppression of the recurrence of HCC the eradication of HCV by IFN would be very important.
[Show abstract][Hide abstract] ABSTRACT: Aims: Infection with hepatitis viruses following blood exposure accidents, such as needle stick injuries, is a serious issue for medical staff. In particular, although accidental exposure to hepatitis C virus (HCV) occurs frequently, postexposure prophylactic measures have not been established yet. In this study we investigate the efficacy of recombinant α-2b interferon (IFN) as a single, 10 MU intramuscular injection for preventing transmission.
Methods: 264 incidents of accidental blood to HCV antibody-positive blood, occurring between 1993 and 2003 in the Social Insurance Chukyo Hospital, were surveyed. Accident reports, which described in detail the circumstances and the presence or absence of infectious disease in the blood, and accidental exposure to HCV antibody-positive blood was investigated.
Results: Pre-emptive IFN treatment was given in 115 out of 157 cases occurring between 1993 and 1998. One case developed acute HCV. Phylogenetic analysis provided evidence that the accident caused the infection and the patient was cured by immediate IFN therapy. Between 1999 and 2003, the exposed were in principle followed-up without IFN treatment; IFN treatment was only given when requested. As a result, IFN was given in 14 of 107 cases. During this period, no transmission was observed.
Conclusion: Taken together, the benefits of pre-emptive IFN treatment were considered unremarkable and a follow-up without treatment, or immediate IFN therapy after confirmation of the onset, was recommended.
No preview · Article · Mar 2007 · Hepatology Research
[Show abstract][Hide abstract] ABSTRACT: We report an investigation of the therapeutic efficacy and safety of TS-1 single-agent therapy administered as first-line therapy in 23 cases of unresectable advanced gastric cancer treated at our institution. TS-1 was administered at 80 mg-120 mg (divided into two doses) per day for 28 days followed by a 14-day rest interval, making up a single cycle. The response rate for its antitumor efficacy was 39.1%, with partial response in nine cases, no change in seven cases, progressive disease in five cases, and two cases not evaluable (9 5% confidence interval: 19.7%-61.5%). By site, the response rate was 43.5% for primary tumors (10/23), 33.3% for lymph nodes (3/9), and 16.7% for liver metastasis (1/6). In 1 patient, the carcinomatous ascites disappeared,and in 3 patients they decreased remarkably. No significant differences were observed with regard to age (70 and over/under 70) or histological type (differentiated/undifferentiated). The one-year survival rate was 32.8%, and the 50% survival period was 29 9 days. The most common side effect was leucopenia in seven cases (30.4%), followed by decreased hemoglobin, loss of appetite, hepatic dysfunction and the like. Most side effects, however, were mild and did not exceed grade 2; grade 3 side effects were seen only in two cases (8.7%) of leucopenia and two (8.7%) of hepatic dysfunction, a low rate of occurrence. The outpatient follow-up ratio(outpatient period/total treatment period) was high at 69.6%, meaning that first-line single-agent therapy with TS-1 is beneficial in terms not only of efficacy but also in maintaining quality of life.
No preview · Article · Nov 2005 · Gan to kagaku ryoho. Cancer & chemotherapy
[Show abstract][Hide abstract] ABSTRACT: The relationship between Helicobacter pylori (H. pylori) and gastric diseases (e.g. peptic ulcer, MALT lymphoma, and stomach cancer) has been widely accepted. Recent studies have also suggested an association between H. pylori infection and idiopathic thrombocytopenic purpura (ITP). In this study, an H. pylori eradication treatment was administered to 20 ITP patients and elucidated for its effectiveness. Among those 20 patients, H. pylori infection was confirmed in 17 (85%) through a C14 urea breath test, a rapid urease test, or a culture examination of a biopsied sample obtained by gastrointestinal endoscopy. Although the other 3 were negative to H. pylori, the H. pylori eradication treatment was also attempted because no other effective treatments had been established at the time of this study. In the H. pylori eradication treatment, lansoprazole (LPZ) 60 mg bid, amoxicillin (AMPC) 1500 mg bid, and clarithromycin (CAM) 400 mg bid were given to each patient for 7 days. For 4 cases, CAM was replaced with metronidazole (MNZ) 750 mg bid. The patients whose H. pylori infection was not eradicated after the first treatment received the re-eradication treatment with LPZ 60 mg bid, AMPC 1500 mg bid, and MNZ 750 mg bid for 7 days. After the treatments, the success of eradicating H. pylori was confirmed in all 17 H. pylori positive patients. In addition, platelet recovery was obtained in 11/20 patients (55%), which included 2 H. pylori negative patients and 2 patients whose H. pylori eradication was not successful after the first treatment. No relationship was found between the eradication effectiveness and the following clinical parameters: age, gender, previous therapies, disease duration, presence of anti-nucleus antibody, endoscopic atrophic change in the stomach, or kinds of antibiotics used for the treatment. These results support the efficacy of an H. pylori eradication treatment for ITP patients. A noteworthy result of this study was that an increase of platelet count was observed not only in H. pylori positive ITP patients, but also in 2 out of 3 H. pylori negative ITP patients after H. pylori eradication. Further studies are required to elucidate the efficacy of H. pylori eradication therapy in the patients negative for H. pylori.
No preview · Article · Dec 2004 · Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology