[A case of gastric cancer treated with modified docetaxel, cisplatin and 5-fluorouracil(mDCF)with ingestion inability].

The standard regimen of S-1 and cisplatin is not adaptable for patients with gastric cancer with an ingestion inability. A 74- year-old man was revealed to have unresectable gastric cancer with severe pyloric stenosis(cT4, cN3, cH1, cP0, cStage IV). He was treated with systemic chemotherapy using modified docetaxel, cisplatin and 5-fluorouracil(mDCF). He had manageable neutropenia(grade 3 and 4)during his treatment. CT findings after 3 courses showed reduced primary tumor and metastatic lesions. A curative operation was performed based on the effective response with downstaging. Palliative surgery was considered before receiving chemotherapy. mDCF therapy is one of the recommended options for gastric cancer with an ingestion inability.

The recovery rate at the human terminal ileum of an orally administered non-digestive oligosaccharide (raffinose).

We clarified how raffinose, one of the non-digestive oligosaccharides, reaches the large intestine. Seven healthy male volunteers were given a test meal containing 10.0 g raffinose. A double-lumen tube was placed in the terminal ileum, and the ileal contents were aspirated through the tube. The amounts of raffinose were orally administered and collected from the terminal ileum and were compared with each other. The result was that the mean+/-standard error percentage of the amount of ingested raffinose collected in the terminal ileum was 97.1+/-2.4%. Furthermore, the average times taken for 20%, 40%, 60% and 80% of raffinose to reach the terminal ileum were 2.0+/-0.6 h, 2.6+/-0.7 h, 3.6+/-0.7 h and 4.9+/-0.7 h, respectively. In conclusion, approximately 100% of ingested raffinose was recovered in the terminal ileum in the present study. This corresponds with the present generally accepted definition of a dietary fibre.

[A case report--gastric stenosis due to primary gastric malignant lymphoma after administration of R-CHOP].

A 67-year-old man was diagnosed with primary gastric malignant lymphoma by an endoscopic examination. Endoscopy revealed irregular ulcerative regions from body to antrum of the stomach. With a diagnosis of diffuse large B-cell lymphoma based on the biopsy finding, the patient was treated with R-CHOP chemotherapy. After three cycles of chemotherapy, a tight stenosis was located at the antrum of the stomach. Total gastrectomy was performed due to an obstruction. Pathological diagnosis was complete response. It was thought that the tumor organization rapidly disappeared due to the effectiveness of the chemotherapy, and that the origin of the stricture caused fibrosis.

Pilot study of combination chemotherapy using irinotecan plus S-1 for metastatic pancreatic cancer.

OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of a combination regimen using irinotecan plus S-1 in patients with metastatic pancreatic cancer. METHODS: Based on the results of our previous phase I/II study in patients with gastric and colorectal cancer, we initiated a regimen with irinotecan at 100 mg/m(2) on days 1 and 15 and S-1 at 80 mg/m(2) starting at day 1 for 14 consecutive days, followed by a 14-day rest period. This treatment was repeated every 28 days. RESULTS: From November 2003 to December 2006, a total of 16 patients were enrolled. All patients presented with metastatic disease. Six patients had received prior gemcitabine. The median number of treatment cycles was 4 (range 1-16) and the response rate was 43.7% (95% confidence interval 19.5-68.1). The median time to progression was 4.9 months, and the median survival time was 11.3 months. Grade 3-4 neutropenia developed in 5 of 16 patients and grade 3 diarrhea in 1 patient. CONCLUSIONS: The combination of irinotecan and S-1 is feasible and promising for pancreatic cancer. Further evaluation of this combination chemotherapy is required.

Change in the capability of reactive oxygen species production by neutrophils following weight reduction in female judoists.

OBJECTIVE: Athletes undergoing weight reduction are recognised as being more prone to infection. Few studies exist for athletes on the weight reduction-mediated changes in neutrophil function and related activities such as reactive oxygen species (ROS) production capability, phagocytic activity (PA) and serum opsonic activity (SOA). METHODS: 16 Japanese female university judoists were examined in the early morning of the first day (pre-values) and the last day (post-values) of a 20-day pre-competition training period. Of the 16 subjects, 8 needed to reduce weight (WR group) and the other 8 did not (control group). The parameters assessed were the neutrophil count, serum immunoglobulins and complements, myogenic enzymes, ROS production capability, PA and SOA. RESULTS: Comparing the post-values with the pre-values, ROS production significantly increased in both groups (p<0.01 for both). PA significantly decreased in the WR group (p<0.05); it also decreased in the control group but the decrease was not significant. SOA significantly increased in the control group (p<0.05), but showed no significant change in the WR group. CONCLUSIONS: The changes in the WR group were probably a direct consequence of the weight-reduction regimen coupled with the exercise regimen, suggesting that neutrophil parameters (ROS production, PA and SOA) had tended to deviate from their typical compensatory changes to maintain immune system homoeostasis.

[A case of hepatic metastasis from colon cancer successfully treated with 5-FU, levofolinate (l-LV) and low-dose CPT-11].

The patient was a 67-year-old man in whom hepatic metastasis from transverse colon cancer was detected 15 months after transverse colectomy (D2). We treated the patient by systemically administering 2 courses of 5-FU 750 mg/day with l-LV 350 mg/day (once weekly for 6 weeks per course). Assessment of therapeutic effects by CT showed PD in the patient. As a second-line therapy, we treated the patient by systemically administering 3 courses of 5-FU 750 mg/day, l-LV 350 mg/day and CPT-11 40 mg/day x 3 days (once a week for 4 weeks per course). After 3 courses of this chemotherapy, CT examination revealed a reduction in the tumor size of the liver, and CEA levels decreased at the end of this chemotherapy. This chemotherapy also showed no high-grade toxicities. l-LV/5-FU/low-dose CPT-11 seems to be effective for metastatic colon cancer, and safe from the toxicity standpoint.

The decreasing burden of gastric cancer in Japan.

Gastric cancer in Japan, previously the top killer cancer, has recently shown decreased incidence and mortality rates. Epidemiological studies have demonstrated that environmental factors are closely associated with stomach oncogenesis, as evident from the geographical differences seen throughout Japan in both incidence and mortality. Moreover, Japanese immigrant populations gradually exhibit the lower incidence and mortality rates of gastric cancer in their chosen country. Likewise, younger generations in Japan have lower mortality rates than older generations at the same age, which may be accounted by the dramatic lifestyle changes in Japan after World War II. In addition to exploring and learning from the impact of these environmental factors, deliberate strategies to further lower the incidence and mortality rates of gastric cancer must include aggressive eradication programs for Helicobacter pylori and dietary education in both school curricula and for the general adult population to lower the intake of causative agents such as salt and increase the intake of beneficial agents such as fruits, vegetables and seaweeds. The dietary education should be coupled with better motivation for the general population to undergo regular screening with improved techniques. In the future, changes in these environmental factors and progresses in the diagnosis of and therapeutic strategies for gastric cancer will lead to further decrease in the incidence and mortality rates of this disease in Japan.