ABSTRACT
We report a case of lung and bone metastases of right advanced breast cancer in a 33-year-old woman. Her breast cancer (T4bN1M1, StageIV)was resected in December 2003 (mastectomy [BT] plus axillary lymph node dissection [AX]) after local arterial infusion therapy and subsequent systemic chemo-endocrine therapy was initiated and continued. In June 2007, a computed tomography (CT) scan revealed cardiac tamponade due to pericarditis carcinomatosa. Pericardiocentesis was performed, and the bloody effusion was drained immediately. Subsequently, the sysytemic chemo-endocrine therapy was modified. In 2009, multiple cerebellar metastases were discovered and treated via whole brain irradiation. In 2010, multiple liver metastases appeared, and they were treated by intravenous (IV) administration of nab-paclitaxel. In 2011, superior vena cava syndrome appeared gradually, and it was treated via venous metallic stenting. In 2012, epidural spinal cord compression appeared gradually, and it was treated via irradiation. In November 2012, the patient died because of lymphangitis carcinomatosa; her prognosis was good, as it was approximately 5 years after the pericardiocentesis.
Subject(s)
Breast Neoplasms/therapy , Cardiac Tamponade/therapy , Pericarditis/etiology , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/complications , Breast Neoplasms/pathology , Cardiac Tamponade/etiology , Fatal Outcome , Female , Humans , Neoplasm Staging , Pericardiocentesis , Pericarditis/therapyABSTRACT
We report the case of an effectively treated 50-year-old woman with liver metastasis of left breast cancer. Her breast cancer (T2N0M0, Stage IIA) was resected in November 1998 (radical mastectomy+axillary lymph nodes dissection). After this operation, tamoxifen(TAM 20 mg daily) was administered. In February 2002, a solitary liver metastasis(S5, 4 cm in diameter) was found by computed tomography(CT) scan. Hepatic arterial infusion of docetaxel(DOC 20 mg weekly)was started. In March 2003, the solitary liver metastasis had become smaller and showed partial remission (PR), but DOC intravenous injection(iv) therapy(40 mg weekly) was started because lung metastases appeared. Therefore, epirubicin+ cyclophosphamide therapy, DOC ia therapy (120 mg triweekly), and anastrozole (1 mg daily) were continued. However, in March 2005, she refused chemotherapy. In January 2011, a CT scan showed progressive disease of multiple liver and lung metastases. Nab-paclitaxel(PTX) iv therapy(400 mg triweekly) and exemestane(25 mg daily) were administered. In March 2012, a CT scan showed PR of the metastatic breast cancer. She has continued to receive nab-PTX iv therapy as an outpatient.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Breast Neoplasms/pathology , Liver Neoplasms/drug therapy , Albumins/administration & dosage , Breast Neoplasms/drug therapy , Docetaxel , Female , Humans , Infusions, Intra-Arterial , Liver Neoplasms/secondary , Middle Aged , Paclitaxel/administration & dosage , Taxoids/administration & dosageABSTRACT
We report an effective case of fifty-seven year-old female with unresectable pancreatic cancer. Its chief complaint of the case was epigastralgia in April 2007, and the diagnosis was locally-advanced cancer of pancreatic body (4 cm, Stage IVa) in June 2007. Laparotomy was performed, but the locally-advanced cancer was unresectable because of the invasion to the celiac trunk and superior mesenteric artery. Tumor biopsy and intra-operative radiotherapy (IORT, 12 MeV, 20 Gy) were only performed. The result of biopsy was moderately-differentiated adenocarcinoma. After laparoptomy, systemic chemotherapy (gemcitabine 1,000 mg/body) was performed once a week. After 4-set chemotherapy, her cancer pain was completely relieved and the tumor size was decreased to 25 mm on CT scan in October 2007. She has been treated as an outpatient.
Subject(s)
Deoxycytidine/analogs & derivatives , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/radiotherapy , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Biomarkers, Tumor/blood , Combined Modality Therapy , Deoxycytidine/administration & dosage , Deoxycytidine/therapeutic use , Female , Humans , Infusions, Intra-Arterial , Middle Aged , Pancreatic Neoplasms/blood , Pancreatic Neoplasms/surgery , GemcitabineABSTRACT
We report a death case of 56-year-old male with unresectable pancreatic cancer. Its diagnosis was locally-advanced cancer of pancreatic head (Stage IVa) in February 2006. However, he desired no medical treatment until obstructive jaundice (T-Bil 25 mg/dL) appeared. In September 2006, endoscopic biliary metallic stenting was performed and the obstructive jaundice had improved. In November 2006, systemic chemotherapy (S-1 +gemcitabine) was performed. After the chemotherapy, vomiting had appeared because of duodenal stenosis. In December 2006, gastrojejunostomy and intraoperative radiotherapy (IORT) were performed, and the dose of oxicodon was decreased. However, in January 2007, he was suddenly in a state of bleeding-shock and died because of intraabdominal bleeding. The autopsy demonstrated the rupture of splenic pseuoaneurysm due to necrotizing pancreatitis of pancreatic tail, and cancer of pancreatic head was almost viable and IORT was not effective.
Subject(s)
Abdominal Cavity/pathology , Hemorrhage/pathology , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/radiotherapy , Autopsy , Humans , Male , Middle Aged , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/surgery , Treatment FailureABSTRACT
We analyzed a recurrence pattern and prognosis of 42 gastric cancer cases with histological serosal exposure of cancer and without macroscopical residual cancer in the operation. These cases received adjuvant MTX-5-FU chemotherapy intraperitoneally. Twenty four patients showed a recurrence of gastric cancer. Twenty two patients died of recurrence, and two patients were still alive with recurrence. Seventeen patients (71%) developed peritoneal seeding, which means intraperitoneal chemotherapy made no influence to the pattern of recurrence of gastric cancer with serosal invasion. All of the recurred patients with Stage II and IIIA gastric cancer and about 60% of the recurred patients with Stage IIB and IV developed peritoneal metastasis. The prognosis of recurred 24 patients showed that 9 patients (38%) were kept alive for more than 3 years, and 5 patients (21%) were kept alive for more than 5 years. Intraperitoneal chemotherapy of MTX-5-FU did not touch the pattern of recurrence of gastric cancer with serosal invasion, but the analysis of the prognosis revealed a possibility of improvement of the prognosis.
Subject(s)
Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/metabolism , Stomach Neoplasms/drug therapy , Stomach Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Infusions, Parenteral , Male , Middle Aged , Neoplasm Staging , Peritoneal Neoplasms/surgery , Prognosis , Recurrence , Stomach Neoplasms/surgeryABSTRACT
A level of PyNPase activity was measured after intraperitoneal (ip) and intravenous (i.v.) administrations of paclitaxel on the animal model. Nude mice received the subcutaneous implantation of WiDr cells. About 3 weeks later, the ip and i.v. administrations of paclitaxel were performed 2 times at 20 mg/kg and 15 mg/kg, respectively. About 1 week later, the mice were sacrificed. The level of PyNPase activity was measured by the ELISA method. The level of PyNPase of ip and i.v. was higher than that of the control group, but the level of PyNPase revealed no significant difference between ip and i.v.. This result suggested that intraperitoneal administration of paclitaxel enhanced an efficiency of 5'-DFUR and capecitabine as much as intravenous administration of paclitaxel.
Subject(s)
Antimetabolites, Antineoplastic/administration & dosage , Neoplasms, Experimental/enzymology , Paclitaxel/administration & dosage , Pentosyltransferases/analysis , Animals , Female , Injections, Intraperitoneal , Injections, Intravenous , Mice , Mice, Nude , Pyrimidine PhosphorylasesABSTRACT
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.
Subject(s)
Ascitic Fluid/pathology , Colorectal Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Colorectal Neoplasms/mortality , Colorectal Neoplasms/surgery , Female , Humans , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Staging , Peritoneal Neoplasms/pathology , Peritoneal Neoplasms/secondary , PrognosisABSTRACT
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Subject(s)
Carcinoma, Squamous Cell/radiotherapy , Esophageal Neoplasms/radiotherapy , Radiation-Sensitizing Agents/therapeutic use , Taxoids/therapeutic use , Aged , Docetaxel , Humans , Male , Middle Aged , Neoadjuvant Therapy , Radiation-Sensitizing Agents/administration & dosage , Radiation-Sensitizing Agents/toxicity , Radiotherapy Dosage , Taxoids/administration & dosage , Taxoids/toxicityABSTRACT
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.
Subject(s)
Antineoplastic Agents, Phytogenic/administration & dosage , Kidney Diseases/complications , Paclitaxel/administration & dosage , Stomach Neoplasms/drug therapy , Antineoplastic Agents, Phytogenic/pharmacokinetics , Antineoplastic Agents, Phytogenic/toxicity , Ascites/complications , Female , Humans , Infusions, Parenteral , Middle Aged , Paclitaxel/pharmacokinetics , Paclitaxel/toxicity , Stomach Neoplasms/metabolismABSTRACT
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.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Agents, Phytogenic/administration & dosage , Ascites/drug therapy , Paclitaxel/administration & dosage , Stomach Neoplasms/drug therapy , Aged , Ascites/complications , Drug Administration Schedule , Female , Humans , Remission InductionABSTRACT
Recently, with the improvement of the prognosis of esophageal cancer, subsequent gastric cancer has increased. However, the standard surgical treatment for such patients has not been established as of yet. Since the patient's physical condition is relatively poor after Ivor-Lewis esophagectomy, it is important that surgical strategies must be decided according to both physical and cancerous conditions. Hence, various surgical procedures have been reported to date. The authors experienced two cases with cancer occurring in the reconstructed gastric tube after Ivor-Lewis esophagectomy. One was subsequent primary gastric cancer, and the other was metastatic gastric cancer. Distal resection of the gastric tube including the dissection of the right gastroepiploic vessels was carried out in both cases. Vascular reconstruction by utilizing microsurgery technique was attempted for each case, but failed in one case. After surgery, four sessions of endoscopic examinations were carried out. In the early period, we could identify mucosal ischemic change in the remnant gastric tube in the case without successful vascular reconstruction. On the contrary, no ischemic change was revealed in the other with successful vascular reconstruction. Hence, we came to the conclusion that vascular reconstruction must be added to the cases, which undergo distal resection of the reconstructed gastric tube with regional vascular dissection.
Subject(s)
Adenocarcinoma, Papillary/surgery , Endoscopy, Digestive System , Esophageal Neoplasms/surgery , Neoplasms, Second Primary/surgery , Plastic Surgery Procedures , Stomach Neoplasms/surgery , Aged , Carcinoma, Squamous Cell/surgery , Esophagectomy , Female , Humans , Male , Middle AgedABSTRACT
Paclitaxel is an effective antitumor agent that shows ideal pharmacological characteristics for intraperitoneal chemotherapy. Intraperitoneal administration of this agent was compared with intravenous administration in mouse models of peritoneal seeding and liver metastasis. The peritoneal seeding model and liver metastasis model were established by inoculation of Colon 26 tumor cells into the peritoneal cavity and spleen of female BALB/c mice, respectively. Paclitaxel (20 mg/kg) was injected into the peritoneal seeding model intraperitoneally or intravenously on day 2 and 4 after inoculation of tumor cells. Paclitaxel (30 mg/kg) was injected into the liver metastasis model intraperitoneally and intravenously on days 4 and 8 after inoculation of tumor cells. Median survival time for intraperitoneal administration (17.50 +/- 0.86 days) was longer than that for intravenous administration (13.70 +/- 0.47 days) in the peritoneal seeding model experiment. Median survival time for intraperitoneal administration (19.78 +/- 0.74 days) was longer than that for intravenous administration (17.50 +/- 0.54 days) in the liver metastasis model experiment. Intraperitoneal administration of paclitaxel may be a more efficient form of adjuvant chemotherapy for prevention of both peritoneal seeding and liver metastasis in patients with gastrointestinal cancer.
Subject(s)
Antineoplastic Agents, Phytogenic/administration & dosage , Camptothecin/analogs & derivatives , Camptothecin/administration & dosage , Liver Neoplasms/drug therapy , Peritoneal Neoplasms/drug therapy , Animals , Colonic Neoplasms/pathology , Female , Infusions, Intravenous , Injections, Intraperitoneal , Irinotecan , Liver Neoplasms/secondary , Mice , Mice, Inbred BALB C , Peritoneal Neoplasms/secondaryABSTRACT
A 46-year-old man underwent polypectomy of sigmoid colon in January 1996. The adenocarcinoma invaded the submucosal layer, and sigmoidectomy and D2 lymph node dissection were performed one month later. Follow-up CT revealed liver metastases, and partial hepatectomy was performed in January 1998. Afterward, weekly high dose intra-hepatic arterial chemotherapy (5-FU: 1,000 mg/body) was performed 41 times, but CT revealed multiple liver metastases in October 1998. Therefore, intra-hepatic arterial infusion of mitomycin C (MMC) with degradable starch microspheres (DSM) was given in November 1998. As follow-up CT revealed that the liver metastases were growing, partial hepatectomy was performed again in March 1999. No carcinoma was seen in the resected liver. After the second hepatectomy, intra-hepatic arterial infusion of MMC with DSM was performed five times. No evidence of recurrence has been seen. Intra-hepatic arterial infusion of MMC with DSM is recommended for liver metastases of colorectal cancer as a second line treatment.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/secondary , Antibiotics, Antineoplastic/administration & dosage , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Mitomycin/administration & dosage , Sigmoid Neoplasms/pathology , Antimetabolites, Antineoplastic/administration & dosage , Biodegradation, Environmental , Fluorouracil/administration & dosage , Hepatectomy , Hepatic Artery , Humans , Infusions, Intra-Arterial , Male , Microspheres , Middle Aged , Starch/administration & dosageABSTRACT
5-FU hepato-arterial infusion (HAI) is powerful chemotherapy for liver metastases of colorectal cancers. Event though hepatic lesions are controlled by 5-FU HAI, we have found that extra-hepatic lesions are the limiting factor for colorectal cancer patients. General chemotherapy is necessary in addition to 5-FU HAI. The chemotherapy of 5-FU venous infusion plus oral UFT is called "pharmacokinetic modulating chemotherapy (PMC)." This protocol is very effective for colorectal cancers, because UFT reduces the rate of metabolism of infused 5-FU. We studied the plasma 5-FU concentration at the time of weekly high dose 5-FU HAI plus oral UFT. The plasma concentration of 5-FU in 5-FU HAI plus UFT is 1.5-6 times as high as with 5-FU HAI only. 5-FU concentration in the liver tissue is likely to be much higher at the time of 5-FU HAI. 5-FU HAI plus oral UFT can be more effective for not only liver metastases but also for extra-hepatic lesions than 5-FU HAI alone.
Subject(s)
Antimetabolites, Antineoplastic/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Fluorouracil/administration & dosage , Fluorouracil/pharmacokinetics , Infusions, Intra-Arterial , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Tegafur/administration & dosage , Uracil/administration & dosage , Administration, Oral , Colorectal Neoplasms , HumansABSTRACT
We studied the pharmacokinetics of CPT-11 with intraperitoneal administration in a patient with a PTCD tube. The patient had advanced gastric cancer with peritoneal metastasis. CPT-11 was administrated in a dose of 40 mg and the intraperitoneal, plasma and bile levels of CPT-11, SN-38 and SN-38 glucuronide (SN-38 GLU) were measured periodically. The results showed that the periodical concentration pattern of CPT-11, SN-38 and SN-38 GLU in the bile was closely related to that of CPT-11 in the abdominal cavity.
Subject(s)
Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Agents, Phytogenic/pharmacokinetics , Camptothecin/analogs & derivatives , Camptothecin/administration & dosage , Camptothecin/pharmacokinetics , Glucuronides/pharmacokinetics , Aged , Aged, 80 and over , Ascites/metabolism , Bile/chemistry , Humans , Infusions, Parenteral , Irinotecan , Male , Stomach Neoplasms/drug therapyABSTRACT
We report the pharmacological findings on levofolinate after the intraperitoneal administration of leucovorin-5-FU. Levofolinate 300 mg/saline 500 ml and 5-FU 750 mg/saline 500 ml were administered intraperitoneally over 1.5 h. The plasma and intraperitoneal concentrations of levofolinate at 0, 0.5, 1, 2, 4, 8, 22(20) h after the administration were evaluated at 6 points with HPLC analysis. The intraperitoneal levofolinate concentration went up as high as 100 micrograms/ml and remained above 10 micrograms/ml over 8 hours. This suggested that intraperitoneal administration elevated the portal vein and abdominal lymphatic levofolinate levels. Intraperitoneal levofolinate-5-FU is a promising protocol for gastro-intestinal cancers.
Subject(s)
Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Fluorouracil/pharmacology , Aged , Colorectal Neoplasms/drug therapy , Female , Fluorouracil/administration & dosage , Humans , Infusion Pumps, Implantable , Infusions, Parenteral/instrumentation , Leucovorin/administration & dosage , Male , Middle AgedABSTRACT
Staging laparoscopy was carried out for 12 cases of advanced primary gastric cancer to evaluate the condition of peritoneal seeding. Peritoneal seeding was indicated in five cases. Abdominal lavage sampling was positive in six cases. Among six cases with positive cytology, surgery was adopted in three cases to lessen bleeding or stricture. Chemotherapy were carried out for the other three cases. Radical lymph node resection was carried out in six cases without peritoneal seeding. Laparoscopic observation was easier and more feasible under general anesthesia than local anesthesia. Preoperative staging laparoscopy for advanced gastric carcinoma can evaluate the condition of peritoneal seeding. Based on the results, a suitable treatment plan for each patient can be determined.
Subject(s)
Laparoscopy , Neoplasm Seeding , Neoplasm Staging/methods , Peritoneal Neoplasms/secondary , Stomach Neoplasms/pathology , Anesthesia, General , Anesthesia, Local , Humans , Lymph Node Excision , Peritoneal Neoplasms/pathologyABSTRACT
The result of airway stent and adjuvant therapy for airway obstruction caused by advanced esophageal carcinoma was evaluated. In Tokyo Metropolitan Ohkubo Hospital, four cases of esophageal carcinoma with airway obstruction were treated by tracheo-bronchial stent. Two were primary cases and the others were recurrent cases. Three of the patients demonstrated progressive dyspnea due to airway obstruction, and the other complained of bloody discharge. An ultraflex non-covered stent was used cases. After insertion of the airway stent. The patients' dyspnea improved immediately. One patient was discharged without adjuvant treatment, and died of the cancer one month later. Adjuvant treatment was adopted in the other three cases. The size of the tumor decreased, but fistula formation was observed in two cases. An airway stent is an effective treatment with immediate results for dyspnea caused by airway obstruction. Adjuvant treatment after stent placement is often associated with fistula formation. It should be considered carefully.
Subject(s)
Airway Obstruction/therapy , Esophageal Neoplasms/complications , Stents , Airway Obstruction/etiology , Humans , Stents/adverse effectsABSTRACT
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.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , Stomach Neoplasms/pathology , Adenocarcinoma/secondary , Aged , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Chemotherapy, Adjuvant , Humans , MaleABSTRACT
BACKGROUND: The 5 fluorouracil hepato-arterial infusion (5-FU HAI) therapy has a good effect on the liver metastases of colorectal cancer. To gain the antitumor effect of the extra-hepatic lesion, an oral UFT was combined with 5-FU HAI (pharmacokinetic modulating chemotherapy, PMC) to enhance the plasma 5-FU concentration. METHODS: UFT (200-400 mg/day) was orally administered daily and a continuous infusion of 5-FU (1,000-1,500 mg/5 h) was given once a week. Eight patients were treated with this regimen. Five of the eight have extra-hepatic lesions with liver metastases when this treatment was started. The response, time to progression, survival, and toxicity were detected. RESULTS: Four of the five patients with extra-hepatic lesion were evaluated. The response rate was 50% (1 CR, 1 PR, and 2 SD). For the liver metastases, the response rate was 62.5% (1 CR, 4 PR, 2 SD, and 1 PD). Grade 2 leukopenia was found in 1 patient. CONCLUSIONS: The 5-FU HAI with an oral UFT therapy had a good effect on the extra-hepatic lesions as well as hepatic metastases of colorectal cancer.