[A study of the efficacy of high-dose toremifene in advanced and recurrent breast cancer].

Recently, many patients have been treated with aromatase inhibitors(AI), either in an adjuvant setting or as a treatment for recurrence. The efficacy and safety of high-dose toremifene(HD-TOR)were evaluated in 18 patients with advanced/recurrent breast cancer. Twelve of the 18 patients had received AI just prior to the study treatment. The clinical benefit rate was 56%(PR: 28%, long SD: 28%). Progression-free median survival was 5. 5 months. Adverse events were mild and toremifene was well-tolerated. The results suggest that HD-TOR should be considered early on as a second-line treatment, or as a later treatment option for AI-resistant breast cancer.

Clinical experience with chemoradiotherapy comprising S-1 plus low-dose cisplatin in a patient with stage IV anal cancer.

We report a case of anal cancer in a 58-year-old woman who complained of narrow, bloody stools and anal pain. Physical examination revealed anal stenosis associated with a circular mass arising in the anal canal. Histological examination of biopsy specimens confirmed a diagnosis of moderately differentiated squamous cell carcinoma. Enhanced computed tomography revealed anal cancer invading the levator ani and the vagina, with lymph-node, multiple hepatic, and pulmonary metastases. The patient received two cycle of chemoradiotherapy with S-1 plus low-dose cisplatin with rest for 4 weeks, leading to complete response of the primary lesion and a partial response of the metastatic lesions. Each cycle included oral S-1 (120 mg/body; day 1-21), cisplatin (10 mg/body; day 1-5, 8-12) and radiotherapy (2 Gy/day; day 1-5, 8-12, 15-19). Adverse effects of treatment were mild perineal skin erosion and mild appetite loss, but no hematologic toxicity. Although the patient died 16 months after first admission, chemoradiotherapy with S-1 plus cisplatin is potentially effective for the management of advanced anal cancer.

Abdominal cocoon in an aged man: report of a case.

An abdominal cocoon is an extremely rare condition, which has been mainly reported in young adolescent women as a cause of small bowel obstruction. In these patients the small bowel is encased in a fibrous sac called an abdominal cocoon. We herein describe a 74-year-old man who demonstrated an abdominal cocoon without having any history associated with an abdominal cocoon. A laparotomy showed bloody ascites and the entire small bowel was encased in a thin white fibrous membrane like a cocoon. The small intestine entered into a defect of the membrane, thus presenting as an internal hernia with intestinal necrosis. The necrotic intestine and the membrane were removed. A histopathological examination of the membrane showed a few signs of inflammation cells.

[A case of advanced gastric cancer with multiple liver metastases successfully treated with TS-1/low-dose CDDP/lentinan combination chemotherapy].

We report herein a case of advanced gastric cancer successfully treated with TS-1/low-dose CDDP/Lentinan combination chemotherapy. A 74-year-old male suffering from anorexia was admitted to our hospital and diagnosed as having type 2 gastric cancer metastasizing to the liver. TS-1 was orally administered at 100 mg/body/day for 28 days with a 14-day interval as one session. During the second session, because grade 1 thrombocytopenia was noted, administration of TS-1 was rescheduled to every other day. CDDP was infused at 10 mg/body/day on day 6 to 10, 13, 15, and 17. After his discharge, CDDP at 10 mg/body and Lentinan at 2 mg/body were weekly infused as ambulant patient chemotherapy. The abdominal CT scan showed reduction of hepatic tumors by 86% in three months and 97% in 16 months. Metastatic lymph nodes disappeared in 4 months. The primary tumor was reduced and flattened to a cicatrix, and endoscopic biopsy revealed no cancer cells. The tumor markers, CEA (716.9 ng/ml) and CA 19-9 (57.2 U/ml), were reduced to normal range. The therapeutic efficacy was judged as a partial response (PR), which lasted for 16 months without severe adverse effects. He maintained good quality of life. This combination chemotherapy was thought to be beneficial for patients with advanced gastric cancer.

[Four cases of gastric cancer with multiple hepatic metastases successfully treated with TS-1 in combination with low-dose cisplatinum].

We treated five cases for multiple hepatic metastases from gastric cancer with a novel combination of TS-1 and low-dose cisplatinum (CDDP). TS-1 was orally administered at 100 mg/body/day every day or only on weekdays, and 10 mg of CDDP was infused once or twice a week. The efficacy was evaluated by body CT after the treatment. The CT showed more than a 60% reduction of hepatic tumors in four patients. The tumor markers, CEA and CA19-9, were reduced to 10%. The response rate was 80%. Adverse reactions of grade 1 anemia were observed in two patients and grade 1 leucopenia in one patient. The liver function normalized in one patient. The hemoglobin level was increased from 6.8 g/dl to 11.8 g/dl in one patient. In conclusion, this combined chemotherapy of TS-1 and low-dose CDDP proved useful for advanced gastric cancer patients with multiple hepatic metastases, in view of its therapeutic efficacy, patients' quality of life and low toxicity.