[A case of metastatic choriocarcinoma responding to combination chemotherapy with paclitaxel and carboplatin].

A 53-year-old woman with choriocarcinoma (high-risk gestational trophoblastic disease: FIGO score 17) was treated with paclitaxel (175 mg/m(2)) and carboplatin (AUC=5). The patient was treated with an EMA/CO regimen as initial chemotherapy, but she developed EMA/CO-induced interstitial lung disease after the 3rd course of treatment. After high-dose steroid therapy, she received combination chemotherapy with paclitaxel and carboplatin. Her hCG-/b dropped to <0.1 ng/mL after 11 courses of the chemotherapy. A paclitaxel+carboplatin regimen is potentially effective for high-risk GTD, but a more effective combination or schedule with a platinum-taxane regimen should be explored.

[Neoadjuvant chemotherapy with intraperitoneal paclitaxel for advanced gynecologic cancer].

OBJECTIVES: We evaluated safety and activity of intraperitoneal paclitaxel [=PTX (ip)] for neoadjuvant chemotherapy (NAC) of patients with advanced gynecologic cancer. METHODS: 13 patients with gynecologic cancer who had diffuse peritoneal dissemination received PTX (ip) with systemic chemotherapy (TC regimen) for NAC. After 3-6 courses of NAC, interval debulking surgery (IDS) was done. At IDS, we explored intraperitoneal cavity and debulked as much as possible, and examined pathological effects of NAC. RESULTS: PTX (ip) was well tolerated with apparent anti-cancer activity. Eleven patients were done with IDS after 3-6 NAC courses. Ten of 11 patients were completed an optimal surgery without extended resections. Eight of 11 patients with IDS had grade 2 (5 cases) or grade 3 (3 cases) effects of pathological examination. CONCLUSION: According to this exploratory research, we considered PTX (ip)=80 mg/m2 with PTX (iv)=115 mg/m2 and CBDCA (iv) AUC=4 as an optimum drug dose. Although evaluated in a small number of patients, PTX (ip) appeared to have safety and anti-cancer activity, and should be evaluated further.

Antenatal sonographic detection of vesicoureteral reflux. A case report.

We report a case with vesicoureteral reflux (VUR), diagnosed antenatally. A 31-year-old Japanese woman was referred at 37 weeks' gestation because of the fetus having unilateral renal pelvis dilatation. The real-time ultrasound revealed a right renal pyelectasia with periodic changes in size over intervals lasting several minutes. The simultaneous examinations of both anteroposterior dimension of the renal pelvis and the ellipse size of urine-filled bladder area demonstrated that they varied in size in a reciprocal fashion, leading us to diagnose the fetus as having VUR. Postnatally, bilateral VUR was confirmed by the voiding cystogram. This case has typical ultrasonographic findings of fetal VUR, in which both the renal pelvis and urinary bladder dimensions change periodically in a reciprocal manner with each other, when the reflux really occurred.