[Efficacy of S-1 combined with weekly Paclitaxel for gastric cancer with cancerous ascites].

We used combination therapy of S-1 and Paclitaxel to treat gastric cancer complicated by carcinomatous ascites and assessed the clinical results. The subjects were 8 patients who were gastric-cancer-ascites-positive, and they were treated by biweekly administration of S-1 orally, continuously for 2 weeks, and Paclitaxel on day 1 and day 8 of S-1 administration. The results showed disappearance of the ascites on diagnostic images in 37.5% (3/8) and PR in 50% (4/8) in terms of the main gastric cancer focus. An average 15 courses were conducted, and the overall adverse event rate was 87.5% (7/8). Hematologic toxicity occurred in 75.0% (6/8), and it was G3 or 4 in 37.5% (3/8). Non-hematological toxicity was confirmed in 75.0% (6/8), but none of it was G3 or 4. Although they were historical controls, we assessed the results of treatment in a conventional treatment group (control group; n=24) and the S-1 and Paclitaxel group (S-1+Paclitaxel group; n=8) by comparing the survival rates. MST in the S-1 and Paclitaxel group was 413 days, and the longest survival time was 1,148 days. The 1-year survival rate was 62.5%, and the 2-year survival rate was 37.5%. The survival rate in the S-1+Paclitaxel group was better than in the control group (p<0.001). We have reported this study because S-1+Paclitaxel therapy appears to be an important method of treating gastric cancer complicated by carcinomatous ascites.

[A case of paclitaxel-resistant cancerous ascites secondary to gastric carcinoma responding well to TS-1 therapy].

Paclitaxel was used as the first-line drug for treatment of a case with peritoneal recurrence of gastric cancer, accompanied by cancerous ascites. Because paclitaxel was ineffective, TS-1 was used as the second-line drug, resulting in disappearance of cancerous ascites on diagnostic imaging. This case was an 81-year-old male patient. In February 2004, he underwent resection of the pyloric side of the stomach (D 2) based on a diagnosis of advanced gastric cancer. CT scans, conducted in February 2005, revealed ascites, and a diagnosis of cancerous peritonitis was made on the basis of subsequent cyto-diagnostic findings. He was later hospitalized because of anorexia and difficulty with oral ingestion, and received paclitaxel therapy (60 mg/m(2)). Abdominal CT scans in May of the same year showed the disappearance of ascites. Thereafter, he was managed as an outpatient. In June of the same year, relapse of ascites was detected by CT scans, and exacerbation of ascites was seen in August. In October, paclitaxel was switched to TS-1 (80 mg/m(2)). CT scans, obtained at the end of two cycles of TS-1 therapy, revealed complete disappearance of ascites. This therapy was administered for 4 cycles in total. CT scans, performed at the end of each cycle of TS-1 therapy, confirmed the absence of ascites. At present (July 2006), the patient is managed on an outpatient basis. Our experience with this case suggests that if paclitaxel therapy fails to exert satisfactory efficacy, switching to second-line TS-1 therapy is a promising means of treating gastric cancer complicated by cancerous peritonitis.

[A case of inoperable scirrhous gastric cancer that responded remarkably to a combination of TS-1+paclitaxel and showed complete loss of ascites].

Complete loss of malignant ascites by combination chemotherapy of TS-1+paclitaxel was experienced. The case was a 56-year-old woman who was diagnosed with inoperable scirrhous gastric cancer with malignant ascites. The administered regimen of chemotherapy was TS-1 100 mg/day (80 mg/m2) for 2 weeks. Paclitaxel 60 mg/day (50 mg/m2) on day 1 and 8 of TS-1 intake, followed by 2-weeks rest. Partial response was confirmed by gastrography and gastrofiberscope after 3 courses were performed. Furthermore, computed tomography (CT) showed complete loss of malignant ascites. Adverse reactions were grade 3 leukopenia and grade 2 nausea, vomiting and diarrhea. This result indicates the possibility of combination chemotherapy of TS-1+paclitaxel becoming an effective option in treating inoperable scirrhous gastric cancer.

[A case of heterochronous liver metastasis of gastric cancer favorably responding to TS-1].

We report herein a case of heterochronous hepatic metastasis of gastric cancer that responded well to chemotherapy using TS-1. The patient was a 72-year-old man who underwent total gastrectomy for gastric cancer. Liver metastasis (S8, 4 cm in diameter) was found 3 months after surgery. TS-1 (100 mg/day) was administered orally everyday for a total of 33 weeks, after which the liver metastasis showed CR. Grade 2 fever and grade 2 dermatitis were the only adverse reactions observed, and the patient did not require hospitalization by discontinuing TS-1 administration. The present case suggests the usefulness of chemotherapy using TS-1.

[Examination of the feasibility of TS-1 for postoperative advance stomach cancer patients].

AIM: The purpose of this study was to assess the safety of TS-1 when used as adjuvant chemotherapy after surgical resection of advanced stomach cancer. SUBJECTS: The subjects were 20 patients with stage III or IV, curability B resected gastric cancer. METHODS: The methods consisted of analysis of background factors, assessment of the administration and dosage of TS-1, and associations with adverse reactions. RESULTS: Mean age was 62.8 years, and the histological type was differentiated in 7 cases and undifferentiated in 13 cases. There were 4 stage IIIA cases, 10 stage IIIB cases, and 6 stage IV cases, and the extent of gastric resection consisted of gastrectomy in 8 cases and total gastrectomy in 12 cases. TS-1 administration was started an average of 57 days postoperatively. The dosage regimen was 4 weeks on and 2 weeks off in 10 cases, and different regimens were used in the other 10 cases. The dose of TS-1 was the recommended dose in 9 cases and a reduced dose in 11 cases, and the mean number of courses was 2.8. Adverse reactions occurred in a total of 14 cases. Digestive system toxicity developed in 5 cases and hematological toxicity in 12. No grade 3 or 4 toxicity was observed. Treatment could be continued in 18 cases. The occurrence of adverse reactions tended to be concentrated immediately after administration of TS-1. CONCLUSION: TS-1 was safely used as adjuvant chemotherapy after resection of advanced stomach cancer.

[One case of locally advanced breast cancer in which multidisciplinary treatment, chiefly, therapy with preoperative intraarterial infusion of docetaxel (TXT), was successful].

We herein report 1 case in which hormone therapy and neoadjuvant chemotherapy by local intraarterial infusion were conducted for locally advanced breast cancer, and were revealed to be useful in terms of local control. Administration of doxifluridine (5'-DFUR: Furtulon) (1,200 mg/day, 5 day continuous dosing followed by 2 day washout) and medroxyprogesterone acetate (MPA: Hysron H) (1,200 mg/day) was followed by chemotherapy consisting of intraarterial infusion of 100 mg of docetaxel (TXT: Taxotere), once monthly, via the left internal thoracic artery and left lateral thoracic artery. As a result, marked shrinkage of tumors was confirmed. Under these circumstances, left standard radical mastectomy plus skin grafting were performed. While under treatment, no serious adverse events were observed, and the patient made satisfactory progress after surgical procedure. She thus left hospital in a positive frame of mind.

[A case of gastric carcinoma with metastasis in a paraaortic lymph node that responded to TS-1/CDDP combination therapy, in which the patient was able to undergo extirpation with grade B curability].

Since the introduction of TS-1 for the treatment of gastric carcinoma, an overall high response rate of cancer to TS-1 therapy has been recognized. Therefore, TS-1 in combination with cisplatin (CDDP) can be reasonably expected to be an effective new strategy for the treatment of advanced gastric carcinoma. We administered three courses of the TS-1/CDDP combination in a case of gastric carcinoma with metastasis in a paraaortic lymph node. Regression of the primary carcinoma (72.7% decrease in tumor mass) and reduction in size of the lymph node were observed. Consequently, the patient underwent total gastrectomy, resection of the splenic arterial trunk, splenectomy and D3 lymph node dissection, which resulted in grade B curability. The state of the patient was favorable both at the time of surgery and postoperatively, and the course of therapy remained uneventful. Although grade 1 nausea and vomiting were noted as adverse reactions to the treatment resulting in insufficient oral intake and necessitating intravenous infusion in the hospital, the treatment was completed without any other adverse events during the course of the therapy.