Nihon Gan Chiryo Gakkai shi最新文献

Numerous reports have recently indicated that the DNA content of various malignant tumors can be of great value in predicting biological behavior and prognosis of the tumors. This study was undertaken to determine the nuclear DNA content in the primary and recurrent ovarian carcinoma of the same 20 consecutive patients by flow cytometry, and the results on clinical outcome was examined. The tissue samples of the recurrent tumors were obtained at second-look laparotomy. Of the primary tumors, 12 were diploid, 4 were pure aneuploid, and 4 were "mosaic", while of the recurrent tumors, 17 were diploid and 3 showed pure aneuploid. No significant difference of the DNA index at recurrence was observed. DNA ploidy was preserved in 12 out of 20 patients at recurrence. The time to recurrence after the initial treatment showed no significant difference versus DNA ploidy and change of ploidy. The sites and status of recurrence differed by DNA ploidy. At recurrence, the patients with DNA diploidy had a tendency to survive longer than those with DNA aneuploidy. The determination of DNA ploidy at recurrence may be useful as a variable parameter in predicting the survival of patients with ovarian carcinomas.

It is known that a high incidence of hepatocellular carcinoma in rat liver can be induced with 3'-methyl-4-dimethylaminoazobenzene (3'-MeDAB). In the present study, we investigated serum levels of alpha-fetoprotein (AFP) and thymidine kinase (TK), DNA-synthesizing enzyme in the salvage pathway, and tissue TK and its isozyme activities in the liver of rats treated with 3'-MeDAB. Serum TK activities rose abruptly right after the onset of 3'-MeDAB treatment, peaking after one week and then gradually decreasing. At 3 weeks, though serum TK was decreasing, serum AFP and tissue TK began to increase, and oval cells appeared in the liver. At 5 weeks, though serum TK reached a nadir, serum AFP and tissue TK formed transient peaks, and oval cells occupied a major part of the hepatic lobules with hyperplastic nodules. Thereafter, serum TK continued to increase, and serum AFP and tissue TK, after transiently decreasing, re-increased; at 20 weeks, each value was at high level, and mixed type hepatocarcinoma was observed. The liver TK isozymes were separated into 3 types by DEAE-cellulose column chromatography. A 3'-MeDAB induced a remarkable increase in activity of cytosolic and fetal type isozyme in non-tumorous regions of livers at 5 weeks and tumorous regions at 20 weeks. These results indicate that biochemical changes in 3'-MeDAB-treated rat liver may provide a valuable insight into two step process in hepatocarcinogenesis.

Direct action of lentinan (LNT) on tumor cells in an in vivo system was observed by scanning electron microscopy. LNT was injected intraperitoneally 7 consecutive days (0.1 mg/mouse/day) in to C3H/He mice along with MM2 ascitic carcinoma cells. MM2 tumor cells adhering to the peritoneal wall were examined every day until the day after the last LNT injection, and compared with cells of non-treated tumor bearing mice. On the day after the first LNT injection, LNT was observed as granulated material both on the tumor cells, which were degenerated and on the mesothelial cells, which were not changed. On the 7th day, almost all tumor cells were seen to be surrounded by many lymphocytes in the LNT-treated mice. Retention of ascitic fluid and fibrin deposition were almost the same as or less than in non-treated mice. From these results, it is suggested that direct action of LNT on tumor cells contributed to enhancement of antitumor immunity, although LNT did not have direct killing activity against tumor cells.

FK973, a novel antitumor antibiotic, was obtained as a fermentation product of Streptomyces sandaensis. FK973 had excellent cytotoxic effects against in vitro cultured human glioblastomas, medulloblastomas, and murine glioma (203 glioma) cells. The antitumor effects were also well observed against ACNU resistant glioma cells. FK973 did not go through the blood-brain barrier. The median survival time (MST) of MG models treated with FK973 was 21 days. On the other hand, the MST of the control group was 15 days. In the in vitro assessment against neural disturbance, FK973 showed a little disturbance of murine brain cells but less toxic than ADM. In the in vivo neurotoxicity examination, FK973 showed no clear damage to the neural cells and myelin sheaths.

Fundamental concepts of combination multi-drug chemotherapy have not been well recognized from the aspects of chemo-sensitivity test upon malignant tumors. A chemo-sensitivity test by in-vitro bioassay for Dunn osteosarcoma and NR fibrosarcoma was developed by us to study the simultaneous interactions between two anticancerous agents. 0.1 ml of cell suspension of either mouse sarcoma was immersed in 0.4 ml of RPMI 1640 cell culture medium containing an anticancerous agent such as Mitomycin (MC), Cyclophosphamide (CPM), Vincristine (VC), Bleomycin (BM), 5-FU, Adriamycin (ADM), Cisplatin (CDDP) or Methotrexate (MTX) in a test-tube, and incubated at 37 degrees C for 3 or 6 hours. Then, the sedimented cell suspension of 0.1 ml was inoculated subcutaneously in the dorsum of C3H mouse which provided 4 sites for 4 different sensitivity tests. In 3 weeks, sensitivities of the anticancerous agents were evaluated as positive sensitivity if no growth of the tumor was observed, or negative sensitivity if the growth of more than 10 mm in diameter was observed. Then, the determination of antitumorous effect on 2-drug combination out of the 8 anticancerous agents, were performed on each mouse sarcoma by the same method. In Dunn osteosarcoma or NR fibrosarcoma, the combination of 2 sensitivity-positive agents revealed no apparent synergistic effects. In any combinations of one sensitivity-positive agent with the other sensitivity-negative agent, except the combinations with CPM which possessed mighty antitumorous effect, apparent reduction of antitumorous effects was observed. The combination of 2 sensitivity-negative agents never produced any antitumorous effects.(ABSTRACT TRUNCATED AT 250 WORDS)

To evaluate the usefulness of tumor markers in monitoring the patients with prostate cancer, serial measurements of serum prostate-specific antigen (PA), prostatic acid phosphatase (PAP) and gamma-seminoprotein (gamma-Sm) were performed in 78 stage C or D patients. Positive rates of each marker prior to the treatment were as follows; PA; 75%, PAP; 56% and gamma-Sm; 62% in stage C, and PA; 95%, PAP; 79% and gamma-Sm; 91% in stage D. In most cases showing PR (partial response) and S (stable) in clinical responses, these three markers decreased their serum titers corresponding to clinical course if the markers were elevated at the start of the treatment. But the usefulness of PAP was lessened because of its lower positive rate than those of PA and gamma-Sm. In 33 PD (progressive disease) cases, positive rates of each marker at time of clinical diagnosis as PD were found to be 85% in PA, 55% in PAP and 76% in gamma-Sm. And with the combination assays of these three tumor markers, positive rate was elevated to 88%. Moreover, elevation of serum values of these three markers at 3 months before the progression event were observed in 50% of PA, 39% of PAP and 46% of gamma-Sm. Then the prognostic significance of each marker was examined. In PA and PAP, there were statistical differences in non-relapsing rates between patients whose reduction rates from the pretreatment value on 7th day were more than and less than 50%. But in gamma-Sm, a statistical difference between each group was firstly observed on 14th day. As a result, in monitoring patients with prostate cancer, PA and gamma-Sm are more useful than PAP and, in prediction of patients' prognosis, PA is more useful than gamma-Sm.

Malignant mixed mesodermal tumor (MMMT) of the ovary is a rare neoplasm with a dismal prognosis and therapeutic modalities remain an enigma. The present paper describes our experience with an impressive response utilizing a cis-platinum based combination chemotherapy in a 56-year-old female with this disease and a review of the literature. The patient was treated with PAIE therapy following a cytoreductive surgery. Two further courses of a single-agent chemotherapy of cis-platinum were given. A PR was obtained after completion of the third course and tumor markers showed a prompt fall with a tumor response. Nevertheless, no further therapy was performed because of her refusal. She expired 5 months after diagnosis because of tumor progression.

Primary mediastinal malignant germinoma is a rare disease, and only about 15 patients have been reported in Japan. We treated a patient with this disease by intra-arterial CDDP infusion and observed good effects. A 29 year-old male was admitted to our hospital due to SVC syndrome in 1980. A right mediastinal tumor was detected, and the resection of this tumor was performed. Histological examination showed seminoma. Though postoperative Co irradiation was performed, radiation pneumonitis developed in the right lung. Subsequently, the tumor metastasized to the right kidney and spinal cord. After removal of the right kidney followed by Co irradiation, the clinical course was good. In 1987, a mass (10 x 6 cm) was detected in the left mediastinum, suggesting recurrence. Four courses of CDDP infusion into the left bronchial artery and left internal thoracic artery (1 course: 45-70 mg) were performed, and good effects were obtained. No side effects were observed, and the clinical course has been good until now. This case is of interest in evaluating the multidisciplinary treatment for mediastinal seminoma.

Malignant skin carcinomas occur in a large variety of forms, among them malignant melanoma with a poor prognosis, such as squamous cell carcinoma, basal cell carcinoma, appendix tumors of skin (e.g., sweat gland carcinoma, sebaceous gland carcinoma), metastatic carcinomas of skin, intraepidermal carcinomas (e.g., Bowen's disease, Paget's disease) and mesenchymal carcinomas including mycosis fungoides (cutaneous T cell lymphoma). Furthermore, not only do they present with varied clinical symptoms, some forming tumors or erythemas, some being infiltrative in nature and some being flat in shape, but the clinical symptoms also vary with time during treatment. All these conditions conspire to make the evaluation of chemotherapeutics complicated and difficult. In the field of dermatology topical drugs provide a no less powerful weapon than drugs for systemic administration with which to combat skin carcinomas and are simple and easy to administer. In consideration of those clinical and therapeutic aspects of malignant skin carcinomas new evaluation criteria for chemotherapeutics for topical and systemic administration have been established by adding three-way measurement to the conventional methods of one- and two-way measurement for measurable lesions along with the evaluation of the response of clinical symptoms to chemotherapeutics in unmeasurable carcinomas. The new version of criteria is based in its general framework on the Japan Society for Cancer Therapy's Evaluation Criteria for Chemotherapeutics for Solid Carcinomas by Koyama and Saito and the new version has been approved at the 26th general meeting of the Japan Society for Cancer Therapy (1988, Niigata).

We reviewed treatment and prognosis in 7 operative and 7 non-operative cases of renal cell carcinoma with venous tumor thrombosis formation, 14 cases in total. Treatment after around 1983 involved the use of biological response modifier (BRM), chiefly interferon (IFN), and operation by thoracoabdominal approach. Before that, chemotherapy, radiotherapy and operation by peritoneal approach were used, with many cases judged inoperable. Even in non-operative cases, life-prolongation was frequently achieved by embolization of the renal artery and administration of various BRMs. On the other hand, in cases judged operable which were always treated by resection, early postoperative death sometimes occurred. These facts brought home to us the difficulty of choosing appropriate treatment. Though it is hard to determine the relative merits of various treatments from the present data, since the series is small and contains cases from 1963 onwards, the clinical and pathological pictures should be carefully evaluated for each case, and the most suitable course of treatment should be selected individually. We describe a non-operative case in which a combined use of embolization, IFN-gamma and tumor necrosis factor (TNF) elicited a lasting partial response, and an operative case in which postoperative complications such as pulmonary infarction and renal failure occurred after operation under extracorporeal circulation and patient died at 2 months after operation.