Nihon Gan Chiryo Gakkai shi最新文献

The usefulness of Lentinan, as an agent for postoperative adjuvant therapy, was investigated in patients with gastrointestinal cancer. Sixty-one patients were classified into three stages by a degree of advance for cancer (Stage II, III, IV). Furthermore, each group was put into the control group (C group) and the Lentinan group (L group), received 600 mg/day of Tegafur p. o. only or 600 mg/day of Tegafur p. o. and 2 mg/week of Lentinan i. v., respectively. Then total lymphocyte counts and NK cell activities were measured and analysis of lymphocyte subsets by two color flow cytometry was carried out every two months. The results were as follows: 1) Some parameters were preserved in higher levels in the L group especially in the stage IV. 2) In the stage IV, total lymphocyte counts of the L group were preserved higher levels compared to those of the C group. The same tendency was observed in OKT3, OKT4 and OKT8 positive cell counts. 3) In the stage IV, both OKT8+ x Leu15+ cell (suppressor T cell) and OKT8+ x Leu15- cell (killer T cell) counts tended to decrease in the C group. 4) In the stage IV, the NK cell activities of the L group were preserved in higher level compared to those of the C group. Leu7+ x Leu11-, Leu7+ x Leu11+ and Leu11- x Leu11+ cells counts tended to preserve in the L group. From these results, it was suggested that Lentinan had a marked immunopotentiating efficacy in the stage IV among gastrointestinal cancer patients.

A case of advanced esophageal carcinoma with liver and lung metastases who survived more than 3 years by combination chemotherapy consisting of Cisplatin and continuous 120 hours infusion of 5-Fluorouracil was reported. The primary lesion and liver metastases achieved complete response (CR) but the lung metastases attained only partial response. CR was, however, achieved by another regimen of chemotherapy. Forty months after the initiation of treatment, brain metastasis was recognized, which was controlled by radiotherapy. The patient is still alive three years after the onset of disease but with lung metastases. Quality of life in these 3 years was considered to be relatively good.

Ninety cases with 96 tumors were treated by the 430 MHz microwave heating systems, HTS-100, at Tokyo Metropolitan Komagome Hospital, Kyoto University and Aichi Cancer Center. The results of treatment were analyzed, and the following have been clarified. Three cases are demonstrated showing feature of HTS-100. 1) The results of 383 sessions of heating by HTS-100 were analyzed, and it has been clarified that even the larger tumors, more than 5 cm both in size and depth, can be heated satisfactorily to temperatures higher than 42 degrees C. This system is capable of heating remarkably wider areas compared with the conventional microwave heating systems. 2) Hyperthermia by HTS-100 and radiotherapy were combined for treatment. The success rate (total percentage of CR plus PRa) of 89 cases analyzed was as high as 66.3%. Furthermore, local heating was successful for 60.7% of tumors, larger than 5 cm and deeper than 4 cm. 3) Combination of microwave heating and RF wave heating is a new method which is helpful for expansion of indications. 4) The frequencies of side effects of HTS-100 heating were: pain, 15.6%; sensation of heat, 6.3%; burns, 3.6%. Most of side effects were transient and slight. The higher frequency of pain than the conventional microwave heating is attributable to expansion of heating area.

Preoperative endoscopic intratumoral injection (IT) of biological response modifiers (BRM), such as OK432, a compound composed of attenuated Streptococcus pyogens, in gastric cancer patients has been tried and this method has been improving the prognosis compared to surgical resection only. We tried to clarify this mechanism using experimental mouse system and demonstrated here the preoperative IT of OK432 significantly prolonged the survival and induced the tumor-specific cytotoxic T lymphocytes (CTL) in the spleen. By contrast, tumor necrosis factor (TNF) IT failed to prolong the survival and to induce specific CTL response, although it reduced primary tumor size significantly. To analyze why OK432 IT induce the systemic CTL response, viable tumor cells and infiltrating dish-adherent cells from the OK432 injected tumor mass were harvested and examined the class I and class II antigen expression by flow cytometer. Class I and class II antigen expression of the tumor cells remained unchanged, however, the class II positive dish-adherent cells markedly increased by OK432 pretreatment. As same in these results, histological finding in gastric cancer specimen has shown prominent increase of Langerhans cells, possessing potent antigen-presenting function and positive class II antigen, by OK432 pretreatment. Taken together, these findings strongly suggest that the increased class II positive antigen-presenting cells (APC) activity by OK432 IT augment the CTL response via cascade reaction and finally, resulted in anti-tumor efficacy in vivo.

A clinical trial of recombinant human granulocyte colony-stimulating factor (rG-CSF), produced by Chinese hamster ovary cells, was conducted in 66 patients receiving intensive chemotherapy for non-Hodgkin's lymphoma. Each patient received 2 cycles of CHOP therapy, and one cycle of them was performed with rG-CSF treatment and another one without rG-CSF treatment, in a cross-over fashion. rG-CSF (0.4, 2, 5, 10 micrograms/kg/day) was given intravenously or subcutaneously to each patient for 14 days from 2 days after initiation of the chemotherapy. rG-CSF increased the absolute neutrophil counts (ANC) at nadir, and reduced the period of neutropenia with ANC less than 1,000/mm3 and also the period for restoration to ANC greater than or equal to 2,000/mm3 after initiation of chemotherapy. These effects were remarkable at doses of more than 5 micrograms/kg/day intravenously and 2 micrograms/kg/day subcutaneously. Fourteen infective episodes were observed during the cycles of chemotherapy without rG-CSF treatment, while 7 infective episodes were observed during the cycles with rG-CSF treatment. rG-CSF was well tolerated. These results demonstrated that rG-CSF was effective in neutropenia induced by cancer chemotherapy at a intravenous dose of 5 micrograms/kg/day and a subcutaneous does of 2 micrograms/kg/day.

Color and pulsed Doppler ultrasound examinations were done on 11 normal volunteers (NU) and 286 patients that consisted of cervical carcinoma (CC), leiomyoma and/or adenomyosis (M), endometrial carcinoma (EC), trophoblastic disease (TD), benign ovarian tumor (BO), Krukenberg tumor (KT) and ovarian carcinoma (OC). The vascularity was based on the resistance index (RI) and maximum blood flow velocity (Vmax). In uterine disease, there was significant difference (p less than 0.01) among each group, except but one correspondence between NU and CC with RI, and there was significant difference (p less than 0.001) between NU and M, CC and M with Vmax. In ovarian disease, there was significant difference among each group with RI, and there was no significant difference among each group with Vmax. Therefore, Doppler ultrasound is a useful diagnostic tool for assessing gynecologic tumor vascularity.

Six patients with advanced renal cell carcinoma was treated with a new chemo-endocrine regimen consisting of Tegafur, Adriamycin, Methotrexate and Tamoxifen. Estrogen receptor was measured in four cases from renal or metastatic tumors by DCC method, presenting 14.7, 9.7, 1.0 and 0 f moles/mg protein respectively. The patients were medicated with 800-1,200 mg of Tegafur and 20 mg of Tamoxifen daily po, and 20 mg of Adriamycin and 10 mg of Methotrexate intermittently for two weeks interval iv. According to a criteria of Japan Society for Cancer Therapy, two were regarded as CR, one as PR, one as NC and two as PD. The one out of two cases with and without estrogen receptor responded favourably to this therapy. Side effects observed in the treatment were mild gastrointestinal disorders including nausea and vomiting, slight degree of leukopenia, stomatitis, pigmentation and liver dysfunction. The patients were found to be in good quality of life during the treatment because of less toxicity. This therapy can be regarded as a good modality for a treatment of advanced renal cell carcinoma. This is a first report of combined chemo-endocrine therapy with Tegafur, Adriamycin, Methotrexate and Tamoxifen for renal cell carcinoma in the world.

The study included a total of 634 patients with cervical cancer; 311 were in stage I b and 323 were in stage II. All patients received radical hysterectomy at the Department of Obstetrics and Gynecology, Kinki University, between May 1975 and December 1986. One out of 311 patients in stage I b (0.3%) and eight out of 323 patients in stage II (2.5%) had ovarian metastases confirmed histologically. Nine patients who had ovarian metastases were investigated about stages, histological types of the cervical cancer (WHO and CPL classification), incidence of metastases in pelvic lymph nodes, corpus infiltration, parametrial infiltration, and peritoneal cytology. Results obtained were as follows: 1. As to histological types, patients with adenocarcinoma and/or PL type in CPL classification had high incidence of ovarian metastases. 2. Patients with corpus infiltration had high incidence of ovarian metastases. 3. Metastases to both ovary and pelvic lymph nodes tended to occur on the same side, but ovarian metastases and parametrial infiltration did not necessarily occur on the same side. We suggest removal of ovaries, even before menopause, in patients with cervical cancer who have cervical adenocarcinoma, or corpus infiltration, or are suspicious for metastases in more than two pelvic lymph nodes.

Eight patients with untreated squamous cell carcinoma of the esophagus accompanying distant metastases who were treated by one to five cycles of chemotherapy consisting of Cisplatin and 120 hour infusion of 5-Fluorouracil were reported. Two patients showed complete response (CR), four partial response (PR), one minor response, and one no response. High response rate of 75% (6 of 8) was obtained. Radiation therapy was then administered to six of the patients. After definitive treatment, CR was obtained in four, and PR in two of the cases. However, relapses were noted in all four of the CR cases, with four at distant sites, and one locally. Five of the eight patients (62.5%) survived one year and two survived three years (25%). Two patients could not receive radiotherapy because of uncontrollable lung metastases or death from duodenal ulcer. Although the follow-up period is still short, the combined treatment of radiation and pre-radiation chemotherapy appears to be an effective treatment, and has made a major impact upon survival time in cases of disseminated esophageal carcinoma.

Thirteen patients with previously untreated advanced squamous cell carcinoma of the esophagus were treated with pre-radiation chemotherapy followed by radiation therapy. The chemotherapy consisted of two or three cycles of Cisplatin and 120 hour continuous infusion of 5-Fluorouracil. Three patients showed complete response (CR), three partial response (PR), three minor response (MR) and four non-response (NR). The overall response rate was 46%. The predominant side effects were nausea, vomiting and anorexia. Mild or moderate degree of anemia and leukocytopenia were also noticed. However, no serious toxicity was observed. Radiation therapy was administered to eleven of the thirteen patients, excluding one patient who refused it and one patient who died during chemotherapy. In two of the eleven cases, however, radiotherapy was discontinued because of MR, and surgery was performed. In one additional case, post-radiotherapy surgery was performed. One of these three cases received curative esophagectomy. After definitive treatment, CR was obtained in 54% (7 of 13), PR in 15% (2 of 13), MR in 15% and NR in 15%. The non-effective patients (PR + MR + NR) died within nine months after the initiation of treatment. Two of the CR patients later died, one due to local recurrence and another due to aortic-esophageal fistula with no residual cancer discovered at autopsy. The remaining CR patients are still alive and well, after 11.5 to 32 months. Although the follow-up period is yet short, the combination of radiation therapy with pre-radiotherapy chemotherapy appears to be an effective treatment.