[A multicenter study of epirubicin-docetaxel(ET)as primary chemotherapy for patients with inflammatory breast cancer(IBC)].

We evaluated the efficacy and safety of the epirubicin plus docetaxel(ET)regimen, which is a combination of active agents given to patients with inflammatory breast cancer(IBC)as a primary therapy. Nineteen patients received ET(60, 60mg/m2) every 3 weeks for 4 courses, and appropriate surgery was offered unless disease progression occurred. Seventeen patients completed the ET regimen and 1 patient was excluded because of no diffuse erythema, leaving 18 patients evaluable for the response and safety profile of this regimen. Grade 3/4 hematological toxicities were neutropenia in 15 patients(79%), febrile neutropenia in 8 patients(42%)and anemia in 3 patients(16%). Six patients(63%)received granulocyte colony-stimulating factor for febrile neutropenia. Febrile neutropenia was observed only for 1 course in all 6 patients and progression to apparent infection was not observed. Grade 3/4 non-hematological toxicities were constipation in 3, nausea in 2, anorexia in 2, fatigue in 1, vomiting in 1, diarrhea in 1, and stomatitis in 1 patient. The ET regimen was given to 16 patients(89%)as planned. The median number of courses was 4(range: 2-4). The clinical response rate was 44%. The median time to progression was 9 months, and median overall survival was 26 months. It is concluded that the ET regimen was well tolerated and effective as a primary chemotherapy for IBC.

Neoadjuvant epirubicin/docetaxel (ET) concomitant chemotherapy for primary breast cancer with tumor diameter >=3.1 cm: results of the Kyushu ET therapy phase II trial.

AIM: Neoadjuvant epirubicin/docetaxel (ET) combination chemotherapy was administered to breast cancer patients in order to investigate their clinical and pathological response. Moreover, the breast-conserving surgery (BCS) rate, disease-free (DFS) and overall survival (OS), safety profile and the correlation of biological markers were investigated. PATIENTS AND METHODS: Out of the 46 enrolled patients, 45 patients were analyzed for clinical response, and 40 patients were examined for pathological response. Estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor type2 (HER2) expression were examined immunohistologically. RESULTS: The median tumor size was 4.5 cm in diameter. Complete (CR) and partial responses were seen in 3 and 30 patients, respectively. A pathological CR was achieved in 4 patients and correlated with ER and PgR negativity. Moreover, BCS was performed on 16 patients. The 5-year cumulative DFS was 60.7% and OS was 91.8%. CONCLUSION: ET therapy is clinically effective with a pathological CR rate of 10% for patients with a large tumor, and should be considered as a neoadjuvant treatment option.

Experimental study on changes in energy metabolism and urine outflow with nonpulsatile low blood-flow perfusion in the canine kidney.

OBJECTIVE: Renal artery perfusion is useful to prevent renal ischemic injury during thoracoabdominal aortic aneurysm repair, and this study was designed to clarify the relationship between the perfusion flow rate and the renal function. METHODS: Canine left renal arteries were perfused at selective low flow rates (10% of native flow in Group I, 25% in Group II, and 50% in Group III) using a roller pump for 2 h, and thereafter reperfused with native flow for 2 h. At the end of perfusion and reperfusion, the energy metabolites were measured. The urinary output was measured for 30 min during selective perfusion and reperfusion. Thus, the renal function was evaluated using energy metabolites and urine outflow. RESULTS: Adenosine triphosphate levels decreased significantly after perfusion in all groups and were recovered after reperfusion in Group II and in Group III. Inorganic phosphate and lactic acid levels increased after perfusion in Group I and in Group II and decreased after reperfusion. Changes in the perfusion pressure and in the urine outflow, and histologic findings were found to be correlated with the changes in energy metabolite levels. CONCLUSIONS: Renal function was impaired depending on the degree of low perfusion flow and the function was restored after reperfusion at a flow rate of 25% or more of native flow.