[A comparative study of the effect of granisetron and a combination of granisetron plus steroids on cancer chemotherapy induced emesis].

Effects of 40 micrograms/kg of granisetron monotherapy (K group) and concurrent therapy with a steroid (KS group) on acute and delayed emesis induced by cancer chemotherapy which included CDDP at a dose of 60 mg/m2 or more were compared in random clinical trials under the central registration method. In KS group, either 500 mg of methylprednisolone succinate or 8 mg of dexamethasone phosphate was given prior to granisetron administration. Clinical symptoms such as vomiting, nausea and anorexia were better in KS group than in K group, on any day from day 1 to day 7, and there was a statistically significant difference on day 1 and day 2. The cumulative total control rate throughout the period of seven days was also significantly higher in KS group. KS group was rated higher in the final clinical evaluation based on doctor's impressions, but there was no significant difference between the two groups. Augmented antiemetic effect of granisetron by concurrent therapy with a steroid was most notably demonstrated in male patients under 60 years of age. The antiemetic effect at the acute stage was proven to influence the final clinical effectiveness, thus suggesting the importance of antiemetic therapy of acute emesis. Adverse reactions were seen in two out of 122 patients (1.6%). They were slight headache and moderate diarrhea in 1 case each, both of which disappeared soon, confirming the high safety profile of granisetron.

[A case of hyperosmolar nonketotic coma occurring during chemotherapy in lung cancer].

A 61-year-old woman was admitted to our hospital because of hoarseness and abnormal shadow on chest X-ray. We diagnosed this patient as large cell carcinoma of the right upper lobe of the lung; T3N3M1 Stage IV. She was treated with OK-432, CDDP and CQ. On the 6th day after 2nd cycle chemotherapy, she was confused, and we diagnosed her as a case of hyperosmolar nonketotic coma (HNC) on the 7th day. Unfortunately, she died on the 8th day, after 20 hours of treatment for HNC. She suffered from chronic dehydration due to trouble with left recurrent nerve palsy. Although continuous intravenous hyperalimentation was used, she had severe HNC. HNC might be one complication in chemotherapy for patients with malignancy.

[A long survival case of small cell lung cancer synchronized with renal cancer].

A long survival case of small cell lung cancer synchronized with renal cancer was reported. The patient was a 73-year-old male, complaining of cough and fever up. The chest roentgenogram showed a tumor mass in the right lower lung field. The specimen obtained from transbronchial lung biopsy of right S8b was diagnosed as small cell carcinoma of lung. In the check of the metastasis to other organs, abdominal CT scanning and the echogram demonstrated a solitary mass in the left kidney. We supposed a possibility of primary renal cancer rather than the metastasis from the lung because of being solitary mass, no existence of the metastasis except the kidney, and from the finding of the renal angiography. The patient underwent left nephrectomy for the renal cancer, and also underwent right lower lobectomy for the lung cancer after neo-adjuvant chemotherapy using cisplatinum and carboquone. Pathologically, the renal lesion was diagnosed as typical clear cell carcinoma of the kidney. He has survived for more than 4 years.

[Clinical significance of Su-polysaccharide (Su-PS) skin test in patients with primary lung cancer treated with chemotherapy and administration of OK-432, with special reference to the therapeutic effect and prognosis].

In order to evaluate the significance as a parameter for monitoring immunological status and for predicting therapeutic effect and prognosis, Su-PS skin test was performed in 68 cases of primary lung cancer treated with chemotherapy and administration of OK-432. In 16 of 68 cases, lymphocyte subsets of peripheral blood using Leu monoclonal antibodies were analyzed to investigate the immunological status. Su-PS skin test was performed at the time of before treatment, 1 week after administration of OK-432, 4 weeks after chemotherapy and intervals during treatment. The reactions to Su-PS skin test in these patients were divided into 3 groups according to the maximum size during the treatment as follows; less than 20 mm, 20 mm to 50 mm and over 50 mm. As compared with the reaction to Su-PS skin test and the survival, there was a significant difference between each group. The analysis of the lymphocyte subsets also indicated that immunological status tended to be activated more in strong responders to the Su-PS skin test than in weak responders. Therefore, Su-PS skin test is considered to be an useful immunological parameter of cancer patients under treatment.

[Clinical study of combination chemotherapy using carboquone, cisplatin, UFT and OK-432 in 7 cases of advanced gastric cancers and a relapsed gastric cancer].

In 8 cases of advanced and/or relapsed gastric cancer (7 cases advanced, 1 case relapsed), we undertook combination chemotherapy with systemic administration of cisplatin and celiac arterial infusion of carboquone intermittently under continuous administration of OK-432 i.m. and UFT p.o. The male to female ratio was 5 to 3 and the age distribution from 53 to 77 years (mean age, 70 years.) Eight cases were divided into the following histological types: 1 papillary adenocarcinoma, 1 well-differentiated tubular adenocarcinoma, 3 moderately differentiated tubular adenocarcinomas, and 3 poorly differentiated adenocarcinomas. Complete response (CR) was obtained in one case, partial response (PR) in four cases, minor response (MR) in two cases, and no change (NC) in one case. The response rate was 62.5%. CR was noted in a relapsed case. The median survival time from the beginning of the chemotherapy was 8 months (ranging from 6 to 13 months). The major toxicity was bone marrow suppression, but there were no cases of serious renal damage.

[A case of relapsed pulmonary carcinoma showing an interesting chemotherapeutic course].

A patient with relapsed primary pulmonary carcinoma (T2N0M0 Stage II adenocarcinoma) showing contralateral metastasis after 4 postoperative years was given Carboquone (CQ), Cisplatin (CDDP) and OK-432, and positive therapeutic results were obtained. However, aggravation ensued and so UFT was given in combination with the above chemotherapy, resulting in repeatedly good results. The details of this case of relapsed pulmonary carcinoma, which was resistant to chemotherapy but showed positive therapeutic results with combined use of UFT, are reported.

[Relation between prognosis and the Su-PS skin reaction in patients with non-resected primary lung cancer receiving OK-432].

Chemotherapy and administration of OK-432 were performed concomitantly in 49 cases of inoperable primary lung cancer, and the Su-PS skin reaction was measured. In the group of patients under 60 years of age, the maximum diameter of the reaction after chemotherapy tended to be large, and evaluation of the results showed that the maximum diameter tended to be large in the group showing tumor contraction effects. In a comparison of the prognosis between the group which survived for less than 6 months and that which survived for 6 months or longer, there was no significant difference between them before administration of OK-432, but when the maximum reaction diameter after chemotherapy was compared, that in the group which survived for 6 months or longer was significantly stronger (p less than 0.05). The Su-PS skin reaction at the time of administration of OK-432 is therefore considered to be a useful immunological parameter for predicting the results of treatment and also for prognosis.

[Combination therapy of high-dose carboquone and OK-432 in unresectable non-small cell lung cancer].

A combination of OK-432 and high-dose Carboquone (12-22 mg/m2) was administered to 17 patients with unresectable non-small cell lung cancer. The response rate was 42.9% (CR-1, PR-5) among 14 patients in whom measurement of tumor diameter was possible. With regard to hematologic adverse effects, 13 patients had a WBC count of less than 3,000, and 6 patients had a platelet count of less than 50,000. Duration of WBC nadir was not longer than 3 days, and there were no cases of infectious complication or bleeding tendency. Other side effects were all transient.

[A case of relapsed gastric cancer treated successfully by chemotherapy--lung metastasis and relapsed cancer in the hepatic portal system].

A case of relapsed gastric cancer postoperatively presenting obstructive jaundice due to metastases in the hepatic portal and periaortic lymph nodes and multiple lung metastases was given OK-432 continuously i.m. and UFT p.o., and then generally given cisplatin and massive doses of carboquone i.a. intermittently into the peritoneal cavity. The chemotherapy led to complete remission of the obstructive jaundice and disappearance of the metastases in the lungs and lymph nodes.

[Case of primary double lung cancer in the same lobe].

In a 70-year-old male complaining chiefly of cough and expectoration, an abnormal shadow was detected in the left upper lobe by chest X-ray. Therefore, he was admitted for further examination. A tumorous shadow, 5 X 4.5 X 2.5 cm was noted; it corresponded to S1 + 2b on the left side. Left upper lobectomy was performed. Histologic findings of the excised lung were giant cell cancer in the tumorous part, and squamous epithelial cancer at the cut end of the bronchus, i.e. the cut end of the left upper bronchi. This is a rare case with primary double cancer in the same lobe.

[Combination therapy of large amount of carboquone and OK-432 for unresectable lung cancer].

The combination of 1 KE/day of OK-432 (everyday) and 10 mg/day of Carboquone (once a week) had been administered for three weeks to 18 cases of the patients with unresectable lung cancer. The response rate was 50% in the patients whose diameters of tumors could be measured. These results might be provided by the fact that the large dose administration of Carboquone became possible with simultaneous administration of OK-432, which might have an activating effect of bone marrow function; consequently, original properties of alkylating agent could be utilized in this therapy. Leukopenia, (leukocyte counts: less than 3,000) was observed in 10 out of 18 cases (55.6%) at one week after administration of the drugs, and in all but one case leukopenia was recovered after 4 weeks of the administration. No other severe side effects were observed.