[Multimodal treatment including intraoperative irradiation for advanced pancreatic cancer with extended metastasis].

From January 1987 to December 1999, we treated 11 advanced pancreatic cancer patients with extended metastasis with multimodal treatment. Two patients received external radiation therapy (ERT) and systemic chemotherapy, 1 received intraoperative radiation therapy (IORT) and ERT and arterial infusion chemotherapy (AIC), 2 received IORT and AIC, 4 received only IORT, 2 received only AIC, and 15 did not receive any of these treatments. There was a significant difference in the survival rate between treatment and no treatment cases (median survival of 177 days and 109 days, respectively) (p = 0.04). A significant difference in the survival rate was also observed between IORT cases and no treatment cases (median survival of 212 days and 109 days, respectively) (p = 0.02). However, there was no significant difference in the survival rate between AIC cases and no treatment cases (median survival of 177 days and 109 days, respectively) (p = 0.10). Therefore, our experience suggests that multimodal treatment including intraoperative irradiation is effective for advanced pancreatic cancer patients with extended metastasis.

[Intrahepatic arterial infusion chemotherapy for the colon cancer patients with liver metastases--a comparison of arterial embolization chemotherapy versus continuous arterial infusion chemotherapy].

To compare the prognostic benefit between arterial embolization chemotherapy (AEC) and continuous arterial infusion chemotherapy (CAIC), we clinicopathologically examined 32 colorectal cancer patients with liver metastases. Seventy patients were treated with AEC, and 15 patients with CAIC. In the AEC regimen, either ADR or CDDP dissolved in Lipiodol was infused by the implanted reservoir every one to two months. Otherwise, for the CAIC regimen, 360 mg/m2/day of 5-FU was continuously infused by the reservoir for 14 days. Subsequently, on day 22 after the initial 5-FU infusion, 180 mg/m2/day of 5-FU was continuously infused for 7 days. After a 7-day interval without infusion, 180 mg/m2/day of 5-FU was infused for 7 days. This 7-day infusion/7-day no-infusion cycle was repeated. The efficacy of the AEC was 6% (1 PR + 7 NC + 9 PD), CAIC (6 PR + 4 NC + 5 PD), suggesting that CAIC provides the better response rate. With regard to prognosis, the 1- and 2-year survival rates of AEC were 63% and 19%, respectively. The median survival time was 415 days. Otherwise, the 1- and 2-year survival with CAIC was 54% and 40%, respectively, and the median survival time was 470 days. No significant difference between the AEC and the CAIC was observed in the colorectal cancer patients with liver metastases.

[The clinical effect of cisplatin and 5-FU infusion in oral cancer].

The combination chemotherapy of cisplatin and 5-fluorouracil (5-FU) is more effective than monotherapy of either drug in the head and neck cancer. In 1982, Kish reported that CF-therapy, the combination of cisplatin and 5-FU, had a high curative rate (about 82%). CF-therapy was utilized in 9 patients with carcinoma of the oral region from March, 1987 to September, 1990 in our hospital. The patients' ages ranged from 23 to 74 years old with an average of 55. All tumor were squamous cell carcinoma. There were 2 cases in stage II, 4 cases in stage III and 3 cases in stage IV. Two patients treated with only CF-therapy and the other patients treated with radiotherapy and operation in addition to CF-therapy. Our regimen is cisplatin 80-100 mg i.v. or i.a. in day 1 and 5-FU 250 mg i.a. or 5-FU 750 mg i.v. in day 2-6. The therapeutic results showed a 78% response rate to the therapy with 4 cases of CR (complete response), 3 cases of PR (partial response), 1 case of MR (minor response) and 1 case of PD (progressive disease). Side effects of cisplatin plus 5-FU (eg. nausea and vomiting) were so severe that the treatment had to the stopped in many patients. The method we have reported here was evaluated, and it is concluded that this CF-therapy is very effective as a first treatment of oral cancer.