[A case of high CEA colon cancer responding to neoadjuvant chemotherapy with FOLFIRI].

We report a case of high CEA advanced colon cancer, which we were able to down stage after treatment with FOLFIRI-1. The patient was a 56-year-old woman who had advanced sigmoid colon cancer with high CEA. It was suspected that the tumor had directly invaded the ovary by CT scan. For curative operation, hysterectomy was considered necessary. Neoadjuvant therapy was performed to avoid an extensive operation. After the fourth course, according to colonoscopy and CT findings, a significant tumor reduction was obtained. Sigmoid colorectomy with D3 nodal dissection was then performed. The histological diagnosis was pT1, pN0, PStage I. The histological effect was observed in lymph node metastasis. The patient was recurrence free at her 3-year follow-up examination.

[Advanced gastric cancer in an elderly woman showing histopathologic CR after a course of S-1 and CDDP combination therapy].

An 80-year-old woman was diagnosed with advanced gastric cancer of T2N0H0P0M0, Stage IB. She was strongly advised to undergo surgery, but refused this option. Because the performance status (PS)was 1, combination chemotherapy with S1 100 mg/day (day 1-21) and CDDP 50 mg/m2 (day 8) was initiated. After one course of treatment was completed, she changed her mind and expressed the wish to undergo an operation for her disease, which led to proximal gastrectomy (double tract reconstruction) being performed. A histopathological examination revealed CR of the disease with no cancer cells. As the population grows older, the number of elderly patients with advanced gastric cancer will increase in the future. Therefore, S-1 and CDDP combination therapy may be a treatment of choice for gastric cancer with dose reduction according to patient status, if the elderly patient refuses a curative operation. It may well prove to be an effective treatment in the elderly provided the dosage and administration are appropriate.

[Successful resection of an advanced gastrointestinal stromal tumor by neoadjuvant chemotherapy with imatinib- a case report].

We report a case of a large gastric gastrointestinal stromal tumor (GIST), which we were able to curatively resect after treatment with a daily dosage of 400 mg imatinib for 3 months. The patient was a 46-year-old man whose chief complaint was anemia. Historical diagnosis by endoscopic biopsy was a c-kit-positive GIST of the stomach. From a CT scan, it was suspected that the tumor had directly invaded the pancreas. The tumor was 9 cm in size. For this case, total gastrectomy with distal pancreato splenectomy was necessary for curative resection. Imatinib mesilate was administered as neoadjuvant therapy according to the NCCN guidelines. After 3 months of treatment, CT revealed a dramatic reduction in tumor diameter of 61% and showed direct invasion of the pancreas. The radical operation was considered feasible and a partial gastrectomy was performed. The tumor did not invade other organs, and radical surgery was possible without rupture. The patient was recurrence free at his 12-month follow-up examination.

A liquid/liquid interface excited by stimulation with water.

An immiscible interface, which was composed of CaCl(2) aqueous and ester phases, was excited by the addition of a small amount of water. The excitation, i.e., burst and flow at the interface, was observed above a critical concentration of CaCl(2) in the aqueous phase. The critical concentration and degree of excitation depended on the kind of ester. The mechanism of excitation is discussed in relation to the interfacial tension and the Marangoni effect.

[Evaluation of weekly low-dose CPT-11 combined with 5-FU/l-LV therapy for advanced and recurrent colorectal cancer--preliminary study].

In Japan, cancer chemotherapy for advanced and recurrent colorectal cancer has not been adequately developed in comparison with the USA and Europe. However, the number of patients with advanced colorectal cancer has increased dramatically in this decade. Therefore, effective and feasible regimens against colorectal cancer are urgently needed. We designed a new regimen to evaluate the efficacy and feasibility of weekly low dose CPT-11 combined with 5-FU/l-LV therapy based on an RPMI regimen against advanced and recurrent colorectal cancer. Twenty patients were enrolled in this study. Weekly administration (CPT-11; 60 mg/m(2) div for 1st-line chemotherapy, 40 mg/m(2) div for 2nd-or 3rd-line chemotherapy, l-LV; 200 mg/m(2) div, 5-FU; 500 mg/m(2) iv, 3 consecutive weeks, 1-week break) was performed on an ambulatory basis. The treatment cycles were repeated every 4 weeks until disease progression and/or severe toxic events occurred. The overall response rate was 31.6% with 5.3% complete response and 26.3% partial response in addition to 42.1% with no changes beyond 3 months. These results suggested that the clinical benefit was shown in 73.7% of patients. Furthermore, median TTF (time to failure) of this regimen was 6.5 months and MST was 20.4 months, respectively. On the other hand, adverse events were restricted to grade 3 with 30.0% neutorocytopenia and 5.0% thrombocytopenia. Therefore, weekly low-dose CPT-11 combined with 5-FU/l-LV therapy seems to be extremely useful, with excellent anti-tumor effect and tolerable adverse reactions, for the treatment of advanced and recurrent colorectal cancer on an ambulatory basis.