A clinicopathological study was made on 14 cases of thyroid cancer in children and younger patients treated in the department. The male-to-female ratio was 1:2.5 and their ages ranged from 6 to 19 ...years. The most common complaint was a tumor in the neck in 13 cases. As preoperative diagnosing methods, measurements of blood thyroglobulin level and needle aspiration cytology yielded relatively high correct diagnosing rates. Operative procedures included total thyroidectomy in six cases, subtotal thyroidectomy in seven, and lobectomy in one. Lymph nodes dissection was performed in 12 cases. All cases were of papillary carcinoma and lymph node involvement was seen in 10 cases (71%) of them. Lung metastasis was seen in three patients who are alive at present. Thyroid cancers in children and younger patients are prone to metastasize to the lymph nodes and lung in an early stage, so that correct preoperative diagnosis, choice of surgical procedure, strict followup of the patient's postoperative course would be necessary.
Irinotecan hydrochloride has been administered to patients with breast cancer resistant to anthracyclines and/or taxanes in our department. A retrospective analysis of the efficacy and toxicity of ...irinotecan therapy was conducted to clarify its clinical usefulness. A total of 35 consecutive patients with advanced or recurrent breast cancer were treated with irinotecan between June 1996 and March 2002. The patients ranged in age from 37 to 66 years old (median, 52). The most frequent metastatic lesion was in the liver. The number of previous chemotherapy was 2 to 7 regimens (median, 3). Ninety-one percent and 97% of the tumors were anthracycline- and taxane-resistant, respectively. The weekly dose of irinotecan was 40-160 mg/body (median, 100), and the total dose was 40-6, 110 mg/body (median, 840). An objective response rate of 6% and a clinical benefit rate of 23% were obtained. The median time-to-progression and overall survival were 3 months and 8 months, respectively. Severe toxicity (grade 3 or 4) was observed in 34% of the patients for a decrease in the white blood count, in 26% for neutropenia, in 17% for nausea/vomiting and in 6% for diarrhea. Although this study suggests that irinotecan is a clinically useful treatment of anthracycline- and/or taxane-resistant breast cancer, its anti-tumor effect was not satisfactory. The activity of first-line irinotecan therapy or the combined use of irinotecan with other agents should be investigated in clinical studies.
Our department recently began using paclitaxel in treating patients with breast cancer. Retrospective analysis was conducted to clarify its clinical usefulness. Forty-one patients with metastatic ...breast cancer were treated with paclitaxel between November 2000 and September 2002. Hospital records of the patients, except for one unsensored patient, were retrospectively reviewed. Characteristics of the patients were as follows: age, 36-81 Y (median, 56); 8 stage IV and 32 recurrent diseases; most frequent dominant site of metastasis was the liver (22 patients, 55%); number with previous chemotherapy was 0-5 (median, 2); anthracycline-based treatment and docetaxel treatment were previously performed in 21 (53%) and 15 (38%) patients, respectively; weekly dose of paclitaxel was 30-150 mg/body (median, 100); and total dose administered was 600-6, 480+ mg/body (median, 1,820). Objective response and clinical benefit rates were 35% and 80%, respectively. Median duration of response, time-to-progression and overall survival were 27+, 33+ and 41.5 weeks, respectively. Common adverse events were sensory neuropathy (45%) and nausea/vomiting (37.5%). Most were graded as 1 or 2. Various agents, such as hormonal agents and trastuzumab, were administered with paclitaxel in 26 patients (65%). No significant difference was observed in efficacy or toxicity among patients treated with paclitaxel alone or paclitaxel plus other agents. Paclitaxel seems to be a feasible, safe and active agent for patients with metastatic breast cancer.
Background
The Response Evaluation Criteria in Solid Tumors (RECIST) was revised in 2009, based on a large dataset of 6512 patients from 16 trials. However, no gastric cancer patients were included ...in those data. The purpose of this study was to clarify the difference between RECIST version 1.0 and version 1.1 in advanced gastric cancer.
Methods
From 2004 to 2009, 129 consecutive patients with advanced gastric cancer received S-1 plus cisplatin as first-line treatment at the National Cancer Center Hospital East. Ninety-seven of these patients who had had baseline and post-treatment computed tomography scans performed were included in this study. Measurements of tumors were conducted retrospectively.
Results
At the baseline of first-line chemotherapy, 172 lymph nodes in 54 patients were considered to be candidate target lesions by RECIST version 1.0. However, only 38 % of the lymph nodes were classified as target lesions by RECIST version 1.1, with 47 % classified as non-target lesions and 15 % classified as non-pathological. By RECIST version 1.0, the proportion of patients with target lesions at the baseline of first-line chemotherapy was 67 % (65/97), and this percentage was significantly reduced according to RECIST version 1.1 (53 %; 51/97) (McNemar’s exact test,
P
< 0.001). The findings at the baseline of second-line chemotherapy were similar (reduced from 62 to 49 %; McNemar’s exact test,
P
= 0.002). Overall response rates of first-line chemotherapy were 52 % (34/65) according to RECIST version 1.0 and 55 % (28/51) according to version 1.1.
Conclusions
The revision of RECIST significantly reduced the proportion of patients classified with target lesions at the baselines of first-line and second-line chemotherapies. No obvious difference in overall response rates was observed.
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