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Cytotoxic Chemotherapy for Advanced Gastric Cancer: From the viewpoint of macroscopic improvement on x-ray and gastroscopic views M. kurihara 1 1Department of Gastroenterology, Juntendo University pp.1623-1637
Published Date 1979/12/25
DOI https://doi.org/10.11477/mf.1403107856
  • Abstract
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 315 patients with advanced gastric cancer have been treated with cytotoxic agents in the past ten years. Gastrectomy was not done in about 70% of them, but in the remaining patients, cytotoxic chemotherapy was carried out for postoperative recurrence or as postoperative adjuvant therapy.

 The age of non-operated patients ranges from 20 to 80, and 32.5% of them were older than 70 years of age. In this group, Borrmann type 2 cancer was seen in 16%, Borrmann type 3 in 38% and Borrmann type 4 in 45%. Performance status in this group was 1 in 12.4%, 2 in 35.6%, 3 in 40.7% and 4 in 11.3%.

 Recently, new criteria at evaluation of chemotherapy for solid tumor were proposed in Japan by the reference to WHO and ECOG's criteria. 151, 112 nonoperated and 39 operated cases, of the 315 cases were evaluable on the criteria. Complete response was achieved in 2 cases and partial response in 11 with the response rate of 11.6% in the 112 non-operated cases. While, in the 39 cases with postoperative recurrence, complete response was encountered in 1 case and partial response in 2 with the response rate of 7.7%. The response rate in both groups was 10.6%.

 Tumor regression rate in these patients was calculated by the X-ray measurement of either palpable tumor or tumor on the views. Tumor regression rate could be calculated on the X-ray views in 109 cases. 62% of whom had palpable tumor. The response rate in the 109 cases was 6.4% with complete response of 3 cases and partial response of 3.

 From the viewpoint of improvement in X-ray and gastroscopic findings, cytotoxic chemotherapy was thought to be effective in 13 cases on our own criteria with the effective rate of 11.9%, and the tumor on the X-ray view disappeared in 3 of them. X-ray and gastroscopic findings altered from those of advanced cancer to those of early cancer in 3 cases, and furthermore, minor improvement on the x-ray and gastroscopic views, judged by several doctors, was also encountered in 7 cases. Improvement on the X-ray and gastroscopic views was not seen in relation to tumor regression, and flattening of the elevative part of cancer focus and shrinkage of the ulcerative part were the sign of improvement.

 In Borrmann type 4 cancer, improvement in pliability or deformity of the stomach seems to be the sign of response to chemotherapy, and therefore, Borrmann type 4 cancer is not evaluable on the new criteria.

 50% survival period in the 13 patients was 46 weeks, and that in the patients with complete or partial response on the new criteria was 32 Weeks.

 In view of the clinical effect of cytotoxic chemotherapy for gastric cancer, the criteria should be made on the basis of improvement in various x-ray and gastroscopic findings.


Copyright © 1979, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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