A case report of advanced breast cancer effectively treated with etoposide, adriamycin and cis-platinum combination therapy

A 61-year-old woman with left advanced breast cancer (T3a, N2, M0, Stage IIIa) underwent preoperative chemotherapy. The regimen consisted of etoposide 70 mg/m2 (day 4, 5, 6 i.v.), adriamycin 20 mg/m2 (day 1, 7 i.v.) and cis-platinum 40 mg/m2 (day 2, 8 i.v.). By the third week of administration, the size of the breast tumor reduced markedly, with the rate of 97%, resulting in partial response. Following preoperative combination-chemotherapy, a left extended radical mastectomy was performed. Histological findings of the resected specimen showed sufficient effects of chemotherapy; degeneration of tumor cells, infiltration of histiocytes and fibrosis of stroma. After operation, chemotherapy with the same dosage and sequential irradiation were undergone. As the side effect of this chemotherapy, slight nausea, vomiting and leucocytopenia were observed. The result of this case suggested that combination-chemotherapy with etoposide, adriamycin and cisplatinum was an effective chemotherapy for advanced breast cancer.     

A case of advanced male breast cancer treated effectively with estrogen

A 47-year-old man was admitted because of a left axillary tumor. A biopsy of the tumor disclosed adenocarcinoma. The bone survey showed multiple sclerotic metastases. Thirteen months after his first admission, a left breast tumor developed and a simple mastectomy revealed a papillotubular carcinoma. Skin metastases appeared postoperatively and were exacerbated with accumulation of pericardial effusion and a high CEA level (401.7 ng/ml) despite radiation and chemotherapy. Estrogen therapy with diethylstilbestrol sodium phosphate was started, resulting in the disappearance of pericardial effusion and skin metastases. The patient remains well 10 months after starting estrogen therapy with a normal CEA level.     

A case of advanced breast cancer effectively treated with tamoxifen]

A 69-year-old female with advanced breast cancer was daily administered 20 mg of tamoxifen. After 4 months, her left breast tumor decreased in size. Left breast tumor and metastatic lymph nodes disappeared completely (CR) 7 months later. CR has been continued for 6 months up to the present, and the patient has been enjoying favorable quality of life.     

A case report of advanced breast cancer effectively treated by chemo-endocrine therapy with diethylstilbestrol diphosphate and cyclophosphamide

A woman more than 5 years postmenopausal with right advanced breast cancer (T4, T3, M1, stage IV) was treated with a mild chemo-endocrine therapy. The regimen consisted of diethylstilbestrol diphosphate (Honvan) at 15 mg/day orally and cyclophosphamide at 100 mg/day orally. By the sixth month after administration, both the right breast cancer and multiple lymph node metastases completely disappeared. The change of hormonal therapy from Honvan, as estrogen, to tamoxifen, as antiestrogen, was done 2 years and 9 months after the beginning of initial treatment. The breast cancer recurred 9 months after the change of treatment. At that time, Honvan was again administered instead of tamoxifen. Complete remission was again obtained for 6 months beginning 2 months after the change of drugs, but then the tumor recurred. Although combination chemotherapy was undertaken, the patient died 5 years after initial treatment. These results suggest that chemoendocrine therapy using a low dose of Honvan and cyclophosphamide is effective for advanced breast carcinoma.     

A case of advanced accessory breast cancer effectively treated with trastuzumab and paclitaxel

A 53-year-old woman was admitted for left axillary mass. The computed tomography showed an invasive mass in the left axilla and left supraclavicular lymph node swelling. Histological findings of axillary mass revealed infiltrating ductal carcinoma of scirrhous type. We diagnosed advanced accessory breast cancer, and the patient was treated by combination chemotherapy with paclitaxel and trastuzumab. The lesions disappeared after 4 courses of chemotherapy and was clinically diagnosed as complete response(CR).     

A case report of bone metastasis diagnosed by MRI and effectively treated with UFT after breast conserving therapy for breast cancer]

A 66-year-old woman with left breast cancer (medullary carcinoma; T1cN1M0; Stage II A) was treated with breast conserving therapy combined with lumpectomy, radiotherapy, chemotherapy and endocrine therapy beginning in March, 1990. She complained of back pain and was diagnosed as having bone metastasis to the lower thoracic spine by bone scintigram and MRI examination in September, 1990. Oral administration of UFT (300 mg/day) was started, and 5 months later, back pain disappeared; nineteen months later, no definite findings of bone metastasis were observed on bone scintigram and MRI. It was concluded that long-term oral administration of UFT is an effective remedy for bone metastasis after breast conserving therapy for breast cancer.     

A case of multiple bone metastases from advanced breast cancer effectively treated with pamidronate]

A 57-year-old woman, with bone, lymph node and skin metastases underwent mastectomy and extirpation of skin tumors. Chemoenderine-therapy was performed from the 15th day after operation, with a toremifene and CEF regimen consisting of cyclophosphamide, epirubicin and 5-fluorouracil. She had nausea and neurological symptoms from hypercalcemia (21.5 mg/dl) on the 28th day after operation. Her serum PTHrP level was found to be high at 214 pmol/l. We administered pamidronate in a dose of 45 mg biweekly, and she improved. The CEF regimen and pamidronate therapy was continued for 6 cycles and the regions of bone metastases were reduced on the bone scintography. Thereafter she has been administered pamidronate 30 mg/4 weeks as an outpatient with no further symptoms, and serum Ca and PTHrP have remained normal. In conclusion, pamidronate combined with chemotherapy can be a therapeutic option for not only hypercalcemia but also bone metastases of breast cancer.     

A case of multi-drug resistant breast cancer with liver metastasis treated effectively by S-1 monotherapy

We report a case of multi-drug-resistant breast cancer with liver metastases which completely responded and improved the quality of life (QOL)by S-1 monotherapy. The patient was a 53-year-old woman, who was diagnosed as breast cancer with invasive chest wall, cervical lymph node metastases, multiple bone metastases and bilateral pleural effusion[invasive ductal carcinoma, scirrhous type, ER(-), PgR(+), HER2(1+)]. After six courses of cyclophosphamide+epirubicin(CE)and weekly paclitaxel for 3 months, cervical lymph node metastasis was judged as a partial response(PR)and the bilateral pleural effusion disappeared. After chemotherapy, aromatase inhibitor (AI) was used. However, primary lesion and multiple bone metastases no change(NC). Following pass through AI+ oral anticancer drug combination chemotherapy and oral anticancer drug monotherapy, the therapy was changed to palliative, and she was referred to our hospital in January 2007. On arrival at the hospital, respiratory distress and bilateral pleural effusion had appeared, so it was an emergency admission. After removing the pleural effusion, pleurodesis was done and the symptoms disappeared. Although AI plus bisphosphonate therapy were started at hospital discharge, disease progression and fatigue appeared. In December 2007, we started S-1 monotherapy. S-1 was given orally at 80 mg/m2 for day 1-28 followed by a 2-week rest period, within a 6-week courses. Six months after treatment was started, multiple liver metastases disappeared and peritoneal effusion decreased. During the period of S-1 treatment, there were no serious adverse events, and treatment was possible without compromising QOL. This result suggested that S-1 treatment was a reasonable option for multi-drug-resistant breast cancer.     

A case report of radiation-induced cancer of the buccal mucosa, effectively treated with CF therapy

We report favorable effect of combination chemotherapy with CDDP and 5-FU for a case of radiation-induced cancer of the left buccal mucosal membrane. A 71-year-old man underwent external-beam radiotherapy for a squamous cell carcinoma of the tongue. He developed left buccal mucosal cancer 13 years after the start of this radiotherapy. One course of the therapeutic regimen consisted of CDDP 70 mg/m2/day drip infusion for 2 hours (day 1) and 5-FU 700 mg/m2/day drip infusion for 120 hours (days 1-5). The patient underwent 4 courses. A partial response was achieved after 1 course, after which additional treatment with the same regimen was made with favorable effect. Four years after the treatment, 2 courses of the same chemotherapy were performed because of a recurrence of radiation-induced cancer, with a complete response. No serious side effects appeared. A histopathological examination of the lesion showed no cancer tissue. The patient was alive and cancer free 4 years after the treatment, and has been followed.     

A case of colorectal cancer effectively treated with UFT/LV

5-FU/LV therapy has been standard chemotherapy for advanced and recurrent colorectal cancer. Several studies reported that a new alternative chemotherapy, UFT/LV, had anti-cancer effects the same as with conventional 5-FU/LV therapy. We report a patient who had advanced and recurrent colorectal cancer treated with UFT/ LV. This 70-year-old male was admitted to our hospital because of a right lower abdominal mass, which was diagnosed as a peritoneal recurrence of transverse colon cancer by abdominal CT. UFT/LV therapy was started on an outpatient basis. After one course of chemotherapy, the intra-abdominal mass disappeared, and this therapy was continued for three courses. He did not suffer from any adverse effect during chemotherapy. Although this therapy was resumed because of the recurrence at the same site after nine months, it was refractory to chemotherapy. Thereafter, surgical resection was performed, and it was diagnosed as lymph node metastasis of previous surgery.     

A case of inflammatory breast cancer successfully treated with intra-arterial infusion of high-dose epirubicin

A 56-year-old female with extensive inflammatory breast cancer was treated with intra-arterial infusion chemotherapy using a high dose of epirubicin. One cycle consisted of epirubicin; 150 mg (day 1, 4, 7) and daily administration of tamoxifen; 40 mg. After completion of 2 cycles of the regimen, both the main tumor and the extensive inflammatory skin lesion completely disappeared (CR). Hair loss, gastrointestinal disorders and leukopenia (nadir; 1,600) were the side effects encountered, but all of them were reversible. These findings suggested that dose-escalation of epirubicin was effective, and that cases with extensive skin involvement were also candidates for this modality.     

A case report of liver metastasis from rectal cancer effectively treated with intravenous infusion of cisplatin alone

A 49-year-old man with liver metastasis from rectal cancer was treated with cisplatin (CDDP) alone. Cisplatin was administered intravenously 3 times at a dose of 50 mg (31 mg/m2). He achieved an excellent PR (94% decrease) as determined by CT scanning, and plasma CEA level decreased from 37 to 2.2 ng/ml. The side effects were nausea, vomiting, and reflux esophagitis, but neither leucopenia nor renal dysfunction was observed. As a result, a radical operation could be undertaken.     

A case report of locally advanced rectal carcinoma effectively treated with preoperative chemoradiotherapy

The patient was an 80-year-old woman who was diagnosed with locally advanced low rectal cancer. It was unresectable and we performed chemoradiotherapy combined with S-1 (S-1 80 mg/m2, RT 1.8 Gy × 25, total 45 Gy). An effective reduction of primary region resulted in curative resection (super low anterior resection, D3 lymph node dissection, covering ileostomy) with preserving the anal sphincter. Histopathologically, therapeutic efficacy was Grade 2. Preoperative chemoradiation has been a standard therapy in Western countries and would control local recurrence. This case indicated that CRT could improve a rate of curative resection in patients with locally advanced rectal carcinomas.     

A case of colon cancer with pulmonary metastasis treated effectively by uracil futraful

A 57-year-old female was admitted for advanced ascending colon cancer with a solitary pulmonary metastasis measuring 1.5 cm in diameter. As laparotomy revealed an absolute noncurable tumor of stage V (H0, p2, s2 n1 (+], palliative right hemicolectomy was performed. A pathological diagnosis of well differentiated adenocarcinoma was made postoperatively. A daily dose of 400 mg of UFT was given orally. After 8 months, plain chest film and tomography revealed a reduction in the size of the pulmonary metastasis to 1.0 cm in diameter. The metastatic lung tumor was controlled for a period of 1 year and 9 months. It was suggested that UFT was rather effective for pulmonary metastasis from colon cancer.     

A case of breast cancer with multiple metastases effectively treated with long-term administration of docetaxel, aclarubicin and UFT]

A 46-year-old woman had undergone a mastectomy in 1994, and metastases to the lung, bones and liver were detected in 1998. Brain metastases were detected later. Chemotherapy consisting of docetaxel, aclarubicin and UFT was administered, and image diagnosis revealed that CR was achieved. The chemotherapy was continued on a long-term basis, both as an inpatient and outpatient. The total administered doses have reached 2,000 mg of docetaxel and 1,000 mg of aclarubicin. The CR is being maintained as of this writing, 2 years and 4 months after the detection of the metastases. The patient's course continues to be monitored.     

A case of docetaxel-resistant lung cancer effectively treated with chemotherapy of gemcitabine and vinorelbine

We report a NSCLC patient effectively treated with anti-cancer agents on an outpatient basis despite chemotherapy with carboplatin and docetaxel, he relapsed after achieving a transient response. Combination chemotherapy with gemcitabine and vinorelbine administered every three weeks in an outpatient clinic caused the lung cancer volume to reduce remarkably. This regimen was well tolerated and suitable for outpatients. Its usefulness as a second line chemotherapy in the treatment of NSCLC should be investigated.     

A case of pleural and mediastinal lymph node metastases from breast cancer effectively treated with fadrozole hydrochloride in combination with cyclophosphamide

A 63-year-old woman was diagnosed with pleural and mediastinal lymph node metastases 116 months after operation because of bilateral breast cancer. She was then treated with fadrozole hydrochloride (FH) (2 mg). Adriamycin (30 mg) administration into the pleural cavity was attempted, but did not prove effective. Thus, we tried to combine FH with cyclophosphamide (100 mg). After one month, chemoendocrine therapy relieved her complaints of cough and shortness of breath. CT revealed a remarkable decrease of pleural effusion and disappearance of mediastinal lymph nodes. She was alive 9 months after the treatment. Fadrozole hydrochloride in combination with cyclophosphamide is promising as an effective treatment in postmenopausal patients.     

A case of colonic cancer with multiple liver metastases effectively treated by intra-arterial chemotherapy

A 36-year-old female underwent sigmoidectomy and insertion of an intra-hepatic arterial catheter for advanced sigmoid cancer with multiple liver metastases. After the operation, intra-hepatic arterial infusion of the chemotherapeutic agents that showed sensitivity in the histoculture drug response assay (HDRA) to the liver metastasis was done for one year. The metastatic liver lesions other than those in the lateral segment which were fed by an accessory artery decreased remarkably. Therefore, we performed lateral segmentectomy. The patient has been doing well without recurrence for 18 months after the first operation. Intra-hepatic arterial infusion chemotherapy for liver metastasis from colorectal cancer can produce an excellent result with the use of sensitive chemotherapeutic agents.     

A case of gastric cancer with extraordinary liver metastasis effectively treated by adjuvant chemotherapy

This was an extraordinary liver metastasis case with complication when the patient, a 70-year-old male, was diagnosed with stomach cancer for the first time. However, the patient has been in remission and is a long-term survivor due to an active chemotherapy after the operation. His chief complaints were stomachache and a loss of weight. He was diagnosed with stomach cancer by endoscopy. During the surgery, the mass was found to be 3 QFB palpable caused from hepatomegaly. The liver dysfunction was revealed in the blood biochemistry inspection. The abdominal CT revealed that the stomach cancer had spread to the whole liver. Distal gastrectomy was performed on May 22, 1997. In pathological findings, the tumor was diagnosed as a well-differentiated adenocarcinoma. Final findings: M, type3, T3 (SE), N2, H3, P0, CY0, and Stage IVb. The 5-FU based chemotherapy was performed and a complete response was temporarily obtained. However, it has recurred one year later and two or more kinds of chemotherapy have continued. He is alive for more than 7 years and comes to our hospital as an outpatient.     

A case of stage IVb vulvar cancer effectively treated by concurrent chemoradiotherapy with cisplatin

A 72-year-old woman was hospitalized because of a 10 cm tumor in her right inguinal area. Furthermore, a 6 cm tumor mass was observed in her right vulva. Computed tomography revealed multiple swollen lymph nodes in the para-aortic and pelvic areas. On the basis of these findings, the patient was diagnosed with stage IVb squamous cell carcinoma of the vulva. Radiation therapy of 67.4 Gy/33 Fr was administered to the pelvis, inguinal area and vulva. Four courses of chemotherapy with cisplatin (40 mg/m(2)) were concurrently administered every week during radiation therapy. The response to chemoradiotherapy was assessed to be complete. The patient has been doing well without any recurrence for 24 months.