Giant cell tumors of the bone are benign but locally aggressive, and they rarely metastasize to the lungs. The purpose of this study was to retrospectively review the clinical presentation, long-term outcomes, and treatment of pulmonary metastasis of these tumors. Between 1991 and 2004, a total of 168 patients with giant cell tumors of the bone were treated at the authors' institution, 7 of whom developed lung metastasis. Four of the 7 patients were men, and mean age of these patients at initial surgery was 40 years (range, 19-56 years). All patients underwent wide excision and reconstruction or curettage and bone grafting for the bony lesions. Lung metastases were detected at a mean of 44 months after the treatment of bone lesions. Five patients had multiple metastases, and 2 had solitary pulmonary metastases. Six of these patients underwent delayed treatment, locally aggressive, or multiple recurrent and surgical procedures. All of the aforementioned procedures had similar risk factors to those previously reported in the literature. One patient had multiple giant cell tumors of the bone. At last follow-up, 2 patients had died due to complications from the pulmonary metastases or chemotherapy. One patient underwent a metastasectomy 4 years after treatment due to the progression of pulmonary metastasis. The remaining 4 patients were alive and healthy after chemotherapy or conservative treatment. Therefore, early detection, adequate treatment of the primary bone lesion, conservative treatment of lung metastases, and regular long-term follow-up are recommended.

The formulation excipient Cremophor EL (CrEL) is known to limit absorption of oral paclitaxel given together with cyclosporin A (CsA). We hypothesized that the use of oral Genetaxyl, a paclitaxel formulation containing only 20% CrEL would have an improved oral bioavailability. Cohorts of 6 patients were treated with oral Genetaxyl at a dose of 60, 120, or 180 mg/m 2 and 10 mg/kg of oral CsA in cycle 1. In cycle 2, patients received intravenous (i.v.) Genetaxyl (175 mg/m 2 , 3-hour infusion). Three additional patients received one dose of generic i.v. paclitaxel (Genaxol, containing 50% CrEL; 175 mg/m 2 , 3-hour infusion). The median area under the plasma concentration-time curve (AUC) and peak concentration of total paclitaxel following i.v. Genetaxyl were lower than those for i.v. Genaxol, as a result of significantly increased clearance (P = 0.017), and the AUC ratio for unbound to total paclitaxel for i.v. Genetaxyl was about 2 times higher than that for i.v. Genaxol (P = 0.0077). After oral administration of Genetaxyl at doses of 60, 120, and 180 mg/m 2 , the median total paclitaxel AUCs were 1.29, 1.60, and 1.85 µg×h/mL, respectively, suggesting a less than proportional increase in systemic exposure with increasing doses. The corresponding median values for the apparent bioavailability of oral Genetaxyl were similar when calculated either based on data for total paclitaxel (30.1%) or unbound paclitaxel (30.6%) when compared to i.v. Genetaxyl.

The response rate to an FMP regimen was still unsatisfactory, although a specific subgroup of patients (good performance status, smaller liver tumor mass, good liver reserve, and distant metastasis) may benefit from this regimen.We evaluated the anti-tumor efficacy and toxicity of 5-fluorouracil (5-FU), mitoxantrone, and cisplatin (FMP) in patients with advanced hepatocellular carcinoma (HCC), and conducted an analysis of the prognostic factors for response to such therapy and patient survival.

Central nervous system germinoma historically has been treated with radiotherapy alone. Although this regimen provides good tumor control, there are risks of long-term complications; this study used a combination of chemotherapy and low-dose radiotherapy to reduce these risks. Between January 2002 and June 2009, 16 patients (14 male, 2 female) with a median age of 14.7 years (9.2 to 19.6 y), were treated. Thirteen of the tumors had a single focus and 3 were multifocal: 8 were located in the pineal, 8 were suprasellar, and 3 were in the basal ganglion or other periventricular areas. All patients had negative spinal magnetic resonance imaging findings. Treatment consisted of cisplatin-based and etoposide-based chemotherapy, and 2340 cGy of radiotherapy delivered to the whole brain/ventricle. The median time of follow-up was 45 months. None of the patients suffered from treatment failure. Tumors larger than 2.5 cm regressed less completely after upfront chemotherapy than smaller tumors, but overall treatment outcome was not affected by tumor size. One patient developed a new complication (hypopituitarism) 8 months after treatment, and 1 patient developed a second malignancy 3 years after diagnosis. The results confirm that short courses of chemotherapy combined with low-dose whole-brain or whole-ventricular radiotherapy have favorable outcomes.

Purpose The current study assessed the eYcacy and safety of biweekly oxaliplatin combining oral tegafur-uracil/ leucovorin in treating chemonaive patients with advanced gastric cancer. Methods Eligible patients were 18-75 years old, had stage IV disease or post-surgery recurrence, no prior palliative chemotherapy, and an ECOG performance status of 0-2. Patients in the current study received 2-h i.v. infusion of oxaliplatin at a dose of 100 mg/m 2 after diluting in 500 mL 5% dextrose/water (dexan premedication), and 5-HT3 antagonist biweekly. Oral tegafur-uracil and leucovorin was given at a dose of 300 mg/m 2 /day and 60 mg/day three times daily from day 1 to 21, respectively, followed by a 1-week rest. Response assessment was based on the RECIST criteria and was performed every two courses.Toxicity was assessed according to NCI common toxicity criteria version 2. Results From October 2003 to April 2006, 57 patients were evaluated (55 eligible) with a median age of 61 years (range 31-75). According to the assessment of response in 48 evaluable patients, partial response rate was 24/48 (50.0%) (95% CI: 35.23-64.73%) and stable disease was observed in 11 patients (22.92%), and diseased progressed in 13 patients (27.08%). Mean number of oxaliplatin cycles was 3 (0.5-6.5). Median time to progression was 177 days. Median overall survival was 318 days. Major-grade (III/IV) toxicities were diarrhea 25.5%, vomiting 16.5%, anemia 10.9%, numbness 12.7%, thrombocytopenia 7.3%, neutropenia 3.6% and leucopenia 1.8%. Conclusions Biweekly, oxaliplatin combining oral tegafur-uracil/leucovorin in treating patients with advanced gastric cancer showed acceptable activity and manageable toxicity.