The underlying hepatopath may cause intra-hepatic recurrence even if curative resection for hepatocellular carcinoma (HCC) is achieved. Two patterns of intra-hepatic recurrence is exist, multicentric carcinogenesis with chronic hepatopath and intra-hepatic metastasis. We must diagnose the difference of these 2 characters after treatment, hepatectomy or ablation, for HCC and perform the post-operative adjuvant therapy expecting the 2 patterns. The prevention of multicentric carcinogenesis is postoperative interferon (IFN) therapy on hepatitis C virus-related HCC and the prevention of intrahepatic metastasis is postoperateive transcatheter arterial infusion chemotherapy (TAI) and cell immunotherapy on advanced HCC. The postoperative adjuvant therapy for HCC was found to be an effective adjuvant therapy that significantly improved survival and disease-free survival rates, and we have been not satisfied with the therapiatic effects. Although randomized controlled study with a greater number of patients is necessary.
We previously reported that we should first induce a prolonged cytostatic (dormant) phase rather than strive to shrink tumors, because the survival time of most patients with solid tumors depends on the length of the induced cytostatic (dormant) phase rather than on induced tumor reduction. To confirm this concept, we examined whether the survival of SD with a prolonged dormant phase is equal or superior to that of an "effective" (CR and PR) case in three late phase II clinical studies of patients with gastric cancer and non-small cell lung cancer. These results led to the conclusion that we can achieve survival without tumor shrinkage, and we call it "tumor dormancy therapy. "In order to apply our strategy in chemotherapy, we developed and established a new dose finding system "individualized maximum repeatable dose (iMRD)" instead of the present only dose finding system, maximum tolerated dose (MTD). Our results showed that chemotherapy by iMRD for pancreatic cancer using gemcitabine induced longer median survival without severe toxicities and may expect a tailor made dose treatment. A large-scale comparative clinical study is starting to verify such a potential. [Skin Cancer (Japan) 2003; 18 : 7-12]
ABSTRACT-Background.Cancer-associated retinopathy (CAR) is one of the paraneoplastic syndromes and is characterized by retinal degeneration. CAR is often associated with epithelial cancers, mostly small-cell lung carcinoma.We describe the second report of CAR associated with invasive thymoma. Case. A 41-year-old woman was admitted for visual disturbance. Chest X-ray film and CT scanning images showed a mediastinal tumor. In her serum antiacetylcholine receptor antibody was elevated and CAR autoantibody was detected. CAR and thymoma with myasthenia gravis were diagnosed, and steroid pulse therapy was performed. Her visual disturbance progressed but the tumor diminished. She underwent extended thymectomy and resection of the mediastinal tumor, which was invasive thymoma.After operation radiotherapy and steroid therapy were performed. Ten months after operation CAR autoantibody was negative, but her visual loss had not improved. Conclusion. CAR is often associated with lung cancer, but may occur in a patient with invasive thymoma. (JJLC. 2002; 42: 119-123)
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