[Combination chemotherapy of TS-1 +cisplatin for inoperable gastric cancer].

There is no chemotherapy considered to be standard treatment for advanced gastric cancer worldwide, and there is no consensus as to whether combination or single agent therapy is preferred. In the phase I portion, a dose-escalation study of cisplatin (CDDP) combined with TS-1, new oral dihydropyrimidine dehydrogenase inhibitory fluoropyrimidine, was performed to determine the maximum-tolerated dose (MTD), recommended dose (RD), dose-limiting toxicities (DLTs), and objective response rate (RR) in advanced gastric cancer (AGC). TS-1 was given orally at 40 mg/m2 bid for 21 consecutive days following a 2-week rest.

An extensive metabolizer with recurrent ulcer responding to high dose of lansoprazole.

A 51-year-old man underwent surgery for duodenal ulcer in 1983. Ulcer recurred several times. Recently, the patient was receiving 30 mg/day of lansoprazole.

[A case of 10-year survival after combination chemotherapy of 5'-deoxy-5-fluorouridine and cisplatin and adjuvant surgery for gastric cancer with liver metastasis].

A 36-year-old woman was diagnosed with type 3 advanced gastric cancer with multiple liver metastases in March 1992. The patient was treated with systemic chemotherapy of 5'-deoxy-5-fluorouridine and cisplatin. After 4 courses of chemotherapy, the primary lesion responded and the multiple liver metastases disappeared.

A double-blind, crossover, randomized comparison of granisetron and ramosetron for the prevention of acute and delayed cisplatin-induced emesis in patients with gastrointestinal cancer: is patient preference a better primary endpoint?

Background: Serotonin receptor antagonists are recommended by the American Society of Clinical Oncology for the prevention of acute and delayed chemotherapy-induced emesis. However, the most effective agent in this class of antiemetic drugs for preventing emesis has not been clearly defined. We therefore performed a double-blind, crossover, randomized, controlled trial comparing the efficacy of granisetron and ramosetron, using patient preference as the primary endpoint.

[Controversial issues in chemotherapy for inoperable gastric cancer].

Randomized trials demonstrated the significantly improved survival benefit of 5-fluorouracil (5-FU) based chemotherapy in patients with unresectable advanced gastric cancer (AGC) in comparison with best supportive care (BSC). However there is no chemotherapy considered worldwide to be the standard treatment for AGC and there is no consensus as to whether combination or single agent therapy is preferable. Therefore, 2 large Phase III studies JCOG 9912 5-FU vs TS-1 vs CPT + CDDP and TS-1 vs TS-1 + CDDP are now ongoing to establish an acceptable frontline standard for patients with AGC.

Inhibition of peptic ulcer relapse by ranitidine and ecabet independently of eradication of Helicobacter pylori: a prospective, controlled study versus ranitidine.

Background/aims: The recent increase in resistant strains of Helicobacter pylori has become a serious problem. Ecabet is a novel anti-ulcer agent that acts directly on the gastric mucosa, has bactericidal activity, and inhibits adhesion of Helicobacter pylori to the gastric mucosa. These actions result from inhibition of urease and ATPase in Helicobacter pylori, a mechanism distinct from that of antibiotics.

Clinical outcome of endoscopic aspiration mucosectomy for early stage gastric cancer.

Background: Endoscopic mucosal resection is an established treatment option for early stage gastric cancer. However, several problems with endoscopic mucosal resection remain to be solved, such as appropriate treatment for recurrence and incomplete tumor resection. The outcome for patients undergoing endoscopic aspiration mucosectomy (endoscopic mucosal resection) by a modification of the cap-fitted technique was evaluated retrospectively to determine factors associated with complete resection and tumor recurrence.