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A 43 -year-old woman presented to the hospital with a right breast tumor. She had been treated for human immunodeficiency virus(HIV)infection for 5 years. After being diagnosed with right breast cancer, she underwent total mastectomy and sentinel lymph node biopsy, which indicated T2N1M0 triple-negative breast cancer. She received doxorubicin and cyclophosphamide( AC)followed by docetaxel(AC-T)as postoperative adjuvant chemotherapy. However, 14 months after the adjuvant chemotherapy finished, distant metastasis occurred in the brain, lung, and mediastinum lymph nodes. Treatment for relapse was initiated, with whole brain radiotherapy followed by paclitaxel plus bevacizumab combination therapy(PB); however, new metastatic lesions were found in the bone, liver, and mediastinum lymph node after 2 courses of PB. Given the risk of hereditary breast and ovarian cancer syndrome, a BRCAgene test was performed when the patient received radiotherapy for left recurrent laryngeal nerve paralysis caused by mediastinal lymph nodes; this showed a result positive for a deleterious mutation in BRCA1. Thus, treatment with olaparib, a poly(ADP-ribose)polymerase(PARP)inhibitor, was started. Metastatic lesions, including barky growth, in the liver metastasis were well controlled, as confirmed by CT imaging 4 months after the start of olaparib.

The present study reports the outcomes of chemotherapy using nab-PTXplus RAM in 6 patients with metastatic gastric cancer as recommended in the JGCA guidelines for special conditions. Four cases exhibited Grade 3 neutropenia, 1 exhibited Grade 3 hypertension, and no case developed febrile neutropenia; however, the adverse events were tolerated. One case showed partial response, 1 showed stable disease, 2 cases showed non-complete response/non-progressive disease, and 2 cases could not be evaluated. These results suggest that this treatment may be performed safely in ambulatory patients.

Therapy-related leukemia(TRL)is a distinctive clinical syndrome that occurs after exposure to chemotherapy or radiotherapy. We report a case of suspected TRLafter chemotherapy in a patient with breast cancer. A 61-year-old woman underwent total mastectomy and sentinel lymph node biopsy(negative)for her breast cancer. Histopathologic analysis showed invasive ductal carcinoma, pStage I. Her subtype histology was Luminal B-type, and postoperative adjuvant chemotherapy and endocrine therapy were administered. Four years after chemotherapy, a blood examination showed pancytopenia. Bone marrow examination showed acute promyelocytic leukemia. She was treated with chemotherapy and achieved complete remission. Breast cancer provides long-term survival after treatment. Attention should be paid to the occurrence of TRLin breast cancer surveillance.

A 75-year-old female with squamous cell carcinoma in the left margin of the tongue (T2N0M0) was referred to our hospital. She was treated with oral administration TS-1 80 mg/day as preoperative chemotherapy. After commencement of TS-1 administration, the tumor size was reduced at 1 week and had disappeared clinically at 4 weeks. Oral administration of TS-1 was done in 2 courses at the same dose. After two courses, histological examination reveled a complete disappearance of the cancer cells. No adverse effects were seen during the treatment period. She remains under oral administration of UFT for maintenance chemotherapy and there is no evidence of recurrence of the tumor.

A 73-year-old male with squamous cell carcinoma of the oral floor (T1N0M0), who had not consented to radical treatment was treated with UFT by oral administration alone. After commencement of the administration, tumor remission was observed at 2 weeks and disappeared clinically at 8 weeks. The total period of oral administration of UFT was twenty-three months, and the total dose was 186.5 g as tegafur. Major adverse effects were pigmentation of hands and liver dysfunction. He remains under observation, and there is no evidence of tumor recurrence.

Recurrence of gastric cancer or colon cancer was observed in some patients who received 5-fluorouracil (5-FU) high-dose continuous Methotrexate (MTX)-Leucovorin (LV) therapy (FML therapy) previously. 5-FU high-dose 48-hours continuous therapy (5-FU therapy) as maintenance therapy for the patients was performed in the hospital and successively at home. The patients included 3 with recurrent gastric cancer and 2 with recurrent colon cancer: there were 4 males and 1 female, the mean age was 51.8 years (33-59 years). All patients had received FML therapy during the hospital stay before the maintenance chemotherapy at home. 5-FU therapy (30 mg/kg/day x 2 days/w), 30.2 courses on an average (11-40 courses), was performed through a catheter (Port-A-Cath), which was introduced into the right subclavian vein and placed under the skin, with a Baxter infusion pump. The concentration of 5-FU was 197 +/- 172-401 +/- 127 ng/ml between the 2nd and 48th hour. Adverse reaction included anorexia in 5 patients, stomatitis in 4, pigmentation in 4, leukopenia in 3, neuropathy in 2 and alopecia in 1. The therapy was effective for 10.4 months on an average (4-18 months) and the mean survival period was 12.0 months (7-18 months).