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Eight patients with thymic carcinoma were surgically treated at Sapporo City General Hospital from September 1990 to January 2002. The histological subtypes of thymic carcinoma were squamous cell in 5, undifferentiated in 2, and small cell in one. After median sternotomy, 5 patients had total resection of the tumor, and 3 had incomplete resection due to extensive mediastinal invasion involving the main pulmonary artery in the A-P window. Of 3 cases with intra pericardial malignant effusion, one patient survived 7 years without recurrence of the tumor after the exploratory operation followed by mediastinal irradiation without chemotherapy. In this patient, existence of the malignant cells in the pericardial effusion was not associated with poor outcome.

A 64-year-old male, who had received successful radiotherapy for the previous laryngeal cancer, was admitted to our department for the treatment of a peripheral pulmonary tumor in the right upper lobe and an endotracheal tumor in the carina. The endotracheal biopsy of the carinal tumor demonstrated squamous cell carcinoma, though preoperative examination of the intrapulmonary tumor was unable to clarify it's pathological type. The intrapulmonary tumor required right upper lobectomy and R2 lymph node dissection as a measure against the possibility of primary lung cancer. Since the endotracheal cancer was diagnosed as an intra mucosal tumor by the preoperative computed tomography (CT) scans and the bronchoscopic examination, laser abrasion therapy to the endotracheal tumor was performed 4 days before the lobectomy of the intrapulmonary tumor. After the pulmonary operation, the intrapulmonary tumor was diagnosed as squamous cell carcinoma without lymph node metastasis, and it was suggested to be a metastatic tumor of the previous laryngeal cancer. Both radiotherapy to the carina and general chemotherapy with docetaxel hydrate and carboplatin were used as adjuvant therapies 36 days after the lobectomy. One year after the pulmonary surgery, there is no recurrence of the tumor in the lung or carina. Laser abrasion therapy to the endotracheal tumor is very useful and safe for the patient, who should then receive pulmonary resection soon after the therapy.

From June 1997 through December 1999, we treated twenty-two metastatic breast cancer patients with Docetaxel (60 mg/m2 administered intravenously every four weeks). All patients had received prior chemotherapy including anthracycline, and also another agent such as MMC-VDS, HDMTX-5-FU or CPT-11. One CR, 5 PR, and 4 Long NC were achieved. Grade 3/4 leukocytopenia occurred in 16 patients. Using the Kaplan Meier method, the median time to progression was 179 days, and the median survival time was 369 days. No serious adverse effects were observed. In this study Docetaxel seems to have shown significant activity, even for poor candidates, with intensive prior therapy.

From April 1996 through 1998, we treated twelve metastatic breast cancer patients with CPT-11 100 mg/m2 given on day 1, 8, and 15. All patients had received prior chemotherapy including anthracycline, and also another schedule such as MMC-VDS or HDMTX-5-FU. CPT-11 was well tolerated. One CR, two PR, and two long NC were achieved. Grade 3 leukocytopenia occurred in 2 patients. Grade 1 diarrhea occurred in 3 patients. According to the Kaplan-Meier method, the 50% survival was 354 days. In spite of intense prior chemotherapy, the treatment results with CPT-11 were satisfactory for anthracycline resistant metastatic breast cancer.

In this study we compared two methods of granisetron administration. One method was via a drip infusion with 100 ml of normal saline 30 minutes prior to administration of CDDP (Group A). The other method was direct injection of granisetron into the CDDP containing bottle (Group B). By employing a randomized cross-over method, we evaluated the acute response (less than 24 hours) according to Furue's criteria in 34 patients. Each of the patients received more than two cycles of chemotherapy containing more than 50 mg of CDDP. In both arms of the study nausea, vomiting and anorexia showed no difference. Moreover, there was no evidence of toxicity due to granisetron. The overall response rate of granisetron to nausea was 84.4%. We conclude that granisetron is an effective drug as an antiemetic, and the direct injection of granisetron into the CDDP containing bottle has the same effect when compared to the normal method of administration, together with an equivalent safety profile.

Sixteen patients with advanced or recurrent squamous cell carcinoma of the esophagus were treated with cisplatin 80 mg/m2 i.v. on day 1, methotrexate 40 mg/m2 i.v. on day 2 and peplomycin 15 mg/day 24 hours continuous subcutaneous infusion from day 2 to day 5. Each course was repeated every 3 weeks. The overall response rate was 56% (9/16) with no complete response. Of 10 patients with no prior therapy, 7 (70%) showed partial response. Toxic effects were acceptable with no fatalities, but severe nausea and vomiting (56%), transient nephrotoxicity (44%), anemia (44%), thrombocytopenia (31%) and leukocytopenia (19%) occurred. No clinical evidence of pulmonary toxicity was seen. The dose-limiting toxic effect of this regimen was myelosuppression.