Atsushi Morio

Efficacy of induction chemoradiotherapy in thymic cancer: report of a successful case and review of the literature

Abstract Thymic cancer is a rare tumor, the optimal treatment of which remains controversial. The efficacy of induction therapy in thymic cancer is unclear. A 51-year-old man was diagnosed as having a poorly differentiated carcinoma of the thymus with lymph node metastasis (stage IVb according to the Masaoka staging system), through an echo-guided biopsy. The patient was administrered cisplatin (CDDP) combined with paclitaxel once per week for 4 weeks, under concurrent local radiation. Once a partial response was achieved, the residual tumor was completely resected, and bilateral mediastinal lymph nodes were dissected. Histopathological examination of the resected specimen showed no evidence of viable malignant cells. At present, 15 months after surgery, the patient is doing well and shows no signs of recurrence. This case demonstrates that induction chemoradiotherapy with CDDP and paclitaxel may be well tolerated and useful for patients with advanced thymic cancer.

Enhanced induction of apoptosis in lung adenocarcinoma after preoperative chemotherapy with tegafur and uracil (UFT).

PurposeTo determine if the preoperative administration of tegafur and uracil (UFT) to patients with lung adenocarcinoma could induce apoptosis.MethodsWe conducted a randomized prospective study on 30 patients with lung adenocarcinoma, divided into two groups of 15 patients each. One group received UFT 600 mg/day preoperatively for 7 consecutive days and a control group received no chemotherapy or radiotherapy. The apoptotic index (AI) was determined by the terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate biotin nick end-labeling (TUNEL) method. Expression of Ki-67 was examined by immunohistochemical staining. The concentration of 5-fluorouracil (5-FU) in tumor tissue was measured by chemical assay.ResultsThe AI of lung adenocarcinoma cells increased significantly in the UFT-treated group but not in the control group. A significant positive correlation was seen between the AI and the 5-FU concentrations in the tumor tissue.ConclusionsThe continuous oral administration of UFT for 7 days preoperatively resulted in enhanced apoptosis and a significant positive correlation between the AI and 5-FU concentrations in lung adenocarcinoma. Therefore, it may be possible to evaluate the effects of adjuvant chemotherapy based on the AI.

Complete resection via medial sternotomy for non-small cell lung cancer in the right upper lobe

Background:  Right upper lobectomy with right cervical and bilateral mediastinal lymph node dissection via a median approach was performed for non‐small cell lung cancer.

Drug concentration in lymph nodes after preoperative administration of UFT (a blend of Tegafur and uracil) for non-small-cell lung cancer

AbstractBackground. UFT a blend of uracil and Tegafur (1-[2-tetrahydrofuryl]-5 fluorouracil), molar ratio, 4 : 1 is an anti-tumor agent for oral administration that is presumed to maintain the concentration of 5-fluorouracil (5-FU) in tumor tissue. The concentration of 5-FU achieved with UFT in lymph node metastases has, however, not yet been examined; in this study we aimed to clarify the transfer of 5-FU to lymph node metastases in patients treated with UFT. Methods. The subjects were 21 patients with primary non-small-cell lung cancer (NSCLC). Tegafur (600 mg per day), in the form of UFT-E (UFT enteric-coated granules), was administered for 7 days prior to surgery. At the time of lobectomy and lymphadenectomy, 0.3-g tissue specimens were collected from the primary lung tumor, normal lung, lymph node metastases, and normal lymph nodes. The concentrations of Tegafur and 5-FU in each sample were measured. Results. The concentration of 5-FU in lymph node metastases was 63.5 ± 11.6 ng/g, which was greater than the minimum effective tissue concentration (50 ng/g), and was significantly higher than the concentration in normal lymph nodes (P = 0.0053). The concentration of 5-FU in the tumor (50.7 ± 9.7 ng/g) was also greater than the minimum effective tissue concentration, and was significantly higher than the concentration in normal lung tissue (P = 0.0193). No serious side effects were observed during the administration of UFT-E. Conclusions. We concluded that UFT would be useful as a postoperative adjuvant chemotherapeutic agent in patients with NSCLC and lymph node metastases, considering the excellent transfer of 5-FU to lymph node metastases during treatment with UFT.