A study on improvement of the effect of chemotherapy for digestive cancers

1.大剂量化疗联合自体骨髓移植治疗晚期胃癌11例有可测量病灶的晚期胃癌患者接受了由足叶乙甙组成的大剂量联合治疗（1200 mg/m^2）、阿霉素（ADR）（80 mg/m^2）和顺铂（CDDP）（120 mg/m^2）或卡铂（900 mg/m^2）[高剂量EAP治疗]。然后，静脉输注1 × 10^7/kg的单核细胞，所述单核细胞从治疗前的自体骨髓制备并冻存。所有患者均从再生障碍期恢复，无严重并发症。在9例可评估病例中，8例观察到部分应答（应答率为89%）。粘附式肿瘤细胞培养系统（ATCCS）药敏试验：（1）11例标本取自手术切除的胃，药敏试验成功8例（73%）。2例因肿瘤细胞生长缓慢，1例因真菌污染而无法获得结果。15例术前均经内镜检查获得标本。10例（67%）可获得结果，但4例因肿瘤细胞生长缓慢而无法获得结果，1例因真菌污染而无法获得结果。(2)组织学分型不能解释肿瘤细胞生长缓慢的原因。(3)试验结果以90%抑制浓度（IC 90）和百分位数表示。17%的肿瘤对ADR敏感，50%对CDDP敏感，28%对5-FU敏感，40%对MMC敏感。(4)ATCCS结果与5-FU的组织学效应之间存在相关性.下一个试验将是术前大剂量化疗，包括抗癌药物，将根据术前胃活检标本ATCCS的结果选择。

1. HIgh-dose chemotherapy with autologous bone marrow transplantation in the treatment of advanced gastric cancer : Eleven patients with late-stage gastric cancer with measurable lesions were treated with high-dose combination therapy consisting of etoposide (1200 mg/m^2) , adriamycin (ADR)(80 mg/m^2) , and cisplatin (CDDP)(120 mg/m^2) or carboplatin (900 mg/m^2)[High-dose EAP therapy]. Afterward, 1X10^7/kg of mononuclear cells, which were prepared from autologous bone marrow before treatment and cryopreserved, were transfused intravenously. All patients recovered from the aplastic period without severe complications. of nine assessable cases, partial response was obseved in eight (89% response rate).2. Chemosensitivity assay by means of adhesive tumor cell culture system (ATCCS) : (1) Specimens were obtained from resected stomach during operations in 11 cases, and chemosensitivity assay was carried out successfully in 8 cases (73%). The results could not be obtained because of low growth of tumor cells in 2 cases and fungal contamination in one case. Specimens were obtained by endoscopic examination before operation in 15 cases. Results could be obtained in 10 cases (67%) , but could not be obtained because of low growth of tumor cells in 4 cases and fungal contamination in one case. (2) The histological typing could not explain the reason of low growth of tumor cells. (3) Results of the assay were expressed in terms of inhibition concentration of 90% (IC90) and percentile. Seventeen percent of tumors were sensitive for ADR, 50% were sensitive for CDDP, 28% were sensitive for 5-FU, and 40% were sensitive for MMC.(4) There was a correlation between the results of ATCCS and the histological effects of 5-FU.3. The next trial would be high-dose preoperative chemotherapy consisting of anticancer drugs which would be chosen by the rusults of ATCCS using gastrobiopsy specimen before operation.