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

1. 自体骨髓移植大剂量化疗治疗晚期胃癌：对11例病变可测量的晚期胃癌患者进行依托泊苷（1200mg /m^2）、阿霉素（80mg /m^2）、顺铂（CDDP）（120mg /m^2）或卡铂（900mg /m^2）[高剂量EAP治疗]的大剂量联合治疗。取治疗前制备的自体骨髓冷冻保存的单个核细胞1 × 10^7/kg静脉输注。所有患者均从再障期恢复，无严重并发症。在9例可评估的病例中，8例观察到部分缓解（有效率89%）。黏附肿瘤细胞培养系统（ATCCS）的化学敏感性试验：(1)11例患者术中切除胃标本，成功进行化学敏感性试验8例（73%）。2例因肿瘤细胞生长缓慢，1例因真菌污染而未能获得结果。15例患者术前经内镜检查获得标本。10例（67%）可获得结果，4例因肿瘤细胞生长缓慢，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低生长的原因。(3)测定结果以90%抑制浓度（IC90）和百分位数表示。17%的肿瘤对ADR敏感，50%的肿瘤对CDDP敏感，28%的肿瘤对5-FU敏感，40%的肿瘤对MMC敏感。(4) ATCCS结果与5- fu的组织学作用有相关性。下一个试验是术前大剂量化疗，由术前胃活检标本的ATCCS结果选择抗癌药物。

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.