PURPOSE: The International Organization for Standardization-5fluorouracil (FU) 10 trial found that bolus 5-FU and l-leucovorin was not inferior to S-1 in the treatment of gastric cancer (GC). Continuous 5-FU and the rapid injection of 5-FU have different anti-cancer effects. Thus, bolus 5-FU and l-leucovorin treatment might be useful for oral FU-resistant GC. MATERIALS AND METHODS: We retrospectively analyzed the medical records of all patients with S-1 or capecitabine-resistant, unresectable, or recurrent GC treated with bolus 5-FU and l-leucovorin between January 2010 and December 2015 at Hokkaido University Hospital. The bolus 5-FU and l-leucovorin regimen consisted of intravenous l-leucovorin (250 mg/m²/2 h) and bolus 5-FU (600 mg/m²) administered once weekly followed by a 2-week rest period; each cycle was repeated every 8 weeks. RESULTS: A total of 14 patients were identified. The disease control rate was 35.7%. The median progression-free survival was 1.6 months (95% confidence interval [CI], 1.3~2.0 months), and the median overall survival was 6.3 months (95% CI, 4.7~7.9 months). No patient died from treatment-related causes. The most common severe adverse event associated with bolus 5-FU and l-leucovorin was neutropenia, which occurred in 21.4% of patients. CONCLUSIONS: Bolus 5-FU and l-leucovorin treatment might be useful for oral FU-resistant GC. We are planning a multi-center prospective phase II trial to evaluate the efficacy and safety of bolus 5-FU and l-leucovorin treatment for pre-treated unresectable or recurrent GC to confirm the results of this limited, retrospective study.
Disease-Free Survival ; Drug Therapy* ; Fluorouracil* ; Humans ; Leucovorin ; Medical Records ; Neutropenia ; Prospective Studies ; Retrospective Studies ; Stomach Neoplasms*

A 24-year-old woman underwent successful repair of a traumatic pseudoaneurysm of the aortic isthmus concomitant with right diaphragmatic hernia which developed after a traffic accident, and the steering wheel of the crashed car was considered responsible for both lesions. Due to the right diaphragmatic hernia, she could breathe mainly with the left lung only. The aortic isthmus aneurysm was considered to be a pseudoaneurysm, and because of the potential risk of rupture, we performed urgent aortic surgery. Prior to a left thoracotomy, we anastomosed an 8-mm prosthetic graft to the right axillary artery. When the left lung was collapsed in order to perform a femoro-femoral bypass, the SpO₂ level of her right index finger and her cerebral rSO₂ markedly decreased. Therefore, we administered additional perfusion via the right axillary artery, which provided sufficient oxygen to the upper body and brain. The patient underwent Marlex mesh reinforcement of the right diaphragmatic hernia 30 days after grafting, and is doing well 1 year postoperatively.

Although the Outpatient Cancer Chemotherapy (OCC) Unit was established with in Anjo-Kosei Hospital in 2006, its real worth remains to be elucidated. To address this, the following subjects were examined;effective usage of hospital beds changes in the number of outpatients given to chemotherapy, length of hospitalization, the number of patients transferred by ambulance to the hospital, hospital occupancy rate, and the number of frequently used chemotherapy regimens.Since the establishment of the OCC Unit, the number of patients transferred by ambulance has increased and length of hospitalization has gradually decreased, accompanied by the increase in the number of outpatients treated at the OCC Unit. Additionally, no significant change was observed in the hospital occupancy rate. Furthermore, of the frequently used chemotherapy regimens, nine regimens were available for 62.4% of the total number of outpatients of the OCC Unit.These results indicated the useful effect of the establishment of the OCC Unit on the usage of hospital beds, and provided significant information helpful in promoting the effective and safe chemotherapy for outpatients in the OCC Unit.
Chemotherapy-Oncologic Procedure ; Unit ; seconds ; Outpatients ; Malignant Neoplasms