竹井 裕二

The aim of this study was clarification of the feasibility, effects, and adverse events of combination chemotherapy with paclitaxel and carboplatin in Japanese women with epithelial ovarian cancer. In patients with stage Ic to IV epithelial ovarian cancer, primary cytoreductive surgery was performed. Paclitaxel (175 mg/m(2)) was intravenously infused for 3 h. Subsequently, carboplatin was infused, with an area under the plasma concentration-time curve of 5. Ninety-one patients were enrolled in this study. The mean dose of paclitaxel at the sixth course was 161 mg/m(2). Of 51 patients, a complete response was observed in 19 patients (37%), and a partial response in 23 patients (45%). The response rate for clear cell adenocarcinoma was 25%. With regard to adverse events, grade 4 granulopenia was observed in 80% of patients, suggesting dose-limiting toxicity. However, none of the patients developed serious infection. With regard to non-hematological toxicity, grade 2 or 3 alopecia, arythralgia/myalgia, and peripheral neurotoxicity were noted in 97, 29, and 20% of the patients, respectively. Although hematological toxicity was relatively marked, this regimen can be applied in Japanese women.

We evaluated microsatellite instability (MSI) in primary lesions and lymph node metastatic lesions in 66 patients with endometrial carcinoma (FIGO stage IIIC) accompanied by lymph node metastasis. DNA was extracted from paraffin-embedded tissue of both the primary and lymph node metastatic lesions of endometrial carcinoma, and MSI was evaluated using microsatellite markers at five loci. Microsatellite instability was positive in the primary lesion in 27 patients (41%). All patients with MSI-positive primary lesions also showed MSI-positive in lymph node metastatic lesions. Of the other 39 patients with MSI-negative primary lesions, 4 showed MSI-positive in lymph node metastatic lesions. As the result of individual identification by polymerase chain reaction (PCR) using short tandem repeat loci in these 4 patients, PCR profiles of primary and metastatic lesions matched with those of normal controls in all 4 patients. Therefore, it was confirmed that both primary and metastatic lesions developed from the same individual. These results suggest that MSI is also involved in lymph node metastasis in the development and/or progression of endometrial carcinoma in some patients.