Selection of Postoperative Systemic Chemotherapy for Advanced Gastric Cancer Patients with Hepatic Metastasis Using the Histoculture Drug Response Assay

The usefulness of histoculture drug response assay (HDRA) before the start of antitumor chemotherapy was explored to predict the antitumor response of chemotherapy for progressive gastric cancer patients with hepatic metastasis. Cancer tissue was collected from 6 advanced gastric cancer patients with hepatic metastasis, to assess whether the tumor is sensitive to chemotherapeutic agents of 5-fluorouracil (5-FU), mitomycin C (MMC), docetaxel hydrate (TXT), and cisplatin (CDDP) by the HDRA method. The size of hepatic tumor was measured by CT scan 3 and 6 months after the start of the chemotherapy and examined the relationship between the selected chemotherapy and antitumor response. Of 6 patients investigated in the present study, 3 patients received monotherapy with TS-1[○!R], which was found to be effective in 2 patients (66.7%). In the patient who received MMC monotherapy, the HDRA showed the cancer tissue to be less sensitive to any of antitumor agents tested, resultantly indicating no antitumor response. In the remaining 2 patients with combination therapy with TS-1[○!R] and MMC, the selected chemotherapeutic agents showed anti-tumor effect. The HDRA is useful to predict the antitumor response of postoperative adjunctive chemotherapy for advanced gastric cancer patients with hepatic metastasis, and plays an important role in selection of antitumor agents

ホンガク ニオケル シンリョウ サンカガタ リンショウ ジッシュウ ニ カンスル コウサツ : モデル・コア・カリキュラム ノ ドウニュウ ト シンリョウ サンカガタ リンショウ ジッシュウ ノ アリカタ

獨協医科大学では,医学教育モデル・コア・カリキュラムに準じた診療参加型臨床実習を実施する予定である.平成16年度以降の臨床実習形式は46週と従来より長くなり,診療参加型となる.これを円滑に導入するためには,臨床実習開始以前から学生の準備教育を充実させ,コ・メディカルを含めた実習にかかわるすべてのスタッフに,臨床実習の意義を徹底させることが必要である.現実的な問題点として,現状では実習教育にたずさわる教員数の絶対的な不足が挙げられ,マンパワーの補充を目的とした組織的な対応を早急に検討することが望まれる.(本論文は,第8回医学教育ワークショップCグループの発表内容を中心に加筆検討を加えたものである.)In introducing clinical clerkship incorporating a core curriculum at Dokkyo University School of Medicine, its problems and concrete plans were evaluated. For smooth introduction of this plan, improving the preliminary education of students before the beginning of clinical training and assuring the understanding of all the staff members involved in clinical training including co - medicals about its significance were considered to be necessary. As a practical problem, a lack of instructors who can be involved in clinical training was raised, and prompt evaluation of systematic measures to increase the staff was strongly recommended