[Chemotherapeutic effect on metastatic tumors]

A study was made of the response rates of primary and metastatic lesions of advanced gastric cancer patients receiving chemotherapy from 1978 to 1987. The patients administered adriamycin (ADR), 5-FU, mitomycin C (MMC) or their analogues showed a response rate of 12.2% (5/41) in primary lesions, 15.9% (7/44) in liver metastases and 20.0% (4/20) in lymphnode metastases, respectively. The response rates were 14.3% (5/35) in primary lesions 16.7% (6/36) in liver metastases and 12.5% (2/16) in lymphnode metastases from chemotherapy using at least two kinds of the above drugs. No significant difference was seen among the response rates per above. By elevating blood pressure induced with angiotensin II, selective increase in blood flow in tumor tissue but no increase in normal tissue was observed experimentally (JNCI, 67, 663, 1981). This finding was clinically applied to cancer chemotherapy, termed Induced Hypertension Chemotherapy (IHC) for enhancing selective drug delivery to tumor tissue. The response rates were 47.6% (10/21) in primary lesions, 28.6% (2/7) in liver metastases and 81.8% (9/11) in lymphnode metastases when combination chemotherapy mainly with ADR, 5-FU and MMC with IHC was performed. Although the response rates were better than the results without IHC, the liver metastases did not indicate any statistical differences. The metastatic lesions in the lymphnode indicated a higher response than that of the primary lesions in the group treated with IHC, but no significant difference was seen. As to the primary lesions and the lymphnode metastases, the treatment with IHC showed higher response rates than those without IHC. It is conceivable that the results obtained would clinically prove the mechanism of selective drug delivery to tumor tissue as described in the experiment stated above. To detect the cause of unsatisfactory response rates of liver metastases, further clinical analysis of accumulated cases may be required.