[Chemotherapy of unresectable Borrmann's type IV stomach cancer]

In the inoperable Borrmann type 4 Gastric cancer, which is to be used as a synonym of gastric scirrhus clinically, it is regrettable but effect is hardly expected from radiotherapy or immunotherapy, and the treatment relies entirely on chemotherapy. We have reported the results of our questionnaires collected from 108 hospitals (internal medicine-40 and surgical-68) all over Japan to investigate the prevailing circumstances of inoperable Borrmann type 4 gastric cancer. Therapies performed by singular medication were: 1). oral and intravenous 5-FU-33.3%, 2). oral, intravenous and suppository tegafur-27.4% and intravenous MMC-27.4%, of the total 84 methods reported in the field of internal medicine; and 1). administration of 5-FU-29.1%, 2). intravenous MMC-26.8% and 3). tegafur-22%, of the total 127 therapies reported in the surgical field. The therapies performed by combined medications were: 1). 5-FU+MMC-22.6%, 2). MFC-12.1%, 3). tegafur+MMC, and FAM-8.3% (further 29 examples of combination medications consisting of 2-4 preparations), of the total 124 therapies reported in the field of internal medicine; and 1). 5-FU+MMC-22.6%, 2). MFC-12.1% and tegafur+MMC-7.3% (further 37 examples consisting of 2-4 preparations), of the total 124 therapies reported in the surgical field. The total cases judged as 'effective' in all the hospitals were 71. The breakdown is as follows: 1). 'effective for the primary focus'-47 cases/66.7%, expansion of affected site proved by gastric radiogram and endoscopic image-33 cases/46.5%, expansion of affected site proved only by endoscopy-4 cases/5.6%; shrinkage of malignant ulcer and flattening of randwall, disappearance of extra-gastric compression by endoscopic image-2 cases. 2). ineffective for the primary focus'-24 cases/33.8%, of which disappearance of or decrease in ascites-11 cases/15.5%; improvement of anorexia, nausea, vomiting, abdominal fullness, strange epigastric sensation, abnormal evacuation, disappearance of diarrhea etc. and increase in body weight-13 cases. In 50% survival period, the cases in which chemotherapy was judged as entirely ineffective were 283 and the period was 2.9 months. The 50i% survival period for the above-mentioned total effective cases was 8.5 months, of which the 50%r survival period for the effective cases by radiographic and endoscopic findings in the primary focus was 10.65 months showing the prolongation effect of life span. One year survival rate was also 36%. Draft of the Critria of Cancer Chemotherapy for Gastric Cancer proposed by Japanese Research Society for Gastric Cancer, which including the evaluation of Borrmann type 4 cancer, was introduced.