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We report the case of a patient with colon cancer accompanied by multiple unresectable liver metastases who showed complete response (CR) to modified TEGAFIRI (mTEGAFIRI) (tegafur-uracil/leucovorin+irinotecan) chemotherapy. The patient was a 58-year-old Japanese male with cancer of the descending colon accompanied by multiple unresectable liver metastases. Following resection of the sigmoid colon cancer, mTEGAFIRI chemotherapy was administered. Abdominal computed tomography performed upon completion of 12 courses of chemotherapy showed that the unresectable liver metastatic lesions had disappeared, indicating CR. The only adverse drug reactions (ADRs) experienced to date have been stomatitis (grade 1) and neutropenia (grade 1). Anticancer therapy has thus been continued, and CR has been maintained for 15 months. The present patient achieved CR in response to mTEGAFIRI chemotherapy, a regimen that has not previously been reported, while experiencing only mild ADRs and maintaining a good quality of life. mTEGAFIRI chemotherapy is convenient to administer and is thought to be a potentially useful treatment option for patients with unresectable, recurrent colon cancer.

Background: Colorectal cancer most commonly metastasizes to the liver. However, in patients with liver metastases precluding radical resection, we still have no other choice but to

症例は56歳，女性．下血を主訴に当院を受診し，大腸内視鏡検査で直腸に粘膜下腫瘍様病変を認め精査目的に入院となった．生検にて胞体がクリアな腫瘍細胞を認め，子宮・卵巣由来の悪性腫瘍が考えられたが，子宮および卵巣摘出術後状態であり診断に難渋した．直腸癌の可能性も否定できず，低位前方切除術を施行した．腫瘍は直腸壁外に主座をおき直腸内腔に潰瘍を形成した病変で，組織型はclear cell adenocarcinomaであった．腫瘍周囲の直腸壁内に子宮内膜組織を認めたため直腸子宮内膜症の癌化と診断した．術後18カ月経過した現在，再発の徴候は認めていない．腸管子宮内膜症の癌化は稀な症例であり報告する．

食道平滑筋肉腫と扁平上皮癌が同時発生した極めて稀な症例を経験したので報告する．症例は60歳代，男性．嚥下時咽頭部の不快感を認め近医受診．食道腫瘍を指摘され精査目的に当科に紹介入院となった．上部消化管内視鏡検査では胸部上部食道に隆起性病変を認め，その肛門側に陥凹性病変を認めた．生検では，隆起性病変に異型細胞を認め，陥凹性病変に扁平上皮癌を認めた．食道内癌多発の診断で胸腔鏡下食道亜全摘術，3領域リンパ節郭清術を施行した．切除標本で，隆起性病変は平滑筋肉腫，陥凹性病変は食道癌と診断された．食道亜全摘術1年後に，右肺上葉に平滑筋肉腫の転移を認め，右肺上葉切除術施行．肺切除後6カ月経過した現在，再発の徴候は認めていない．平滑筋肉腫は比較的稀な食道腫瘍であり，さらに扁平上皮癌との同時発生症例は極めて稀であり報告した．

Purpose: The aim of this retrospective study was to clarify the effect of the antiemetics for chemotherapy-induced nausea and vomiting associated with FOLFOX chemotherapy. Methods: Fifty patients were given FOLFOX as chemotherapy for colorectal cancer, and granisetron were used as first-line antiemetics. The severity of CINV was evaluated using (1) questioning, (2) Common Terminology Criteria for Adverse Events version 4.0, and (3) Multinational Association of supportive care in cancer method for patient self‑assessment. When a patient indicated that another antiemetic was desired, granisetron was switched to palonosetron. Results: Forty two patients did not express a desire for another antiemetic, but eight patients expressed a desire for it. They were evaluated as Grade 2 according to the CTCAE 4.0. The MAT method identified a score of 6 points or more. Granisetron was switched to palonosetron as a second-line antiemetic. The severity of CINV decreased to Grade 1 or less, while the MAT method score decreased to 0 points in 3 patients and ≤ 4 points in 5 patients. None of the 8 patients expressed a desire for another antiemetic. Conclusion: Granisetron/palonosetron can be thought to have improved the patients’ QOL, relieved their anxiety, and contributed to continuation of the chemotherapy.

Alpha-fetoprotein-Producing gastric cancer is associated with poor prognosis because of frequent liver and lymph node metastasis. We present a case with synchronous liver metastasis who survived for 5 years. A 69-year-old man with upper abdominal pain was referred to our hospital. Gastrointestinal endoscopy revealed a Borrmann II-like tumor in the lower part of the stomach. Computed tomography revealed a tumor in the left lobe of the liver. Serum alpha-fetoprotein levels were markedly increased. We performed distal gastrectomy after administering oral tegafur/gimeracil/oteracil potassium and administered hepatic intra-arterial cisplatin injection. Liver metastasis showed partial response on computed tomography. Despite left hepatic lobectomy, further metastases to the liver and mediastinal lymph nodes became difficult to control. After sorafenib tosylate administration, stabilization of the disease was observed for 4 months. We conclude that hepatic intra-arterial chemotherapy and oral administration of sorafenib tosylate may potentially improve the prognosis in such cases.