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2005 ; 32*6+: 789-794.
00+Hamada C, Sakamoto J, Satoh T, et al. : Dose 1 year adjuvant chemotherapy with oral 5-FUs in colon cancer
ruduce the peak of recurrence in 1 year and provide long-term OS benefit? Jpn J Clin Oncol. 2011 ; 41*2+: 299-302.
01+Takahashi Y, Sakamoto J, Takeuchi T, et al : A randomized phase  clinical trial of tailored CPT11 + S1 vs
16

JFMC
!Japanese Foundation for Multidisciplinary Treatment of Cancer"

S1 in patients with advanced or recurrent gastric carcinoma as the first line chemotherapy. Jpn J Clin Oncol.
2004 ; 34&6': 342-345.
*,'Komatsu Y, Takahashi Y, Kimura Y, et al. : Randomized phase K trial of first-line treatment with tailoredirinotecan and S1 therapy versus S1 monotherapy for advanced or recurrant gastric carcinoma&JFMC310301'. Anti-Cancer Drugs. 2011 ; 22&6': 576-583.
*-'Toi M, Saji S, Masuda N, et al. : Ki67 index changes, pathological response and clinical benefits in primarybreast cancer patients treated with 24 weeks of aromatase inhibition. Cancer Science. 2011 ; 102&4': 858-865.
*.'Takada M, Saji S, Masuda N, et al.:Relationship between body mass index and preoperative treatment
response to aromatase inhibitor exemestane in postmenopausal patients with primary breast cancer. The
Breast. 2012 ; 21 : 40-45.
*/'Chanplakorn N, Chanplakorn P, Suzuki T, et al. : Increased estrogen sulfatase&STS'and 17 beta-hydroxysteroid dehydrogenase type1&17beta-HSD1'following neoadjuvant aromatase inhibitor therapy in breast cancer
patients. Breast Cancer Res Treat. 2010 ; 120&3': 639-48.
*0'Hattori T, Nakajima T, Nakazato H, et al. : Postoperative adjuvant immunochemotherapy with Mitomycin C,
tegafur, PSK and/or OK-432 for gastric cancer, with special reference to the change in stimulation index after
gastrectomy. Jpn J Surg. 1990 ; 20&2': 127-136.
*1'6C[¬Êha{¦ÎH%E%MRW

B CEA §=Æm?X"µÁ`|ÁQ!¨É·!²­z!¢$O`Ä>47

Ê[W. 1991 ; 26&11': 2365-2373.

*2'Takahashi Y, Takeuchi T, Sakamoto J, et al.&Tumor Marker Committee': The usefulness of CEA and/or CA
19-9 in monitoring for recurrence in gastric cancer patients : a prospective clinical study.

Gastric Cancer.

2003 ; 6 : 142-145.
+)'~´!d°¥¼$O`m½T[Ê¿>47B SDI test ?ÅÈ>_9Bvb±ha(:?hagV?«>;3<("`=T[Ê¿. 1993 ; 20&4': 432-439.
+*'Kondo T, Yamauchi M, Tominaga S : Evaluation of usefulness of in-vitro drug sensitivity testing for adjuvant
chemotherapy of stomach cancer. Int J Clin Oncol. 2000 ; 5 : 174-182.
++'Yasumoto K, Osaki T, Watanabe Y, et al.&Cooperative Project No.24 Group of The Japanese Foundation For
Multidisciplinary Treatment of Cancer': Prognostic value of cytokeratin-positive cells in the bone marrow andlymph nodes of patients with resected nonsmall cell lung cancer : A multicenter prospective study. Ann Thorac
Surg. 2003 ; 76 : 194-202.
+,'ejÂ!q¶!ªPp!¢$O`m½T[Ê¿?Ã}NT¸Zi>47B QOL ©yº>@B QOL¸Z"µÁÌÍ. 2001 ; 59&¡]t-': 546-561.
+-'²­z!°®S!¼®nQ!¢$sÈË CDDP!5FU Ê¿?rO6C>£9Bm½Ê¿=8<?oU>_9Bha(6C[¬Êha{¦³«ha20?¨^¾u("`=T[Ê¿. 2000 ; 27&3': 395-403.

25'²­z, ¨É·, ~¹, ¢ : lfÎ>£9BË CDDP+5FU Ê¿?kc&¤2¾'(³>ÅY>;3<?vDIF%G5A("`=T[Ê¿. 2000 ; 27&4': 549-558.
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Cisplatin#5FU m¯Ç?ÅÈ>_9BhÃ}N\»i?¨^¾u("`=T[Ê¿, 2002 ; 29&13': 2499-2507.

+0'Nakata B, Mitachi Y, Tsuji A, et al. : Combination phase I trial of a novel oral fluorouracil derivative S1 with
low-dose cisplatin for unresectable and recurrent gastric cancer&JFMC27-9902'. Clin Cancer Res. 2004 ; 10 :1664-1669.
+1'Morita S, Ohashi Y, Hirakawa K, et al. : Clinical trial note ; Phase J/K study of combination therapy of oral
17"#)'(*%&!$
fluorinated pyrimidine compound S1 with low-dose cisplatin in patients with unresectable and/or recurrent
advanced gastric cancer : a novel study design to evaluate safety and efficacy. Jpn J Clin Oncol. 2004 ; 34$3%:
159-161.
)-%Nakata B, Tsuji A, Mitachi Y, et al. : Moderate neutropenia with S1 plus low-dose cisplatin may predict a
more favourable prognosis in advanced gastric cancer. Clinical Oncology. 2006 ; 18 : 678-683.
*'%Nakata B, Sowa M, Tsuji A, et al.:Continuous infusion of 5fluorouracil with versus without low-dose,
consecutive administration of cisplatin in advenced colorectal cancer. A prospecive randomized phase = study.
J Exp Clin Cancer Res. 2007 ; 26$1%: 51-60.
*(%Morita S, Nakata B, Tsuji A, et al. : A phase < study of combination therapy of the oral fluorinated pyrimidine
compound S1 with low-dose cisplatin twice-a-week administration$JFMC27-9902 Step2%in patients withadvanced gastric cancer using a continual reassessment method. Jpn J Clin Oncol. 2007 ; 37$12%: 924-9.
*)%Nakata B, Tsuji A, Mitachi Y:Phase = Trial of S1 plus low-dose cisplatin for unresectable and recurrent gastriccancer$JFMC27-9902 Step2%. Oncology. 2010 ; 79 : 337-342.
**%Gochi A, Saji S, Sakamoto J, et al. : A phase III study of combination therapy of the oral fluorinated pyrimidine
compound tegafur-uracil$UFT%with low dose cisplatin compared with UFT alone in patients with locallyadvanced gastric cancer as postoperative adjuvant chemotherapy. Annals of Cancer Research and Therapy.
2012 ; 20$1%: 17-23.
*+%GIKX!ES]F!RSNT!O"P-A:;:\LJ^C@9)'VM85UY2BH/1&:;:64.6
UY6Z0>Q7# D3?C[W, 38$6%: 885-891, 2011.
*,%Saji S, Taguchi T, Yoshida K, Osada S.: Recent advances of cancer in Asian countries. Cancer and Chemotherapy
Publishers Co. Japan, Tokyo, p75, 2010.

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