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Miyano T, Ayukawa Y, Anada T, Takahashi I, Furuhashi H, Tokunaga S, Hirata A, Nakashima N, Kato K, Fukuda H. Association Between Reduced Posterior Occlusal Contact and Alzheimer's Disease Onset in Older Japanese Adults: Results from the LIFE Study. J Alzheimers Dis 2024; 97:871-881. [PMID: 38160352 PMCID: PMC10894584 DOI: 10.3233/jad-230449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND An association between poor oral health and cognitive decline has been reported. Most of these studies have considered the number of teeth as a criterion, only a few studies have analyzed the relationship between occlusal status and Alzheimer's disease (AD). OBJECTIVE To elucidate whether posterior occlusal contact is associated with AD, focusing on the Eichner classification, among an older population aged 65 years or older in Japan. METHODS This study used monthly claims data of National Health Insurance in Japan from April 2017 to March 2020. The outcome was newly diagnosed AD defined according to ICD-10 code G30. The number of teeth was estimated by dental code data, and occlusal contact was divided into three categories, namely A, B, and C, according to the Eichner classification. Multivariate Cox proportional hazards models were used to analyze the association between a new diagnosis of AD and the Eichner classification. RESULTS A total of 22,687 participants were included, 560 of whom had newly diagnosed AD during a mean follow-up period of 12.2 months. The AD participants had a lower proportion of Eichner A and a higher proportion of Eichner C. After adjusting for covariates, hazard ratios (95% confidence intervals) with Eichner B and C were 1.34 (1.01-1.77) and 1.54 (1.03-2.30), respectively. CONCLUSION In older people aged≥65 years old, reduced posterior occlusal contact as well as tooth loss have an impact on AD. This study emphasizes the importance of paying attention to occlusal contacts to reduce the risk of AD.
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Affiliation(s)
- Takashi Miyano
- Department of Applied Chemistry, Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
- Nissan Chemical Corporation, Tokyo, Japan
| | - Yasunori Ayukawa
- Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Takahisa Anada
- Department of Chemistry and Biochemistry, Graduate School of Engineering, Kyushu University, Fukuoka, Japan
- Institute for Materials Chemistry and Engineering, Kyushu University, Fukuoka, Japan
| | - Ichiro Takahashi
- Section of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Science, Kyushu University, Fukuoka, Japan
| | - Hiroko Furuhashi
- Department of Epidemiology and Public Health, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Akie Hirata
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Koichiro Kato
- Department of Applied Chemistry, Graduate School of Systems Life Sciences, Kyushu University, Fukuoka, Japan
- Center for Molecular Systems, Kyushu University, Fukuoka, Japan
| | - Haruhisa Fukuda
- Department of Health Care Administration and Management, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Tsubouchi K, Hamada N, Tokunaga S, Ichiki K, Takata S, Ishii H, Kitasato Y, Okamoto M, Kawakami S, Yatera K, Kawasaki M, Fujita M, Yoshida M, Maeyama T, Harada T, Wataya H, Torii R, Komori M, Mizuta Y, Tobino K, Harada E, Yabuuchi H, Nakanishi Y, Okamoto I. Survival and acute exacerbation for patients with idiopathic pulmonary fibrosis (IPF) or non-IPF idiopathic interstitial pneumonias: 5-year follow-up analysis of a prospective multi-institutional patient registry. BMJ Open Respir Res 2023; 10:e001864. [PMID: 37963676 PMCID: PMC10649622 DOI: 10.1136/bmjresp-2023-001864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/03/2023] [Indexed: 11/16/2023] Open
Abstract
OBJECTIVE Few prospective cohort studies with relatively large numbers of patients with non-idiopathic pulmonary fibrosis (non-IPF) of idiopathic interstitial pneumonia (IIP) have been described. We aimed to assess disease progression and cause of death for patients with non-IPF IIPs or IPF under real-life conditions. METHODS Data were analysed for a prospective multi-institutional cohort of 528 IIP patients enrolled in Japan between September 2013 and April 2016. Diagnosis of IPF versus non-IPF IIPs was based on central multidisciplinary discussion, and follow-up surveillance was performed for up to 5 years after patient registration. Survival and acute exacerbation (AE) were assessed. RESULTS IPF was the most common diagnosis (58.0%), followed by unclassifiable IIPs (35.8%) and others (6.2%). The 5-year survival rate for non-IPF IIP and IPF groups was 72.8% and 53.7%, respectively, with chronic respiratory failure being the primary cause of death in both groups. AE was the second most common cause of death for both non-IPF IIP (24.1%) and IPF (23.5%) patients. The cumulative incidence of AE did not differ significantly between the two groups (p=0.36), with a 1-year incidence rate of 7.4% and 9.0% in non-IPF IIP and IPF patients, respectively. We found that 30.2% and 39.4% of non-IPF IIP and IPF patients, respectively, who experienced AE died within 3 months after an AE event, whereas 55.8% and 66.7% of such patients, respectively, died within 5 years after registration. CONCLUSION Closer monitoring of disease progression and palliative care interventions after AE are important for non-IPF IIP patients as well as for IPF patients.
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Affiliation(s)
- Kazuya Tsubouchi
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hamada
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | | | - Shohei Takata
- Department of Respiratory Diseases, National Hospital Organization, Fukuoka Higashi Medical Center, Fukuoka, Japan
| | - Hiroshi Ishii
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Yasuhiko Kitasato
- Department of Respiratory Medicine, Japan Community Health Care Organization Kurume General Hospital, Kurume, Japan
| | - Masaki Okamoto
- Division of Respirology, Neurology, and Rheumatology, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Satoru Kawakami
- Division of Respiratory Medicine, Kyushu Rosai Hospital, Kitakyushu, Japan
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, University of Occupational and Environmental Health Japan, Kitakyushu, Japan
| | - Masayuki Kawasaki
- Department of Respiratory Diseases, National Hospital Organisation Omuta National Hospital, Omuta, Japan
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Makoto Yoshida
- Department of Respiratory Diseases, National Hospital Organization, Fukuoka National Hospital, Fukuoka, Japan
| | - Takashige Maeyama
- Department of Respiratory Medicine, Hamanomachi Hospital, Fukuoka, Japan
| | - Taishi Harada
- Department of Respiratory Medicine, Japan Community Health Care Organisation Kyushu Hospital, Kitakyushu, Japan
| | - Hiroshi Wataya
- Department of Respiratory Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Ryo Torii
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health Japan, Kitakyushu, Japan
| | - Masashi Komori
- Department of Respiratory Medicine, Steel Memorial Yawata Hospital, Kitakyushu, Japan
| | - Yuichi Mizuta
- Department of Respiratory Medicine, St Mary's Hospital, Kurume, Japan
| | - Kazunori Tobino
- Division of Respiratory Medicine, Aso Iizuka Hospital, Iizuka, Japan
| | - Eiji Harada
- Department of Respiratory Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Hidetake Yabuuchi
- Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Isamu Okamoto
- Department of Respiratory Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Blas L, Shiota M, Miyake H, Takahashi M, Oya M, Tsuchiya N, Masumori N, Matsuyama H, Obara W, Shinohara N, Fujimoto K, Nozawa M, Ohba K, Ohyama C, Hashine K, Akamatsu S, Kamba T, Mita K, Gotoh M, Tatarano S, Fujisawa M, Tomita Y, Mukai S, Ito K, Tanegashima T, Tokunaga S, Eto M. Clinical factors for tumor response, progression, and survival in nivolumab for advanced renal cell carcinoma in the SNiP-RCC study. Int J Urol 2023; 30:788-796. [PMID: 37528632 DOI: 10.1111/iju.15265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 07/18/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND This study is part of the SNPs in Nivolumab PD-1 inhibitor for RCC (SNiP-RCC). Here we aimed to reveal clinical factors for tumor response, progression, and survival in nivolumab for advanced clear cell renal cell carcinoma (RCC) in Japanese patients. METHODS We included patients from 23 institutions in Japan. We evaluated the objective response, radiographic progression-free survival (PFS), overall survival (OS), and treatment-related grade ≥ 3 (serious adverse events [SAEs]). RESULTS We included 222 patients. The median age was 69 years (interquartile range 62-74 years), and 71% of the patients were male. Pancreas metastasis, lung metastases, prior cytokine therapy, and SAEs, were associated with objective response. The median PFS was 18 months. Liver metastases (hazard ratio [HR], 1.61), age ≥ 75 (HR, 0.48), previous resection of primary sites (HR, 0.47), and SAEs (HR, 0.47) were independent prognostic factors for PFS. Karnofsky Performance Status <70 (HR, 2.90), high platelets (HR, 4.48), previous resection of primary sites (HR, 0.23), and pathological grade (HR, 0.19 for grade 2 and HR, 0.12 for grade 3) were independent prognostic factors for OS. SAEs were reported in 45 (20.3%) cases. In the group of patients with prior nephrectomy, SAEs were associated with objective response, PFS, and OS. CONCLUSION The SNiP-RCC study identified clinical parameters correlated with treatment outcomes in Japanese patients with priorly treated advanced clear cell RCC undergoing nivolumab monotherapy.
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Affiliation(s)
- Leandro Blas
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaki Shiota
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masayuki Takahashi
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Wataru Obara
- Department of Urology, Iwate Medical University School of Medicine, Morioka, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Masahiro Nozawa
- Department of Urology, Kindai University Faculty of Medicine, Osakasayama, Japan
| | - Kojiro Ohba
- Department of Urology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Katsuyoshi Hashine
- Department of Urology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan
| | - Shusuke Akamatsu
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomomi Kamba
- Department of Urology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koji Mita
- Department of Urology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuichi Tatarano
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiko Tomita
- Department of Urology and Molecular Oncology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan
| | - Shoichiro Mukai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Keiichi Ito
- Department of Urology, National Defense Medical College, Saitama, Japan
| | - Tokiyoshi Tanegashima
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Kuwano A, Okui T, Kohjima M, Kurokawa M, Goya T, Tanaka M, Aoyagi T, Takahashi M, Imoto K, Tashiro S, Suzuki H, Fujita N, Ushijima Y, Ishigami K, Tokunaga S, Kato M, Ogawa Y. Transcatheter arterial steroid injection therapy improves the prognosis of patients with acute liver failure. Medicine (Baltimore) 2023; 102:e33090. [PMID: 36897684 PMCID: PMC9997803 DOI: 10.1097/md.0000000000033090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/03/2023] [Indexed: 03/11/2023] Open
Abstract
Acute liver failure (ALF) is a disorder defined by coagulopathy and encephalopathy with a poor prognosis. No effective therapies have been established except for liver transplantation. We previously reported a subgroup of patients with acute liver injury who developed microcirculatory disturbance. We also established and reported transcatheter arterial steroid injection therapy (TASIT) as a new treatment of ALF. Here, we analyze the effectiveness of TASIT in a larger cohort and evaluate the impact on ALF patients with or without microcirculatory disturbance. We conducted a single-center retrospective study to evaluate the effectiveness of TASIT in patients with ALF admitted at Kyushu University Hospital between January 2005 and March 2018. TASIT is performed by injecting methylprednisolone via the proper hepatic artery for 3 days. One hundred ninety-4 patients with ALF were enrolled and analyzed in this study. Of the 87 patients given TASIT, 71 (81.6%) recovered without any complications and 16 (18.4%) died or underwent liver transplantation. Of the 107 patients not administered TASIT, 77 (72.0%) recovered and 30 (28.0%) progressed to irreversible liver failure. In the high-lactate dehydrogenase subgroup, 52 (86.7%) of the 60 patients with TASIT recovered, and the survival rate was significantly higher than that in patients who did not receive TASIT. Multivariate regression analysis revealed that the TASIT procedure was one of the significant prognostic factors in the high-lactate dehydrogenase subgroup and was significantly associated with prothrombin activity percentage improvement. TASIT is an effective treatment for patients with ALF, especially in those with microcirculatory disturbance.
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Affiliation(s)
- Akifumi Kuwano
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Higashi-ku, Fukuoka, Japan
| | - Motoyuki Kohjima
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Miho Kurokawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Takeshi Goya
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Masatake Tanaka
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Tomomi Aoyagi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Motoi Takahashi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Koji Imoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Shigeki Tashiro
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Hideo Suzuki
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Nobuhiro Fujita
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Yasuhiro Ushijima
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Higashi-ku, Fukuoka, Japan
| | - Masaki Kato
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
- Graduate School of Nutritional Sciences, Nakamura Gakuen University, Jounan-ku, Fukuoka, Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan
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5
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Shiota M, Miyake H, Takahashi M, Oya M, Tsuchiya N, Masumori N, Matsuyama H, Obara W, Shinohara N, Fujimoto K, Nozawa M, Ohba K, Ohyama C, Hashine K, Akamatsu S, Kamba T, Mita K, Gotoh M, Tatarano S, Fujisawa M, Tomita Y, Mukai S, Ito K, Tanegashima T, Tokunaga S, Eto M. Effect of genetic polymorphisms on outcomes following nivolumab for advanced renal cell carcinoma in the SNiP-RCC trial. Cancer Immunol Immunother 2023; 72:1903-1915. [PMID: 36729213 DOI: 10.1007/s00262-023-03367-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/04/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND Anti-PD-1 antibodies are widely used for cancer treatment including advanced renal cell carcinoma (RCC). However, their therapeutic and adverse effects vary among patients. This study aimed to identify genetic markers that predict outcome after nivolumab anti-PD-1 antibody treatment for advanced RCC. METHODS This study was registered on the website of the University Hospital Medical Information Network (protocol ID, UMIN000037739). Patient enrollment was conducted at 23 institutions in Japan between August 19, 2019, and September 30, 2020. Patient follow-up ended on March 31, 2021. Patients were treated with nivolumab for advanced clear cell RCC. A genome-wide association study was performed in the development set, while genotyping of target regions in the validation set was undertaken. Single nucleotide polymorphisms (SNPs) in genes of interest CD274, PDCD1LG2 and PDCD1 were genotyped in the combined set. The primary endpoint was the association of SNPs with objective response following nivolumab treatment. As secondary endpoints, the associations of SNPs with radiographic progression-free survival (rPFS) and treatment-related grade ≥ 3 adverse events (AEs) were evaluated. RESULTS A genome-wide association study followed by a validation study identified that SNPs in FARP1 (rs643896 and rs685736) were associated with objective response and rPFS but not AEs following nivolumab treatment. Furthermore, SNPs in PDCD1LG2 (rs822339 and rs1411262) were associated with objective response, rPFS, and AEs following nivolumab treatment. Genetic risk category determined according to the number of risk alleles in SNPs (rs643896 in FARP1 and rs4527932 in PDCD1LG2) excellently predicted objective response and rPFS in nivolumab treatment. CONCLUSION This study revealed that SNPs in FARP1 and PDCD1LG2 were correlated with outcome in nivolumab treatment. The use of these SNPs may be beneficial in selecting appropriate treatment for individual patients and may contribute to personalized medicine.
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Affiliation(s)
- Masaki Shiota
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Hideaki Miyake
- Department of Urology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masayuki Takahashi
- Department of Urology, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Norihiko Tsuchiya
- Department of Urology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Naoya Masumori
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Hideyasu Matsuyama
- Department of Urology, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Wataru Obara
- Department of Urology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Nobuo Shinohara
- Department of Renal and Genitourinary Surgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | | | - Masahiro Nozawa
- Department of Urology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Kojiro Ohba
- Department of Urology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Katsuyoshi Hashine
- Department of Urology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime, Japan
| | - Shusuke Akamatsu
- Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomomi Kamba
- Department of Urology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Koji Mita
- Department of Urology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shuichi Tatarano
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiko Tomita
- Department of Urology and Molecular Oncology, Graduate School of Medicine and Dental Sciences, Niigata University, Niigata, Japan
| | - Shoichiro Mukai
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Keiichi Ito
- Department of Urology, National Defense Medical College, Saitama, Japan
| | - Tokiyoshi Tanegashima
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Masatoshi Eto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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6
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Ikenaga N, Miyasaka Y, Ohtsuka T, Nakata K, Adachi T, Eguchi S, Nishihara K, Inomata M, Kurahara H, Hisaka T, Baba H, Nagano H, Ueki T, Noshiro H, Tokunaga S, Ishigami K, Nakamura M. A Prospective Multicenter Phase II Trial of Neoadjuvant Chemotherapy with Gemcitabine Plus Nab-Paclitaxel for Borderline Resectable Pancreatic Cancer with Arterial Involvement. Ann Surg Oncol 2023; 30:193-202. [PMID: 36207481 DOI: 10.1245/s10434-022-12566-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/28/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Only two clinical trials have shown the effects of neoadjuvant treatment for borderline resectable pancreatic cancer with arterial involvement (BRPC-A). Here, we aimed to analyze the efficacy and safety of neoadjuvant gemcitabine plus nab-paclitaxel (GnP) for BRPC-A. PATIENTS AND METHODS A prospective, single-arm, multicenter phase II trial was conducted. Patients who were radiologically and histologically diagnosed with BRPC-A were enrolled. A central review was conducted to confirm the presence of BRPC-A. Patients received two to four cycles of GnP before surgery. The primary endpoint of the study was the R0 resection rate. Overall survival (OS) was evaluated in an ancillary study. RESULTS Thirty-five patients were enrolled, of whom 33 were subjected to central review and 28 were confirmed to have BRPC-A. All eligible patients with BRPC-A received neoadjuvant GnP. Nineteen patients underwent pancreatic resections. Postoperative complications of Clavien-Dindo IIIa or lower were observed in 11 patients. No treatment-related mortalities were observed. R0 resection was achieved in 17 patients (89%); the R0 resection rate was 61% in eligible patients. One patient underwent curative resection after termination of the treatment protocol, resulting in an overall R0 resection rate of 64%. The median overall survival (OS) and 2-year OS rate were 24.9 months [95% confidence interval (CI) 19.0 months to not estimatable] and 53.6%, respectively. OS in patients with BRPC-A who achieved overall R0 resection was significantly longer than that in the other patients (p = 0.0255). CONCLUSIONS Neoadjuvant GnP is a safe and effective strategy for BRPC-A, providing a chance for curative resection and improved survival.
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Affiliation(s)
- Naoki Ikenaga
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Miyasaka
- Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Takao Ohtsuka
- Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan
| | - Kohei Nakata
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiko Adachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuyoshi Nishihara
- Department of Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hiroshi Kurahara
- Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Toshiharu Ueki
- Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | - Hirokazu Noshiro
- Department of Surgery, Saga University Faculty of Medicine, Saga, Japan
| | - Shoji Tokunaga
- The Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Ikenaga N, Miyasaka Y, Ohtsuka T, Nakata K, Adachi T, Eguchi S, Nishihara K, Inomata M, Kurahara H, Hisaka T, Baba H, Nagano H, Ueki T, Noshiro H, Tokunaga S, Ishigami K, Nakamura M. ASO Visual Abstract: A Prospective, Multicenter, Phase II, Trial of Neoadjuvant Chemotherapy with Gemcitabine Plus Nab-Paclitaxel for Borderline Resectable Pancreatic Cancer with Arterial Involvement. Ann Surg Oncol 2023; 30:205-206. [PMID: 36171527 DOI: 10.1245/s10434-022-12611-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Naoki Ikenaga
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Miyasaka
- Department of Surgery, Fukuoka University , Chikushi Hospital, Chikushino, Japan
| | - Takao Ohtsuka
- Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan
| | - Kohei Nakata
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiko Adachi
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kazuyoshi Nishihara
- Department of Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Masafumi Inomata
- Department of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hiroshi Kurahara
- Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan
| | - Toru Hisaka
- Department of Surgery, School of Medicine, Kurume University, Kurume, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological, Breast and Endocrine Surgery, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Toshiharu Ueki
- Department of Gastroenterology, Fukuoka University , Chikushi Hospital, Chikushino, Japan
| | - Hirokazu Noshiro
- Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Shoji Tokunaga
- The Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Kousei Ishigami
- Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masafumi Nakamura
- Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Nishibori Y, Akiyoshi K, Omori R, Nakatani Y, Akaishi Y, Tanaka A, Tokunaga S, Daga H. 105P The efficacy of nivolumab monotherapy for advanced gastric cancer depends on the HER2 status. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Yamashita K, Kamei R, Sugimori H, Kuwashiro T, Tokunaga S, Kawamata K, Furuya K, Harada S, Maehara J, Okada Y, Noguchi T. Interobserver Reliability on Intravoxel Incoherent Motion Imaging in Patients with Acute Ischemic Stroke. AJNR Am J Neuroradiol 2022; 43:696-700. [PMID: 35450854 PMCID: PMC9089262 DOI: 10.3174/ajnr.a7486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/11/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Noninvasive perfusion-weighted imaging with short scanning time could be advantageous in order to determine presumed penumbral regions and subsequent treatment strategy for acute ischemic stroke (AIS). Our aim was to evaluate interobserver agreement and the clinical utility of intravoxel incoherent motion MR imaging in patients with acute ischemic stroke. MATERIALS AND METHODS We retrospectively studied 29 patients with AIS (17 men, 12 women; mean age, 75.2 [SD, 12.0 ] years; median, 77 years). Each patient underwent intravoxel incoherent motion MR imaging using a 1.5T MR imaging scanner. Diffusion-sensitizing gradients were applied sequentially in the x, y, and z directions with 6 different b-values (0, 50, 100, 150, 200, and 1000 seconds/mm2). From the intravoxel incoherent motion MR imaging data, diffusion coefficient, perfusion fraction, and pseudodiffusion coefficient maps were obtained using a 2-step fitting algorithm based on the Levenberg-Marquardt method. The presence of decreases in the intravoxel incoherent motion perfusion fraction and pseudodiffusion coefficient values compared with the contralateral normal-appearing brain was graded on a 2-point scale by 2 independent neuroradiologists. Interobserver agreement on the rating scale was evaluated using the κ statistic. Clinical characteristics of patients with a nondecreased intravoxel incoherent motion perfusion fraction and/or pseudodiffusion coefficient rated by the 2 observers were also assessed. RESULTS Interobserver agreement was shown for the intravoxel incoherent motion perfusion fraction (κ = 0.854) and pseudodiffusion coefficient (κ = 0.789) maps, which indicated almost perfect and substantial agreement, respectively. Patients with a nondecreased intravoxel incoherent motion perfusion fraction tended to show recanalization of the occluded intracranial arteries more frequently than patients with a decreased intravoxel incoherent motion perfusion fraction. CONCLUSIONS Intravoxel incoherent motion MR imaging could be performed in < 1 minute in addition to routine DWI. Intravoxel incoherent motion parameters noninvasively provide feasible, qualitative perfusion-related information for assessing patients with acute ischemic stroke.
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Affiliation(s)
- K Yamashita
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - R Kamei
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - H Sugimori
- Cerebrovascular Medicine and Neurology (H.S., T.K., Y.O.)
| | - T Kuwashiro
- Cerebrovascular Medicine and Neurology (H.S., T.K., Y.O.)
| | - S Tokunaga
- Neuroendovascular Therapy (S.T.), Clinical Research Institute
| | - K Kawamata
- Medical Technology (K.K.), Division of Radiology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - K Furuya
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - S Harada
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - J Maehara
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
| | - Y Okada
- Cerebrovascular Medicine and Neurology (H.S., T.K., Y.O.)
| | - T Noguchi
- From the Departments of Radiology (K.Y., R.K., K.F., S.H., J.M., T.N.)
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Yano T, Hamatake M, Tokunaga S, Okamoto T, Yamazaki K, Miura T, Nagayasu T, Sato M, Fukuyama S, Sugio K. A prospective observational study of postoperative adjuvant chemotherapy for non-small cell lung cancer in elderly patients (≥ 75 years). Int J Clin Oncol 2022; 27:882-888. [PMID: 35212829 DOI: 10.1007/s10147-022-02143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND To examine the effects of postoperative adjuvant chemotherapy for elderly (≥ 75 years of age) patients with completely resected non-small cell lung cancer (NSCLC), we conducted a multi-institutional and prospective observational study. METHODS Patients were recruited between January 2014 and December 2017, and assigned to two cohort groups based on the patients' choice either to receive postoperative adjuvant chemotherapy (Cohort B) or not (Cohort A). All the patients were observed for 2 years after enrollment. The primary endpoint was the postoperative change of Karnofsky Performance Status (KPS) at 2 years. The secondary endpoints were postoperative recurrence-free survival (RFS) and overall survival (OS) at 2 years, and the completion rate of the adjuvant chemotherapy. RESULTS Two hundred and seventy-two patients were enrolled (Cohort A, n = 225; Cohort B, n = 47). At any time point after surgery, no marked difference of KPS was observed between Cohort B and Cohort A. The RFS at 2 years was 70.8% (95% confidence interval [CI], 64.3-76.4) in Cohort A and 76.0% (95% CI 60.8-85.9) in Cohort B. The OS at 2 years was 85.9% (95% CI 80.4-89.9) in Cohort A and 89.1% (95% CI 75.8-95.3) in Cohort B. The completion rate of planned chemotherapy was 49.9% (95% CI 34.1-63.9%). CONCLUSIONS The elderly patients were not likely to choose to receive postoperative adjuvant chemotherapy; however, no significant adverse effect on postoperative KPS was identified. TRIAL REGISTRATION Clinical Trial Registration ID: UMIN000020736.
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Affiliation(s)
- Tokujiro Yano
- Department of General Thoracic Surgery, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, 874-0011, Japan.
| | - Motoharu Hamatake
- Department of Thoracic Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Tatsuro Okamoto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Koji Yamazaki
- Department of Thoracic Surgery and Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Takashi Miura
- Department of Thoracic Surgery, Oita City Medical Association's Almeida Hospital, Oita, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Masami Sato
- Department of Thoracic Surgery, Kagoshima University, Kagoshima, Japan
| | - Seiichi Fukuyama
- Department of General Thoracic Surgery, National Hospital Organization Beppu Medical Center, 1473 Uchikamado, Beppu, 874-0011, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Faculty of Medicine, Oita University, Yufu, Japan
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Fujiwara T, Kondo M, Yamada H, Haraguchi A, Fujimura K, Sakuraba K, Kamura S, Fukushi JI, Miyahara H, Inoue Y, Tsuru T, Shuto T, Yoshizawa S, Suematsu E, Miyamura T, Ayano M, Mitoma H, Arinobu Y, Niiro H, Ohishi M, Hirata A, Tokunaga S, Takada A, Hara D, Tsushima H, Akasaki Y, Ikemura S, Sueishi T, Toya M, Sakuragi T, Tsutsui T, Kai K, Arisumi S, Nakashima Y. Factors affecting patient satisfaction related to cost and treatment effectiveness in rheumatoid arthritis: results from the multicenter observational cohort study, FRANK Registry. Arthritis Res Ther 2022; 24:53. [PMID: 35193646 PMCID: PMC8862466 DOI: 10.1186/s13075-022-02746-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 02/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background To further improve rheumatoid arthritis (RA) treatment, it is necessary to understand each RA patient’s satisfaction and to identify the factors affecting their satisfaction. Despite the rise in medical costs for RA, little is known about the factors that influence patient satisfaction with the cost of treatment in RA patients. Methods This is a multicenter observational study of Japanese RA patients from the FRANK Registry with data analyzed from March 2017 to August 2020. We collected data on demographic characteristics, clinical data, quality of life which was evaluated using the EuroQol 5-dimensional questionnaire (EQ5D), and patient satisfaction. The four categories of patient satisfaction were evaluated individually (i.e., cost, treatment efficacy, activities of daily living [ADL], and global treatment satisfaction). We analyzed the factors that affected each patient’s satisfaction, such as age, sex, EQ5D, disease duration, disease activity, and treatment. Results This study included 2235 RA outpatients (406 males, 1829 females). In RA patients, “very satisfied” and “satisfied” were given for nearly half of each satisfaction aspect (cost 49%; efficacy 72%; ADL 58%; global treatment 66%) at the time of the initial registration. To investigate the factors influencing each satisfaction, multivariate analysis has revealed that the use of b/tsDMARDs increased satisfaction of treatment effect (odds ratio [OR] 0.66) and ADL (OR 0.78) but decreased cost satisfaction (OR 2.21). Age (50–64 years; OR 0.91; 65–74 years, 0.55: ≥ 75 years, 0.35), female (OR 0.81), and history of musculoskeletal surgery (OR 0.60) all increased cost satisfaction. Patients with lower disease activity and higher EQ5D scores had higher levels of satisfaction in all areas. Conclusions In this study, patient satisfaction in terms of cost, treatment effect, ADL, and overall treatment was generally higher, but some patients were dissatisfied. The cost of satisfaction increased with age and a history of musculoskeletal surgery, while it decreased with a lower EQ5D score and the use of b/tsDMARDs. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02746-5.
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Affiliation(s)
- Toshifumi Fujiwara
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Masakazu Kondo
- Kondo Clinic of Rheumatology and Orthopaedic Surgery, Fukuoka, Japan
| | - Hisakata Yamada
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.,Kondo Clinic of Rheumatology and Orthopaedic Surgery, Fukuoka, Japan
| | - Akihisa Haraguchi
- Department of Orthopedics Surgery and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Kenjiro Fujimura
- Department of Orthopedics Surgery and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Koji Sakuraba
- Department of Orthopedics Surgery and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Satoshi Kamura
- Department of Orthopedics Surgery and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Jun-Ichi Fukushi
- Department of Orthopedics Surgery and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Hisaaki Miyahara
- Department of Orthopedics Surgery and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Yasushi Inoue
- Department of Rheumatology, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | | | - Toshihide Shuto
- Department of Orthopedics Surgery, Chiyoda Hospital, Miyazaki, Japan
| | - Seiji Yoshizawa
- Department of Rheumatology, Hamanomachi Hospital, Fukuoka, Japan
| | - Eiichi Suematsu
- Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Tomoya Miyamura
- Department of Internal Medicine and Rheumatology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Masahiro Ayano
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroki Mitoma
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Yojiro Arinobu
- Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Hiroaki Niiro
- Department of Medical Education, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Masanobu Ohishi
- Department of Orthopaedic Surgery, Chihaya Hospital, Fukuoka, Japan
| | - Akie Hirata
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Atsushi Takada
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Daisuke Hara
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Hidetoshi Tsushima
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yukio Akasaki
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Satoshi Ikemura
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takuya Sueishi
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Masakazu Toya
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Takahide Sakuragi
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Tomoko Tsutsui
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazuhiro Kai
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shinkichi Arisumi
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Kyushu University Graduate School of Medical Sciences, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Ishii Y, Aiba N, Ando M, Asakura N, Bierwage A, Cara P, Dzitko H, Edao Y, Gex D, Hasegawa K, Hayashi T, Hiwatari R, Hoshino T, Ikeda Y, Ishida S, Isobe K, Iwai Y, Jokinen A, Kasugai A, Kawamura Y, Kim JH, Kondo K, Kwon S, Lorenzo SC, Masuda K, Matsuyama A, Miyato N, Morishita K, Nakajima M, Nakajima N, Nakamichi M, Nozawa T, Ochiai K, Ohta M, Oyaidzu M, Ozeki T, Sakamoto K, Sakamoto Y, Sato S, Seto H, Shiroto T, Someya Y, Sugimoto M, Tanigawa H, Tokunaga S, Utoh H, Wang W, Watanabe Y, Yagi M. R&D Activities for Fusion DEMO in the QST Rokkasho Fusion Institute. Fusion Science and Technology 2021. [DOI: 10.1080/15361055.2021.1925030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Y. Ishii
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Aiba
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - M. Ando
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Asakura
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - A. Bierwage
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - P. Cara
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - H. Dzitko
- Fusion for Energy, Broader Approach, Garching, Germany
| | | | - D. Gex
- Fusion for Energy, Broader Approach, Garching, Germany
| | - K. Hasegawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hayashi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - R. Hiwatari
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hoshino
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Ikeda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Ishida
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Isobe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Iwai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Jokinen
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - A. Kasugai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Kawamura
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - J. H. Kim
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Kondo
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Kwon
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. C. Lorenzo
- Fusion for Energy, Broader Approach, Barcelona, Spain
| | - K. Masuda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Matsuyama
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Miyato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Morishita
- Kyoto University, Institute of Advanced Energy, Uji, Japan
| | - M. Nakajima
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Nakajima
- National Institute for Fusion Science, Department of Helical Plasma Research Rokkasho Research Center, Rokkasho-Vill., Japan
| | - M. Nakamichi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Nozawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Ochiai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Ohta
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Oyaidzu
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Ozeki
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - K. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Sato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Seto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Shiroto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Someya
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Sugimoto
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - H. Tanigawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Tokunaga
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Utoh
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - W. Wang
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Watanabe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Yagi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
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Shoji H, Tsuda T, Shimokawa M, Akiyoshi K, Tokunaga S, Kunieda K, Kotaka M, Matsumoto T, Nagata Y, Mizukami T, Mizuki F, Danenberg K, Sunakawa Y, Boku N, Nakajima T. P-100 A phase II study of first-line chemotherapy initiating FOLFIRI+cetuximab and switching to FOLFIRI+bevacizumab according to early tumor shrinkage at 8 weeks in RAS wild-type metastatic colorectal cancer: HYBRID trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.05.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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14
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Yamanishi T, Asakura H, Seki N, Tokunaga S. Triple Therapy with Tamsulosin, Dutasteride, and Imidafenacin for Benign Prostatic Hyperplasia in Patients with Overactive Bladder Symptoms Refractory to Tamsulosin: Subgroup Analyses of the DIrecT Study. Urol Int 2021; 105:817-825. [PMID: 33690238 DOI: 10.1159/000513892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/16/2020] [Indexed: 11/19/2022]
Abstract
AIM To verify if the efficacy of the triple therapy with tamsulosin, dutasteride, and imidafenacin (TDI) is influenced by any background characteristics in patients with overactive bladder (OAB). METHODS A subanalysis of data from the DIrecT study was conducted. Superiority of TDI over tamsulosin and dutasteride in terms of efficacy based on the Overactive Bladder Symptom Score (OABSS), total International Prostate Symptom Score (IPSS), IPSS quality of life index, and postvoid residual (PVR) was evaluated in binary subgroups. RESULTS In the treatment groups, there was a significant interaction of total OABSS with testosterone level (≥4.8 vs. <4.8 ng/mL, p = 0.043) and PVR (≥20 vs. <20 mL, p = 0.018). For the total IPSS, no significant interaction was found except for the IPSS QOL index. For the IPSS QOL index, a significant interaction was found with testosterone level (≥4.8 vs. <4.8 ng/mL, p < 0.0001) as well as with total IPSS and total OABSS. For the PVR, no significant interaction was found except with total OABSS. CONCLUSIONS Triple therapy with TDI is suggested to be a therapeutic option for benign prostatic hyperplasia in patients with residual OAB symptoms refractory to tamsulosin and in patients with various background characteristics regardless of severity of OAB symptoms. Trial Registry No. UMIN 000011980.
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Affiliation(s)
- Tomonori Yamanishi
- Department of Urology, Continence Center, Dokkyo Medical University, Mibu, Tochigi, Japan,
| | - Hirotaka Asakura
- Department of Urology, Saitama Medical University Hospital, Iruma, Saitama, Japan
| | - Narihito Seki
- Department of Urology, Kyushu Central Hospital, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Tsuchiya T, Kamohara R, Muraoka M, Nagayasu T, Saeki S, Takenoyama M, Suzuki M, Inada K, Tokunaga S, Hayashi T, Urabe S, Koga T, Akamine S, Sugio K. A single-arm, phase 2 study of adjuvant chemotherapy with oral tegafur-uracil for pathologically lymphovascular invasion positive stage IA non-small cell lung cancer: LOGIK0602 study. BMC Cancer 2020; 20:1192. [PMID: 33276755 PMCID: PMC7718684 DOI: 10.1186/s12885-020-07691-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 11/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Lymphovascular invasion (LVI), which includes vascular or lymphatic invasions, is a representative prognostic factor even in patients with resected stage IA non-small cell lung cancer (NSCLC). Because tegafur-uracil is effective on cancers with LVI, we conducted a multi-center single-arm phase II study to estimate the efficacy of adjuvant tegafur-uracil in patients with LVI-positive stage IA NSCLC. METHODS Patients with completely resected LVI-positive stage IA NSCLC were registered. LVI was diagnosed by consensus of two of three pathologists. Adjuvant chemotherapy consisted of 2 years of oral tegafur-uracil at 250 mg/m2/day. Fifty-five patients from 7 institutions were enrolled from June 2007 to September 2012. RESULTS Among the 52 eligible patients, 36 (69.2%) completed the treatment course. There were 39 male and 13 female patients. The observation period was calculated as 562 to 3107 days using the reverse Kaplan-Meier method. The 5-year overall and relapse free survival rates were 94.2 and 88.5% respectively, which were significantly better than that of any other studies conducted on patients with LVI-positive stage IA NSCLC. Notably, the overall survival rate was 15% better than that of our prior retrospective study. The retrospective analysis of stage IA NSCLC patients who had received an operation in the same period revealed that the 5-year overall survival rate of the LVI positive group was 73.6% when adjuvant chemotherapy was not applied. Among 55 safety analysis sets, 4 cases of grade 3 hepatic function disorder (9.1%) and 5 cases of grade 2 anorexia (10.9%) were most frequently observed. No grade 4 adverse effects were encountered. CONCLUSION A 2-year course of oral tegafur-uracil administration is feasible and might have a significant benefit in the adjuvant treatment of LVI-positive stage IA NSCLC. TRIAL REGISTRATION UMIN identifier: UMIN000005921 ; Date of enrolment of the first participant to the trial: 19 June 2007; Date of registration: 5 July 2011 (retrospectively registered).
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Affiliation(s)
- Tomoshi Tsuchiya
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, 852-8501, Japan.
| | - Ryotaro Kamohara
- Department of Thoracic Surgery, Oita Prefectural Hospital, Oita, Japan
| | - Masashi Muraoka
- Department of Thoracic Surgery, Japan Community Health care Organization Isahaya General Hospital, Isahaya, Japan
| | - Takeshi Nagayasu
- Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, 852-8501, Japan
| | - Sho Saeki
- Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto, Japan
| | - Mitsuhiro Takenoyama
- Department of Respiratory Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Makoto Suzuki
- Department of Thoracic Surgery, Kumamoto University Hospital, Kumamoto, Japan
| | - Kazuo Inada
- Department of Thoracic Surgery, National Hospital Organization Omuta Hospital, Omuta, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Tomayoshi Hayashi
- Department of Pathology, Nagasaki Prefecture Shimabara Hospital, Nagasaki, Japan
| | - Shogo Urabe
- Department of Pathology, Oita Prefectural Hospital, Oita, Japan
| | - Takaomi Koga
- Department of Pathology, Pathophysiological and Experimental Pathology, Fukuoka, Japan
| | - Shinji Akamine
- Department of Thoracic Surgery, Oita Prefectural Hospital, Oita, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University, Oita, Japan
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16
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Shimizu J, Akamatsu H, Murakami H, Harada H, Hayashi H, Daga H, Hasegawa Y, Kim Y, Kato T, Tokunaga S, Nishimura Y, Yamamoto N, Nakagawa K. 1236MO A single-arm phase II study of gefitinib with concurrent thoracic radiotherapy in unresectable locally-advanced non-small cell lung cancer patients with EGFR mutation (West Japan Oncology Group 6911L). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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17
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Takayama K, Takeshita M, Inoue K, Ichiki M, Fujita M, Harada T, Shiraishi Y, Wataya H, Tokunaga S, Yamada T, Uchino J, Sugio K. Randomized Phase II Study of First-Line Biweekly Gemcitabine and Carboplatin Versus Biweekly Gemcitabine and Carboplatin plus Maintenance Gemcitabine in Elderly Patients with Untreated Non-Small Cell Lung Cancer: LOGIK0801. Oncologist 2020; 25:e1146-e1157. [PMID: 32385918 PMCID: PMC7418367 DOI: 10.1634/theoncologist.2020-0322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Indexed: 11/21/2022] Open
Abstract
LESSONS LEARNED The usefulness of maintenance gemcitabine (GEM) after biweekly carboplatin + GEM in elderly patients with non-small cell lung cancer could not be proved. Superior overall survival was obtained in the group that did not receive maintenance therapy. BACKGROUND The primary objective of this randomized phase II study was to assess progression-free survival (PFS) in elderly patients with advanced non-small cell lung cancer (NSCLC) treated with gemcitabine (GEM) maintenance therapy versus best supportive care following first-line GEM plus carboplatin (CBDCA). METHODS Elderly chemotherapy-naive patients with stage IIIB or IV NSCLC were randomly assigned 1:1 to the control arm or the study arm. All patients received biweekly combination therapy with GEM and CBDCA (1,000 mg/m2 GEM and CBDCA at an area under the curve [AUC] of 3 on days 1 and 15, every 4 weeks). In the study arm, patients with objective response or stable disease following three or four cycles of initial chemotherapy received maintenance GEM. RESULTS Eighty-four patients were enrolled. The objective response rates (ORRs) were 17.5% in the control arm and 14.0% in the study arm. The most common toxicity was neutropenia (control arm: 47.5% and study arm: 69.8%). The median progression-free survivals were 4.99 months (control arm) and 4.44 months (study arm), and the median overall survivals (OSs) were 21.7 months (control arm) and 8.2 months (study arm). CONCLUSION Our data do not support maintenance GEM after biweekly CBDCA+GEM in elderly patients with NSCLC.
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Affiliation(s)
- Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of MedicineKyotoJapan
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - Masafumi Takeshita
- Department of Respiratory Medicine, Kitakyushu Municipal Medical CenterKitakyushuJapan
| | - Koji Inoue
- Department of Respiratory Medicine, Kitakyushu Municipal Medical CenterKitakyushuJapan
| | - Masao Ichiki
- Department of Respirology, National Hospital Organization Kyushu Medical CenterFukuokaJapan
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University HospitalFukuokaJapan
| | - Taishi Harada
- Department of Respiratory Medicine, Japan Community Healthcare Organization Kyushu HospitalKitakyushuJapan
| | - Yoshimasa Shiraishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu UniversityFukuokaJapan
| | - Hiroshi Wataya
- Division of Internal Medicine, Saiseikai Fukuoka General HospitalFukuokaJapan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University HospitalFukuokaJapan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of MedicineKyotoJapan
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of MedicineKyotoJapan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University, Faculty of MedicineOitaJapan
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18
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Kimura A, Matsumoto Y, Wakata Y, Oyamada A, Ohishi M, Fujiwara T, Ikuta K, Tsuchiya K, Tayama N, Tomari S, Miyahara H, Mae T, Hara T, Saito T, Arizono T, Kaji K, Mawatari T, Fujiwara M, Sakimura R, Shin K, Ninomiya K, Nakaie K, Antoku Y, Tokunaga S, Nakashima N, Iwamoto Y, Nakashima Y. Predictive factors of mortality of patients with fragility hip fractures at 1 year after discharge: A multicenter, retrospective study in the northern Kyushu district of Japan. J Orthop Surg (Hong Kong) 2020; 27:2309499019866965. [PMID: 31466509 DOI: 10.1177/2309499019866965] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE Fragility hip fractures (FHFs) are associated with a high risk of mortality, but the relative contribution of various factors remains controversial. This study aimed to evaluate predictive factors of mortality at 1 year after discharge in Japan. METHODS A total of 497 patients aged 60 years or older who sustained FHFs during follow-up were included in this study. Expected variables were finally assessed using multivariable Cox proportional hazards models. RESULTS The 1-year mortality rate was 9.1% (95% confidence interval: 6.8-12.0%, n = 45). Log-rank test revealed that previous fractures (p = 0.003), Barthel index (BI) at discharge (p = 0.011), and place-to-discharge (p = 0.004) were significantly associated with mortality for male patients. Meanwhile, body mass index (BMI; p = 0.023), total Charlson comorbidity index (TCCI; p = 0.005), smoking (p = 0.007), length of hospital stay (LOS; p = 0.009), and BI (p = 0.004) were the counterparts for females. By multivariate analyses, previous vertebral fractures (hazard ratio (HR) 3.33; p = 0.044), and BI <30 (HR 5.42, p = 0.013) were the predictive variables of mortality for male patients. BMI <18.5 kg/m2 (HR 2.70, p = 0.023), TCCI ≥5 (HR 2.61, p = 0.032), smoking history (HR 3.59, p = 0.018), LOS <14 days (HR 13.9; p = 0.007), and BI <30 (HR 2.76; p = 0.049) were the counterparts for females. CONCLUSIONS Previous vertebral fractures and BI <30 were the predictive variables of mortality for male patients, and BMI <18.5 kg/m2, TCCI ≥5, smoking history, LOS <14 days, and BI <30 were those for females. Decreased BI is one of the independent and preventable risk factors. A comprehensive therapeutic approach should be considered to prevent deterioration of activities of daily living and a higher risk of mortality.
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Affiliation(s)
- Atsushi Kimura
- 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Matsumoto
- 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Yoshifumi Wakata
- 2 Department of Medical Informatics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Akiko Oyamada
- 3 Department of Orthopaedic Surgery, Saga Handicapped Children's Hospital, Saga, Japan
| | - Masanobu Ohishi
- 4 Department of Orthopaedic Surgery, Chihaya Hospital, Fukuoka, Japan
| | - Toshifumi Fujiwara
- 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
| | - Ko Ikuta
- 5 Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, Saga, Japan
| | - Kuniyoshi Tsuchiya
- 6 Department of Orthopaedic Surgery, JCHO Kyushu Hospital, Fukuoka, Japan
| | - Naohisa Tayama
- 7 Department of Orthopaedic Surgery, Steel Memorial Yawata Hospital, Fukuoka, Japan
| | - Shinji Tomari
- 8 Department of Orthopaedic Surgery, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Hisaaki Miyahara
- 9 Department of Orthopaedic Surgery, National Kyushu Medical Center, Fukuoka, Japan
| | - Takao Mae
- 10 Department of Orthopaedic Surgery, Saga-ken Medical Center Koseikan, Saga, Japan
| | - Toshihiko Hara
- 11 Department of Orthopaedic Surgery, Aso Iizuka Hospital, Fukuoka, Japan
| | - Taichi Saito
- 12 Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
| | - Takeshi Arizono
- 13 Department of Orthopaedic Surgery, Kyushu Central Hospital, Fukuoka, Japan
| | - Kozo Kaji
- 14 Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Taro Mawatari
- 15 Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - Masami Fujiwara
- 16 Department of Orthopaedic Surgery, Sada Hospital, Fukuoka, Japan
| | - Riku Sakimura
- 17 Department of Orthopaedic Surgery, Harasanshin Hospital, Fukuoka, Japan
| | - Kunichika Shin
- 18 Department of Orthopaedic Surgery, Saiseikai Yahata General Hospital, Fukuoka, Japan
| | - Kenichi Ninomiya
- 19 Department of Orthopaedic Surgery, Koga Hospital 21, Fukuoka, Japan
| | - Kazutoshi Nakaie
- 20 Department of Orthopaedic Surgery, Fukuoka-Higashi Medical Center, Fukuoka, Japan
| | - Yasuaki Antoku
- 21 Faculty of Medicine, Hospital Informatic Center, Oita University, Oita, Japan
| | - Shoji Tokunaga
- 22 Clinical Research Support Center Kyushu, Fukuoka, Japan
| | - Naoki Nakashima
- 23 Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Yukihide Iwamoto
- 14 Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Yasuharu Nakashima
- 1 Department of Orthopaedic Surgery, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan
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Tokunaga S, Moreau P, Signoret J, Imbeaux F, Tsitrone E, Loarer T, Salmon T, Hutter T, Giruzzi G, Joffrin E, De Tommasi G, Sartori F, Farthing J, Nakanishi H, Ozeki T, Asakura N, Sakamoto Y, Ohtsu H, Sugie Y, Suzuki S, Fukuda M, Nakano T, Sano R, Ishii Y, Clement-Lorenzo S, Nakajima N. Remote experiment with WEST from ITER Remote Experimentation Centre. Fusion Engineering and Design 2020. [DOI: 10.1016/j.fusengdes.2020.111554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Ando K, Emi Y, Miyanari N, Tsuji A, Sakai K, Sawai T, Imamura H, Mori S, Tokunaga S, Oki E, Saeki H, Kakeji Y, Akagi Y, Baba H, Maehara Y, Mori M. Efficacy and feasibility of S-1 plus oxaliplatin (C-SOX) for treating patients with stage III colon cancer (KSCC1303): final analysis of 3-year disease-free survival. Int J Clin Oncol 2020; 25:1115-1122. [PMID: 32189156 DOI: 10.1007/s10147-020-01646-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/24/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Adjuvant chemotherapy is an accepted treatment to improve survival rates in patients with stage III colon cancer, and regimens including oxaliplatin have been shown to be superior to those containing 5-FU alone. The purpose of this study was to examine the efficacy and feasibility of S-1 plus oxaliplatin (C-SOX) as adjuvant chemotherapy for patients with stage III colon cancer following curative resection. METHODS Patients with colon cancer who underwent curative resection were enrolled and received oral S-1 40-60 mg twice daily on days 1-14 every 3 weeks plus intravenous oxaliplatin 130 mg/m2 on day 1 for eight courses. The primary endpoint was 3-year disease-free survival rate. Secondary endpoints were the rate of treatment completion, adverse events, relative dose intensity, and overall survival. RESULTS Between February 2014 and December 2014, 89 patients were enrolled. One patient was excluded from the analysis because of ineligibility, and the remaining 88 patients were included. The rate of protocol treatment completion was 72.3%. The relative dose intensity of S-1 and oxaliplatin was 72% and 76.3%, respectively. Hematological severe adverse events (Grade 3/4) were neutropenia (21.3%) and thrombocytopenia (15.7%). The most frequent symptom was diarrhea (Grade 3/4: 5.6%). The incidence of grade 2 neuropathy has decreased from 8.1 to 2.7% after 3 years of the therapy. Three-year disease-free survival rate was 73.9% (95% CI 63.8-81.9), and 3-year overall survival rate was 94.3% (95% CI 86.8-97.6) CONCLUSIONS: C-SOX is a safe and feasible adjuvant chemotherapy regimen in patients with stage III colon cancer undergoing curative resection.
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Affiliation(s)
- Koji Ando
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasunori Emi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | | | - Akihito Tsuji
- Department of Clinical Oncology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Kenji Sakai
- Department of Medical Oncology, National Hospital Organization Kumamoto Medical Center, Kumamoto, Japan
| | - Terumitsu Sawai
- Graduate School of Medicine, Nagasaki University, Nagasaki, Japan
| | - Hiroshi Imamura
- Gastroenterology Center, Izumi Regional Medical Center, Kagoshima, Japan
| | - Shinichiro Mori
- Graduate School of Medicine, Kagoshima University, Kagoshima, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Hiroshi Saeki
- Department of General Surgical Science Graduate School of Medicine, Gunma University, Gunma, Japan
| | | | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Masaki Mori
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Yamanishi T, Kaga K, Sakata K, Yokoyama T, Kageyama S, Fuse M, Tokunaga S. Back Cover Image, Volume 39, Number 2, February 2020. Neurourol Urodyn 2020. [DOI: 10.1002/nau.24319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Tomonori Yamanishi
- Department of Urology Continence Center, Dokkyo Medical University Tochigi Japan
| | - Kanya Kaga
- Department of Urology Continence Center, Dokkyo Medical University Tochigi Japan
| | - Koichi Sakata
- Department of Urology Imaichi Hospital Tochigi Japan
| | | | | | - Miki Fuse
- Department of Urology Continence Center, Dokkyo Medical University Tochigi Japan
| | - Shoji Tokunaga
- Medical Information Center Kyushu University Hospital Fukuoka Japan
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Yamanishi T, Kaga K, Sakata K, Yokoyama T, Kageyama S, Fuse M, Tokunaga S. A randomized controlled study of the efficacy of tadalafil monotherapy versus combination of tadalafil and mirabegron for the treatment of persistent overactive bladder symptoms in men presenting with lower urinary tract symptoms (CONTACT Study). Neurourol Urodyn 2020; 39:804-812. [PMID: 31961963 PMCID: PMC7027497 DOI: 10.1002/nau.24285] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 01/10/2020] [Indexed: 11/30/2022]
Abstract
Aim To evaluate efficacy and safety of combination of tadalafil + mirabegron for overactive bladder/benign prostatic hyperplasia (OAB/BPH). Methods Male patients with lower urinary tract symptoms (50 to 89 years), with remaining OAB symptoms even after administering tadalafil for more than 8 weeks were randomly assigned to either tadalafil monotherapy group (5 mg/day) or tadalafil/mirabegron combination therapy group (5 mg/50 mg/day). The primary endpoint was change from baseline in total OAB symptom score (OABSS) at week 12. The secondary endpoints were changes in International Prostate Symptom Score (IPSS), NIH‐chronic prostatitis symptom index (NIH‐CPSI), and micturition chart parameters at weeks 4 and 12. Results A total of 176 patients were randomized to either monotherapy (87 patients) or combination therapy (89 patients). The baseline characteristics of patients in the two groups were similar. The total OABSS (95% confidence interval) of combination therapy was significantly decreased by 1.78 (1.05‐2.50) points compared with that of monotherapy (P < .001). Changes from baseline in OABSS nighttime voiding score, urgency score, urgency incontinence score, IPSS storage subscores, NIH‐CPSI total score, and numbers of voids, nighttime‐voids, and urgency episodes/day in micturition chart were significantly reduced in combination therapy (all P < .001). Patient‐reported outcome was significantly more satisfactory in combination therapy than in monotherapy (P < .001). One moderate adverse event (pain in hip joint) with hardly presumed causal relationship with therapy and seven mild adverse events were noted in monotherapy and combination therapy group, respectively. Conclusions The effect of tadalafil/mirabegron combination therapy on relieving OAB symptoms appeared to be greater than that of tadalafil monotherapy and can be safely used.
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Affiliation(s)
- Tomonori Yamanishi
- Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan
| | - Kanya Kaga
- Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan
| | - Koichi Sakata
- Department of Urology, Imaichi Hospital, Tochigi, Japan
| | | | | | - Miki Fuse
- Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Takayama K, Uchino J, Fujita M, Tokunaga S, Imanaga T, Morinaga R, Ebi N, Saeki S, Matsukizono K, Wataya H, Yamada T, Nakanishi Y. Phase I/II Study of Docetaxel and S-1 in Previously-Treated Patients with Advanced Non-Small Cell Lung Cancer: LOGIK0408. J Clin Med 2019; 8:jcm8122196. [PMID: 31842381 PMCID: PMC6947543 DOI: 10.3390/jcm8122196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 11/20/2022] Open
Abstract
Background: As docetaxel plus S-1 may be feasible for cancer treatment, we conducted a phase I/II trial to determine the recommended docetaxel dose and the fixed S-1 dose (phase I), as well as confirm the regimen’s efficacy and safety (phase II) for previously-treated patients with advanced non-small cell lung cancer. Methods: Patients ≤75 years with performance status ≤1 and adequate organ function were treated at three-week intervals with docetaxel on day 1 and 80 mg/m2 oral S-1 from days 1–14. The starting docetaxel dose was 45 mg/m2 and this was escalated to a maximum of 70 mg/m2. In phase II, response rate, progression-free survival (PFS), overall survival (OS), and safety were assessed. Results: The recommended doses were 50 mg/m2 docetaxel (day 1) and 80 mg/m2 S-1 (days 1–14). Grades 3 and 4 leukocytopenia and neutropenia occurred in 44% and 67% of patients, respectively. Nonhematologic toxicities were generally mild. Overall response to chemotherapy was 7.7% (95% confidence interval (CI), 1.6–20.9%), and median PFS and OS were 18.0 weeks (95% CI; 11.3–22.9 weeks) and 53.0 weeks, respectively. Conclusion: Fifty mg/m2 docetaxel plus 80 mg/m2 oral S-1 had a lower response rate than anticipated; however, the survival data were encouraging. A further investigation is warranted to select the optimal patient population.
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Affiliation(s)
- Koichi Takayama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8190395, Japan; (K.T.); (Y.N.)
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan;
| | - Junji Uchino
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan;
- Correspondence: ; Tel.: +81-75-251-5513
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka 8140133, Japan;
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka 8190395, Japan;
| | - Tomotoshi Imanaga
- Department of respiratory disease, Nippon Steel Yawata Memorial Hospital, Kitakyushu 8058508, Japan;
| | - Ryotaro Morinaga
- Department of Medical Oncology, Oita University Faculty of Medicine, Yuhu 8795593, Japan;
| | - Noriyuki Ebi
- Department of Respiratory Medicine, Iizuka Hospital, Iizuka, 8208505 Japan;
| | - Sho Saeki
- Department of Respiratory Medicine, Kumamoto University Hospital, Kumamoto 8608556, Japan;
| | - Kazuya Matsukizono
- Department of Internal Medicine, Kagoshima City Hospital, Kagoshima 8908544, Japan;
| | - Hiroshi Wataya
- Department of Internal Medicine, Saiseikai Fukuoka General Hospital, Fukuoka 8100001, Japan;
| | - Tadaaki Yamada
- Department of Respiratory Medicine, Kyoto Prefectural University of Medicine, Kyoto 6020841, Japan;
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka 8190395, Japan; (K.T.); (Y.N.)
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Ogata-Suetsugu S, Hamada N, Tsuda T, Takata S, Kitasato Y, Inoue N, Nagata N, Yatera K, Mukae H, Yoshii C, Hoshino T, Fujita M, Watanabe K, Tokunaga S, Nakanishi Y. Characteristics of tobacco-related lung diseases in Fukuoka Prefecture, Japan: A prospective, multi-institutional, observational study. Respir Investig 2019; 58:74-80. [PMID: 31727581 DOI: 10.1016/j.resinv.2019.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 09/09/2019] [Accepted: 10/02/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Tobacco smoking causes a variety of smoking-related diseases, death, and economic damage. Despite targeted anti-smoking campaigns, tobacco-related deaths are expected to increase in Japan. We investigated the current state of non-cancerous lung diseases such as idiopathic interstitial pneumonias (IIPs), chronic obstructive pulmonary disease (COPD), and combined pulmonary fibrosis and emphysema (CPFE), which are known to be highly related to tobacco smoking. METHODS This prospective multi-institutional observational study involved 29 major hospitals within the Fukuoka Prefecture area (Fukuoka tobacco-related lung disease registry study group). Patients diagnosed with IIPs, including CPFE and COPD, registered from September 1, 2013 to April 30, 2016 were included. Clinical background information, laboratory and pulmonary function test results, findings of imaging tests, including chest radiography and chest computed tomography, and DNA isolated from peripheral blood were collected from each patient. Follow-up surveillance involved collection of data regarding the exacerbation of disease and death until 5 years of registration. In the present study, we report the baseline characteristics of the patients registered in this surveillance study. RESULTS Overall, 1016 patients (524 with IIPs, including 145 CPFE and 492 with COPD) were enrolled. Among the patients with COPD, 96.8% were current or former smokers. Among the patients with IIPs, 69.9% were current or former smokers. CONCLUSION This study revealed the current status of lung diseases potentially related to tobacco smoking in Fukuoka Prefecture. Both COPD and CPFE were highly related to tobacco smoking, whereas 30% of patients with IIPs had never smoked.
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Affiliation(s)
- Saiko Ogata-Suetsugu
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Naoki Hamada
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Toru Tsuda
- Kirigaoka Tsuda Hospital, Fukuoka, Japan.
| | - Shohei Takata
- Department of Respiratory Diseases, National Hospital Organization, Fukuoka Higashi Medical Center, Fukuoka, Japan.
| | - Yasuhiko Kitasato
- Department of Respiratory Medicine, Kurume General Hospital, Fukuoka, Japan.
| | - Naoyuki Inoue
- Division of Respiratory Medicine, Kyushu Rosai Hospital, Fukuoka, Japan.
| | - Nobuhiko Nagata
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
| | - Kazuhiro Yatera
- Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan.
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Chiharu Yoshii
- Department of Respiratory Medicine, Wakamatsu Hospital of the University of Occupational and Environmental Health, Fukuoka, Japan.
| | - Tomoaki Hoshino
- Division of Respirology, Neurology, and Rheumatology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
| | - Masaki Fujita
- Department of Respiratory Medicine, Fukuoka University School of Medicine, Fukuoka, Japan.
| | - Kentaro Watanabe
- General Medical Center, Fukuoka University School of Medicine, Fukuoka, Japan.
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan.
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
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Park JS, Okui T, Furuhashi H, Tokunaga S, Nakashima N. Evaluation of polypharmacy in Japan using the national health insurance claims database in 2015-2017. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz187.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is growing awareness of polypharmacy as a global issue. Several countries have introduced policies to optimize multidrug prescriptions. In Japan, hospital prescription fee “F100” and outpatient prescription fee “F400” have been instituted to promote the correct use of drugs, the medical treatment fee is restricted when seven or more types of drugs are prescribed. However, non-polypharmacy patients who need multiple drugs are also comprehensively evaluated within the purview of the same drug insurance claim criteria. Thus, the current state of such policies is still unclear. This study identified the age group in which drug claims have changed based on drug insurance claim criteria and elucidated the relationship between policy interventions and multidrug prescriptions.
Methods
We analyzed F100 and F400 cases using open data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan from April 2015 to March 2017. These sources include a population of about 69 million patients. Moreover, the growth rate of the number of patients who were prescribed seven or more types of drugs was evaluated.
Results
F100 prescription claims decreased by − 12.7% (n = 3,239,070) in 2016 as compared to 2015 (n = 3,700,396), and the number of F400 prescription claims decreased by − 7.7% (n = 28,745,468) in 2016 as compared to 2015 (n = 31,142,484), for seven or more types of drugs. The drug insurance claim rate among people over the age of 65 was 74.2% to F100 and 77.9% to F400, and this age group represented the highest proportion among all age groups.
Conclusions
The rate of health insurance claims for multidrug prescriptions clearly decreased after the institution of policy interventions to optimize the use of seven or more types of drugs. The present study suggests that the prescription fee restriction could reduce the rate of multidrug prescriptions and consequent decreases the risk of adverse drug-related events in polypharmacy patients.
Key messages
Policy interventions related to the optimization of drug prescriptions encourage behavioral factors of healthcare providers. Polypharmacy treatment must be established through prescriptions information linkage between clinical practices and community.
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Affiliation(s)
- J S Park
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - T Okui
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - H Furuhashi
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - S Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - N Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Iwama E, Goto Y, Murakami H, Tsumura S, Sakashita H, Mori Y, Nakagaki N, Fujita Y, Seike M, Bessho A, Ono M, Nishitsuji M, Akamatsu H, Morinaga R, Akagi T, Shimose T, Tokunaga S, Yamamoto N, Nakanishi Y, Sugio K, Okamoto I. Survival Analysis for Patients with ALK Rearrangement-Positive Non-Small Cell Lung Cancer and a Poor Performance Status Treated with Alectinib: Updated Results of Lung Oncology Group in Kyushu 1401. Oncologist 2019; 25:306-e618. [PMID: 32297438 DOI: 10.1634/theoncologist.2019-0728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 09/15/2019] [Indexed: 11/17/2022] Open
Abstract
LESSONS LEARNED Alectinib confers a pronounced survival benefit in patients with ALK rearrangement-positive non-small cell lung cancer and a poor performance status. Survival benefit of alectinib for patients with a poor performance status was consistent regardless of the presence of central nervous system metastases. BACKGROUND We previously reported a marked objective response rate (ORR) and safety for alectinib treatment in patients with ALK rearrangement-positive non-small cell lung cancer (NSCLC) and a poor performance status (PS) in the Lung Oncology Group in Kyushu (LOGiK) 1401 study. It remained unclear, however, whether alectinib might also confer a long-term survival benefit in such patients. METHODS Eighteen patients with ALK rearrangement-positive advanced NSCLC and a PS of 2, 3, or 4 (n = 12, 5, and 1, respectively) were enrolled in LOGiK1401 between September 2014 and December 2015 and received alectinib. We have now updated the survival data for the study. RESULTS The median follow-up time for all patients was 27.3 months. The median progression-free survival (PFS) was 16.2 months (95% confidence interval [CI], 7.1-30.8 months), and the median survival time (MST) and the 3-year overall survival rate were 30.3 months (95% CI, 11.5 months to not reached) and 43.8% (95% CI, 20.8-64.7%), respectively. This survival benefit was similarly manifest in patients with a PS of 2 (MST, 20.5 months) and those with a PS of ≥3 (MST, not reached). PFS did not differ between patients with or without central nervous system (CNS) metastases at baseline (median of 17.5 and 16.2 months, respectively, p = .886). CONCLUSION Alectinib showed a pronounced survival benefit for patients with ALK rearrangement-positive NSCLC and a poor PS regardless of the presence of CNS metastases, a patient population for which chemotherapy is not indicated.
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Affiliation(s)
- Eiji Iwama
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasushi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Haruyasu Murakami
- Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shinsuke Tsumura
- Department of Respiratory Medicine, Kumamoto Regional Medical Center, Kumamoto, Japan
| | - Hiroyuki Sakashita
- Department of Clinical Oncology, Tokyo Medical and Dental University, Tokyo, Japan
- Department of Respiratory Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshiaki Mori
- Department of Respiratory Medicine, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Noriaki Nakagaki
- Department of Respiratory Medicine, Steel Memorial Yawata Hospital, Kita-Kyushu, Japan
| | - Yuka Fujita
- Department of Respiratory Medicine, National Hospital Organization Asahikawa Medical Center, Asahikawa, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Akihiro Bessho
- Department of Respiratory Medicine, Japanese Red Cross Okayama Hospital, Okayama, Japan
| | - Manabu Ono
- Department of Respiratory Medicine, Kesen-numa City Hospital, Kesen-numa, Japan
| | - Masaru Nishitsuji
- Division of Respiratory Medicine, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Hiroaki Akamatsu
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Ryotaro Morinaga
- Department of Thoracic Medical Oncology, Oita Prefectural Hospital, Oita, Japan
| | - Takanori Akagi
- Department of Respiratory Medicine, Fukuoka University Chikushi Hospital, Chikushino, Japan
| | | | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yoichi Nakanishi
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kenji Sugio
- Department of Thoracic and Breast Surgery, Oita University, Oita, Japan
| | - Isamu Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Takayama K, Ichiki M, Matsumoto T, Ebi N, Akamine S, Tokunaga S, Yamada T, Uchino J, Nakanishi Y. Phase II Study on Biweekly Combination Therapy of Gemcitabine plus Carboplatin for the Treatment of Elderly Patients with Advanced Non-Small Cell Lung Cancer. Oncologist 2019; 25:208-e417. [PMID: 32162814 DOI: 10.1634/theoncologist.2019-0717] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 09/15/2019] [Indexed: 11/17/2022] Open
Abstract
LESSONS LEARNED The biweekly GEM plus CBDCA dose and schedule showed satisfactory efficacy with mild toxicities in elderly patients with advanced NSCLC. The biweekly GEM plus CBDCA regimen could be considered an alternative to the 3-week regimen in NSCLC. BACKGROUND The gemcitabine (GEM)-carboplatin (CBDCA) combination is widely used for non-small cell lung cancer (NSCLC) and has some efficacy in elderly patients; however, a high incidence of thrombocytopenia is observed, and the optimal dosage and administration schedules are unknown. This multicenter phase II trial evaluated the efficacy and tolerability of GEM-CBDCA for elderly patients with chemotherapy-naive NSCLC. METHODS Patients with chemotherapy-naive performance status 0-1 and with stage IIIB/IV NSCLC were administered chemotherapy biweekly (GEM 1,000 mg/m2 with CBDCA area under the blood concentration-time curve (AUC) 3 on days 1 and 15 every 4 weeks). The primary endpoint was the objective response rate (ORR), and the secondary endpoints were progression-free survival (PFS), overall survival (OS), and safety. RESULTS Forty-eight patients were enrolled. Median age was 76 years (range, 70-83); 35 patients were men (73%), and 27 patients had adenocarcinoma (56%). The ORR was 29.2% (95% confidence interval [CI], 17.0-44.1). The median PFS, median OS, and 1-year survival was 5.9 months (95% CI, 4.1-6.6), 13.3 months (95% CI, 8.3-23.5), and 58%, respectively. Grade ≥3 hematological toxicities included neutropenia (29.2%), thrombocytopenia (4.2%), and anemia (20.8%). The incidence of grade ≥3 nonhematological toxicities was <5%. CONCLUSION This GEM-CBDCA combination administered biweekly showed satisfactory efficacy with mild toxicities in elderly patients with advanced NSCLC.
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Affiliation(s)
- Koichi Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
- Research Institute for Disease of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masao Ichiki
- Department of Respirology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan
| | - Takemasa Matsumoto
- Department of Respiratory Medicine, Fukuoka University Hospital, Fukuoka, Japan
| | - Noriyuki Ebi
- Department of Respiratory Oncology Medicine, Iizuka Hospital, Fukuoka, Japan
| | - Shinji Akamine
- Department of Thoracic Surgery, Oita Prefectural Hospital, Oita, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Tadaaki Yamada
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Junji Uchino
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoichi Nakanishi
- Research Institute for Disease of the Chest, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Takayama K, Ichiki M, Tokunaga S, Inoue K, Kawasaki M, Uchino J, Nakanishi Y. Randomized Phase II Study of Weekly Paclitaxel plus Carboplatin Versus Biweekly Paclitaxel plus Carboplatin for Patients with Previously Untreated Advanced Non-Small Cell Lung Cancer. Oncologist 2019; 24:1420-e1010. [PMID: 31332099 PMCID: PMC6853129 DOI: 10.1634/theoncologist.2019-0513] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 07/08/2019] [Indexed: 11/26/2022] Open
Abstract
Lessons Learned. This clinical trial, evaluating the efficacy and safety of a carboplatin plus paclitaxel regimen in a biweekly or weekly schedule instead of the more toxic 3‐weekly administration, showed that the weekly regimen was better in efficacy than the biweekly regimen, with mild toxicities, for patients with non‐small cell lung cancer (NSCLC). The weekly carboplatin plus paclitaxel regimen could be considered as an alternative to the 3‐weekly regimen in Japanese patients with NSCLC.
Background. Combination therapy comprising carboplatin (C) and paclitaxel (P) is the most commonly used regimen for the treatment of advanced non‐small cell lung cancer (NSCLC). Common toxicities associated with the regimen, such as neuropathy and myelosuppression, cause its discontinuation. In the present study, we conducted a clinical trial evaluating the efficacy of biweekly (B) and weekly (W) PC therapy to identify the appropriate chemotherapy schedule for Asian patients. Methods. Chemonaive patients with IIIB/IV NSCLC and a performance status of 0–1 were randomly assigned to a biweekly regimen (paclitaxel 135 mg/m2 with carboplatin area under the curve [AUC] 3 on days 1 and 15 of every 4 weeks) or to a weekly regimen (paclitaxel 90 mg/m2 on days 1, 8, and 15 with carboplatin AUC 6 on day 1 of every 4 weeks). Results. A total of 140 patients were enrolled in the study. The objective response rates (ORRs) were 28.1% (B) and 38.0% (W). The most common toxicity was neutropenia, with incidence rates of 62.0% (B) and 57.8% (W). Progression‐free survivals (PFSs) were 4.3 months (B) and 5.1 months (W), and overall survival durations were 14.2 months (B) and 13.3 months (W). Conclusion. The ORR and PFS in the weekly regimen were better than those in the biweekly schedule, although a statistical difference was not observed. The toxicity profile was generally mild for both regimens. The weekly CP regimen was suitable to be considered as an alternative to the current 3‐weekly regimen in NSCLC treatment.
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Affiliation(s)
- Koichi Takayama
- Kyoto Prefectural University of Medicine, Kyoto, Japan
- Kyushu University, Fukuoka, Japan
| | | | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Koji Inoue
- Kitakyushu Municipal Medical Center, Kitakyushu, Japan
| | | | - Junji Uchino
- Kyoto Prefectural University of Medicine, Kyoto, Japan
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Hiwatari R, Katayama K, Nakamura M, Miyoshi Y, Aoki A, Asakura N, Utoh H, Homma Y, Tokunaga S, Nakajima N, Someya Y, Sakamoto Y, Tobita K. Development of plant concept related to tritium handling in the water-cooling system for JA DEMO. Fusion Engineering and Design 2019. [DOI: 10.1016/j.fusengdes.2019.03.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Matsumoto K, Futamura M, Miyaki T, Iwasa T, Imoto S, Doi M, Tokunaga S, Aogi K, Yoshimura K, Takano T. A phase 2 study evaluating dose dense AC (ddAC) followed by dose dense paclitaxel (ddP) supported by 3.6 mg peg-filgrastim (ddAC-ddP3.6) for patients (pts) with primary breast cancer (PBC) in Japan -WJOG9016B-. Breast 2019. [DOI: 10.1016/s0960-9776(19)30103-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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31
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Sawa Y, Matsumiya G, Matsuda K, Tatsumi E, Abe T, Fukunaga K, Ichiba S, Taguchi T, Kokubo K, Masuzawa T, Myoui A, Nishimura M, Nishimura T, Nishinaka T, Okamoto E, Tokunaga S, Tomo T, Tsukiya T, Yagi Y, Yamaoka T. Journal of Artificial Organs 2018: the year in review : Journal of Artificial Organs Editorial Committee. J Artif Organs 2019; 22:1-5. [PMID: 30796540 DOI: 10.1007/s10047-019-01094-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Y Sawa
- Division of Cardiovascular Surgery, Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - G Matsumiya
- Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - K Matsuda
- Emergency and Critical Care Medicine, University of Yamanashi Hospital, Yamanashi, Japan
| | - E Tatsumi
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - T Abe
- Department of Urology, Iwate Medical University School of Medicine, Iwate, Japan
| | - K Fukunaga
- Faculty of Health Sciences, Kyorin University, Tokyo, Japan
| | - S Ichiba
- Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital, Tokyo, Japan
| | - T Taguchi
- Biomaterial Unit, National Institute of Material Science, Ibaraki, Japan
| | - K Kokubo
- Department of Medical Engineering and Technology, Kitasato University School of Allied Health Science, Kanagawa, Japan
| | - T Masuzawa
- Department of Mechanical Engineering, Ibaraki University, Ibaraki, Japan
| | - A Myoui
- Medical Center for Translational Research, Osaka University Hospital, Osaka, Japan
| | - M Nishimura
- Division of Organ Regeneration Surgery, Tottori University Faculty of Medicine, Tottori, Japan
| | - T Nishimura
- Department of Therapeutic Strategy for Heart Failure, The University of Tokyo, Tokyo, Japan
| | - T Nishinaka
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - E Okamoto
- Department of Human Science and Informatics, School of Bioscience and Engineering, Tokai University, Sapporo, Japan
| | - S Tokunaga
- The Department of Cardiovascular Surgery, JCHO Kyushu Hospital, Fukuoka, Japan
| | - T Tomo
- Second Department of Internal Medicine, Faculty of Medicine, Oita University, Oita, Japan
| | - T Tsukiya
- Department of Artificial Organs, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Y Yagi
- Department of Clinical Engineering, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Yamaoka
- Department of Biomedical Engineering, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
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32
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Akamatsu H, Harada H, Tokunaga S, Yoshimura N, Ikeda H, Oizumi S, Sugimoto N, Takano T, Murakami H, Nishimura Y, Yamamoto N, Nakagawa K. A Phase II Study of Gefitinib With Concurrent Thoracic Radiotherapy in Patients With Unresectable, Stage III Non-small-cell Lung Cancer Harboring EGFR Mutations (WJOG6911L). Clin Lung Cancer 2019; 20:e25-e27. [PMID: 30266586 DOI: 10.1016/j.cllc.2018.08.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 08/10/2018] [Accepted: 08/26/2018] [Indexed: 10/28/2022]
Abstract
Locally advanced non-small-cell lung cancer (NSCLC) is curable. Standard treatment is concurrent chemoradiotherapy, but its efficacy with cytotoxic agents seems to reach a plateau. Among patients with advanced NSCLC who have epidermal growth factor receptor (EGFR) mutation, EGFR-tyrosine kinase inhibitor is the key drug. Thus, a similar strategy should be tested in patients with locally advanced NSCLC who have EGFR mutation. This single arm, phase II study aims to explore the efficacy and tolerability of gefitinib with concurrent thoracic radiotherapy in patients with unresectable stage III NSCLC harboring EGFR mutations. The primary endpoint is progression-free survival rate at 2 years. The secondary endpoints are overall response rate, progression-free survival, overall survival, and safety. A total of 27 patients will be enrolled in this trial.
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Affiliation(s)
- Hiroaki Akamatsu
- Third Department of Internal Medicine III, Wakayama Medical University, Wakayama, Japan.
| | - Hideyuki Harada
- Division of Radiation Therapy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naruo Yoshimura
- Department of Pulmonology, Tohoku Medical and Pharmaceutical University, Miyagi, Japan
| | - Hiroko Ikeda
- Department of Radiation Oncology, Osaka City General Hospital, Osaka, Japan
| | - Satoshi Oizumi
- Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer Center, Hokkaido, Japan
| | - Naotoshi Sugimoto
- Department of Medical Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Toshimi Takano
- Department of Medical Oncology, Toranomon Hospital, Tokyo, Japan
| | - Haruyasu Murakami
- Department of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Nobuyuki Yamamoto
- Third Department of Internal Medicine III, Wakayama Medical University, Wakayama, Japan
| | - Kazuhiko Nakagawa
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
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Kawasaki S, Kiyohara C, Tokunaga S, Hoka S. Prediction of hemodynamic fluctuations after induction of general anesthesia using propofol in non-cardiac surgery: a retrospective cohort study. BMC Anesthesiol 2018; 18:167. [PMID: 30414607 PMCID: PMC6234779 DOI: 10.1186/s12871-018-0633-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 10/30/2018] [Indexed: 12/12/2022] Open
Abstract
Background Although propofol is a common anesthetic agent for the induction of general anesthesia, hemodynamic fluctuations are occasionally prominent during induction/intubation. The aims of this study were to determine the influential factors on enhanced hemodynamic fluctuation and to establish a prediction formula to quickly determine the dose of propofol to protect against hemodynamic fluctuations. Methods This retrospective cohort study patients (n = 2097) were 18 years or older. They underwent general anesthesia induction using propofol and orotracheal intubation for non-cardiac surgery at Kyushu University Hospital during April 2015 to March 2016. Preoperative patient clinical information was collected from anesthesia preoperative evaluation records. Intraoperative data were obtained from computerized anesthesia records. If patients’ post-induction mean arterial blood pressure (MAP) decreased or increased 30% or more from their pre-induction MAP, they were determined to have enhanced hemodynamic fluctuations. Unconditional logistic regression was used to assess the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Structural equation modeling (SEM) was conducted to simultaneously examine the direct and indirect effect (path coefficient = r) of potential variables. Results In the SEM analysis, age was significantly associated with enhanced hemodynamic fluctuations (adjusted odds ratio = 1.008, 95% CI = 1.001–1.015, P = 0.03). Age (path coefficient (r) = − 0.0113, 95% CI = − 0.0126–0.010, P < 0.001), American Society of Anesthesiologists physical status (ASA-PS) (r = − 0.0788, 95% CI = − 0.1431–0.0145, P = 0.02), sex (r = 0.057, 95% CI = 0.0149–0.9906, P = 0.01), and fentanyl dose (r = 0.1087, 95% CI = 0.0707–0.1467, P < 0.001) influenced the dose of propofol in induction. The prediction formula of “Propofol dose (mg) = [2.374 – 0.0113 × age (year) – 0.0788 (if ASA-PS 3 or 4) + 0.057 (if female) + 0.1087 × fentanyl dose (μg/kg)] × body weight (kg)” was derived. Conclusions Age was associated with hemodynamic fluctuations in induction. Although the prediction formula is considered to be acceptable, future studies validating whether it can decrease patients’ risk of enhanced hemodynamic fluctuations in clinical situations are necessary.
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Affiliation(s)
- Sho Kawasaki
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Fukuoka, Japan.,Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Chikako Kiyohara
- Department of Preventive Medicine, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Fukuoka, Japan.
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1, Higashi-ku, Fukuoka, Fukuoka, Japan
| | - Sumio Hoka
- Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, Fukuoka, Japan
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Nakatani Y, Ueda S, Tsuboguchi Y, Yoshii Y, Akiyoshi K, Tsuya A, Okazaki S, Tokunaga S, Daga H. TAS-102 followed by regorafenib or the reverse sequence in advanced colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy431.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Yamanishi T, Asakura H, Seki N, Tokunaga S. A 52-week multicenter randomized controlled study of the efficacy and safety of add-on dutasteride and imidafenacin to tamsulosin in patients with benign prostatic hyperplasia with remaining overactive bladder symptoms (DIrecT study). Low Urin Tract Symptoms 2018; 11:115-121. [PMID: 30358116 PMCID: PMC7379254 DOI: 10.1111/luts.12243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 09/18/2018] [Indexed: 11/29/2022]
Abstract
Objective The aim of this study was to examine the long‐term efficacy of combination of tamsulosin 0.2 mg + dutasteride 0.5 mg + imidafenacin 0.2 mg (TDI) therapy compared with tamsulosin + dutasteride (TD) therapy for 52 weeks in benign prostatic hyperplasia (BPH) patients with a prostate volume (PV) ≥30 mL and remaining overactive bladder (OAB) symptoms after having received tamsulosin for ≥8 weeks. Previously, we reported that the improvement in OAB symptoms at 24 weeks was significantly greater in the TDI than TD group. Methods BPH patients with OAB symptoms after ≥8 weeks tamsulosin were randomly assigned to the TDI or TD group in a ratio of 1:1 ratio, and followed‐up for 52 weeks. Changes in the OAB Symptom Score (OABSS), International Prostate Symptom Score (IPSS), and post‐void residual (PVR) were evaluated. Results In all, 163 patients were randomized, and 125 patients (76.7%) completed 52 weeks of treatment. At Week 52, there were significant decreases in the OABSS and IPSS storage subscore compared with baseline in the TDI versus TD group, but the change in the total IPSS did not differ significantly between the two groups. There was no change in PVR from Week 24 to Week 52 in either group. Conclusions For BPH patients with PVR ≥30 mL and remaining storage symptoms despite tamsulosin monotherapy, TDI treatment showed better results in terms of improved OAB symptoms than TD treatment up to 52 weeks.
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Affiliation(s)
- Tomonori Yamanishi
- Department of Urology, Continence Center, Dokkyo Medical University, Tochigi, Japan
| | - Hirotaka Asakura
- Department of Urology, Saitama Medical University Hospital, Saitama, Japan
| | - Narihito Seki
- Department of Urology, Kyushu Central Hospital, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
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Ueda S, Tsuboguchi Y, Nakatani Y, Tsuya A, Nishina SI, Akiyoshi K, Okazaki S, Tokunaga S, Daga H. Sidedness of the primary tumor on the effect of TAS-102 for refractory metastatic colorectal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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37
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Kawakami T, Yamazaki K, Oki E, Shimokawa M, Takahashi N, Yokota M, Tokunaga S, Esaki T, Gamoh M, Maeda A, Tsuji Y, Sakai A, Hatanaka K, Shimada Y, Shiozawa M, Komatsu Y, Okuda H, Ohue M, Maehara Y. Treatment pattern and outcomes of trifluridine/tipiracil therapy for metastatic colorectal cancer in the real-world data from the JFMC50 study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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38
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Yuki S, Shinozaki K, Kashiwada T, Kusumoto T, Iwatsuki M, Satake H, Tokunaga S, Emi Y, Makiyama A, Kawamoto Y, Komatsu Y, Shimokawa M, Saeki H, Oki E, Baba H, Maehara Y. Updated analysis of a phase II study of SOX plus trastuzumab for the patients with HER2 positive advanced or recurrent gastric cancer: KSCC/HGCSG/CCOG/PerSeUS1501B. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy282.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Oyamada A, Matsumoto Y, Wakata Y, Kimura A, Ikuta K, Tsuchiya K, Tayama N, Tomari S, Miyahara H, Mae T, Shiraishi H, Saito T, Arizono T, Kaji K, Mawatari T, Fujiwara M, Sakimura R, Shin K, Ninomiya K, Nakaie K, Antoku Y, Tokunaga S, Nakashima N, Iwamoto Y, Nakashima Y. Characteristics of patients with fragility hip fractures in the northern Kyushu district in Japan: a multicenter prospective registry based on an electronic data capture system. J Bone Miner Metab 2018; 36:596-604. [PMID: 29027045 DOI: 10.1007/s00774-017-0869-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 09/06/2017] [Indexed: 11/29/2022]
Abstract
Osteoporosis has become a worldwide public health problem, in part due to the fact that it increases the risk of fragility hip fractures (FHFs). The epidemiological assessment of FHFs is critical for their prevention; however, datasets for FHFs in Japan remain scarce. This was a multicenter, prospective, observational study in the northern district of Kyushu Island. Inclusion criteria were age > 60 years with a diagnosis of FHF and acquisition of clinical data by an electronic data capture system. Of 1294 registered patients, 1146 enrolled in the study. Nearly one third of patients (31.8%) had a history of previous fragility fractures. The percentage of patients receiving osteoporosis treatment on admission was 21.5%. Almost all patients underwent surgical treatment (99.1%), though fewer than 30% had surgery within 48 h after hospitalization. Bone mineral density (BMD) was evaluated during hospitalization in only 50.4% of patients. The rate of osteoporosis treatment increased from 21.5% on admission to 39.3% during hospitalization. The main reasons that prescribers did not administer osteoporosis treatment during hospitalization were forgetfulness (28.4%) and clinical judgment (13.6%). Age and female ratio were significantly higher in patients with previous FHFs than in those without. There was a significant difference in the rate of osteoporosis treatment or L-spine BMD values in patients with or without previous FHFs on admission. In conclusion, this study confirmed that the evaluation and treatment of osteoporosis and FHFs is still suboptimal in Japan, even in urban districts.
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Affiliation(s)
- Akiko Oyamada
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Yoshihiro Matsumoto
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Yoshifumi Wakata
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Atsushi Kimura
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Ko Ikuta
- Department of Orthopaedic Surgery, Karatsu Red Cross Hospital, Saga, Japan
| | | | - Naohisa Tayama
- Department of Orthopaedic Surgery, Steel Memorial Yahata Hospital, Fukuoka, Japan
| | - Shinji Tomari
- Department of Orthopaedic Surgery, Fukuoka Red Cross Hospital, Fukuoka, Japan
| | - Hisaaki Miyahara
- Department of Orthopaedic Surgery, National Kyushu Medical Center, Fukuoka, Japan
| | - Takao Mae
- Department of Orthopaedic Surgery, Saga-ken Medical Center Koseikan, Saga, Japan
| | | | - Taichi Saito
- Department of Orthopaedic Surgery, Fukuoka City Hospital, Fukuoka, Japan
| | - Takeshi Arizono
- Department of Orthopaedic Surgery, Kyushu Central Hospital, Fukuoka, Japan
| | - Kozo Kaji
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Taro Mawatari
- Department of Orthopaedic Surgery, Hamanomachi Hospital, Fukuoka, Japan
| | - Masami Fujiwara
- Department of Orthopaedic Surgery, Sada Hospital, Fukuoka, Japan
| | - Riku Sakimura
- Department of Orthopaedic Surgery, Harasanshin Hospital, Fukuoka, Japan
| | - Kunichika Shin
- Department of Orthopaedic Surgery, Saiseikai Yahata General Hospital, Fukuoka, Japan
| | - Kenichi Ninomiya
- Department of Orthopaedic Surgery, Koga Hospital 21, Fukuoka, Japan
| | - Kazutoshi Nakaie
- Department of Orthopaedic Surgery, Fukuoka-higashi Medical Center, Fukuoka, Japan
| | - Yasuaki Antoku
- Faculty of Medicine, Hospital Informatic Center, Oita University, Oita, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Yukihide Iwamoto
- Department of Orthopaedic Surgery, Kyushu Rosai Hospital, Fukuoka, Japan
| | - Yasuharu Nakashima
- Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Akiyoshi K, Tsuboguchi Y, Ueda S, Okazaki S, Tsuya A, Tokunaga S, Daga H. Efficacy and safety of nivolumab monotherapy for metastatic gastric cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy151.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Ito K, Yokomizo A, Tokunaga S, Arai G, Sugimoto M, Akakura K, Hasumi H, Sakai H, Ouraji A, Suzuki K. PD06-06 IMPORTANCE OF [-2] PROPSA MEASUREMENT IN A DIAGNOSIS OF PROSTATE CANCER: PROSTATE HEALTH INDEX TRIAL (PROPHET) - DIAGNOSTIC IMPACTS OF CLINICAL LABORATORY-BASED INDICES ON GLEASON GRADE GROUP ≥2 OR ≥3 CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ito K, Yokomizo A, Tokunaga S, Arai G, Sugimoto M, Shiomi H, Hasumi H, Sakai H, Ouraji A, Suzuki K. PD06-02 IMPORTANCE OF [-2] PROPSA MEASUREMENT IN A DIAGNOSIS OF PROSTATE CANCER: PROSTATE HEALTH INDEX TRIAL (PROPHET) - DIAGNOSTIC IMPACTS OF PROSTATE VOLUME-ADJUSTED INDICES ON GLEASON GRADE GROUP ≥2 OR ≥3 CANCER. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Saeki H, Emi Y, Oki E, Tokunaga S, Kakeji Y, Akagi Y, Baba H, Baba E, Maehara Y. Study protocol of a phase II clinical trial (KSCC1501A) examining oxaliplatin + S-1 for treatment of HER2-negative advanced/recurrent gastric cancer previously untreated with chemotherapy. BMC Cancer 2018; 18:57. [PMID: 29310611 PMCID: PMC5759242 DOI: 10.1186/s12885-017-3937-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Accepted: 12/19/2017] [Indexed: 12/30/2022] Open
Abstract
Background Oxaliplatin + S-1 is a recognized treatment regimen in Japan, but there are no Japanese clinical data on an oxaliplatin dose of 130 mg/m2. The current research involves a single-arm, prospective, phase II clinical trial to examine the efficacy and safety of oxaliplatin + S-1 with an oxaliplatin dose of 130 mg/m2 to treat HER2-negative advanced/recurrent gastric cancer previously untreated with chemotherapy in Japan. Methods/design The primary endpoint of this trial will be the response rate, and the secondary endpoints will be the safety profile of oxaliplatin + S-1, progression-free survival, the response rate in subjects under the age of 75, overall survival, time to treatment failure, duration of treatment, time to failure of strategy, and dose intensity. The threshold response rate is 45% and the expected response rate is 60%. Assuming that a one-tailed score test will be performed with an α of 0.05, 68 patients are needed to ensure a statistical power of 80%. Planned enrollment is 70 subjects and the total duration of this trial is expected to be 3 years. Discussion Since replacing cisplatin with oxaliplatin should provide the same level of therapeutic efficacy while limiting adverse events and simplifying treatment, oxaliplatin + S-1 may be increasingly used to treat gastric cancer in Japan. Verifying the efficacy and safety of oxaliplatin + S-1 with an oxaliplatin dose of 130 mg is an important task that the current trial has set out to achieve. Trial registration The protocol was registered at the website of the University Hospital Medical Information Network (UMIN), Japan (protocol ID UMIN000017550) on May 29, 2015. The details are available at the following web address: http://www.umin.ac.jp/ctr/.
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Affiliation(s)
- Hiroshi Saeki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
| | - Yasunori Emi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Yoshihiro Kakeji
- Division of Gastrointestinal Surgery, Department of Surgery, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eishi Baba
- Department of Comprehensive Clinical Oncology, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
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Miyamoto Y, Oki E, Emi Y, Tokunaga S, Shimokawa M, Ogata Y, Akagi Y, Sakamoto Y, Tanaka T, Saeki H, Maehara Y, Baba H. Low Visceral Fat Content Is a Negative Predictive Marker for Bevacizumab in Metastatic Colorectal Cancer. Anticancer Res 2018; 38:491-499. [PMID: 29277814 DOI: 10.21873/anticanres.12249] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 10/29/2017] [Accepted: 11/01/2017] [Indexed: 11/10/2022]
Abstract
AIM This study aimed to clarify the predictive impact of visceral fat on response to bevacizumab in patients with metastatic colorectal cancer (mCRC). PATIENTS AND METHODS Pretreatment computed tomography was used to measure visceral fat area (VFA) and patients with mCRC receiving first-line chemotherapy with/without bevacizumab were divided by median VFA value into two groups: high VFA and low VFA. RESULTS In the bevacizumab-treated group, patients with low VFA had significantly shorter overall survival (OS) than patients with high VFA in univariate (median=21.1 vs. 38.9 months; hazard ratio=1.70, 95% confidence interval=1.06-2.70, p=0.03) and multivariate analysis (hazard ratio=1.85, 95% confidence interval=1.15-3.03, p=0.01). No significant differences were seen in OS between groups treated with chemotherapy alone. The VFA had a marginally significant modifying effect on the relationship between bevacizumab and OS (p for interaction=0.07). CONCLUSION Our findings provide the first evidence that a low VFA might be a negative predictive marker for response to bevacizumab in patients with mCRC.
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Affiliation(s)
- Yuji Miyamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasunori Emi
- Department of Surgery, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | - Mototsugu Shimokawa
- Department of Cancer Information Research, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan
| | - Yutaka Ogata
- Department of Surgery, Kurume University Medical Center, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yasuo Sakamoto
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Takaho Tanaka
- Department of Surgery, Social Insurance Tagawa Hospital, Tagawa, Japan
| | - Hiroshi Saeki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiko Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
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Tokunaga S, Matsuyama A, Someya Y, Utoh H, Sakamoto Y, Asakura N, Tobita K. Conceptual design study of pellet fueling system for DEMO. Fusion Engineering and Design 2017. [DOI: 10.1016/j.fusengdes.2017.02.079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Iwasa T, Tsurutani J, Mizuno Y, Kojima Y, Takashima T, Matsunami N, Morimoto T, Yamamura J, Ohtani S, Tanabe Y, Watanabe S, Kato R, Tanino H, Tokunaga S, Abe H, Tsuyuki S, Hara F, Takano T, Komoike Y, Nakagawa K. Phase II trial of eribulin and S-1 combination therapy for advanced or recurrent breast cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx654.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kenmotsu H, Iwama E, Goto Y, Harada T, Tsumura S, Sakashita H, Mori Y, Nakagaki N, Fujita Y, Seike M, Bessho A, Ono M, Okazaki A, Akamatsu H, Morinaga R, Ushijima S, Shimose T, Tokunaga S, Hamada A, Yamamoto N, Nakanishi Y, Sugio K, Okamoto I. P1.03-004 Alectinib for Patients with ALK Rearrangement–Positive Non–Small Cell Lung Cancer and a Poor Performance Status. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Tamura T, Sakai D, Sugimoto N, Tokunaga S, Tsuji A, Ishida H, Otsu S, Moriwaki T, Satake H, Uchino K, Matsumoto S, Baba E, Sato M, Taniguchi H, Kishimoto J, Boku N, Hyodo I, Muro K. Predictive value of primary tumor location: Results from randomized phase II study of panitumumab + irinotecan versus cetuximab + irinotecan in patients with KRAS exon2 wild-type metastatic colorectal cancer (WJOG6510G). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx393.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shinozaki K, Yuki S, Kashiwada T, Kusumoto T, Iwatsuki M, Satake H, Kobayashi K, Esaki T, Nakashima Y, Kubo N, Tokunaga S, Shimose T, Makiyama A, Saeki H, Oki E, Baba H, Maehara Y. A phase II study (KSCC/HGCSG/CCOG/PerSeUS1501B) of trastuzumab plus S-1 and oxaliplatin for HER2-positive advanced gastric cancer. J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.4059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4059 Background: A combination of S-1 and cisplatin (SP) has been the standard regimen for advanced gastric cancer (AGC) in East Asia. The combination of S-1 and oxaliplatin (SOX100) was demonstrated to be non-inferior to SP in the randomized phase III study. The ToGA study demonstrated that trastuzumab (T-mab) combination therapies with cisplatin and fluoropyrimidines improved the overall survival of patients with HER2-positive AGC. This multicenter study is the first phase II trial to assess the efficacy and safety of T-mab in combination with S-1 and oxaliplatin (HER-SOX130) in HER2-positive AGC. Methods: Patients with HER2-positive AGC or recurrent gastric cancer defined to be IHC 3+ or IHC 2+/FISH positive received 80 mg/m2 S-1 per day orally on days 1–14, 130 mg/m2 oxaliplatin intravenously on day 1, and T-mab (8-mg/kg loading dose and 6 mg/kg thereafter) intravenously on day 1 of a 21-day cycle until one of the criteria for withdrawal of the study treatment occurred. The primary end-point was the response rate (RR). Adverse events were recorded based on the NCI-CTCAE Vers.4.0. The threshold response rate was defined as 50%, and the expected rate was set at 70%, with an 80% power and a 1-sided alpha value of 0.05. The calculated sample size was 37 patients. Results: For this study, 42 patients (median age, 66 years) were enrolled from June 2015 to May 2016. Three patients were excluded owing to ineligibility. Efficacy and safety analyses were conducted in the full analysis set of 39 patients. The proportion of patients with IHC 3+ was 87%. The confirmed RR assessed by the independent review committee was 82.1(32/39) % (95% confidence interval [CI]: 67.3–91.0), and the disease control rate was 87.2(34/39) % (95% CI: 73.3–94.4). The incidence rates of grade 3 or 4 adverse events were as follows: neutropenia, 12.8%; thrombocytopenia, 17.9%; anemia, 10.3%; sensory neuropathy, 5.1%; anorexia, 17.9%; diarrhea, 7.7%; and teary eyes, 2.6%. Conclusions: HER-SOX130 demonstrated encouraging efficacy with a favorable safety profile. The survival benefit of this regimen needs to be validated by conducting further follow-up of patients. Clinical trial information: 000017552.
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Affiliation(s)
- Katsunori Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Satoshi Yuki
- Department of Gastroenterology and Hepatology, Hokkaido University Hospital, Sapporo, Japan
| | - Tomomi Kashiwada
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | | | - Masaaki Iwatsuki
- Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - Hironaga Satake
- Department of Medical Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kazuma Kobayashi
- Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Taito Esaki
- Department of Gastrointestinal and Medical Oncology, National Kyushu Cancer Center, Fukuoka, Japan
| | - Yuichiro Nakashima
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Nobuhide Kubo
- National Hospital Organization Beppu Medical Cente, Beppu, Japan
| | - Shoji Tokunaga
- Medical Information Center, Kyushu University Hospital, Fukuoka, Japan
| | | | - Akitaka Makiyama
- Japan Community Healthcare Organization Kyushu Hospital, Kitakyushu, Japan
| | - Hiroshi Saeki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eiji Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yoshihiko Maehara
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Yamanishi T, Asakura H, Seki N, Tokunaga S. Efficacy and safety of combination therapy with tamsulosin, dutasteride and imidafenacin for the management of overactive bladder symptoms associated with benign prostatic hyperplasia: A multicenter, randomized, open-label, controlled trial (DIrecT Study). Int J Urol 2017; 24:525-531. [DOI: 10.1111/iju.13359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 03/16/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Tomonori Yamanishi
- Department of Urology; Continence Center; Dokkyo Medical University; Mibu Tochigi Japan
| | - Hirotaka Asakura
- Department of Urology; Saitama Medical University Hospital; Saitama Japan
| | - Narihito Seki
- Department of Urology; Kyushu Central Hospital; Fukuoka Japan
| | - Shoji Tokunaga
- Medical Information Center; Kyushu University Hospital; Fukuoka Japan
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