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Rajagopalan NR, Munawar T, Sheehan MC, Fujimori M, Vista WR, Wimmer T, Gutta NB, Solomon SB, Srimathveeravalli G. Electrolysis products, reactive oxygen species and ATP loss contribute to cell death following irreversible electroporation with microsecond-long pulsed electric fields. Bioelectrochemistry 2024; 155:108579. [PMID: 37769509 PMCID: PMC10841515 DOI: 10.1016/j.bioelechem.2023.108579] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/03/2023]
Abstract
Membrane permeabilization and thermal injury are the major cause of cell death during irreversible electroporation (IRE) performed using high electric field strength (EFS) and small number of pulses. In this study, we explored cell death under conditions of reduced EFS and prolonged pulse application, identifying the contributions of electrolysis, reactive oxygen species (ROS) and ATP loss. We performed ablations with conventional high-voltage low pulse (HV-LP) and low-voltage high pulse (LV-HP) conditions in a 3D tumor mimic, finding equivalent ablation volumes when using 2000 V/cm 90 pulses or 1000 V/cm 900 pulses respectively. These results were confirmed by performing ablations in swine liver. In LV-HP treatment, ablation volume was found to increase proportionally with pulse numbers, without the substantial temperature increase seen with HV-LP parameters. Peri-electrode pH changes, ATP loss and ROS production were seen in both conditions, but LV-HP treatments were more sensitive to blocking of these forms of cell injury. Increases in current drawn during HV-LP was not observed during LV-HP condition where the total ablation volume correlated to the charge delivered into the tissue which was greater than HV-LP treatment. LV-HP treatment provides a new paradigm in using pulsed electric fields for tissue ablation with clinically relevant volumes.
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Affiliation(s)
| | - Tarek Munawar
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Mary Chase Sheehan
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | | | - William-Ray Vista
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Thomas Wimmer
- Dept. of Radiology, Division of General Radiology, Medical University of Graz, Austria
| | | | - Stephen B Solomon
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, NY, USA
| | - Govindarajan Srimathveeravalli
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA; Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
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2
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Rajagopalan NR, Vista WR, Fujimori M, Vroomen LGPH, Jiménez JM, Khadka N, Bikson M, Srimathveeravalli G. Cytoskeletal Remodeling and Gap Junction Translocation Mediates Blood-Brain Barrier Disruption by Non-invasive Low-Voltage Pulsed Electric Fields. Ann Biomed Eng 2024; 52:89-102. [PMID: 37115366 DOI: 10.1007/s10439-023-03211-3] [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: 12/28/2022] [Accepted: 04/14/2023] [Indexed: 04/29/2023]
Abstract
High-voltage pulsed electric fields (HV-PEF) delivered with invasive needle electrodes for electroporation applications is known to induce off-target blood-brain barrier (BBB) disruption. In this study, we sought to determine the feasibility of minimally invasive PEF application to produce BBB disruption in rat brain and identify the putative mechanisms mediating the effect. We observed dose-dependent presence of Evans Blue (EB) dye in rat brain when PEF were delivered with a skull mounted electrode used for neurostimulation application. Maximum region of dye uptake was observed while using 1500 V, 100 pulses, 100 µs and 10 Hz. Results of computational models suggested that the region of BBB disruption was occurring at thresholds of 63 V/cm or higher; well below intensity levels for electroporation. In vitro experiments recapitulating this effect with human umbilical vein endothelial cells (HUVEC) demonstrated cellular alterations that underlie BBB manifests at low-voltage high-pulse conditions without affecting cell viability or proliferation. Morphological changes in HUVECs due to PEF were accompanied by disruption of actin cytoskeleton, loss of tight junction protein-ZO-1 and VE-Cadherin at cell junctions and partial translocation into the cytoplasm. Uptake of propidium iodide (PI) in PEF treated conditions is less than 1% and 2.5% of total number of cells in high voltage (HV) and low-voltage (LV) groups, respectively, implying that BBB disruption to be independent of electroporation under these conditions. 3-D microfabricated blood vessel permeability was found to increase significantly following PEF treatment and confirmed with correlative cytoskeletal changes and loss of tight junction proteins. Finally, we show that the rat brain model can be scaled to human brains with a similar effect on BBB disruption characterized by electric field strength (EFS) threshold and using a combination of two bilateral HD electrode configurations.
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Affiliation(s)
| | - William-Ray Vista
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Masashi Fujimori
- Department of Radiology, Interventional Radiology Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
- Department of Radiology, Mie University, Tsu, Mie, Japan
| | | | - Juan M Jiménez
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - Niranjan Khadka
- Division of Neuromodulation, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Synchron Inc, Brooklyn, NY, USA
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY, USA
| | - Govindarajan Srimathveeravalli
- Department of Mechanical and Industrial Engineering, University of Massachusetts Amherst, Amherst, MA, USA.
- Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
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3
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Kimura Y, Fujimori M, Rajagopalan NR, Poudel K, Kim K, Nagar K, Vroomen LGPH, Reis H, Al-Ahmadie H, Coleman JA, Srimathveeravalli G. Macrophage activity at the site of tumor ablation can promote murine urothelial cancer via transforming growth factor-β1. Front Immunol 2023; 14:1070196. [PMID: 36761730 PMCID: PMC9902765 DOI: 10.3389/fimmu.2023.1070196] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/02/2023] [Indexed: 01/26/2023] Open
Abstract
Cell death and injury at the site of tumor ablation attracts macrophages. We sought to understand the status and activity of these cells while focusing on transforming growth factor-β1 (TGF-β1), a potent immunosuppressive and tumorigenic cytokine. Patients with urothelial cancer who underwent ablation using electrocautery or laser demonstrated increased infiltration and numbers of CD8+ T cells, along with FoxP3+ regulatory T cells, CD68+ macrophages and elevated levels of TGF-β1 in recurrent tumors. Similar findings were reproduced in a mouse model of urothelial cancer (MB49) by partial tumor ablation with irreversible electroporation (IRE). Stimulation of bone marrow derived macrophages with MB49 cell debris produced using IRE elicited strong M2 polarization, with exuberant secretion of TGF-β1. The motility, phenotypic markers and cytokine secretion by macrophages could be muted by treatment with Pirfenidone (PFD), a clinically approved drug targeting TGF-β1 signaling. MB49 cancer cells exposed to TGF-β1 exhibited increased migration, invasiveness and upregulation of epithelial-mesenchymal transition markers α-Smooth Muscle Actin and Vimentin. Such changes in MB49 cells were reduced by treatment with PFD even during stimulation with TGF-β1. IRE alone yielded better local tumor control when compared with control or PFD alone, while also reducing the overall number of lung metastases. Adjuvant PFD treatment did not provide additional benefit under in vivo conditions.
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Affiliation(s)
- Yasushi Kimura
- Department of Diagnosis and Interventional Radiology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Dept. of Mechanical and Industrial Engineering, University of Massachusetts Amherst,
Amherst, MA, United States
| | | | | | - Krish Poudel
- Dept. of Mechanical and Industrial Engineering, University of Massachusetts Amherst,
Amherst, MA, United States
| | - Kwanghee Kim
- Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center,
New York, NY, United States
| | - Karan Nagar
- Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center,
New York, NY, United States
| | - Laurien GPH. Vroomen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center (UMC), Amsterdam, Netherlands
| | - Henning Reis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Hikmat Al-Ahmadie
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Jonathan A. Coleman
- Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center,
New York, NY, United States
| | - Govindarajan Srimathveeravalli
- Dept. of Mechanical and Industrial Engineering, University of Massachusetts Amherst,
Amherst, MA, United States
- Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA, United States
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4
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Nagata C, Fujimori M, Yamanaka T, Sugino Y, Matsushita N, Kishi S, Fukui H, Omori Y, Nishikawa K, Sakuma H. Percutaneous Thermal Ablation for Managing Small Renal Metastatic Tumors. Interv Radiol (Higashimatsuyama) 2022; 7:85-92. [PMID: 36483663 PMCID: PMC9719821 DOI: 10.22575/interventionalradiology.2021-0032] [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] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/12/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE To retrospectively evaluate the treatment outcomes of thermal ablation for renal metastatic tumors. MATERIALS AND METHODS Thirteen consecutive patients with small renal metastatic tumors (≤3 cm), who underwent thermal ablation between 2009 and 2020, were included in this study. Eight patients had extra-renal tumors during renal ablation. The primary tumors were adenoid cystic carcinoma in four patients, lung cancer in three, hemangiopericytoma in three, leiomyosarcoma in two, and thyroid cancer in one. The therapeutic effects, safety, survival rate, prognostic factor, and renal function were evaluated. RESULTS We performed 18 ablation sessions (cryoablation, n = 13; radiofrequency ablation, n = 5) on 19 renal metastases with a mean diameter of 1.7 cm, which resulted in a primary technique efficacy rate of 100% without procedure-related deaths or major complications. Renal function significantly declined 6 months after ablation (P = 0.0039). During the mean follow-up period of 31.2 ± 22.4 months (range, 2.7-71.4 months), one patient had local tumor progression at 11.9 months following radiofrequency ablation. The overall survival rates at 1 and 3 years after ablation were 76.9% (95% confidence interval [CI], 54.0%-99.8%) and 59.3% (95% CI, 31.3%-87.3%), respectively. Tumor size ≥ 2 cm (P = 0.02) and metastasis from non-small cell lung cancer (P = 0.001) were significant worse prognostic factors in univariate analysis, and metastasis from non-small cell lung cancer (P = 0.01) was significant in multivariate analysis. CONCLUSIONS Percutaneous thermal ablation for small renal metastases is safe and feasible and can control local tumors.
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Affiliation(s)
- Chisami Nagata
- Department of Radiology, Mie University School of Medicine, Japan
| | - Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, Japan
| | - Takashi Yamanaka
- Department of Radiology, Mie University School of Medicine, Japan
| | - Yuichi Sugino
- Department of Radiology, Mie University School of Medicine, Japan
| | | | - Seiya Kishi
- Department of Radiology, Mie University School of Medicine, Japan
| | - Hikari Fukui
- Department of Radiology, Mie University School of Medicine, Japan
| | - Yuki Omori
- Department of Radiology, Mie University School of Medicine, Japan
| | - Kohei Nishikawa
- Department of Nephro-Urologic Surgery and Andrology, Mie University School of Medicine, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, Japan
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5
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Obama K, Fujimori M, Boku N, Matsuoka A, Mori K, Okizaki A, Miyaji T, Kadowaki M, Okamura M, Majima Y, Shimazu T, Uchitomi Y. Shared Decision-Making Support Program for Elderly Patients with Advanced Cancer Using Question Prompts and Geriatric Assessments: Phase II Randomized Controlled Trial. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00301-0] [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: 11/06/2022]
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6
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Fujimori M, Nakamura M. Association between seasonal influenza vaccines and the increased risk of acute disseminated encephalomyelitis, estimated using the Vaccine Adverse Event Reporting System. Pharmazie 2022; 77:262-269. [PMID: 36199182 DOI: 10.1691/ph.2022.2354] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Acute disseminated encephalomyelitis (ADEM) is a rare and immune-mediated inflammatory disorder of the central nervous system (CNS) that can be triggered by infections and vaccinations. To date, only anecdotal case studies have reported the association between ADEM incidence and seasonal influenza vaccines, and multiple studies have found no association. This study aimed to investigate the association between the incidence of ADEM and seasonal influenza vaccines in a real-world setting using data from the United States Vaccine Adverse Event Reporting System (VAERS). Further, propensity score matching and disproportionality analysis was performed by calculating the adjusted reporting odds ratio (ROR) of reported ADEM cases associated with seasonal influenza vaccines using multiple logistic regression. Additionally, we analysed the time-to-onset using Weibull shape parameters (WSPs). The VAERS database contained 390,352 adverse events reported from January 2011 to December 2020. The ROR of seasonal influenza vaccines for ADEM was 3.02 (95% confidence interval: 1.72-5.33). The median duration (interquartile range) of ADEM was 11.0 (5.0-33.0) days. The median duration of ADEM induced by egg culture-based influenza vaccine (Egg-based vaccine) and cell culture-based influenza vaccine (Cell-based vaccine) was 10.0 (5.0-24.0) and 91.0 (79.0-125.0) days (P < 0.001), respectively. Only Cell-based cases had WSP β > 1, indicating a wear-out failure type. The incidence of ADEM within 30 days after administration of egg- and Cell-based vaccines was 78.6% and 0.0%, respectively. Our findings indicate that ADEM incidence is associated with seasonal influenza vaccines; thus, careful monitoring of ADEM is required within the first month of Egg-based vaccination and after two months of Cell-based vaccination. Neurologists and general practitioners should exercise caution, as the timing for careful monitoring varies depending on the vaccine type.
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Affiliation(s)
- M Fujimori
- General Affairs Team, Marumori-machi National Health Insurance Marumori Hospital, Miyagi, Japan;,
| | - M Nakamura
- Laboratory of Drug informatics, Gifu Pharmaceutical University, Gifu, Japan
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7
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Fukui H, Fujimori M, Yamanaka T, Matsushita N, Kishi S, Nagata C, Omori Y, Nishikawa K, Yuasa H, Sakuma H. Cryptococcus granuloma mimicking local progressed tumor after cryoablation of renal cell carcinoma: A case report. Radiol Case Rep 2022; 17:3419-3424. [PMID: 35899088 PMCID: PMC9309578 DOI: 10.1016/j.radcr.2022.06.084] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 06/25/2022] [Indexed: 12/14/2022] Open
Abstract
Infectious granulomas arising in the kidney are rare. However, there are few reports regarding renal granulomas, such as xanthogranulomatous pyelonephritis, sarcoidosis, malakoplakia, and tuberculosis. Here, we report a case of cryptococcal granuloma resembling a locally progressed tumor after percutaneous cryotherapy for renal cell carcinoma. A male patient in his 80s with rheumatoid arthritis underwent computed tomography (CT)-guided cryoablation for biopsy-proven papillary renal cell carcinoma. Follow-up contrast-enhanced CT imaging obtained 4 months after ablation confirmed an enhanced mass on the edge of the ablation zone. There were no symptoms related to the mass. This mass was radiologically diagnosed as local tumor progression and treated with repeated cryoablation. Percutaneous biopsy of the mass was performed immediately after the second cryoablation, and the mass was pathologically diagnosed as granuloma related to Cryptococcus infection. The patient was administered antifungal fluconazole for 1 year with a good outcome.
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Affiliation(s)
- Hikari Fukui
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
- Corresponding author.
| | - Takashi Yamanaka
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Naritaka Matsushita
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Seiya Kishi
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Chisami Nagata
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Yuki Omori
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Kouhei Nishikawa
- Department of Nephro-Urologic Surgery and Andrology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Hiroto Yuasa
- Department of Pathology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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8
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Tamai Y, Tanaka H, Fujimori M, Iwasa M, Nakagawa H. Successful endoscopic cyanoacrylate injection therapy for ruptured duodenal varices immediately after balloon-occluded retrograde transvenous obliteration. JGH Open 2021; 5:1401-1403. [PMID: 34950785 PMCID: PMC8674538 DOI: 10.1002/jgh3.12683] [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: 10/21/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/11/2022]
Abstract
We present a rare case of acute duodenal variceal rupture after B-RTO that was successfully treated with endoscopic CA injection therapy. A 74-year-old Japanese woman was transferred to our hospital due to progressive general malaise and hematemesis. Gastroduodenoscopy (GDS) showed duodenal varices without active bleeding in the second portion of duodenum. Balloon-occluded retrograde transvenous obliteration (B-RTO) was carried out to prevent duodenal variceal rebleeding. Good pooling of ethanolamine oleate with iopamidol (EOI) was observed in duodenal varices using balloon catheters. However, massive melena was observed immediately after B-RTO. Emergent GDS revealed a white plug on the treated varix, thus endoscopic cyanoacrylate (CA) injection therapy was performed. We speculated that the injection of EOI increased the pressure in the duodenal varices which resulted in rupture of duodenal varices. B-RTO was effective therapy to prevent duodenal variceal rebleeding, but postprocedural monitoring is required as illustrated by this case. We suggest that careful monitoring and backup system for endoscopy are required during or after B-RTO.
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Affiliation(s)
- Yasuyuki Tamai
- Department of Gastroenterology and Hepatology Mie University Graduate School of Medicine Tsu Mie Japan
| | - Hideaki Tanaka
- Department of Gastroenterology and Hepatology Mie University Graduate School of Medicine Tsu Mie Japan
| | - Masashi Fujimori
- Department of Radiology Mie University Graduate School of Medicine Tsu Mie Japan
| | - Motoh Iwasa
- Department of Gastroenterology and Hepatology Mie University Graduate School of Medicine Tsu Mie Japan
| | - Hayato Nakagawa
- Department of Gastroenterology and Hepatology Mie University Graduate School of Medicine Tsu Mie Japan
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9
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Fujimori M, Kimura Y, Ueshima E, Dupuy DE, Adusumilli PS, Solomon SB, Srimathveeravalli G. Lung Ablation with Irreversible Electroporation Promotes Immune Cell Infiltration by Sparing Extracellular Matrix Proteins and Vasculature: Implications for Immunotherapy. Bioelectricity 2021; 3:204-214. [PMID: 34734168 DOI: 10.1089/bioe.2021.0014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: This study investigated the sparing of the extracellular matrix (ECM) and blood vessels at the site of lung irreversible electroporation (IRE), and its impact on postablation T cell and macrophage populations. Materials and Methods: Normal swine (n = 8) lung was treated with either IRE or microwave ablation (MWA), followed by sacrifice at 2 and 28 days (four animals/timepoint) after treatment. En bloc samples of ablated lung were stained for blood vessels (CD31), ECM proteins (Collagen, Heparan sulfate, and Decorin), T cells (CD3), and macrophages (Iba1). Stained slides were analyzed with an image processing software (ImageJ) to count the number of positive staining cells or the percentage area of tissue staining for ECM markers, and the statistical difference was evaluated with Student's t-test. Results: Approximately 50% of the blood vessels and collagen typically seen in healthy lung were evident in IRE treated samples at Day 2, with complete destruction within MWA treated lung. These levels increased threefold by Day 28, indicative of post-IRE tissue remodeling and regeneration. Decorin and Heparan sulfate levels were reduced, and it remained so through the duration of observation. Concurrently, numbers of CD3+ T cells and macrophages were not different from healthy lung at Day 2 after IRE, subsequently increasing by 2.5 and 1.5-fold by Day 28. Similar findings were restricted to the peripheral inflammatory rim of MWA samples, wherein the central necrotic regions remained acellular through Day 28. Conclusion: Acute preservation of blood vessels and major ECM components was observed in IRE treated lung at acute time points, and it was associated with the increased infiltration and presence of T cells and macrophages, features that were spatially restricted in MWA treated lung.
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Affiliation(s)
- Masashi Fujimori
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Radiology, Mie University, Mie, Japan
| | - Yasushi Kimura
- Department of Mechanical & Industrial Engineering, University of Massachusetts, Amherst, Massachusetts, USA
| | | | - Damian E Dupuy
- Department of Radiology, Cape Cod Healthcare, Hyannis, Massachusetts, USA
| | - Prasad S Adusumilli
- Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Stephen B Solomon
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.,Department of Radiology, Mie University, Mie, Japan
| | - Govindarajan Srimathveeravalli
- Department of Mechanical & Industrial Engineering, University of Massachusetts, Amherst, Massachusetts, USA.,Institute for Applied Life Sciences, University of Massachusetts, Amherst, Massachusetts, USA
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10
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Fujimori M, Hasegawa S, Sasaoka S, Iguchi K, Nakamura M. A study of the association between seasonal influenza vaccines and the increased risk of Guillain-Barré syndrome using Vaccine Adverse Event Reporting System, 2018-2019. Pharmazie 2021; 76:437-443. [PMID: 34481535 DOI: 10.1691/ph.2021.1578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The aim of this study was to investigate the association between the incidence of Guillain-Barré syndrome (GBS) and seasonal influenza vaccines using the United States Vaccine Adverse Event Reporting System. Using multiple logistic regression analysis, we calculated the adjusted reporting odds ratio (ROR) of GBS cases associated with seasonal influenza vaccines administered from August 2018 to July 2019. Additionally, we analyzed the time-to-onset profile. The total number of adverse events reported following vaccination during this period was 43,235. Most of the GBS patients received a cell culture-based quadrivalent inactivated influenza vaccine (42.2%), quadrivalent inactivated influenza vaccine (26.6%), or high-dose trivalent inactivated influenza vaccine (15.6%). The adjusted ROR of seasonal influenza vaccines for GBS was 3.44 (2.40-4.95). The adjusted ROR of sex (male) (as reference female) and 0.5-59 years (as reference ≥ 60 years) were 1.90 (0.73-4.95) and 1.57 (0.88-2.78). Male sex and advanced age were not risk factors for GBS. The median duration of GBS was 9.5 (4.0-21.5) days. GBS following seasonal influenza vaccination developed mainly within 14 days and 42 days at most. In sex-stratified analyses, the median durations of GBS in females and males were 12.0 (8.3-28.5) and 5.0 (3.0-15.5) days (P = 0.050). Therefore, our findings indicate that the incidence of GBS is associated with seasonal influenza vaccines, and careful monitoring of GBS is required for up to 42 days, especially in the first 14 days. Moreover, GBS may occur slightly earlier in males than in females.
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Affiliation(s)
- M Fujimori
- General Affairs Team, Marumori-machi National Health Insurance Marumori Hospital, Miyagi, Japan;,
| | - S Hasegawa
- Laboratory of Drug informatics, Gifu Pharmaceutical University, Japan
| | - S Sasaoka
- Laboratory of Drug informatics, Gifu Pharmaceutical University, Japan
| | - K Iguchi
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - M Nakamura
- Laboratory of Drug informatics, Gifu Pharmaceutical University, Japan
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11
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Park BK, Shen SH, Fujimori M, Wang Y. Thermal Ablation for Renal Cell Carcinoma: Expert Consensus from the Asian Conference on Tumor Ablation. Korean J Radiol 2021; 22:1490-1496. [PMID: 34448380 PMCID: PMC8390817 DOI: 10.3348/kjr.2020.1080] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 01/20/2023] Open
Affiliation(s)
- Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Shu-Huei Shen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, Tsu, Japan
| | - Yi Wang
- Department of Urology, Peking University Wujieping Urology Center, Peking University Shougang Hospital, Beijing, China
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12
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Abstract
Thermal ablation is a good alternative treatment in patients who are unable to undergo adrenalectomy. Even though the Asian Conference on Tumor Ablation (ACTA) has been held for many years, adrenal ablation guidelines have not been established. No guidelines for adrenal ablation are established in American and European countries, either. The aim of this review was to introduce the first version of ACTA guidelines for adrenal tumor ablation.
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Affiliation(s)
- Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul,
Korea
| | - Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, Tsu,
Japan
| | - Shu-Huei Shen
- Department of Radiology, Taipei Veterans General Hospital, Taipei,
Taiwan
| | - Uei Pua
- Department of Diagnostic Radiology, Tan Tock Seng Hospital,
Singapore
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13
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Park BK, Shen SH, Fujimori M, Wang Y. Asian Conference on Tumor Ablation guidelines for renal cell carcinoma. Investig Clin Urol 2021; 62:378-388. [PMID: 34190433 PMCID: PMC8246015 DOI: 10.4111/icu.20210168] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 04/18/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 01/20/2023] Open
Abstract
Thermal ablation has been established as an alternative treatment for renal cell carcinoma (RCC) in patients who are poor candidates for surgery. However, while American and European guidelines have been established for American and European patients, respectively, no ablation guidelines for Asian patients with RCCs have been established many years after the Asian Conference on Tumor Ablation (ACTA) had been held. Given that Western guidelines are difficult to apply to Asian patients due to differences in body habitus, economic status, and insurance systems, the current review sought to establish the first version of the ACTA guidelines for treating a RCC with thermal ablation.
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Affiliation(s)
- Byung Kwan Park
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Shu Huei Shen
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, Mie Prefecture, Japan
| | - Yi Wang
- Department of Urology, Peking University Wujieping Urology Center, Peking University Shougang Hospital, Beijing, China
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Nakatsuka A, Fujimori M, Yamanaka T. 3:45 PM Abstract No. 351 Safety and clinical outcomes of percutaneous cryoablation for musculoskeletal tumors: a phase II clinical study (UMIN 000009906). J Vasc Interv Radiol 2020. [DOI: 10.1016/j.jvir.2019.12.409] [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: 11/26/2022] Open
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15
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Fujimori M, Yamanaka T, Sugino Y, Matsushita N, Sakuma H. Percutaneous Image-guided Thermal Ablation for Renal Cell Carcinoma. Interventional Radiology 2020; 5:32-42. [PMID: 36284654 PMCID: PMC9550385 DOI: 10.22575/interventionalradiology.2020-0001] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 03/17/2020] [Indexed: 11/05/2022]
Abstract
Nephrectomy is the gold standard for the treatment of renal cell carcinoma (RCC). However, some patients are not suitable candidates for nephrectomy because of high surgical risk, reduced renal function, or the presence of multiple renal tumors. Percutaneous image-guided thermal ablation, including cryoablation and radiofrequency ablation, is a minimally invasive and highly effective treatment and can be used to treat RCC in patients who are not good candidates for surgery. This article will review percutaneous image-guided thermal ablation for RCC, covering treatment indications, ablation modalities and techniques, oncologic outcomes, and possible complications. In addition, the characteristics of each ablation modality and its comparison with nephrectomy are also presented.
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Affiliation(s)
| | | | - Yuichi Sugino
- Department of Radiology, Mie University School of Medicine
| | | | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine
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16
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Dias A, Almeida A, Rodrigues J, Nakazato L, Fujimori M, Sousa V. Cytological and molecular detection of Leishmania spp. in different biological tissues of dogs in areas endemic for visceral leishmaniasis. ARQ BRAS MED VET ZOO 2019. [DOI: 10.1590/1678-4162-10775] [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: 11/22/2022] Open
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17
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Cornelis FH, Cindrič H, Kos B, Fujimori M, Petre EN, Miklavčič D, Solomon SB, Srimathveeravalli G. Peri-tumoral Metallic Implants Reduce the Efficacy of Irreversible Electroporation for the Ablation of Colorectal Liver Metastases. Cardiovasc Intervent Radiol 2019; 43:84-93. [PMID: 31385006 DOI: 10.1007/s00270-019-02300-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/21/2019] [Accepted: 07/27/2019] [Indexed: 12/18/2022]
Abstract
PURPOSE To evaluate the effect of peri-tumoral metallic implants (MI) on the safety and efficacy of percutaneous irreversible electroporation (IRE) of colorectal liver metastasis (CRLM). MATERIALS AND METHODS In this retrospective study, 25 patients (12 women, 13 men; MI: 13, no MI: 12) were treated for 29 CRLM. Patient characteristics, tumor location and size, treatment parameters and the presence of MI were evaluated as determinants of local tumor progression (LTP) with the competing risks model (univariate and multivariate analyses). Patient-specific computer models were created to examine the effect of the MI on the electric field used to induce IRE, probability of cell kill and potential thermal effects. RESULTS Patients had a median follow-up of 25 months, during which no IRE-related major complications were reported. Univariate analysis showed that tumor size (> 2 cm), probe spacing (> 20 mm) and the presence of MI (p < 0.05) were significant predictors of time to LTP, but only the latter was found to be an independent predictor on multivariate analysis (sub-hazard ratio = 6.5; [95% CI 1.99, 21.4]; p = 0.002). The absence of peri-tumoral MI was associated with higher progression-free survival at 12 months (92.3% [56.6, 98.9] vs 12.5% [2.1, 32.8]). Computer simulations indicated significant distortions and reduction in electric field strength near MI, which could have contributed to under-treatment of the tumor. CONCLUSIONS Peri-tumoral MI increases the risk of treatment failure following IRE of CRLM.
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Affiliation(s)
- Francois H Cornelis
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.,Tenon Hospital, ISCD, Sorbonne Université, 4 Rue de la Chine, 75020, Paris, France
| | - Helena Cindrič
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, 1000, Ljubljana, Slovenia
| | - Bor Kos
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, 1000, Ljubljana, Slovenia
| | - Masashi Fujimori
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Elena N Petre
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Damijan Miklavčič
- Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, 1000, Ljubljana, Slovenia
| | - Stephen B Solomon
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
| | - Govindarajan Srimathveeravalli
- Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, MA, 01003, USA. .,Institute for Applied Life Sciences, University of Massachusetts, Amherst, MA, 01003, USA.
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18
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Ueshima E, Fujimori M, Kodama H, Felsen D, Chen J, Durack JC, Solomon SB, Coleman JA, Srimathveeravalli G. Macrophage-secreted TGF-β 1 contributes to fibroblast activation and ureteral stricture after ablation injury. Am J Physiol Renal Physiol 2019; 317:F52-F64. [PMID: 31017012 PMCID: PMC6692725 DOI: 10.1152/ajprenal.00260.2018] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [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: 06/01/2018] [Revised: 04/10/2019] [Accepted: 04/16/2019] [Indexed: 12/28/2022] Open
Abstract
Iatrogenic injury to the healthy ureter during ureteroscope-guided ablation of malignant or nonmalignant disease can result in ureteral stricture. Transforming growth factor (TGF)-β1-mediated scar formation is considered to underlie ureteral stricture, but the cellular sources of this cytokine and the sequelae preceding iatrogenic stricture formation are unknown. Using a swine model of ureteral injury with irreversible electroporation (IRE), we evaluated the cellular sources of TGF-β1 and scar formation at the site of injury and examined in vitro whether the effects of TGF-β1 could be attenuated by pirfenidone. We observed that proliferation and α-smooth muscle actin expression by fibroblasts were restricted to injured tissue and coincided with proliferation of macrophages. Collagen deposition and scarring of the ureter were associated with increased TGF-β1 expression in both fibroblasts and macrophages. Using in vitro experiments, we demonstrated that macrophages stimulated by cells that were killed with IRE, but not LPS, secreted TGF-β1, consistent with a wound healing phenotype. Furthermore, using 3T3 fibroblasts, we demonstrated that stimulation with paracrine TGF-β1 is necessary and sufficient to promote differentiation of fibroblasts and increase collagen secretion. In vitro, we also showed that treatment with pirfenidone, which modulates TGF-β1 activity, limits proliferation and TGF-β1 secretion in macrophages and scar formation-related activity by fibroblasts. In conclusion, we identified wound healing-related macrophages to be an important source of TGF-β1 in the injured ureter, which may be a paracrine source of TGF-β1 driving scar formation by fibroblasts, resulting in stricture formation.
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Affiliation(s)
- Eisuke Ueshima
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center , New York, New York
| | - Masashi Fujimori
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center , New York, New York
| | - Hiroshi Kodama
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center , New York, New York
| | - Diane Felsen
- Institute for Pediatric Urology, Department of Urology, Weill Cornell Medicine, New York, New York
| | - Jie Chen
- Institute for Pediatric Urology, Department of Urology, Weill Cornell Medicine, New York, New York
| | - Jeremy C Durack
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center , New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Stephen B Solomon
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center , New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
| | - Jonathan A Coleman
- Division of Urology, Department of Surgery, Memorial Sloan Kettering Cancer Center , New York, New York
| | - Govindarajan Srimathveeravalli
- Department of Radiology, Interventional Radiology Service, Memorial Sloan Kettering Cancer Center , New York, New York
- Department of Radiology, Weill Cornell Medicine, New York, New York
- Department of Mechanical and Industrial Engineering, University of Massachusetts, Amherst, Massachusetts
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Koyama Y, Yamada E, Saito R, Takanarita R, Ohnuma A, Okuda A, Hirasawa Y, Iijima A, Fujimori M, Onoma N, Uchiyama M. Subjective taste difference between Japanese and Sri Lankan students: Effect of food composition, nationality and serum zinc level. Clin Nutr 2018. [DOI: 10.1016/j.clnu.2018.06.1916] [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: 11/25/2022]
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Fujimori M, Vroomen L, Ueshima E, Kim K, Nagar K, Coleman J, Srimathveeravalli G. 4:21 PM Abstract No. 321 Transforming growth factor-β1 blockade after irreversible electroporation of murine urothelial tumor does not provide additional survival or cancer control benefits. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.356] [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: 10/17/2022] Open
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21
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Fujimori M, Ueshima E, Vroomen L, Dupuy D, Erinjeri J, Solomon S, Srimathveeravalli G. Abstract No. 2 ■ ABSTRACT OF THE YEAR Sparing of collagen and extracellular matrix proteins in irreversible electroporation-treated normal porcine lung promotes T-cell and macrophage infiltration throughout ablated tissue. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.005] [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: 10/17/2022] Open
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22
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Takafuji M, Nakatsuka A, Yamanaka T, Fujimori M, Sugino Y, Yamakado K. Factors affecting diagnostic value of CT-guided biopsy of renal neoplasms performed before ablation, after radiofrequency ablation, and after cryoablation. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.680] [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: 10/20/2022] Open
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23
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Nakajima K, Yamanaka T, Nakatsuka A, Haruyuki T, Fujimori M, Sugino Y, Matsushita N, Sakuma H, Isaji S, Takei Y, Yamakado K. Clinical utility of radiofrequency ablation following transarterial injection of miriplatin-iodized oil suspension in small hepatocellular carcinoma. Jpn J Radiol 2016; 34:640-6. [PMID: 27455985 DOI: 10.1007/s11604-016-0567-x] [Citation(s) in RCA: 6] [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: 05/18/2016] [Accepted: 07/12/2016] [Indexed: 01/10/2023]
Abstract
PURPOSE To retrospectively evaluate the clinical utility of radiofrequency ablation (RFA) following transarterial injection of miriplatin-iodized oil suspension (MPT-RFA) for hepatocellular carcinoma treatment. MATERIALS AND METHODS We evaluated clinical outcomes of MPT-RFA for three or fewer hepatocellular carcinomas. Twenty-one patients with 30 tumors (maximum diameter: mean 1.4 ± 0.4 cm, range 0.7-2.2 cm) received MPT-RFA. RESULTS Nineteen patients (90.5 %, 19/21) achieved complete ablation at the first RFA session. Two patients (9.5 %, 2/21) required a second RFA session but achieved complete ablation. Primary and secondary technical success rates were 90.5 and 100 %. There were no deaths related to the procedures performed. Grade 3 or 4 increases in the serum aspartate aminotransferase, alanine aminotransferase, and bilirubin levels were found in six patients (38.1 %, 8/21). There were no liver infarctions. During the median follow-up period of 24.1 months (mean ± SD 24.7 ± 6.9 months, range 13.8-38.9 months), the local tumor progression rate and overall survival rate at 2 years was 5.0 % (95 % confidence interval 0.3-20.6 %) and 86.7 % (95 % confidence interval 56.3-96.5 %), respectively. The mean hospital stay was 8.4 ± 3.1 days (range 5-18 days). CONCLUSION MPT-RFA is a safe therapeutic option that initially provides therapeutic results.
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Affiliation(s)
- Ken Nakajima
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Takashi Yamanaka
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Atsuhiro Nakatsuka
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Takaki Haruyuki
- Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yuichi Sugino
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Naritaka Matsushita
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Shuji Isaji
- Hepatobiliary Pancreatic and Transplant Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Yoshiyuki Takei
- Digestive Organ and Liver Internal Medicine, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Koichiro Yamakado
- Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa, Nisinomiya, Hyogo, 663-8501, Japan
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Murata Y, Mizuno S, Kato H, Tanemura A, Kuriyama N, Azumi Y, Kishiwada M, Usui M, Sakurai H, Fujimori M, Yamanaka T, Nakatsuka A, Yamakado K, Isaji S. Technical Feasibility and Clinical Outcomes of Interventional Endovascular Treatment for Hepatic Artery Thrombosis After Living-donor Liver Transplantation. Transplant Proc 2016; 48:1142-8. [DOI: 10.1016/j.transproceed.2015.12.092] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 12/30/2015] [Indexed: 01/27/2023]
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Nakatsuka A, Yamakado K, Uraki J, Takaki H, Yamanaka T, Fujimori M, Hasegawa T, Sakuma H. Safety and Clinical Outcomes of Percutaneous Radiofrequency Ablation for Intermediate and Large Bone Tumors Using a Multiple-Electrode Switching System: A Phase II Clinical Study. J Vasc Interv Radiol 2016; 27:388-94. [DOI: 10.1016/j.jvir.2015.10.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 10/02/2015] [Accepted: 10/25/2015] [Indexed: 11/28/2022] Open
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Fujimori M, Yamakado K, Takaki H, Nakatsuka A, Uraki J, Yamanaka T, Hasegawa T, Sugino Y, Nakajima K, Matsushita N, Mizuno S, Sakuma H, Isaji S. Long-Term Results of Stent Placement in Patients with Outflow Block After Living-Donor-Liver Transplantation. Cardiovasc Intervent Radiol 2015; 39:566-74. [DOI: 10.1007/s00270-015-1210-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/12/2015] [Indexed: 12/14/2022]
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Yamanaka T, Yamakado K, Yamada T, Fujimori M, Takaki H, Nakatsuka A, Sakuma H, Sugimura Y. CT-Guided Percutaneous Cryoablation in Renal Cell Carcinoma: Factors Affecting Local Tumor Control. J Vasc Interv Radiol 2015; 26:1147-53. [DOI: 10.1016/j.jvir.2015.04.031] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/26/2015] [Accepted: 04/26/2015] [Indexed: 12/13/2022] Open
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28
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Kodama H, Yamakado K, Hasegawa T, Fujimori M, Yamanaka T, Takaki H, Uraki J, Nakatsuka A, Sakuma H. Radiofrequency Ablation Using a Multiple-Electrode Switching System for Lung Tumors with 2.0-5.0-cm Maximum Diameter: Phase II Clinical Study. Radiology 2015; 277:895-902. [PMID: 26053308 DOI: 10.1148/radiol.2015141153] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To prospectively evaluate the safety and effectiveness of radiofrequency ablation (RFA) by using a multiple-electrode switching system to treat 2.0-5.0-cm lung tumors. MATERIALS AND METHODS The institutional review board approved this prospective phase II study. Written informed consent was obtained from all patients. Between September 2009 and July 2011, RFA using two or three radiofrequency (RF) electrodes and a multiple-electrode switching system was performed for malignant lung tumors with a maximum tumor diameter of 2.0-5.0 cm in nonsurgical candidates. The primary endpoint was safety, as evaluated using the Common Terminology Criteria for Adverse Events. Patients were observed for at least 1 year. Local tumor progression and overall survival were analyzed with the Kaplan-Meier method. RESULTS Thirty-three patients (26 men, seven women; mean age, 70.5 years ± 10.0; age range, 46-87 years) with 35 lung tumors with a mean maximum diameter of 3.0 cm ± 0.7 (standard deviation; range, 2.0-4.4 cm) underwent treatment in 35 sessions. No procedure-related death or grade 4 adverse events (AEs) occurred. Grade 3 AEs occurred in four patients (12%), with pleural effusion requiring chest tube placement in two patients, pneumothorax requiring pleural adhesion in one patient, and pulmonary hemorrhage requiring pulmonary artery coil embolization in one patient. Grade 2 AEs were detected in 13 patients (39%). The 1-year local tumor progression and overall survival rates were 12.7% (95% confidence interval [CI]: 1.0, 25.5) and 81.2% (95% CI: 67.6, 94.8). CONCLUSION RFA with a multiple-electrode switching system may be a safe therapeutic option with which to treat 2.0-5.0-cm lung cancer tumors.
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Affiliation(s)
- Hiroshi Kodama
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Koichiro Yamakado
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Takaaki Hasegawa
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Masashi Fujimori
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Takashi Yamanaka
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Haruyuki Takaki
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Junji Uraki
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Atsuhiro Nakatsuka
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Hajime Sakuma
- From the Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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Hasegawa T, Yamakado K, Nakatsuka A, Uraki J, Yamanaka T, Fujimori M, Miki M, Sasaki T, Sakuma H, Sugimura Y. Unresectable Adrenal Metastases: Clinical Outcomes of Radiofrequency Ablation. Radiology 2015; 277:584-93. [PMID: 25997031 DOI: 10.1148/radiol.2015142029] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
PURPOSE To retrospectively evaluate the clinical outcomes of radiofrequency (RF) ablation for the treatment of unresectable adrenal metastasis. MATERIALS AND METHODS The institutional review board approved this retrospective study, and informed consent to perform adrenal RF ablation was obtained from all patients. From February 2005 through May 2014, 35 patients (25 men and 10 women; mean age, 64.7 years ± 9.6; age range, 39-82 years) underwent RF ablation to treat 41 metastatic adrenal tumors from lung cancer (n = 15), renal cell carcinoma (n = 9), colorectal cancer (n = 5), hepatocellular carcinoma (n = 4), and other tumors (n = 2). Tumors ranged in size from 1.2 to 8.2 cm (mean, 3.3 cm ± 1.6). The diagnosis was established mainly on the basis of radiologic findings. Adrenal arterial embolization was combined with RF ablation in 12 of the 35 patients (34%). Technical success, safety, local tumor progression, and survival were evaluated. The Kaplan-Meier method and Cox proportional hazard model were used to evaluate prognostic factors. RESULTS There were 48 completed sessions with planned procedures and treatment protocols with no mortality and a major complication rate of 8.3% (four of 48 sessions). Tumor enhancement disappeared after initial adrenal RF ablation in 33 of the 35 patients (94%). Local tumor progression developed in eight of the 35 patients (23%); two patients received repeated RF ablation, resulting in adrenal tumor control in 27 of the 35 patients (77%) at the last follow-up (mean, 30.1 months ± 27.5; range 1.2-96.8 months). The 1-, 3-, and 5-year overall survival rates were 75% (95% confidence interval [CI], 61%, 90%), 34% (95% CI: 17%, 52%), and 30% (95% CI: 13%, 48%), respectively, with a median survival time of 26.0 months. Existence of extra-adrenal tumors (P = .005) and age of 65 years or older (P = .04) were significant indicators of a poor prognosis. CONCLUSION Adrenal RF ablation is a feasible and useful method for controlling adrenal metastases and offers patients opportunities for improved survival.
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Affiliation(s)
- Takaaki Hasegawa
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Koichiro Yamakado
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Atsuhiro Nakatsuka
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Junji Uraki
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Takashi Yamanaka
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Masashi Fujimori
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Manabu Miki
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Takeshi Sasaki
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Hajime Sakuma
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
| | - Yoshiki Sugimura
- From the Departments of Radiology (T.H., K.Y., A.N., J.U., T.Y., M.F., H.S.) and Urology (M.M., T.S., Y.S.), Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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Yamakado K, Takaki H, Nakatsuka A, Yamaknaka T, Fujimori M, Hasegawa T, Uraki J. Radiofrequency ablation for hepatocellular carcinoma. Gastrointestinal Intervention 2014. [DOI: 10.1016/j.gii.2014.04.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Hasegawa T, Nakatsuka A, Uraki J, Yamanaka T, Fujimori M, Nakajima K, Sugino Y, Sakuma H, Yamakado K. Clinical utility of radiofrequency ablation for unresectable malignant adrenal neoplasms. J Vasc Interv Radiol 2014. [DOI: 10.1016/j.jvir.2013.12.191] [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: 10/25/2022] Open
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Takaki H, Soga N, Kanda H, Nakatsuka A, Uraki J, Fujimori M, Yamanaka T, Hasegawa T, Arima K, Sugimura Y, Sakuma H, Yamakado K. Radiofrequency Ablation versus Radical Nephrectomy: Clinical Outcomes for Stage T1b Renal Cell Carcinoma. Radiology 2014; 270:292-9. [DOI: 10.1148/radiol.13130221] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Fujita T, Mizukami T, Okawara T, Inoue K, Fujimori M. Abstract P2-09-11: Identification of a novel inhibitor of triple-negative breast cancer cell growth by screening of a small molecule library. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-09-11] [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: 11/16/2022]
Abstract
Abstract
Background: Triple-negative breast cancers (TNBC) are defined as not having amplification of the estrogen receptor, progesterone receptor, or epidermal growth factor receptor 2. At present, recovery in patients is severely limited following diagnosis of metastatic TNBC, with less than 30% of patients surviving more than 5 years.. The most effective therapy to date is chemotherapy, which has been unsuccessful due to the lack of therapeutic targets for these aggressive cancers. To identify new molecular targets for TNBC, we have developed a novel method for drug discovery using active compounds for identification of pharmacodynamic biomarkers.
Methods: We used chemical informatics to design a small molecule library that has structural diversity. This library was used to screen for compounds that selectively inhibit the proliferation in TNBC cell lines. The differences in gene expression profiles in cell lines before and after the addition of selected compounds were analyzed and compared with control cells.
Results: We identified (E)-3-(3,4-dihydroxybenzylidene)-benzofuran-2(3H)-one (DBBF) that exhibited specific inhibition of the proliferation in a TNBC cell line, MDA-MB-468 with IC50 of 2.4 μM. Microarray analysis identified several signaling pathways, including the irinotecan pathway, which changed specifically in the TNBC cell lines by the addition of DBBF.
Conclusion: We have developed a novel research strategy that involves screening of selective inhibitors of TNBC cell line proliferation that can be used for identification of pharmacodynamic biomarkers for TNBC. The discovery of new pathways by this technique should lead to the identification of new therapeutic targets for this aggressive cancer.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-09-11.
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Affiliation(s)
- T Fujita
- Tokyo Medical University Ibaraki Medical Center, Ami Inashiki, Ibaraki, Japan; Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan; Kumamoto Health Science University, Kumamoto, Japan; Pharma Valley Center, Shizuoka Industrial Foundation, Nagaizumi Sunto, Shizuoka, Japan
| | - T Mizukami
- Tokyo Medical University Ibaraki Medical Center, Ami Inashiki, Ibaraki, Japan; Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan; Kumamoto Health Science University, Kumamoto, Japan; Pharma Valley Center, Shizuoka Industrial Foundation, Nagaizumi Sunto, Shizuoka, Japan
| | - T Okawara
- Tokyo Medical University Ibaraki Medical Center, Ami Inashiki, Ibaraki, Japan; Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan; Kumamoto Health Science University, Kumamoto, Japan; Pharma Valley Center, Shizuoka Industrial Foundation, Nagaizumi Sunto, Shizuoka, Japan
| | - K Inoue
- Tokyo Medical University Ibaraki Medical Center, Ami Inashiki, Ibaraki, Japan; Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan; Kumamoto Health Science University, Kumamoto, Japan; Pharma Valley Center, Shizuoka Industrial Foundation, Nagaizumi Sunto, Shizuoka, Japan
| | - M Fujimori
- Tokyo Medical University Ibaraki Medical Center, Ami Inashiki, Ibaraki, Japan; Nagahama Institute of Bio-Science and Technology, Nagahama, Shiga, Japan; Kumamoto Health Science University, Kumamoto, Japan; Pharma Valley Center, Shizuoka Industrial Foundation, Nagaizumi Sunto, Shizuoka, Japan
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Fujimori M, Takaki H, Nakatsuka A, Uraki J, Yamanaka T, Hasegawa T, Shiraki K, Takei Y, Yamakado K. Combination therapy of chemoembolization and radiofrequency ablation for the treatment of hepatocellular carcinoma in the caudate lobe. J Vasc Interv Radiol 2013. [PMID: 23177108 DOI: 10.1016/j.jvir.2012.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
PURPOSE To evaluate the clinical utility of radiofrequency (RF) ablation combined with chemoembolization in treatment of hepatocellular carcinoma (HCC) located in the caudate lobe. MATERIALS AND METHODS Between September 2000 and October 2011, 20 consecutive patients with single HCC measuring≤5 cm were treated with combination therapy of chemoembolization and RF ablation. Technical success was defined as completion of a planned electrode placement and ablation protocol. The effectiveness of the technique was defined as disappearance of tumor enhancement with an ablative margin of≥5 mm. Technical success, technique effectiveness, local tumor progression, overall and recurrence-free survival, and complications were evaluated. RESULTS RF electrodes were placed in planned sites of each tumor, and ablation was complete in all patients (technical success rate 100%). Tumor enhancement disappeared with sufficient ablative margins after 20 RF sessions in all patients (technique effectiveness rate 100%). Major and minor complication rates were 10.0% and 15.0%. Local tumor progression was found in 2 of 20 patients (10.0%) with local tumor progression rates of 6.3% at 1 year and 13.5% at 3 years and 5 years. Six patients died during the follow-up period (mean, 40.0 months; range, 2.0-110.5 months). Overall and recurrence-free survival rates were 94.4% and 70.8% at 1 year, 86.6% and 36.9% at 3 years, and 67.5% and 45.5% at 5 years. CONCLUSIONS RF ablation combined with chemoembolization is a safe and useful therapeutic option to treat HCCs located in the caudate lobe.
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Affiliation(s)
- Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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Yamanaka T, Takaki H, Nakatsuka A, Uraki J, Fujimori M, Hasegawa T, Sakuma H, Yamakado K. Response to "the use of radiofrequency ablation in gastrointestinal stromal tumor". J Vasc Interv Radiol 2013; 24:751. [PMID: 23622045 DOI: 10.1016/j.jvir.2013.02.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 02/20/2013] [Indexed: 12/01/2022] Open
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Fujimori M, Takaki H, Nakatsuka A, Uraki J, Yamanaka T, Hasegawa T, Shiraki K, Takei Y, Sakuma H, Yamakado K. Combination therapy of chemoembolization and radiofrequency ablation for the treatment of hepatocellular carcinoma: 10-year outcomes and prognostic factors. J Vasc Interv Radiol 2013. [DOI: 10.1016/j.jvir.2013.01.285] [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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Takaki H, Nakatsuka A, Uraki J, Yamanaka T, Fujimori M, Hasegawa T, Arima K, Sugimura Y, Yamakado K. Renal Cell Carcinoma: Radiofrequency Ablation with a Multiple-Electrode Switching System—A Phase II Clinical Study. Radiology 2013; 267:285-92. [DOI: 10.1148/radiol.12121070] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Hasegawa T, Takaki H, Yamanaka T, Fujimori M, Nakatsuka A, Uraki J, Yamada T, Sakuma H, Yamakado K. Experimental assessment of temperature influence on miriplatin and cisplatin iodized-oil suspension viscosity. Jpn J Radiol 2013; 31:424-7. [DOI: 10.1007/s11604-013-0201-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Accepted: 03/08/2013] [Indexed: 02/07/2023]
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Fujimori M, Takaki H, Nakatsuka A, Uraki J, Yamanaka T, Hasegawa T, Shiraki K, Takei Y, Sakuma H, Yamakado K. Survival with up to 10-year follow-up after combination therapy of chemoembolization and radiofrequency ablation for the treatment of hepatocellular carcinoma: single-center experience. J Vasc Interv Radiol 2013; 24:655-66. [PMID: 23428356 DOI: 10.1016/j.jvir.2012.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/03/2012] [Accepted: 12/11/2012] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To report 10-year outcomes of treating hepatocellular carcinomas (HCCs) by combination therapy of chemoembolization and radiofrequency (RF) ablation. MATERIALS AND METHODS Combination therapy was administered in 277 patients with 382 treatment-naïve HCCs. Therapeutic effects, safety, survival rate, and prognostic factors were evaluated. RESULTS Tumor enhancement disappeared after 466 RF sessions in all tumors, resulting in a complete response rate of 100% (277 of 277) based on modified Response Evaluation Criteria In Solid Tumors. Local tumor progression developed in 15 patients (5.4%; 15 of 277) during the mean follow-up of 44.9 months±29.1 (range, 6.0-134.4 mo). Overall and recurrence-free survival rates were 56.3% (95% confidence interval [CI], 52.5%-60.2%) and 22.5% (95% CI, 19.3%-25.6%) at 5 years and 23.5% (95% CI, 17.7%-29.2%) and 9.3% (95% CI, 6.3%-12.4%) at 10 years. The Child-Pugh class was the only significant prognostic factor detected in both the univariate (P<.001) and the multivariate analyses (hazard ratio, 3.8; 95% CI, 2.5-5.6; P<.001). The 5-year and 10-year overall survival rates were 66.4% (95% CI, 62.0%-70.8%) and 30.6% (95% CI, 23.3%-37.9%) in 210 Child-Pugh class A patients. In addition to the Child-Pugh class, the maximum tumor diameter (≤3 cm vs>3 cm) and the tumor number (single vs multiple) were significant independent factors affecting recurrence-free survival. No death was related to the combination therapy. The major complication rate was 3.2% (15 of 466). CONCLUSIONS RF ablation combined with chemoembolization is a safe and useful therapeutic option for treating HCCs. Prognostic factors detected in this study help to stratify patients who benefit from this combination therapy.
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Affiliation(s)
- Masashi Fujimori
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
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Yamanaka T, Takaki H, Nakatsuka A, Uraki J, Fujimori M, Hasegawa T, Sakuma H, Yamakado K. Radiofrequency ablation for liver metastasis from gastrointestinal stromal tumor. J Vasc Interv Radiol 2013; 24:341-6. [PMID: 23352855 DOI: 10.1016/j.jvir.2012.11.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 11/23/2012] [Accepted: 11/27/2012] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate the feasibility, safety, and clinical outcomes of radiofrequency (RF) ablation for the treatment of liver metastases from gastrointestinal stromal tumor (GIST). MATERIALS AND METHODS Seven consecutive patients with 21 GIST liver metastases received RF ablation under computed tomographic (CT) fluoroscopic guidance. Liver metastases were solitary in two patients and multiple in five patients, with a mean maximum tumor diameter of 2.2 cm±1.1 (range, 1.2-4.2 cm). In addition to feasibility and safety, local tumor progression and overall and GIST-related survival associated with RF ablation were assessed. RESULTS All liver metastases were treated in 12 RF sessions, after which contrast-enhanced CT showed disappearance of tumor enhancement. No RF procedure-related complications occurred. Local tumor progression developed in one tumor (4.8%) during the mean follow-up period of 30.6 months±27.5 (range, 5.9-76.4 mo). New liver metastasis in untreated liver and lung metastasis developed in one patient each. One patient died of subarachnoid hemorrhage 5.9 months after RF ablation, but no GIST-related deaths occurred. The respective overall and GIST-related survival rates were 85.7% (95% confidence interval, 33.6%-97.8%) and 100% at 1, 3, and 5 years. CONCLUSIONS RF ablation is a feasible, safe, and useful therapeutic option for the treatment for GIST liver metastases.
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Affiliation(s)
- Takashi Yamanaka
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan.
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Beppu T, Sugimoto K, Shiraki K, Tameda M, Inagaki Y, Ogura S, Kasai C, Kusagawa S, Nojiri K, Yoneda M, Fuke H, Yamamoto N, Takei Y, Fujimori M, Hasegawa T, Yamanaka T, Uraki J, Kashima M, Takaki H, Nakatsuka A, Yamakado K, Takeda K. Clinical utility of transarterial infusion chemotherapy using cisplatin-lipiodol emulsion for unresectable hepatocellular carcinoma. Anticancer Res 2012; 32:4923-4930. [PMID: 23155261] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND We evaluated the clinical efficacy of transarterial infusion chemotherapy using a cisplatin-lipiodol emulsion for unresectable hepatocellular carcinoma (HCC). PATIENTS AND METHODS Fifty-seven patients with advanced HCC, with no indications for surgical resection or local ablative therapy, such as percutaneous ethanol injection and radiofrequency ablation, were enrolled in this retrospective study. RESULTS Twelve patients were treated with cisplatin-alone at a dose of 65 mg/m(2) by infusion into the artery. Forty-two patients were treated with the same dose of cisplatin suspended in 1-10 ml of lipiodol (C/LPD). Cumulative survival rates in the cisplatin-treated group were 46.2% at one year, and 18.5% at two years, whereas these in the C/LPD group were 81.6% and 44.4%, respectively, with a significant difference between the two groups (p<0.01). In the cisplatin-treated group (n=13), no (0%) patients had a complete response (CR), two (15%) a partial response (PR), three (23%) no change (NC), and eight (62%) progressive disease (PD). In the C/LPD group (n=44), four (9%) patients had CR, 16 (35%) PR, 12 (26%) NC, and 12 (26%) PD. CR and PR were seen in 15% of the cisplatin-treated group and in 44% of the C/LPD group. C/LPD was significantly more effective than cisplatin-alone (p=0.039). Some patients showed tumor response to C/LPD after intra-arterial infusion of low-dose 5-fluorouracil. CONCLUSION C/LPD produced superior effects compared to cisplatin-alone for unresectable HCC, causing no major side-effects, and increasing the survival rate.
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Affiliation(s)
- Tetsuya Beppu
- Department of Gastroenterology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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Shimizu K, Nakaya N, Saito-Nakaya K, Akechi T, Yamada Y, Fujimori M, Ogawa A, Fujisawa D, Goto K, Iwasaki M, Tsugane S, Uchitomi Y. Clinical biopsychosocial risk factors for depression in lung cancer patients: a comprehensive analysis using data from the Lung Cancer Database Project. Ann Oncol 2012; 23:1973-1979. [PMID: 22473594 DOI: 10.1093/annonc/mds061] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Various risk factors for depression in lung cancer patients have been suggested but have been examined separately in studies with relatively small sample sizes. The present study examined the biopsychosocial risk factors of depression in lung cancer patients, focusing on psychological factors in the largest patient sample reported to date. PATIENTS AND METHODS A total of 1334 consecutively recruited lung cancer patients were selected, and data on cancer-related variables, personal characteristics, health behaviors, physical symptoms, and psychological factors were obtained. The participants were divided into groups with or without depression using the Hospital Anxiety and Depression Scale. RESULTS Among the recruited patients, 165 (12.4%) manifested depression. The results of a binary logistic regression analysis were significant (overall R2, 36.5%), and a greater risk for depression was strongly associated with psychological factors, such as personality characteristics (neuroticism) and coping style (low fighting spirit, helplessness/hopelessness, and anxious preoccupation). Although the contributions of cancer-related variables, personal characteristics, health behaviors, and clinical state were relatively low, cancer stage, cancer type, sex, and age correlated significantly with depression. CONCLUSION Depression was most strongly linked with personality traits and coping style, and using screening instruments to identify these factors may be useful for preventive interventions.
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Affiliation(s)
- K Shimizu
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo.
| | - N Nakaya
- Department of Nutrition and Dietetics, Faculty of Family and Consumer Sciences, Kamakura Women's University, Kamakura; Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai
| | - K Saito-Nakaya
- Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai
| | - T Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya
| | - Y Yamada
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo
| | - M Fujimori
- Psycho-Oncology Division, National Cancer Center Hospital, Tokyo; Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa
| | - A Ogawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa
| | - D Fujisawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa
| | - K Goto
- Division of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa
| | - M Iwasaki
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo
| | - S Tsugane
- Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo
| | - Y Uchitomi
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Fujimori M, Yamakado K, Takaki H, Nakatsuka A, Kashima M, Uraki J, Yamanaka T, Hasegawa T. Abstract No. 20: Hepatocellular carcinoma in the caudate lobe: radiofrequency ablation combined with chemoembolization under the real-time CT-fluoroscopic guidance. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.054] [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: 10/28/2022] Open
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Yamanaka T, Yamakado K, Nakatsuka A, Uraki J, Kashima M, Takaki H, Fujimori M, Hasegawa T, Takeda K. Abstract No. 25: Radiofrequency ablation for liver metastasis from gastrointestinal stromal tumor. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.059] [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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Hasegawa T, Yamakado K, Takaki H, Nakatsuka A, Uraki J, Kashima M, Yamanaka T, Fujimori M. Abstract No. 15: Hyaluronic acid gel injection to protect adjacent gastro intestine in percutaneous liver radiofrequency ablation: initial experience. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.049] [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: 11/29/2022] Open
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Takaki H, Yamakado K, Nakatsuka A, Uraki J, Kashima M, Fujimori M, Yamanaka T, Hasegawa T. Abstract No. 275: Radiofrequency ablation of renal cell carcinoma using a multiple electrode switching system: a phase-II clinical study. J Vasc Interv Radiol 2012. [DOI: 10.1016/j.jvir.2011.12.329] [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: 11/27/2022] Open
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Toyoda H, Kumada T, Tada T, Sone Y, Fujimori M. Transarterial chemoembolization for hepatitis B virus-associated hepatocellular carcinoma: improved survival after concomitant treatment with nucleoside analogues. J Vasc Interv Radiol 2012; 23:317-22.e1. [PMID: 22265248 DOI: 10.1016/j.jvir.2011.11.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Revised: 11/12/2011] [Accepted: 11/14/2011] [Indexed: 02/09/2023] Open
Abstract
PURPOSE To determine whether nucleoside analogue therapy is associated with improved survival in patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) who are treated solely with transarterial chemoembolization. MATERIALS AND METHODS A retrospective chart review of patients diagnosed with HBV-associated HCC was performed to identify patients treated solely with chemoembolization. Relevant demographic and clinical data were extracted and recorded. The influence of therapy with nucleoside analogues (lamivudine, adefovir dipivoxil, or entecavir) was determined by estimating the survival function using the Kaplan-Meier product-limit method. RESULTS The inclusion criteria for chemoembolization were met by 81 patients (67 men and 14 women, mean age 60.6 years ± 9.2); 21 (25.9%) of these patients had been treated with nucleoside analogues. The number of chemoembolization treatments was significantly greater in the patients who were treated with nucleoside analogues (3.43 ± 2.32) than in the patients who did not receive nucleoside analogues (1.82 ± 0.95; P = .0022). The 1-year, 3-year, and 5-year survival rates were 89.5%, 66.8%, and 40.5% in the patients treated with nucleoside analogues and 72.6%, 27.5%, and 14.3% in the patients not treated with nucleoside analogues. The survival rate was significantly higher in the patients who received nucleoside analogues (P = .0051). Nucleoside analogue intake was an independent factor that was associated with increased survival (P = .0063). CONCLUSIONS Administration of nucleoside analogues was associated with longer survival in patients with HBV-associated HCC who were treated with transarterial chemoembolization.
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Affiliation(s)
- Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan
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Yamamoto K, Kumada T, Kiriyama S, Tanikawa M, Hisanaga Y, Toyoda H, Kanamori A, Tada T, Arakawa T, Fujimori M, Niinomi T, Ando N. [Ruptured aneurysm of a posterior inferior pancreaticoduodenal artery associated with duodenal stenosis after transcatheter arterial embolization]. Nihon Shokakibyo Gakkai Zasshi 2011; 108:978-986. [PMID: 21646766] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We describe a 72-year-old man admitted to hospital as an emergency case of epigastric abdominal pain. CT scan visualized massive hemorrhage around the pancreatic head. Computed tomographic angiography showed stenosis at the origin of the celiac artery and a 10 mm aneurysm of the posterior inferior pancreaticoduodenal artery (PIPDA). An emergency angiogram revealed a long aneurysm in the PIPDA. The aneurysm had irregular width and was 75 mm in length. A gastroduodenal artery and the PIPDA were supplied from the superior mesenteric artery. A transcatheter arterial embolization (TAE) was performed. We reviewed 45 cases of pancreaticoduodenal aneurysms after 2000 and cases of the pancreaticoduodenal false aneurysms after 1972. As a result, we inferred that this case without pancreatitis or pancreas surgery was a true aneurysm made by the bloodstream changes caused by the celiac artery stenosis.
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Affiliation(s)
- Kenta Yamamoto
- Department of Gastroenterology, Ogaki Municipal Hospital.
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Toyoda H, Kumada T, Kiriyama S, Tanikawa M, Hisanaga Y, Kanamori A, Tada T, Hosokawa T, Arakawa T, Fujimori M. Outcome in partial early virologic responders to combination therapy with peginterferon and ribavirin in patients infected with hepatitis C virus genotype 1b. J Med Virol 2011; 83:101-7. [PMID: 21108345 DOI: 10.1002/jmv.21936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The course and outcome in patients infected with hepatitis C virus (HCV) genotype 1b with partial early virologic response during combination therapy with peginterferon and ribavirin, in whom serum HCV RNA is detectable but has decreased by more than 2 log(10) 12 weeks after the start of the therapy, has not been elucidated sufficiently. The outcome in this group of patients was investigated. Serum HCV RNA levels was measured every 4 weeks in 149 patients with HCV genotype 1b infection who underwent combination therapy for 48 weeks. In patients with partial early virologic response, the time point when serum HCV RNA became undetectable as well as the final virologic response to treatment was determined. Sixty-three patients (42.3%) had partial early virologic response. The time when serum HCV RNA became undetectable ranged from 16 to 48 weeks after the start of therapy. Serum HCV RNA remained detectable in 17 patients. The rates of sustained virologic response decreased with the delay of the time when serum HCV RNA became undetectable; sustained virologic responder was not found in patients in whom HCV RNA was still detectable at 24 weeks after the start of treatment. The degree of decrease in serum HCV RNA levels at 12 weeks corresponded to the rate of sustained virologic response in partial early virologic responders. The outcome of partial early virologic responders varied greatly, and close monitoring of serum HCV RNA is required for predicting the outcome of treatment in these patients.
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Affiliation(s)
- Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
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Toyoda H, Kumada T, Kiriyama S, Tanikawa M, Hisanaga Y, Kanamori A, Tada T, Takagi M, Hiramatsu T, Hosokawa T, Arakawa T, Fujimori M. An early viral response to standard interferon-alpha identifies resistance to combination therapy with peginterferon and ribavirin in patients infected by HCV genotype 1. J Med Virol 2010; 82:1537-44. [PMID: 20648607 DOI: 10.1002/jmv.21858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
As combination therapy with peginterferon (PEG-IFN) and ribavirin has a high morbidity, identifying individuals with hepatitis C virus (HCV) who will not respond to the treatment would be beneficial. The early responses of serum HCV RNA levels to standard interferon (IFN) and PEG-IFN were examined to determine if it was possible to identify resistance to combination therapy. One hundred thirty-one patients infected with HCV genotype 1b were enrolled. Patients were given 6 MU of standard IFN alpha-2b at least 2 weeks before initiating combination therapy. Serum HCV RNA levels were measured before, 24 hr after the administration of standard IFN, and 24 hr after the administration of PEG-IFN (at the start of the combination therapy). The association between reductions in HCV RNA levels at 24 hr after the administration of standard IFN and PEG-IFN and the outcome of combination therapy were analyzed. Reductions in HCV RNA levels were poorer in patients who did not respond than in those with a sustained virologic responses or relapses (P < 0.0001), both 24 hr after the administration of standard IFN and 24 hr after the administration of PEG-IFN. Reductions in HCV RNA levels 24 hr after the administration of standard IFN were an independent factor associated with non-response by multivariate analysis. An early reduction in viral load to a single administration of standard IFN is a useful predictor of non-response in patients with HCV genotype 1, allowing for pretreatment identification of patients who will not benefit from combination therapy.
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Affiliation(s)
- Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu 503-8502 Japan.
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