Publications (12)9.49 Total impact
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Article: [A Case of Recurrent Gastrointestinal Stromal Tumor with Complete Response from Treatment with Reduced Dose of Imatinib Mesylate.]
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ABSTRACT: We report a patient who had a complete response by treatment with 200 mg of imatinib mesylate daily for peritoneal recurrences of gastrointestinal stromal tumor(GIST)of the stomach. On March 2007, a 68-year-old woman underwent distal gastrectomy for GIST of the stomach. On May 2007, peritoneal recurrences were recognized on CT scan, and treatment with 400 mg daily of imatinib mesylate was started. Because grade 2 systemic edema and rash developed one week later, the imatinib mesylate dose had to be reduced to 200 mg daily from July 2007. After reduction of imatinib mesylate, the adverse reactions resolved. Peritoneal dissemination disappeared on CT scan from April 2010, and complete response has been maintained for 18 months.Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(11):1723-1725. -
Article: [Two long-term survival cases of unresectable intrahepatic cholangiocarcinoma treated with hepatic arterial infusion chemotherapy and radiation therapy].
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ABSTRACT: The prognosis for patients with unresectable intrahepatic cholangiocarcinoma(ICC) is extremely poor. Case 1 was a 65- year-old woman who had an ICC of 9 cm in diameter (mass-forming type) in the right lobe with portal trunk invasion. She was treated with hepatic arterial infusion chemotherapy[cisplatin(CDDP)/5-fluorouracil(5-FU)/l-leucovorin(l-LV)] and radiation therapy (total dose, 50 Gy). After 6 months, abdominal computed tomography (CT) revealed that the tumor had regressed. She survived for 7 years without recurrence of the ICC; subsequently, she died of peritoneal cancer. Case 2 was a 59-year-old woman who had an ICC of 8 cm in diameter (mass-forming type) in the left lobe with lymph node metastasis in the hepatoduodenal ligament; the right hepatic artery was involved by the metastatic lymph nodes. She was treated with hepatic arterial infusion chemotherapy(CDDP/5-FU/l-LV) and radiation therapy(total dose, 30 Gy). After 10 months, abdominal CT revealed that the tumor had disappeared, but paraaortic and mediastinal lymph node metastases were detected. She was therefore treated with systemic chemotherapy. Treatment with systematic chemotherapy enabled her to survive for over 5 years with a good performance status.Gan to kagaku ryoho. Cancer & chemotherapy 11/2012; 39(12):2006-8. -
Article: First indicators of relapse in breast cancer: evaluation of the follow-up program at our hospital.
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ABSTRACT: BACKGROUND: Guidelines for breast cancer patient follow-up have not been widely adopted in Japan. To assess our intensive follow-up program, we evaluated first relapse and its indicators in patients with breast cancer. PATIENTS: Of 964 patients, 126 relapsed and 43 died in the median follow-up term of 45 months. Follow-ups were scheduled every 6-12 months for imaging and tumor marker (TM) evaluation. RESULTS: Of 126 relapsed patients, 30 (23.8%) had symptoms of relapse. First indicators of relapse in 96 asymptomatic patients were physical examination in 24 patients (19%); imaging, 57 patients (45.3%); and TMs, 15 patients (11.9%). The most sensitive indicators were physical examination for local relapse, ultrasonography for regional lymph nodes, scintigraphy for bone, computed tomography for lung, and TMs for liver metastasis. During intensive follow-up, 43% of relapsed patients were identified by symptoms or physical examination. These patients had poor prognosis compare to patients identified by imaging or TMs in overall survival and post-relapse survival (p = 0.009 and 0.019, respectively). In all 964 patients, the relapse rates for stage I, IIA, IIB, and III tumors were 7.4, 7.9, 19.9, and 43.5%, respectively. The percentage of first relapse detected by imaging or TMs for stage I, IIA, IIB, and III were 4.7, 5.1, 11.8, and 19.8%, respectively. The cost of our follow-up program for 10 years was approximately 290,000 yen per patient. CONCLUSION: A routine intensive follow-up program involving imaging and evaluation of TMs in all patients has low efficacy and high expenditure.International Journal of Clinical Oncology 03/2012; · 1.41 Impact Factor -
Article: [Two cases of advanced gastric cancer completely responding to S-1 neoadjuvant chemotherapy].
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ABSTRACT: CASE 1: A 67-year-old man had advanced gastric cancer with lymph node metastasis (cT3N1M0, cStage IIIA). S-1 120 mg was administered for 21 days as neoadjuvant chemotherapy (NAC). A month later, total gastrectomy (with splenectomy) was performed. Histopathological examination revealed no cancer cells in the gastric wall and dissected lymph nodes. CASE 2: A 62-year-old man had advanced gastric cancer with lymph node metastasis (cT4aN2M0, cStage IIIB). He was treated with daily oral administration of S-1 120 mg (28-day administration followed by 7-day rest, and then 14- day administration) as NAC. A month later, total gastrectomy was performed. Histopathological examination revealed no cancer cells in the gastric wall and dissected lymph nodes. In both cases, the pathological effect was judged as grade 3. This suggests that NAC with S-1 mono-therapy can have a distinct therapeutic value for advanced gastric cancer.Gan to kagaku ryoho. Cancer & chemotherapy 11/2011; 38(12):2339-41. -
Article: A role for elastography in the diagnosis of breast lesions by measuring the maximum fat lesion ratio (max-FLR) by tissue Doppler imaging.
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ABSTRACT: The role of elastography for breast tumors is still ambiguous. The purpose of this study was to inquire how effectively elastography can be used in the diagnosis of breast tumors. The fat lesion ratio (FLR) of 244 lesions (99 malignant and 145 benign lesions) was calculated using tissue Doppler imaging with elastography. The pathological confirmations were performed by core needle or excisional biopsy. Conventional ultrasonography (US) findings were classified according to the Breast Imaging Reporting and Data System. We tried to set the region of interest (ROI) at the hardest area of the target and measured the maximum FLR (max-FLR) of the target with elastography, whereas the control ROI was placed in the subcutaneous adipose tissue. The diagnostic potential of the max-FLR combined with the US category was evaluated. The mean max-FLR of malignant lesions was significantly greater than that of benign lesions, at 11.0 and 4.4, respectively (p < 0.01). The max-FLR showed a wide overlap range between benign and malignant lesions, but there were no malignant lesions showing a less than 2.0 max-FLR. Ninety-six percent of the lesions interpreted as category 3 were benign, and the negative predictive value measuring the max-FLR was kept at 98% as long as the max-FLR was less than 4.0. Measuring the max-FLR may reduce unnecessary biopsies by 57.5% in the category 3 group. Combining conventional US categories and measuring max-FLR with elastography may be helpful in reducing the number of unnecessary biopsies in category 3 lesions.Breast Cancer 05/2011; 19(1):71-6. · 1.36 Impact Factor -
Article: [Combination chemotherapy of S-1/low-dose CDDP/lentinan for advanced gastric cancer].
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ABSTRACT: Eight patients with inoperable advanced gastric cancer were treated with combination chemotherapy of S-1, low-dose cisplatin(CDDP)and Lentinan. S-1 80 mg/ m² was orally administered for 2 weeks followed by 1-week rest, CDDP 15 mg/ m² and Lentinan 2 mg/body were given intravenously on day 1 and 8. One complete response and four partial responses were observed for an overall response rate of 63%(5 of 8 patients). Only one patient developed over grade 3 toxicity leukocytopenia. Many patients could be maintained by long-term continuous treatment. Since combination chemotherapy of S-1/low-dose CDDP/Lentinan for advanced gastric cancer was very tolerable, it could be used for a long time.Gan to kagaku ryoho. Cancer & chemotherapy 02/2011; 38(2):293-5. -
Article: [Evaluation of liaison-clinical pathway for patients with breast cancer undergoing adjuvant therapy after curative operation--data from questionnaire survey of 56 clinics and 105 patients].
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ABSTRACT: To evaluate the liaison-clinical pathway for patients with breast cancer introduced since May 2008, the data from a questionnaires survey of 56 clinics and 105 patients were reviewed. Half of the clinics specialized in internal medicine. 93% of physicians recognized the utility of the pathway while 24% made the most of the pathway. About 40% of the clinics wished to enlarge both the patient number and treatment materials. Half of the patients were employed. 55% of patients valued the pathway as helpful. And 29% of patients used the patient booklet at all times. 8% of patients replied they had complaints went to clinics. There has been no serious problem in using the pathway. Countermeasures to electronic health records in clinics, and responses to requests from each patient will be needed.Gan to kagaku ryoho. Cancer & chemotherapy 08/2010; 37(8):1477-81. -
Article: [Introduction and management of a liaison-clinical pathway for patients with gastric cancer after curative operation].
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ABSTRACT: A liaison-clinical pathway for patients with stageI to III gastric cancer after curative operation has been introduced and managed in our hospital from July 2009. We made two kinds of liaison-clinical pathway in the presence or absence of postoperative adjuvant therapy. The duration of follow-up was 5 years in proportion to the Guidelines for Diagnosis and Treatment of Carcinoma of the Stomach. We held a briefing session for practicing physicians involved after liaison-clinical pathway making, conducted a questionnaire, and judged whether induction was possible. The liaison-clinical pathway consists of a chart for practicing physicians, leaflets with checklists for the patients, and other documents. We began to use them in July, 2009, and involved patients are 11 to date. Because postoperative treatment planning became clear by using the liaison-clinical pathway, we were able to relieve the anxiety of patients with cancer, and it seemed that it was easy to facilitate to perform cancer cooperation by the practicing physicians. For the introduction and management of this pathway, a thorough explanation to the patients with gastric cancer and good communication is required with the practicing physicians in cooperation with the coordinator.Gan to kagaku ryoho. Cancer & chemotherapy 06/2010; 37(6):1081-5. -
Article: [A case of advanced gastric cancer responding to S-1 chemotherapy for three weeks].
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ABSTRACT: We reported a patient with advanced gastric cancer successfully treated with S-1 chemotherapy for three weeks. The patient was a 67-year-old man who had gastric cancer clinically diagnosed as cT3N1H0P0M0, stage IIIA. His treatment was supposed to be daily oral administration of 120 mg S-1 for 28 days. At 21 days, this treatment was stopped due to severe appetite loss. The histological diagnosis of the resected stomach revealed complete disappearance of cancer cells in the stomach and the regional lymph nodes. Our report suggested that S-1 may have a potent therapeutic effect in neoadjuvant chemotherapy for advanced gastric cancer.Gan to kagaku ryoho. Cancer & chemotherapy 02/2010; 37(2):315-8. -
Article: [A case of the local advanced gastric cancer which became a resection possible in S-1/CDDP/lentinan neoadjuvant chemotherapy].
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ABSTRACT: A 61-year-old man with esophagus invasive advanced gastric cancer and peritoneum dissemination underwent three courses of S-1/CDDP/Lentinan (LNT) combination neoadjuvant chemotherapies (T3N1P1H0, Stage IV) (It is S-1 80 mg/m2,CDDP 15 mg/m2 and LNT 2 mg/body twice/week for two weeks) since down staging was obtained. We performed the surgery of total gastrectomy, splenectomy, D2 lymph node dissection, and Roux-en Y reconstruction in March 2008. With the surgical examination, there was no ascites and peritoneal dissemination. Although there was serious infiltration, we were able to remove it. In the histopathological effect judgment, it was Grade 1b. We changed the therapy to S-1 alone after the same chemotherapy for six months. One year after the operation, he is still alive one year after the surgery.Gan to kagaku ryoho. Cancer & chemotherapy 11/2009; 36(12):2309-11. -
Article: [Introduction of a liaison-clinical pathway for patients with breast cancer undergoing adjuvant therapy after curative operation].
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ABSTRACT: A liaison-clinical pathway for patients with stage I to III breast cancer undergoing adjuvant oral chemoendocrine therapy after curative operation has been introduced in our hospital since May of 2008. The form of this pathway was developed from the former cooperative treatment system between our hospital and local clinics. One hundred thirty four patients and 69 clinics have been using this pathway for 6 months. Our liaison-clinical pathway consists of a chart for the clinic-doctor, a leaflet with a checklist for the patient, and supplements. The aim of this pathway was care for patients with breast cancer in addition to total health care in a local clinic. Our pathway decreased patient anxiety and facilitated clinic-doctor acceptance for the cooperative cancer treatment system. A coordinator is a key person who constructs and manages this pathway. There has been no trouble in managing the pathway for 6 months. The liaison clinical pathway will be useful to reduce patient burden while maintaining treatment quality.Gan to kagaku ryoho. Cancer & chemotherapy 08/2009; 36(7):1115-8. -
Article: Successful hemostasis for Dieulafoy's lesion with a large protruding vessel in the stomach: clipping of the artery under the mucosa (with video).
Gastrointestinal endoscopy 07/2009; 70(4):810-1. · 6.71 Impact Factor
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2009–2012
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Osaka City General Hospital
Ōsaka-shi, Osaka-fu, Japan
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