4 results on '"Kitamura, Hiroaki"'
Search Results
2. Successful adjuvant bi-weekly gemcitabine chemotherapy for pancreatic cancer without impairing patients' quality of life.
- Author
-
Toyama, Yoichi, Yoshida, Seiya, Saito, Ryota, Kitamura, Hiroaki, Okui, Norimitsu, Miyake, Ryo, Ito, Ryusuke, Son, Kyonsu, Usuba, Teruyuki, Nojiri, Takuya, and Yanaga, Katsuhiko
- Subjects
DRUG therapy ,PANCREATIC cancer ,NAUSEA ,DIARRHEA ,DRUGS ,UNIVARIATE analysis - Abstract
Background: Although adjuvant gemcitabine (GEM) chemotherapy for pancreatic cancer is standard, the quality of life (QOL) in those patients is still impaired by the standard regimen of GEM. Therefore, we studied whether mild dose-intensity adjuvant chemotherapy with bi-weekly GEM administration could provide a survival benefit with acceptable QOL to the patients with pancreatic cancer. Methods: After a phase I trial, an adjuvant bi-weekly 1,000 mg/m
2 of GEM chemotherapy was performed in 58 patients with pancreatic cancer for at least 12 courses (Group A). In contrast, 36 patients who declined the adjuvant bi-weekly GEM chemotherapy underwent traditional adjuvant 5FU-based chemotherapy (Group B). Careful periodical follow-ups for side effects of GEM and disease recurrence, and assessment of patients' QOL using the EORTC QOL questionnaire (QLQ-C30) and pancreatic cancer-specific supplemental module (QLQ-PAN26) were performed. Retrospectively, the degree of side effects, patients' QOL, compliance rate, disease-free survival (DFS), and overall survival (OS) in Group A were compared with those in Group B. Results: No severe side effects (higher than Grade 2 according to the common toxicity criteria of ECOG) were observed, except for patients in Group B, who were switched to the standard GEM chemotherapy. Patients' QOL was better in Group A than B (fatigue: 48.9 ± 32.1 versus 68.1 ± 36.3, nausea and vomiting: 26.8 ± 20.4 versus 53.7 ± 32.6, diarrhea: 21.0 ± 22.6 versus 53.9 ± 38.5, difficulty gaining weight: 49.5 ± 34.4 versus 67.7 ± 40.5, P < 0.05). Compliance rates in Groups A and B were 93% and 47%. There was a significant difference in the median DFS between both groups (Group A : B =12.5 : 6.6 months, P < 0.001). The median OS of Group A was prolonged markedly compared with Group B (20.2 versus 11.9 months, P < 0.005). For OS between both groups, univariate analysis revealed no statistical difference in 69-year-old or under females, and T1-2 factors, moreover, multivariate analysis indicated three factors, such as bi-weekly adjuvant GEM chemotherapy, T2 or less, and R0. Conclusions: Adjuvant chemotherapy with bi-weekly GEM offered not only the advantage of survival benefits but the excellent compliance with acceptable QOL for postoperative pancreatic cancer patients [ABSTRACT FROM AUTHOR]- Published
- 2013
- Full Text
- View/download PDF
3. Efficacy of a half-grip technique using a fine tip LigaSure™, Dolphin Tip Sealer/Divider, on liver dissection in swine model.
- Author
-
Toyama Y, Yoshida S, Saito R, Iwase R, Haruki K, Okui N, Shimada J, Kitamura H, Matsumoto M, and Yanaga K
- Subjects
- Anesthesia, General, Animals, Blood Loss, Surgical prevention & control, Digestive System Surgical Procedures methods, Dissection methods, Equipment Design, Hand Strength physiology, Liver blood supply, Swine, Blood Loss, Surgical veterinary, Digestive System Surgical Procedures instrumentation, Dissection instrumentation, Liver surgery
- Abstract
Background: Recently, a lot of energy devices in the surgical field, especially in the liver surgery, have been developed, and a fine tip LigaSure™, Dolphin Tip Sealer/Divider (DT-SD) also has been used frequently to dissect liver parenchyma as well as ultrasonically activated device (USAD). However, the utility of this instrument for liver dissection (LD) is still unknown. Moreover, to reduce bleeding during LD, a half-grip technique (HGT) was contrived. We herein report an experimental study in swine model to evaluate the feasibility and effectiveness of HGT using DT-SD for LD., Methods: The swine model experiment was carried out under general anesthesia by veterinarians. LD was performed repeatedly by DT-SD with the HGT (Group A, n = 6), or the conventional clamp-crush technique (CCT) (Group B, n = 6), and by variable mode USAD (Group C, n = 6). The dissection length and depth (cm) as well as bleeding volume (g) were measured carefully, and the dissection area (cm(2)) and speed (cm(2)/min) were calculated precisely. Histological examinations of the dissection surfaces were also executed. Mann-Whitney's U test was used for Statistical analyses with variance at a significance level of 0.05., Results: Among the three groups, the three averages of dissection lengths were unexpectedly equalized to 8.3 cm. The dissection area (cm(2)) was 9.9 ± 5.1 in Group A, 9.8 ± 4.7 in Group B, and 9.9 ± 4.5 in Group C. The mean blood loss during LD was 10.6 ± 14.8 g in Group A, 41.4 ± 39.2 g in Group B, and 34.3 ± 39.2 g in Group C. For Group A, the bleeding rate was the least, 0.9 ± 1.0 g/cm(2), and the average depth of coagulation was the thickest, 1.47 ± 0.29 mm, among the three groups (p < 0.05). The dissection speed in Group A (1.3 ± 0.3 cm(2)/min) was slower, than that in Group C (p < 0.05)., Conclusions: This report indicates firstly that the HGT using DT-SD bring the least blood loss when compared with CCT or USAD. Although the HGT is feasible and useful for LD, to popularize the HGT, further clinical studies will be needed.
- Published
- 2015
- Full Text
- View/download PDF
4. Possibility of sandwiched liver surgery with molecular targeting drugs, cetuximab and bevacizumab on colon cancer liver metastases: a case report.
- Author
-
Toyama Y, Ushigome T, Watanabe K, Kitamura H, Onda S, Saito R, Yoshida S, Kawahara H, Yanagisawa S, and Yanaga K
- Subjects
- Adenocarcinoma blood, Adenocarcinoma drug therapy, Adult, Angiogenesis Inhibitors administration & dosage, Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal, Humanized administration & dosage, Antineoplastic Agents administration & dosage, Antineoplastic Combined Chemotherapy Protocols administration & dosage, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bevacizumab, Camptothecin administration & dosage, Camptothecin analogs & derivatives, Carcinoembryonic Antigen blood, Cetuximab, Electrocoagulation, Fluorouracil administration & dosage, Fluorouracil therapeutic use, Humans, Leucovorin administration & dosage, Leucovorin therapeutic use, Liver Neoplasms blood, Liver Neoplasms diagnostic imaging, Liver Neoplasms drug therapy, Liver Neoplasms secondary, Male, Microwaves therapeutic use, Organoplatinum Compounds therapeutic use, Quality of Life, Sigmoid Neoplasms blood, Sigmoid Neoplasms drug therapy, Sigmoid Neoplasms surgery, Tomography, X-Ray Computed, Adenocarcinoma secondary, Adenocarcinoma surgery, Angiogenesis Inhibitors therapeutic use, Antibodies, Monoclonal, Humanized therapeutic use, Antineoplastic Agents therapeutic use, ErbB Receptors antagonists & inhibitors, Hepatectomy, Liver Neoplasms surgery, Molecular Targeted Therapy, Neoadjuvant Therapy methods, Sigmoid Neoplasms pathology
- Abstract
A 31-year-old man with sigmoid colon cancer with concomitant simultaneous multiple liver metastases had received FOLFIRI (leucovorin, fluorouracil and irinotecan) and FOLFOX6 (leucovorin, fluorouracil and oxaliplatin) after an ordinary sigmoidectomy. However, his serum carcinoembryonic antigen (CEA) level increased rapidly during the fifteen months after the operation while he was on FOLFOX6. Abdominal computed tomography revealed expanding multiple liver tumors. As the third line chemotherapy, a combination therapy of cetuximab with irinotecan was given, which markedly reduced his levels of serum CEA, and the size and number of liver tumors. He underwent lateral segmentectomy of the liver and microwave coagulation of the liver metastases in the remnant liver. Thereafter, a good quality of life with tumor dormancy was obtained for 6 months. However, his serum CEA started to rise again in the absence of liver tumors. Therefore, FOLFOX6 with bevacizumab was chosen as the fourth line chemotherapy, and the serum CEA was reduced with tumor dormancy. A good quality of life was obtained again at 3 years after the first surgery. This report indicates the effectiveness of sandwiched liver surgery with the molecular targeting drugs cetuximab and bevacizumab on multiple liver metastases of colon cancer, and suggests the possibility of a regimen consisting of bevacizumab following cetuximab.
- Published
- 2012
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.