16 results on '"Tsukasa Oshima"'
Search Results
2. Pseudo‐elevation of conduction system pacing threshold through parallel connection of an intracardiac electrogram recording system
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Takumi Matsubara, Katsuhito Fujiu, Jun Yokota, Issei Komuro, Tsukasa Oshima, Yu Shimizu, Jun Matsuda, Eriko Hasumi, Kent Doi, and Toshiya Kojima
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Bundle of His ,business.industry ,Connection (vector bundle) ,Cardiac Pacing, Artificial ,Recording system ,Electrocardiography ,Electrophysiology ,Heart Conduction System ,Physiology (medical) ,Humans ,Medicine ,Oscilloscope ,Electrical conduction system of the heart ,Electrophysiologic Techniques, Cardiac ,Cardiology and Cardiovascular Medicine ,business ,Intracardiac Electrogram ,Biomedical engineering - Abstract
Parallel connection of an electrophysiology recording system (EP system) to equipment for conduction system pacing (CSP) has been widely used for fine monitoring of intracardiac electrograms and pacing evaluation. We experienced a case showing unexpected pacing threshold exacerbation under specific conditions when the EP system was connected in parallel. We evaluated the underlying mechanism using an ex vivo model. An ex vivo pacing and intracardiac electrogram monitoring model was generated using an oscilloscope, pacing system analyzer (PSA), EP system, and simulated heart. The discrepancy between expected output at the PSA and the actual measured output value at the simulated heart was measured under various conditions and using various combinations of pacing equipment. Parallel connection of the EP system was associated with reduced electrical output from the PSA as recorded at the simulated heart. The unexpected adverse effects were particularly noticeable when using an RMC-5000 EP system with the pacing function on. The trouble is completely resolved by simply turning off the pacing function of the system. There is a possibility that the EP system might increase the pacing threshold in CSP when the PSA and EP system is are deployed in parallel. The issue may provoke pseudo failure of CSP due to the high pacing threshold. When the RMC-5000 is used for conduction system pacing in parallel with a PSA for the pacing test, the pacing function of RMC-5000 should be turned off.
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- 2021
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3. Cardiac macrophages prevent sudden death during heart stress
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Eriko Hasumi, Katsuhito Fujiu, Jun Matsuda, Ichiro Manabe, Junichi Sugita, Takumi Matsubara, Ryozo Nagai, Issei Komuro, Keisuke Asano, Ayumu Ishijima, Naoki Tomii, Tsukasa Oshima, Masatoshi Yamazaki, Ichiro Sakuma, Yujin Maru, Toshiya Kojima, Hiroshi Seno, Yuxiang Liu, Fujimi Kudo, and Yukiteru Nakayama
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Male ,0301 basic medicine ,medicine.medical_specialty ,Science ,General Physics and Astronomy ,Connexin ,Heart failure ,Arrhythmias ,030204 cardiovascular system & hematology ,Amphiregulin ,Sudden death ,Article ,General Biochemistry, Genetics and Molecular Biology ,Sudden cardiac death ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Receptors, Adrenergic, beta ,medicine ,Animals ,Humans ,Myocyte ,Myocytes, Cardiac ,Monocytes and macrophages ,Cells, Cultured ,Mice, Knockout ,Pressure overload ,Multidisciplinary ,business.industry ,Macrophages ,Myocardium ,Gap Junctions ,Arrhythmias, Cardiac ,General Chemistry ,medicine.disease ,Cardiovascular physiology ,Mice, Inbred C57BL ,Death, Sudden, Cardiac ,030104 developmental biology ,Animals, Newborn ,cardiovascular system ,Cardiology ,Female ,business ,HeLa Cells - Abstract
Cardiac arrhythmias are a primary contributor to sudden cardiac death, a major unmet medical need. Because right ventricular (RV) dysfunction increases the risk for sudden cardiac death, we examined responses to RV stress in mice. Among immune cells accumulated in the RV after pressure overload-induced by pulmonary artery banding, interfering with macrophages caused sudden death from severe arrhythmias. We show that cardiac macrophages crucially maintain cardiac impulse conduction by facilitating myocardial intercellular communication through gap junctions. Amphiregulin (AREG) produced by cardiac macrophages is a key mediator that controls connexin 43 phosphorylation and translocation in cardiomyocytes. Deletion of Areg from macrophages led to disorganization of gap junctions and, in turn, lethal arrhythmias during acute stresses, including RV pressure overload and β-adrenergic receptor stimulation. These results suggest that AREG from cardiac resident macrophages is a critical regulator of cardiac impulse conduction and may be a useful therapeutic target for the prevention of sudden death., Cardiac immune cells play various roles in the maintenance of homeostasis and diseases in the heart. Here the authors show that cardiac resident macrophages are a critical regulator of cardiac impulse conduction through amphiregulin production, contributing to the prevention of sudden death.
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- 2021
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4. The New Target of Vulnerable Plaque
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Katsuhito Fujiu and Tsukasa Oshima
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medicine.medical_specialty ,Text mining ,business.industry ,MEDLINE ,medicine ,Humans ,General Medicine ,Cardiology and Cardiovascular Medicine ,business ,medicine.disease_cause ,Intensive care medicine ,Vulnerable plaque ,Plaque, Atherosclerotic - Published
- 2020
5. A long noncoding RNA regulates inflammation resolution by mouse macrophages through fatty acid oxidation activation
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Katsuhito Fujiu, Ichiro Manabe, Junichi Sugita, Masaki Suimye Morioka, Fujimi Kudo, Yukiteru Nakayama, Yusuke Endo, Atsushi Kaneda, Toshinori Nakayama, Tsukasa Oshima, Issei Komuro, Yumiko Oishi, Ryozo Nagai, Ryuzaburo Yuki, Takayuki Isagawa, Takumi Matsubara, and Jun Matsuda
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Lipopolysaccharides ,Male ,Lipopolysaccharide ,Primary Cell Culture ,Inflammation ,Mitochondrial trifunctional protein ,chemistry.chemical_compound ,Mice ,medicine ,Macrophage ,Animals ,Humans ,Beta oxidation ,Skin ,Wound Healing ,Multidisciplinary ,biology ,Macrophages ,Fatty Acids ,Macrophage Activation ,Biological Sciences ,Long non-coding RNA ,Cell biology ,Disease Models, Animal ,chemistry ,Gene Knockdown Techniques ,Mitochondrial Trifunctional Protein, beta Subunit ,biology.protein ,RNA, Long Noncoding ,medicine.symptom ,Oxidation-Reduction ,HADHB ,Homeostasis - Abstract
Proper resolution of inflammation is vital for repair and restoration of homeostasis after tissue damage, and its dysregulation underlies various noncommunicable diseases, such as cardiovascular and metabolic diseases. Macrophages play diverse roles throughout initial inflammation, its resolution, and tissue repair. Differential metabolic reprogramming is reportedly required for induction and support of the various macrophage activation states. Here we show that a long noncoding RNA (lncRNA),lncFAO, contributes to inflammation resolution and tissue repair in mice by promoting fatty acid oxidation (FAO) in macrophages.lncFAOis induced late after lipopolysaccharide (LPS) stimulation of cultured macrophages and in Ly6Chimonocyte-derived macrophages in damaged tissue during the resolution and reparative phases. We found thatlncFAOdirectly interacts with the HADHB subunit of mitochondrial trifunctional protein and activates FAO.lncFAOdeletion impairs resolution of inflammation related to endotoxic shock and delays resolution of inflammation and tissue repair in a skin wound. These results demonstrate that by tuning mitochondrial metabolism,lncFAOacts as a node of immunometabolic control in macrophages during the resolution and repair phases of inflammation.
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- 2020
6. Effect of Sympatholytic Therapy on Circadian Cardiac Autonomic Activity in Non-Diabetic Chronic Kidney Disease
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Masao Daimon, Hisaki Makimoto, Tsukasa Oshima, Christian Meyer, Katsuhito Fujiu, Tina Lin, Kayo Waki, Toshiya Kojima, Ritsuko Nagatomo, Eisuke Amiya, Kenichiro Yamagata, Kohei Shimizu, and Issei Komuro
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Adult ,Male ,medicine.medical_specialty ,Adrenergic beta-Antagonists ,030204 cardiovascular system & hematology ,Autonomic Nervous System ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Heart Rate ,Sympatholytic ,Internal medicine ,medicine ,Humans ,Heart rate variability ,030212 general & internal medicine ,Circadian rhythm ,Renal Insufficiency, Chronic ,Adrenergic alpha-Antagonists ,Aged ,Retrospective Studies ,Balance (ability) ,business.industry ,Significant difference ,Vagus Nerve ,General Medicine ,Middle Aged ,medicine.disease ,Case-Control Studies ,Heart failure ,Multivariate Analysis ,Sympatholytics ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Kidney disease ,Non diabetic - Abstract
Although beta-blockade itself is not a first choice for chronic kidney disease (CKD) patients, alpha-beta-blockers (ABB) do improve their prognoses. This study's aim was to evaluate the effect of beta-selective-blockers (BSB) and ABB on circadian cardiac autonomic activity in CKD patients.The study consisted of 496 non-diabetic individuals who underwent 24-hour Holter monitoring (149 CKD patients and 347 controls without CKD). Using heart rate variability analysis, we evaluated the proportion of NN50 and the high-frequency component (reflecting parasympathetic activity), and low- to high-frequency ratio (reflecting sympathovagal balance). These indices were evaluated by regression analysis incorporating gender, age, related comorbidities, and medications. BSB increased vagal activity only in the day-time and not the night-time in controls. In CKD patients, BSB was significantly related to higher vagal activity throughout the day and with lower sympathovagal balance at night. The night sympathovagal balance of CKD patients taking ABB was significantly higher than that of CKD patients taking BSB, which was the only significant difference between the effects of BSB and ABB.The sympatholytic therapy effect is different depending on CKD presence and whether patients are treated with BSB or ABB. In CKD patients without severe heart failure, BSB could be associated with higher parasympathetic activity and lower sympathovagal balance compared to ABB.
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- 2018
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7. Periprocedural Complications in Patients Undergoing Catheter Ablation of Atrial Fibrillation Without Discontinuation of a Vitamin K Antagonist and Direct Oral Anticoagulants
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Nobuaki Fukuma, Jun Matsuda, Issei Komuro, Hiroshi Matsunaga, Yu Shimizu, Gaku Oguri, Hiroyuki Morita, Eriko Hasumi, Tsukasa Oshima, Katsuhito Fujiu, Takumi Matsubara, and Toshiya Kojima
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Male ,medicine.medical_specialty ,Vitamin K ,medicine.drug_mechanism_of_action ,medicine.drug_class ,medicine.medical_treatment ,Factor Xa Inhibitor ,Hemorrhage ,Catheter ablation ,030204 cardiovascular system & hematology ,Pulmonary vein ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Atrial Fibrillation ,medicine ,Humans ,030212 general & internal medicine ,Aged ,Retrospective Studies ,Ejection fraction ,business.industry ,Anticoagulants ,Atrial fibrillation ,General Medicine ,Middle Aged ,Vitamin K antagonist ,medicine.disease ,Cardiac Tamponade ,Discontinuation ,Stroke ,Heart failure ,Catheter Ablation ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Periprocedural anticoagulation is important in catheter ablation (CA) of atrial fibrillation (AF) and there is increasing evidence that uninterrupted vitamin K antagonist (VKA) therapy is superior to interrupted anticoagulation strategies. Since the emergence of direct oral anticoagulants (DOACs), numerous studies have shown promising results for their use in uninterrupted strategies. However, further studies are needed to further define the efficacy and safety of performing AF ablation with uninterrupted factor XA inhibitors or direct thrombin inhibitors.Methods and Results:We have performed CA of AF without discontinuation of either VKA or DOAC therapy since April 2014. A total of 376 patients with AF underwent CA including pulmonary vein isolation. All of the patients were divided into 2 groups (uninterrupted VKA or uninterrupted DOACs). Anticoagulation with DOACs was associated with fewer complications than uninterrupted VKA therapy (P=0.04). There were significant differences between groups in the rates of congestive heart failure, left ventricular ejection fraction, body weight, and estimated glomerular filtration rate and of the CHADS2, CHA2DS2-VASc and HAS-BLED scores. Therefore, we also analyzed the results using the propensity score-matching method. We found no significant difference in periprocedural complications between uninterrupted VKA or DOACs therapy (P=0.65). Conclusions CA of AF without discontinuation of DOACs is not inferior to CA without discontinuation of a VKA, with regard to ischemic or hemorrhagic complications.
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- 2018
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8. Cell Cycle Arrest-Driven Fibrosis
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Katsuhito Fujiu and Tsukasa Oshima
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Cell cycle checkpoint ,Heart Diseases ,business.industry ,MEDLINE ,Cell Cycle Checkpoints ,General Medicine ,medicine.disease ,Fibrosis ,Cancer research ,Humans ,Medicine ,Cardiology and Cardiovascular Medicine ,business - Published
- 2019
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9. The Impact of Non-Cardiac Drugs on the Cardiac Repolarization Phase
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Katsuhito Fujiu and Tsukasa Oshima
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medicine.medical_specialty ,Cardiac drugs ,business.industry ,Action Potentials ,Arrhythmias, Cardiac ,General Medicine ,030204 cardiovascular system & hematology ,Cardiac repolarization ,Ion Channels ,Electrocardiography ,03 medical and health sciences ,0302 clinical medicine ,Eicosapentaenoic Acid ,Internal medicine ,Phase (matter) ,Fatty Acids, Omega-3 ,medicine ,Cardiology ,Humans ,Risk Adjustment ,030212 general & internal medicine ,Electrophysiologic Techniques, Cardiac ,Cardiology and Cardiovascular Medicine ,business ,Antipsychotic Agents - Published
- 2018
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10. Pulseless Electric Activity with Pre-Excitation
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Tsukasa, Oshima, Katsuhito, Fujiu, Jun, Matsuda, Takumi, Matsubara, Eriko, Hasumi, Oguri, Gaku, Toshiya, Kojima, and Issei, Komuro
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Adult ,Male ,Pre-Excitation Syndromes ,Remission, Spontaneous ,Electric Countershock ,Accessory Atrioventricular Bundle ,Diagnosis, Differential ,Electrocardiography ,Death, Sudden, Cardiac ,Ventricular Fibrillation ,Humans ,Treatment Failure ,Electrophysiologic Techniques, Cardiac ,Brugada Syndrome ,Defibrillators - Abstract
A 41-year-old man developed cardiac arrest. A resting 12-lead electrocardiogram showed a delta wave, suggestive of preexcitation syndrome. An electrophysiological test revealed the existence of inducible atrial fibrillation and a fasciculoventricular accessory pathway (FVAP). After these examinations, idiopathic ventricular arrhythmia was suspected. For evaluating concealed Brugada syndrome, pilsicainide was administered, which diminished the delta wave and no Brugada-like electrocardiogram was observed. Ventricular double extra-stimulation from the RV apex easily induced VF, which could not be defibrillated by an external defibrillator, and later stopped spontaneously. These results established the diagnosis of FVAP and idiopathic VF, and not pre-excited atrial fibrillation or Brugada syndrome.
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- 2019
11. Noncompaction of the Ventricular Myocardium and Polycystic Kidney Disease: A Case Report
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Masayasu Ikutomi, Toshihiro Amaki, Tsunashi Kozaki, Fumitaka Nakamura, Tsukasa Oshima, Hiroki Shinohara, Keiko Fukino, and Junpei Ishiwata
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medicine.medical_specialty ,030232 urology & nephrology ,Autosomal dominant polycystic kidney disease ,Cardiomyopathy ,Disease ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,03 medical and health sciences ,Aortic aneurysm ,0302 clinical medicine ,Aneurysm ,Internal medicine ,Polycystic kidney disease ,medicine ,Humans ,cardiovascular diseases ,Aged ,Isolated Noncompaction of the Ventricular Myocardium ,urogenital system ,business.industry ,Polycystic Kidney, Autosomal Dominant ,medicine.disease ,Ventricular aneurysm ,female genital diseases and pregnancy complications ,Left Ventricular Aneurysm ,Nephrology ,cardiovascular system ,Cardiology ,Female ,business - Abstract
Autosomal dominant polycystic kidney disease (ADPKD) is one of the most common hereditary disorders, characterized by the formation of multiple cysts in the kidneys and other organs, as well as noncystic manifestations such as cerebral aneurysm. The most common cardiovascular disorders associated with ADPKD include valvular abnormalities and aortic aneurysm. An association between ADPKD and impaired left ventricular function has occasionally been reported. We describe a 74-year-old woman with ADPKD and exertional dyspnea. Impaired left ventricular function resulting from noncompaction of the ventricular myocardium (NVM) and secondary left ventricular aneurysm were diagnosed. Cardiac sarcoidosis and ischemic heart disease were ruled out. Myocardial ischemia resulting from NVM was the presumptive cause of the ventricular aneurysm. To our knowledge, this is the first report of concurrent isolated NVM and left ventricular aneurysm in a patient with ADPKD. ADPKD and various cardiomyopathies, including NVM, are all reported to involve mutations of sarcomere genes, suggesting a possible link between the conditions.
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- 2016
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12. Interleukin-13 receptor α2 is a novel marker and potential therapeutic target for human melanoma
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Hirofumi Hamada, Rina Takayama, Katarzyna A. Podyma-Inoue, Katsuhito Fujiu, Akiko Kunita, Kazuki Takahashi, Teppei Morikawa, Hiroaki Uchida, Tetsuro Watabe, Hayato Okamoto, Shumpei Ishikawa, Masashi Fukayama, Moegi Sato, Yasuhiro Yoshimatsu, Tsukasa Oshima, Daisuke Komura, Taishi Tomizawa, Takeshi Fukuhara, and Mao Komai
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0301 basic medicine ,Angiogenesis ,lcsh:Medicine ,Article ,03 medical and health sciences ,Mice ,0302 clinical medicine ,Amphiregulin ,Epidermal growth factor ,Pancreatic cancer ,Glioma ,Cell Line, Tumor ,Biomarkers, Tumor ,Medicine ,Animals ,Humans ,lcsh:Science ,neoplasms ,Melanoma ,Cell Proliferation ,Mice, Knockout ,Multidisciplinary ,business.industry ,lcsh:R ,Cancer ,Interleukin-13 receptor ,medicine.disease ,Neoplasm Proteins ,Gene Expression Regulation, Neoplastic ,030104 developmental biology ,Cancer research ,Interleukin-13 Receptor alpha2 Subunit ,lcsh:Q ,business ,030217 neurology & neurosurgery - Abstract
Malignant melanoma is one of the untreatable cancers in which conventional therapeutic strategies, including chemotherapy, are hardly effective. Therefore, identification of novel therapeutic targets involved in melanoma progression is urgently needed for developing effective therapeutic methods. Overexpression of interleukin-13 receptor α2 (IL13Rα2) is observed in several cancer types including glioma and pancreatic cancer. Although IL13Rα2 is implicated in the progression of various types of cancer, its expression and roles in the malignant melanoma have not yet been elucidated. In the present study, we showed that IL13Rα2 was expressed in approximately 7.5% melanoma patients. While IL13Rα2 expression in human melanoma cells decreased their proliferation in vitro, it promoted in vivo tumour growth and angiogenesis in melanoma xenograft mouse model. We also found that the expression of amphiregulin, a member of the epidermal growth factor (EGF) family, was correlated with IL13Rα2 expression in cultured melanoma cells, xenograft tumour tissues and melanoma clinical samples. Furthermore, expression of amphiregulin promoted tumour growth, implicating causal relationship between the expression of IL13Rα2 and amphiregulin. These results suggest that IL13Rα2 enhances tumorigenicity by inducing angiogenesis in malignant melanoma, and serves as a potential therapeutic target of malignant melanoma.
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- 2018
13. Coronary Artery Perforation During Percutaneous Coronary Intervention in a Patient with a Prior Modified Bentall Procedure
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Haruo Yamauchi, Jiro Ando, Masafumi Watanabe, Tsukasa Oshima, Masae Uehara, Issei Komuro, Masaki Tsuji, Arihiro Kiyosue, Satoshi Kodera, and Minoru Ono
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medicine.medical_specialty ,medicine.medical_treatment ,Bentall procedure ,030204 cardiovascular system & hematology ,Anastomosis ,Balloon ,03 medical and health sciences ,Aortic aneurysm ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Postoperative Complications ,medicine.artery ,medicine ,Humans ,Intraoperative Complications ,Coronary Artery Perforation ,Aorta ,Aged ,business.industry ,Coronary Stenosis ,Percutaneous coronary intervention ,General Medicine ,medicine.disease ,Coronary Vessels ,Hemostasis, Surgical ,Surgery ,Aortic Aneurysm ,surgical procedures, operative ,Treatment Outcome ,030228 respiratory system ,Right coronary artery ,Aortic Valve ,Conventional PCI ,Female ,Vascular Grafting ,Cardiology and Cardiovascular Medicine ,business - Abstract
The Bentall procedure is a surgical technique for an ascending aortic or aortic aneurysm in combination with valve disease. A well-known uncommon complication of after the Bentall procedure is coronary artery stenosis related to coronary anastomosis of an interposed graft. We report on a 73-year-old woman who presented with heart failure secondary to graft stenosis of the right coronary artery 6 months after undergoing a modified Bentall procedure. Percutaneous coronary intervention (PCI) was performed and type II coronary artery perforation occurred during PCI of the right coronary artery. We used a perfusion balloon and achieved hemostasis successfully. We report a case of coronary artery perforation that was treated with perfusion balloon during PCI in a patient with a prior modified Bentall procedure. In addition, we present a case series of PCI for ostial coronary stenosis after the Bentall procedure.
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- 2018
14. Coronary Artery Aneurysm Caused by a Stent Fracture
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Tsukasa, Oshima, Shun, Minatsuki, Masahiro, Myojo, Satoshi, Kodera, Kan, Nawata, Jiro, Ando, Hiroshi, Akazawa, Masafumi, Watanabe, Minoru, Ono, and Issei, Komuro
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Male ,Reoperation ,Electrocardiography ,Percutaneous Coronary Intervention ,Computed Tomography Angiography ,Coronary Aneurysm ,Humans ,ST Elevation Myocardial Infarction ,Drug-Eluting Stents ,Coronary Angiography ,Coronary Vessels ,Aged ,Prosthesis Failure - Abstract
Coronary stent fracture (SF) is rare as a complication of percutaneous coronary intervention (PCI), and its adverse events are increasingly being recognized with the development in devices of PCI. The major adverse events caused by SFs are in-stent restenosis due to neointimal overgrowth caused by poor drug delivery.
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- 2018
15. Acute Myocardial Infarction Caused by Thrombotic Microangiopathy Complicated With Myelodysplastic Syndrome
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Fumitaka Nakamura, Jumpei Ishiwata, Keiko Fukino, Toshihiro Amaki, Masayasu Ikutomi, Tsukasa Oshima, and Hiroki Shinohara
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Male ,Acute coronary syndrome ,medicine.medical_specialty ,Thrombotic microangiopathy ,Myocardial Infarction ,Thrombotic thrombocytopenic purpura ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,immune system diseases ,hemic and lymphatic diseases ,Internal medicine ,medicine ,Humans ,Myocardial infarction ,neoplasms ,Aged ,Thrombotic Microangiopathies ,business.industry ,General Medicine ,Microangiopathic hemolytic anemia ,medicine.disease ,Thrombosis ,Pancytopenia ,female genital diseases and pregnancy complications ,Multisystem disease ,Myelodysplastic Syndromes ,030220 oncology & carcinogenesis ,Cardiology and Cardiovascular Medicine ,business - Abstract
Thrombotic microangiopathy (TMA) is a rare but lethal multisystem disease characterized by peripheral thrombocytopenia, microangiopathic hemolytic anemia, fever, and various stages of renal and neurological dysfunctions.(1,2)) The causes of TMA are mainly thrombotic thrombocytopenic purpura (TTP) or hemolytic-uremic syndrome (HUS), and cases of TMA related to myelodysplastic syndrome (MDS) are quite rare. Herein, we report a case of acute myocardial infarction (AMI) caused by TMA which is strongly suspected to have a relationship to MDS, and discuss the treatment of our patient who needed antiplatelet or anticoagulant therapy after AMI, while on the other hand, had pancytopenia and a bleeding event due to MDS.
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- 2016
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16. Phase II study of concurrent thoracic radiotherapy in combination with weekly paclitaxel plus carboplatin in locally advanced non-small cell lung cancer: LOGIK0401
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Masafumi Takeshita, Yoshiyuki Shioyama, Taishi Harada, Mutsuo Kuba, Yoichi Nakanishi, Masayuki Kawasaki, Koji Inoue, Takemasa Matsumoto, Tomotoshi Imanaga, Koichi Takayama, Tsukasa Oshima, and Shoji Tokunaga
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Adult ,Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Paclitaxel ,Phases of clinical research ,Vinblastine ,Toxicology ,Vinorelbine ,Disease-Free Survival ,Carboplatin ,chemistry.chemical_compound ,Carcinoma, Non-Small-Cell Lung ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Pharmacology (medical) ,Lung cancer ,Survival rate ,Aged ,Neoplasm Staging ,Pharmacology ,business.industry ,Standard treatment ,Consolidation Chemotherapy ,Chemoradiotherapy ,Middle Aged ,medicine.disease ,Survival Rate ,Treatment Outcome ,chemistry ,Carcinoma, Squamous Cell ,Female ,business ,medicine.drug - Abstract
Concurrent chemoradiotherapy for regionally advanced stage III non-small cell lung cancer is the standard treatment method. However, the clinical implications of consolidation chemotherapy following chemoradiation have been unclear. Therefore, we conducted a phase II study of concurrent weekly carboplatin plus paclitaxel treatment in combination with radiotherapy followed by vinorelbine monotherapy. The primary endpoint was the 1-year survival rate.Chemonaive PS 0-1 patients with stage IIIA/B NSCLC were enrolled. During the concurrent chemoradiation phase, patients were treated with weekly paclitaxel 40 mg/m(2) plus carboplatin AUC 2. The primary tumor and involved nodes received 60 Gy in 2-Gy fractions over 6 weeks. During the consolidation phase, vinorelbine 25 mg/m(2) on days 1 and 8 was repeated for three cycles.A total of 40 eligible patients (72.5 % male; median age, 63 years; range 29-74 years) were analyzed for efficacy. Squamous cell carcinoma was the most common histology (47.5 %), and more patients had clinical stage IIIB (55 %) cancer. The average radiation dose was 56.5 Gy, and the average number of carboplatin plus paclitaxel cycles was 4.93. Seventeen patients proceeded to the consolidation chemotherapy phase, and 14 completed three cycles of vinorelbine monotherapy. The objective response rate was 75.0 %, including 1 patient who achieved a complete response. Progression-free survival and overall survival (OS) were 46 weeks [95 % confidence interval (CI) 31-64 weeks] and 110 weeks (95 % CI 90-184 weeks), respectively. The OS rate at 1 and 2 years was 85.0 % (95 % CI 69.6-93.0 %) and 53.9 % (95 % CI 37.1-68.0 %), respectively.Concurrent chemoradiation with weekly carboplatin and paclitaxel followed by vinorelbine consolidation is effective for stage III non-small cell lung cancer and shows a generally mild toxicity profile.
- Published
- 2013
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