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1. Local tumor progression following lipiodol-based targeted chemoembolization of hepatocellular carcinoma: a retrospective comparison of miriplatin and epirubicin

Author

Iwazawa J, Ohue S, Hashimoto N, and Mitani T

Subjects
Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Jin Iwazawa1, Shoichi Ohue2, Naoko Hashimoto1, Takashi Mitani11Department of Radiology, Nissay Hospital, Nishiku, Osaka, 2Department of Radiology, Komatsu Hospital, Neyagawa, JapanPurpose: We aimed to compare the local control rates between miriplatin and epirubicin in lipiodol-based transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Patients and methods: Patients who underwent targeted TACE using miriplatin (47 patients, 66 lesions) or epirubicin (64 patients, 79 lesions) as the sole therapy were enrolled. The local control rates were compared using the Kaplan–Meier estimator with the log-rank test. The patient and tumor parameters were subjected to univariate and multivariate analyses using the Cox proportional hazards model.Results: The overall local recurrence rates were 39.3% and 31.6% for the miriplatin and epirubicin groups, respectively. The local control rate was significantly higher in the epirubicin group than in the miriplatin group (P < 0.001). The local control rates at 6 months and 1 year were 70.7% and 44.8% for the miriplatin group and 83.4% and 69.2% for the epirubicin group, respectively. Multivariate analysis showed that the serum a-fetoprotein level ≥20 ng/mL (hazard ratio 2.96; P < 0.001), miriplatin usage (hazard ratio 2.53; P = 0.002), and Child-Pugh class B (hazard ratio 1.89; P = 0.042) affected local progression.Conclusion: Lipiodol-based targeted TACE using miriplatin had inferior local control rates as compared to epirubicin in patients with HCC.Keywords: chemoembolization, miriplatin, epirubicin, liver, neoplasms

Published
2012

8. Effect of transarterial chemoembolization with miriplatin plus epirubicin on local control of hepatocellular carcinoma: a retrospective comparison with miriplatin monotherapy

Author

Hashimoto N, Iwazawa J, Ohue S, and Mitani T

Subjects
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, lcsh:RC254-282
Abstract

Naoko Hashimoto,1 Jin Iwazawa,1 Shoichi Ohue,2 Takashi Mitani11Department of Radiology, Nissay Hospital, Nishiku, Osaka, Japan; 2Department of Radiology, Komatsu Hospital, Neyagawa, JapanObjective: We aimed to evaluate local tumor control after transarterial chemoembolization (TACE) for hepatocellular carcinoma using miriplatin and low-dose epirubicin combination therapy.Methods: We retrospectively analyzed the records of patients who underwent TACE using miriplatin plus low-dose epirubicin (30 patients, 61 nodules, August 2011–March 2012) and control patients who underwent TACE using miriplatin alone (36 patients, 70 nodules, June 2010–July 2011). The local control rate was compared between the two groups using the Kaplan–Meier estimator and the log-rank test. Factors affecting local tumor recurrence were analyzed using multivariate logistic regression analysis. Treatment-related toxicity was evaluated using the Common Terminology Criteria for Adverse Events.Results: The local control rates at 6 months and 1 year were 87% and 65% for the miriplatin plus low-dose epirubicin group, and 61% and 43% for the miriplatin group, respectively. Local tumor control rates were significantly better in the miriplatin plus low-dose epirubicin group than in the miriplatin group (P = 0.038). Multivariate analysis showed that the addition of epirubicin was an independent factor associated with better local tumor control (hazard ratio 0.2, P = 0.001). Overall incidence rates for adverse events were not significantly different between the two groups.Conclusion: Additional usage of low-dose epirubicin for TACE using miriplatin improved local tumor control of hepatocellular carcinoma with adverse effects comparable to those observed with TACE using miriplatin alone.Keywords: combination therapy, local recurrence, liver, embolization, comparative study

Published
2013

9. Segmental transarterial chemoembolization with lipiodol mixed with anticancer drugs for nonresectable hepatocellular carcinoma: follow-up CT and therapeutic results

Author

Tetsuya Yoshioka, Hiroshi Sakaguchi, Noritada Nagano, Shinji Hirohashi, Hajime Ohishi, Qiyong Guo, Kiyoshi Nishimine, Tadasu Tsujii, Naoki Matsuo, Ohue S, Hiroshi Fukui, Nishimura Y, and Hideo Uchida

Subjects
Adult, Male, Cancer Research, medicine.medical_specialty, Carcinoma, Hepatocellular, Mitomycin, medicine.medical_treatment, Pharmacology toxicology, Antineoplastic Agents, Toxicology, Cumulative survival, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Pharmacology (medical), Embolization, Chemoembolization, Therapeutic, Aged, Aged, 80 and over, Pharmacology, Chemotherapy, business.industry, Liver Neoplasms, Iodized Oil, Middle Aged, medicine.disease, Survival Rate, Injections, Intra-Arterial, Oncology, Doxorubicin, Homogeneous, Hepatocellular carcinoma, Lipiodol, alpha-Fetoproteins, Radiology, Cisplatin, Neoplasm Recurrence, Local, Tomography, X-Ray Computed, business, Follow-Up Studies, medicine.drug
Abstract

We developed segmental Lp-TAE, which is transcatheter hepatic sub-subsegmental, subsegmental, or segmental chemoembolization using Lipiodol introduced into the tumor-bearing hepatic sub-subsegment, subsegment, or segment as the target area. A total of 98 patients with nonresectable hepatocellular carcinoma (HCC) undergoing segmental Lp-TAE (Seg-Lp-TAE) were studied, and the relationship between the CT pattern observed after Seg-Lp-TAE (Seg-Lp-CT) and the therapeutic results obtained in those patients was evaluated. Seg-Lp-CT was classified into four types (type I, homogeneous; type II, defective; type III, inhomogeneous; and type IV, only slight accumulation, if any) according to the Lipiodol accumulation pattern observed after Seg-Lp-TAE. The cumulative nonrecurrence rates of type I were higher than those of types II–IV. The cumulative survival rates of type Ia, in which Lp accumulation is also seen around the main tumor, were the highest (93.8% at 1 year, 85.9% at 2 years, 85.9% at 3 years, and 57.3% at 4 years). The cumulative survival rates achieved with Seg-Lp-TAE were 89.2% at 1 year, 69.4% at 2 years, 58.9% at 3 years, 44.0% at 4 years, and 30.2% at 5 years, which were higher than those achieved with conventional Lp-TAE. Seg-Lp-TAE is very useful in the treatment of HCC limited to one sub-subsegment, subsegment, or segment, and it is important to choose subsubsegmental, subsegmental, subsegmental, or segmental Lp-TAE on the basis of the size and site of the tumor as well as the type and the number of feeding arteries.

Published
1994

11. Transcatheter hepatic segmental arterial embolization using lipiodol mixed with an anticancer drug and gelfoam particles for hepatocellular carcinoma

Author

Yoshioka T, Naoki Matsuo, Munehiro Maeda, Nishimura Y, Hajime Ohishi, Ohue S, Hideo Uchida, and Kiyoshi Nishimine

Subjects
Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Necrosis, Normal tissue, Hepatic segment, Hepatic Artery, medicine, Humans, Radiology, Nuclear Medicine and imaging, business.industry, Arterial Embolization, Liver Neoplasms, Iodized Oil, Middle Aged, medicine.disease, Embolization, Therapeutic, Gelatin Sponge, Absorbable, Anticancer drug, Doxorubicin, Hepatocellular carcinoma, Lipiodol, Radiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Transcatheter hepatic segmental arterial chemoembolization using Lipiodol mixed with an anticancer drug followed by the injection of Gelfoam particles, introduced into the tumor-bearing hepatic segment as the target area (segemental Lipiodol-TAE), was carried out in 54 patients with hepatocellular carcinoma (HCC), 7 of whom were later resected. In 5 of the resected 7 cases, complete necrosis was histologically verified. No death due to HCC was encountered in 47 nonoperated cases, and better therapeutic results were obtained with segmental Lipiodol-TAE. It was concluded that this technique does not adversely affect normal tissues, and it does reinforece the effect of TAE.

Published
1990

12. CELL BIOLOGY AND SIGNALING

Author

Agarwal, M., primary, Nitta, R., additional, Dovat, S., additional, Li, G., additional, Arita, H., additional, Narita, Y., additional, Fukushima, S., additional, Tateishi, K., additional, Matsushita, Y., additional, Yoshida, A., additional, Miyakita, Y., additional, Ohno, M., additional, Collins, V. P., additional, Kawahara, N., additional, Shibui, S., additional, Ichimura, K., additional, Kahn, S. A., additional, Gholamin, S., additional, Junier, M.-P., additional, Chneiweiss, H., additional, Weissman, I., additional, Mitra, S., additional, Cheshier, S., additional, Avril, T., additional, Hamlat, A., additional, Le Reste, P.-J., additional, Mosser, J., additional, Quillien, V., additional, Carrato, C., additional, Munoz-Marmol, A., additional, Serrano, L., additional, Pijuan, L., additional, Hostalot, C., additional, Villa, S. l., additional, Ariza, A., additional, Etxaniz, O., additional, Balana, C., additional, Benveniste, E. T., additional, Zheng, Y., additional, McFarland, B., additional, Drygin, D., additional, Bellis, S., additional, Bredel, M., additional, Lotsch, D., additional, Engelmaier, C., additional, Allerstorfer, S., additional, Grusch, M., additional, Pichler, J., additional, Weis, S., additional, Hainfellner, J., additional, Marosi, C., additional, Spiegl-Kreinecker, S., additional, Berger, W., additional, Bronisz, A., additional, Nowicki, M. O., additional, Wang, Y., additional, Ansari, K., additional, Chiocca, E. A., additional, Godlewski, J., additional, Brown, K., additional, Kwatra, M., additional, Bui, T., additional, Zhu, S., additional, Kozono, D., additional, Li, J., additional, Kushwaha, D., additional, Carter, B., additional, Chen, C., additional, Schulte, J., additional, Srikanth, M., additional, Das, S., additional, Zhang, J., additional, Lathia, J., additional, Yin, L., additional, Rich, J., additional, Olson, E., additional, Kessler, J., additional, Chenn, A., additional, Cherry, A., additional, Haas, B., additional, Lin, Y. H., additional, Ong, S.-E., additional, Stella, N., additional, Cifarelli, C. P., additional, Griffin, R. J., additional, Cong, D., additional, Zhu, W., additional, Shi, Y., additional, Clark, P., additional, Kuo, J., additional, Hu, S., additional, Sun, D., additional, Bookland, M., additional, Darbinian, N., additional, Dey, A., additional, Robitaille, M., additional, Remke, M., additional, Faury, D., additional, Maier, C., additional, Malhotra, A., additional, Jabado, N., additional, Taylor, M., additional, Angers, S., additional, Kenney, A., additional, Ren, X., additional, Zhou, H., additional, Schur, M., additional, Baweja, A., additional, Singh, M., additional, Erdreich-Epstein, A., additional, Fu, J., additional, Koul, D., additional, Yao, J., additional, Saito, N., additional, Zheng, S., additional, Verhaak, R., additional, Lu, Z., additional, Yung, W. K. A., additional, Gomez, G., additional, Volinia, S., additional, Croce, C., additional, Brennan, C., additional, Cavenee, W., additional, Furnari, F., additional, Lopez, S. G., additional, Qu, D., additional, Petritsch, C., additional, Gonzalez-Huarriz, M., additional, Aldave, G., additional, Ravi, D., additional, Rubio, A., additional, Diez-Valle, R., additional, Marigil, M., additional, Jauregi, P., additional, Vera, B., additional, Rocha, A. A. d. l., additional, Tejada-Solis, S., additional, Alonso, M. M., additional, Gopal, U., additional, Isaacs, J., additional, Gruber-Olipitz, M., additional, Dabral, S., additional, Ramkissoon, S., additional, Kung, A., additional, Pak, E., additional, Chung, J., additional, Theisen, M., additional, Sun, Y., additional, Monrose, V., additional, Franchetti, Y., additional, Shulman, D., additional, Redjal, N., additional, Tabak, B., additional, Beroukhim, R., additional, Zhao, J., additional, Buonamici, S., additional, Ligon, K., additional, Kelleher, J., additional, Segal, R., additional, Canton, D., additional, Diaz, P., additional, Scott, J., additional, Hara, K., additional, Kageji, T., additional, Mizobuchi, Y., additional, Kitazato, K., additional, Okazaki, T., additional, Fujihara, T., additional, Nakajima, K., additional, Mure, H., additional, Kuwayama, K., additional, Hara, T., additional, Nagahiro, S., additional, Hill, L., additional, Botfield, H., additional, Hossain-Ibrahim, K., additional, Logan, A., additional, Cruickshank, G., additional, Liu, Y., additional, Gilbert, M., additional, Kyprianou, N., additional, Rangnekar, V., additional, Horbinski, C., additional, Hu, Y., additional, Vo, C., additional, Li, Z., additional, Ke, C., additional, Ru, N., additional, Hess, K. R., additional, Linskey, M. E., additional, Zhou, Y.-a. H., additional, Hu, F., additional, Vinnakota, K., additional, Wolf, S., additional, Kettenmann, H., additional, Jackson, P. J., additional, Larson, J. D., additional, Beckmann, D. A., additional, Moriarity, B. S., additional, Largaespada, D. A., additional, Jalali, S., additional, Agnihotri, S., additional, Singh, S., additional, Burrell, K., additional, Croul, S., additional, Zadeh, G., additional, Kang, S.-H., additional, Yu, M. O., additional, Song, N.-H., additional, Park, K.-J., additional, Chi, S.-G., additional, Chung, Y.-G., additional, Kim, S. K., additional, Kim, J. W., additional, Kim, J. Y., additional, Kim, J. E., additional, Choi, S. H., additional, Kim, T. M., additional, Lee, S.-H., additional, Kim, S.-K., additional, Park, S.-H., additional, Kim, I. H., additional, Park, C.-K., additional, Jung, H.-W., additional, Koldobskiy, M., additional, Ahmed, I., additional, Ho, G., additional, Snowman, A., additional, Raabe, E., additional, Eberhart, C., additional, Snyder, S., additional, Gugel, I., additional, Bornemann, A., additional, Pantazis, G., additional, Mack, S., additional, Shih, D., additional, Sabha, N., additional, Tatagiba, M., additional, Krischek, B., additional, Schulte, A., additional, Liffers, K., additional, Kathagen, A., additional, Riethdorf, S., additional, Westphal, M., additional, Lamszus, K., additional, Lee, J. S., additional, Xiao, J., additional, Patel, P., additional, Schade, J., additional, Wang, J., additional, Deneen, B., additional, Song, H.-R., additional, Leiss, L., additional, Gjerde, C., additional, Saed, H., additional, Rahman, A., additional, Lellahi, M., additional, Enger, P. O., additional, Leung, R., additional, Gil, O., additional, Lei, L., additional, Canoll, P., additional, Sun, S., additional, Lee, D., additional, Ho, A. S. W., additional, Pu, J. K. S., additional, Zhang, X.-q., additional, Lee, N. P., additional, Dat, P. J. R., additional, Leung, G. K. K., additional, Loetsch, D., additional, Steiner, E., additional, Holzmann, K., additional, Pirker, C., additional, Hlavaty, J., additional, Petznek, H., additional, Hegedus, B., additional, Garay, T., additional, Mohr, T., additional, Sommergruber, W., additional, Lukiw, W. J., additional, Jones, B. M., additional, Zhao, Y., additional, Bhattacharjee, S., additional, Culicchia, F., additional, Magnus, N., additional, Garnier, D., additional, Meehan, B., additional, McGraw, S., additional, Hashemi, M., additional, Lee, T. H., additional, Milsom, C., additional, Gerges, N., additional, Trasler, J., additional, Pawlinski, R., additional, Mackman, N., additional, Rak, J., additional, Maherally, Z., additional, Thorne, A., additional, An, Q., additional, Barbu, E., additional, Fillmore, H., additional, Pilkington, G., additional, Tan, S. L., additional, Tan, S., additional, Choi, S., additional, Potts, C., additional, Ford, D. A., additional, Nahle, Z., additional, Kenney, A. M., additional, Matlaf, L., additional, Khan, S., additional, Zider, A., additional, Singer, E., additional, Cobbs, C., additional, Soroceanu, L., additional, McFarland, B. C., additional, Hong, S. W., additional, Rajbhandari, R., additional, Twitty, G. B., additional, Gray, G. K., additional, Yu, H., additional, Benveniste, E. N., additional, Nozell, S. E., additional, Minata, M., additional, Kim, S., additional, Mao, P., additional, Kaushal, J., additional, Nakano, I., additional, Mizowaki, T., additional, Sasayama, T., additional, Tanaka, K., additional, Mizukawa, K., additional, Nishihara, M., additional, Nakamizo, S., additional, Tanaka, H., additional, Kohta, M., additional, Hosoda, K., additional, Kohmura, E., additional, Moeckel, S., additional, Meyer, K., additional, Leukel, P., additional, Bogdahn, U., additional, Riehmenschneider, M. J., additional, Bosserhoff, A. K., additional, Spang, R., additional, Hau, P., additional, Mukasa, A., additional, Watanabe, A., additional, Ogiwara, H., additional, Aburatani, H., additional, Mukherjee, J., additional, Obha, S., additional, See, W., additional, Pieper, R., additional, Otsuka, R., additional, Kung, D., additional, Sinha, T., additional, Meares, G., additional, Nozell, S., additional, Ott, M., additional, Litzenburger, U., additional, Rauschenbach, K., additional, Bunse, L., additional, Pusch, S., additional, Ochs, K., additional, Sahm, F., additional, Opitz, C., additional, von Deimling, A., additional, Wick, W., additional, Platten, M., additional, Peruzzi, P., additional, Read, R., additional, Fenton, T., additional, Wykosky, J., additional, Vandenberg, S., additional, Babic, I., additional, Iwanami, A., additional, Yang, H., additional, Mischel, P., additional, Thomas, J., additional, Ronellenfitsch, M. W., additional, Thiepold, A. L., additional, Harter, P. N., additional, Mittelbronn, M., additional, Steinbach, J. P., additional, Rybakova, Y., additional, Kalen, A., additional, Sarsour, E., additional, Goswami, P., additional, Silber, J., additional, Harinath, G., additional, Aldaz, B., additional, Fabius, A. W. M., additional, Turcan, S., additional, Chan, T. A., additional, Huse, J. T., additional, Sonabend, A. M., additional, Bansal, M., additional, Guarnieri, P., additional, Soderquist, C., additional, Yun, J., additional, Kennedy, B., additional, Sisti, J., additional, Bruce, S., additional, Bruce, R., additional, Shakya, R., additional, Ludwig, T., additional, Rosenfeld, S., additional, Sims, P. A., additional, Bruce, J. N., additional, Califano, A., additional, Stockhausen, M.-T., additional, Kristoffersen, K., additional, Olsen, L. S., additional, Poulsen, H. S., additional, Stringer, B., additional, Day, B., additional, Barry, G., additional, Piper, M., additional, Jamieson, P., additional, Ensbey, K., additional, Bruce, Z., additional, Richards, L., additional, Boyd, A., additional, Sufit, A., additional, Burleson, T., additional, Le, J. P., additional, Keating, A. K., additional, Sundstrom, T., additional, Varughese, J. K., additional, Harter, P., additional, Prestegarden, L., additional, Petersen, K., additional, Azuaje, F., additional, Tepper, C., additional, Ingham, E., additional, Even, L., additional, Johnson, S., additional, Skaftnesmo, K. O., additional, Lund-Johansen, M., additional, Bjerkvig, R., additional, Ferrara, K., additional, Thorsen, F., additional, Takeshima, H., additional, Yamashita, S., additional, Yokogami, K., additional, Mizuguchi, S., additional, Nakamura, H., additional, Kuratsu, J., additional, Fukushima, T., additional, Morishita, K., additional, Tang, Y., additional, Vaka, D., additional, Chen, S., additional, Ponnuswami, A., additional, Cho, Y.-J., additional, Monje, M., additional, Nakamura, T., additional, Cahill, D., additional, Tiemann, K., additional, Hedman, H., additional, Niclou, S. P., additional, Timmer, M., additional, Tjiong, R., additional, Rohn, G., additional, Goldbrunner, R., additional, Stavrinou, P., additional, Perrech, M., additional, Tokita, M., additional, Mikheev, S., additional, Sellers, D., additional, Mikheev, A., additional, Kosai, Y., additional, Rostomily, R., additional, Tritschler, I., additional, Seystahl, K., additional, Schroeder, J. J., additional, Weller, M., additional, Wade, A., additional, Robinson, A. E., additional, Phillips, J. J., additional, Gong, Y., additional, Ma, Y., additional, Cheng, Z., additional, Thompson, R., additional, Fan, Q.-W., additional, Cheng, C., additional, Gustafson, W., additional, Charron, E., additional, Zipper, P., additional, Wong, R., additional, Chen, J., additional, Lau, J., additional, Knobbe-Thosen, C., additional, Jura, N., additional, Reifenberger, G., additional, Shokat, K., additional, Weiss, W., additional, Wu, S., additional, Hu, J., additional, Taylor, T., additional, Villa, G. R., additional, Mischel, P. S., additional, Gonias, S. L., additional, Yamashita, D., additional, Kondo, T., additional, Takahashi, H., additional, Inoue, A., additional, Kohno, S., additional, Harada, H., additional, Ohue, S., additional, Ohnishi, T., additional, Li, P., additional, Ng, J., additional, Yuelling, L., additional, Du, F., additional, Curran, T., additional, Yang, Z.-j., additional, Zhu, D., additional, Castellino, R. C., additional, Van Meir, E. G., additional, Begum, G., additional, Wang, Q., additional, Yang, S.-S., additional, Lin, S.-H., additional, and Kahle, K., additional

Published
2013
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13. SURGICAL THERAPIES

Author

Aghi, M., primary, Vogelbaum, M. A., additional, Jolly, D. J., additional, Robbins, J. M., additional, Ostertag, D., additional, Ibanez, C. E., additional, Gruber, H. E., additional, Kasahara, N., additional, Bankiewicz, K., additional, Cloughesy, T. F., additional, Chang, S. M., additional, Butowski, N., additional, Kesari, S., additional, Chen, C., additional, Mikkelsen, T., additional, Landolfi, J., additional, Chiocca, E. A., additional, Elder, J. B., additional, Foltz, G., additional, Pertschuk, D., additional, Anaizi, A., additional, Taylor, C., additional, Kosty, J., additional, Zimmer, L., additional, Theodosopoulos, P., additional, Gantwerker, E., additional, Pensak, M., additional, Grewal, S., additional, Arakawa, Y., additional, Kang, Y., additional, Murata, D., additional, Fujimoto, K.-i., additional, Miyamoto, S., additional, Blagia, M., additional, Paulis, M., additional, Orunesu, G., additional, Serra, S., additional, Akers, J., additional, Ramakrishnan, V., additional, Kim, R., additional, Skog, J., additional, Nakano, I., additional, Pingle, S., additional, Kalinina, J., additional, Breakfield, X., additional, Hochberg, F., additional, Van Meir, E., additional, Carter, B., additional, Czech, T., additional, Nicholson, J., additional, Frappaz, D., additional, Kortmann, R.-D., additional, Alapetite, C., additional, Garre, M.-L., additional, Ricardi, U., additional, Saran, F., additional, Calaminus, G., additional, Hamer, P. D. W., additional, Hendriks, E., additional, Mandonnet, E., additional, Barkhof, F., additional, Zwinderman, K., additional, Duffau, H., additional, Esquenazi, Y., additional, Johnson, J., additional, Tandon, N., additional, Friedman, E., additional, Lin, Y., additional, Zhu, J.-J., additional, Fujimaki, T., additional, Kobayashi, M., additional, Wakiya, K., additional, Ohta, M., additional, Adachi, J., additional, Fukuoka, K., additional, Suzuki, T., additional, Yanagisawa, T., additional, Matsutani, M., additional, Mishima, K., additional, Sasaki, J., additional, Nishikawa, R., additional, Hoffermann, M., additional, Bruckmann, L., additional, Ali, K. M., additional, Asslaber, M., additional, Payer, F., additional, von Campe, G., additional, Jungk, C., additional, Beigel, B., additional, Abb, V., additional, Herold-Mende, C., additional, Unterberg, A., additional, Kim, J. H., additional, Cho, Y. H., additional, Kim, C. J., additional, Mardor, Y., additional, Nissim, O., additional, Grober, Y., additional, Guez, D., additional, Last, D., additional, Daniels, D., additional, Hoffmann, C., additional, Nass, D., additional, Talianski, A., additional, Spiegelmann, R., additional, Cohen, Z., additional, Zach, L., additional, Marupudi, N., additional, Mittal, S., additional, Michaud, K., additional, Cantin, L., additional, Cottin, S., additional, Dandurand, C., additional, Mohammadi, A., additional, Hawasli, A., additional, Rodriguez, A., additional, Schroeder, J., additional, Laxton, A., additional, Elson, P., additional, Tatter, S., additional, Barnett, G., additional, Leuthardt, E., additional, Moriuchi, S., additional, Dehara, M., additional, Fukunaga, T., additional, Hagiwara, Y., additional, Soda, H., additional, Imakita, M., additional, Nitta, M., additional, Maruyama, T., additional, Iseki, H., additional, Ikuta, S., additional, Tamura, M., additional, Chernov, M., additional, Okamoto, S., additional, Okada, Y., additional, Muragaki, Y., additional, Ohue, S., additional, Kohno, S., additional, Inoue, A., additional, Yamashita, D., additional, Kumon, Y., additional, Ohnishi, T., additional, Oppido, P., additional, Villani, V., additional, Vidiri, A., additional, Pace, A., additional, Pompili, A., additional, Carapella, C., additional, Orringer, D., additional, Lau, D., additional, Niknafs, Y., additional, Piquer, J., additional, Llacer, J. L., additional, Rovira, V., additional, Riesgo, P., additional, Cremades, A., additional, Rotta, R., additional, Levine, N., additional, Prabhu, S., additional, Sawaya, R., additional, Weinberg, J., additional, Rao, G., additional, Tummala, S., additional, Tilley, C., additional, Rovin, R., additional, Kassam, A., additional, Schwartz, C., additional, Romagna, A., additional, Thon, N., additional, Tonn, J.-C., additional, Schwarz, S. B., additional, Kreth, F.-W., additional, Sonoda, Y., additional, Shibahara, I., additional, Saito, R., additional, Kanamori, M., additional, Kumabe, T., additional, Tominaga, T., additional, Steele, C., additional, Lawrence, J., additional, Winn, R., additional, Rachinger, W., additional, Simon, M., additional, Dutzmann, S., additional, Feigl, G., additional, Kremenevskaya, N., additional, Whelan, H., additional, Kelly, M., additional, Jogel, S., additional, Kaufmann, B., additional, Foy, A., additional, Lew, S., additional, Quirk, B., additional, Yong, R. L., additional, Wu, T., additional, Mihatov, N., additional, Shen, M. J., additional, Brown, M. A., additional, Zaghloul, K. A., additional, Park, G. E., additional, and Park, J. K., additional

Published
2013
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14. PATHOLOGY

Author

Adachi, J.-i., primary, Totake, K., additional, Shirahata, M., additional, Mishima, K., additional, Suzuki, T., additional, Yanagisawa, T., additional, Fukuoka, K., additional, Nishikawa, R., additional, Arimappamagan, A., additional, Manoj, N., additional, Mahadevan, A., additional, Bhat, D., additional, Arvinda, H., additional, Indiradevi, B., additional, Somanna, S., additional, Chandramouli, B., additional, Petterson, S. A., additional, Hermansen, S. K., additional, Dahlrot, R. H., additional, Hansen, S., additional, Kristensen, B. W., additional, Carvalho, F., additional, Jalali, S., additional, Singh, S., additional, Croul, S., additional, Aldape, K., additional, Zadeh, G., additional, Choi, J., additional, Park, S.-H., additional, Khang, S. K., additional, Suh, Y.-L., additional, Kim, S. P., additional, Lee, Y. S., additional, Kim, S. H., additional, Coberly, S., additional, Samayoa, K., additional, Liu, Y., additional, Kiaei, P., additional, Hill, J., additional, Patterson, S., additional, Damore, M., additional, Dahiya, S., additional, Emnett, R., additional, Phillips, J., additional, Haydon, D., additional, Leonard, J., additional, Perry, A., additional, Gutmann, D., additional, Epari, S., additional, Ahmed, S., additional, Gurav, M., additional, Raikar, S., additional, Moiyadi, A., additional, Shetty, P., additional, Gupta, T., additional, Jalali, R., additional, Georges, J., additional, Zehri, A., additional, Carlson, E., additional, Martirosyan, N., additional, Elhadi, A., additional, Nichols, J., additional, Ighaffari, L., additional, Eschbacher, J., additional, Feuerstein, B., additional, Anderson, T., additional, Preul, M., additional, Jensen, K., additional, Nakaji, P., additional, Girardi, H., additional, Monville, F., additional, Carpentier, S., additional, Giry, M., additional, Voss, J., additional, Jenkins, R., additional, Boisselier, B., additional, Frayssinet, V., additional, Poggionovo, C., additional, Catteau, A., additional, Mokhtari, K., additional, Sanson, M., additional, Peyro-Saint-Paul, H., additional, Giannini, C., additional, Hide, T., additional, Nakamura, H., additional, Makino, K., additional, Yano, S., additional, Anai, S., additional, Shinojima, N., additional, Kuroda, J.-i., additional, Takezaki, T., additional, Kuratsu, J.-i., additional, Higuchi, F., additional, Matsuda, H., additional, Iwata, K., additional, Ueki, K., additional, Kim, P., additional, Kong, J., additional, Cooper, L., additional, Wang, F., additional, Gao, J., additional, Teodoro, G., additional, Scarpace, L., additional, Mikkelsen, T., additional, Schniederjan, M., additional, Moreno, C., additional, Saltz, J., additional, Brat, D., additional, Cho, U., additional, Hong, Y.-K., additional, Lober, R., additional, Lu, L., additional, Gephart, M. H., additional, Fisher, P., additional, Miyazaki, M., additional, Nishihara, H., additional, Itoh, T., additional, Kato, M., additional, Fujimoto, S., additional, Kimura, T., additional, Tanino, M., additional, Tanaka, S., additional, Nguyen, N., additional, Moes, G., additional, Villano, J. L., additional, Kanno, H., additional, Kato, Y., additional, Ohnishi, T., additional, Harada, H., additional, Ohue, S., additional, Kouno, S., additional, Inoue, A., additional, Yamashita, D., additional, Okamoto, S., additional, Nitta, M., additional, Muragaki, Y., additional, Maruyama, T., additional, Sawada, T., additional, Komori, T., additional, Saito, T., additional, Okada, Y., additional, Omay, S. B., additional, Gunel, J. M., additional, Clark, V. E., additional, Li, J., additional, Omay, E. Z. E., additional, Serin, A., additional, Kolb, L. E., additional, Hebert, R. M., additional, Bilguvar, K., additional, Ozduman, K., additional, Pamir, M. N., additional, Kilic, T., additional, Baehring, J., additional, Piepmeier, J. M., additional, Brennan, C. W., additional, Huse, J., additional, Gutin, P. H., additional, Yasuno, K., additional, Vortmeyer, A., additional, Gunel, M., additional, Pugh, S., additional, Rogers, C. L., additional, Brachman, D., additional, McMillan, W., additional, Jenrette, J., additional, Barani, I., additional, Shrieve, D., additional, Sloan, A., additional, Mehta, M., additional, Prabowo, A., additional, Iyer, A., additional, Veersema, T., additional, Anink, J., additional, Meeteren, A. S.-v., additional, Spliet, W., additional, van Rijen, P., additional, Ferrier, T., additional, Capper, D., additional, Thom, M., additional, Aronica, E., additional, Chharchhodawala, T., additional, Sable, M., additional, Sharma, M. C., additional, Sarkar, C., additional, Suri, V., additional, Singh, M., additional, Santosh, V., additional, Thota, B., additional, Srividya, M., additional, Sravani, K., additional, Shwetha, S., additional, Arivazhagan, A., additional, Thennarasu, K., additional, Hegde, A., additional, Kondaiah, P., additional, Somasundaram, K., additional, Rao, M., additional, Kumar, V. P., additional, Shastry, A., additional, Narayan, R., additional, Naz, S., additional, Venneti, S., additional, Garimella, M., additional, Sullivan, L., additional, Martinez, D., additional, Heguy, A., additional, Santi, M., additional, Thompson, C., additional, Judkins, A., additional, Voronovich, Z., additional, Chen, L., additional, Clark, K., additional, Walsh, M., additional, Mannas, J., additional, Horbinski, C., additional, Wiestler, B., additional, Holland-Letz, T., additional, Korshunov, A., additional, von Deimling, A., additional, Pfister, S. M., additional, Platten, M., additional, Weller, M., additional, Wick, W., additional, Zieman, G., additional, Dardis, C., additional, and Ashby, L., additional

Published
2013
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19. Evaluation by ultrasonography of arterial embolization therapy for hepatocellular carcinoma.

Author

Ohishi, Hajime, Uchida, Hideo, Kurosaki, Yoshihisa, Yoshimura, Hitoshi, Ohue, Shoichi, Katsuragi, Masami, Matsuo, Naoki, Hosogi, Yasuhiro, Ohishi, H, Uchida, H, Kurosaki, Y, Yoshimura, H, Ohue, S, Katsuragi, M, Matsuo, N, and Hosogi, Y

Abstract

Twelve cases of hepatocellular carcinoma treated by arterial embolization were followed with ultrasonography. Shrinkage of the tumor after the therapy was confirmed in all cases. Echo level reduction in the tumor occurred in 10 cases. High-level reverberation echoes with acoustic shadows emerged in seven cases; however, these echoes were not detected in any cases 3 weeks after the procedure. Echoes were considered either as the consequence of gas produced in the tumor or air trapped in the embolic substance. Ultrasonography, therefore, is an effective technique for the posttherapeutic evaluation of arterial embolization therapy for hepatocellular carcinoma. [ABSTRACT FROM AUTHOR]

Published
1983
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20. Hepatocellular carcinoma detected by iodized oil. Use of anticancer agents

Author

Hajime Ohishi, Jun Ueda, Matsuo N, Hosogi Y, Hideo Uchida, Katsuragi M, H Yoshimura, and Ohue S

Subjects
Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Iodized oil, Antineoplastic Agents, Ethiodized Oil, Hepatic Artery, Humans, Medicine, Radiology, Nuclear Medicine and imaging, Aged, medicine.diagnostic_test, Tumor size, business.industry, Arterial Embolization, Liver Neoplasms, Angiography, Middle Aged, medicine.disease, Combined Modality Therapy, Embolization, Therapeutic, Gelatin Sponge, Absorbable, Anticancer drug, medicine.anatomical_structure, Injections, Intra-Arterial, Hepatocellular carcinoma, Female, Hepatic tumor, Radiology, Tomography, X-Ray Computed, business, Artery
Abstract

Transcatheter arterial embolization (TAE) was performed in 97 patients with hepatocellular carcinoma. Ethiodol (iodized oil) containing an anticancer drug was infused via the hepatic artery followed by Gelfoam particles. The Ethiodol emulsion was selectively retained in the tumor vessels and also remained in the small daughter nodules that could not be detected by angiography or computed tomography (CT) prior to TAE. Ethiodol remained in the tumor for more than 1 year. Following TAE, main tumors and small daughter nodules appeared as areas of markedly high density on CT. In most patients there was a reduction in the tumor size following TAE, and serum alpha-fetoprotein levels were reduced in all patients whose initial levels had exceeded 400 ng/ml. This method is considered to be effective not only for treatment of hepatic tumor but also useful for evaluation of post-TAE changes in the tumor and diagnosis of small daughter nodules, due to the long-term accumulation of Ethiodol in tumor vessels.

Published
1985

21. Evaluation of arterial embolization therapy for hepatocellular carcinoma by computed tomography

Author

Naoki Matsuo, Hideaki Otsuji, Yoshioka T, Yasuhiro Hosogi, Yoshihisa Kurosaki, Hajime Ohishi, Hideo Uchida, Masami Katsuragi, and Ohue S

Subjects
Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Necrosis, medicine.medical_treatment, Bioengineering, Text mining, Carcinoma, medicine, Humans, Radiology, Nuclear Medicine and imaging, Embolization, Stage (cooking), Aged, business.industry, Arterial Embolization, Liver Neoplasms, Middle Aged, medicine.disease, Embolization, Therapeutic, Hepatocellular carcinoma, Female, Tomography, Radiology, medicine.symptom, Tomography, X-Ray Computed, business, Follow-Up Studies
Abstract

Changes in tumor area and the attenuation value determined from computed tomography (CT) slice section of the tumor at its maximum size were investigated in 18 patients with hepatocellular carcinoma who were studied by CT after arterial embolization therapy. The tumor area was reduced in all cases after embolization therapy. Greater than 50% reduction of the tumor area occurred during the follow-up period in 13 cases (87%). In cases evaluated by follow-up CT, the relative attenuation value of tumor to nontumor regions decreased during the initial stage after embolization therapy, but showed a tendency towards greater elevation than in the initial stage, despite tumor reduction. This change in the attenuation value was considered to reflect necrosis and shrinkage of the tumor after embolization therapy. The absence of such changes in nontumor regions supports the use of arterial embolization therapy as an effective, conservative treatment for hepatocellular carcinoma. Follow-up examination by CT of hepatocellular carcinoma after embolization therapy contributes to the post-therapeutic evaluation of tumors and to the determination of the appropriate time for reembolization therapy.

Published
1983

22. The changes in serum AFP levels after transhepatic arterial embolization (TAE) in hepatocellular carcinoma

Author

Naoki Matsuo, Hideaki Otsuji, Fusayuki Nakagawa, Hajime Ohishi, Jun Ueda, Yasuhiro Hosogi, Tetsuya Yoshioka, Toshihiko Murata, Ohue S, Masami Katsuragi, Hideo Uchida, Yutaka Kinoshita, M. Tamura, and Tadasu Tsujii

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Hepatocellular carcinoma, Arterial Embolization, medicine, medicine.disease, business, Gastroenterology
Abstract

肝細胞癌に対する肝動脈塞栓術(TAE)後の血清AFP値の推移を,TAE前のAFP値が400ng/ml以上の群(高値群)と未満の群(低値群)に分け,それぞれの群につきTAE後の期間(8週以内の初期変動と6カ月以上の長期変動),塞栓回数(1回施行群と2回以上施行群),塞栓物質の差異(GS:ゼラチンスポンジ使用群とLp:リピオドール併用群)について比較検討し,各種画像との関連についても検討した.高値群と低値群では,高値群のAFP下降がすみやかである以外は,両群にほとんど差はなかった.TAE 2回以上施行群の方が1回施行群よりもAFPが低値を維持する例が多く,くり返すTAEが延命に結びつく結果が得られた.塞栓物質としてGSにLpを併用した群は,GS単独群よりもTAE後のAFP下降がすみやかであり,さらにAFPの再上昇する割合も低く,Lp併用が効果的であることが判明した.US, CTならびに血管造影とAFP値の推移との間には相関性が認められる例が多かった.

Published
1985

23. Clinicopathological studies of 11 hepatocellular carcinomas smaller than 5cm in diameter with hepatic resection

Author

Atuo Hotta, Hajime Ohishi, Hideaki Yoshida, Tuneo Shiratori, Hideo Uchida, Masao Kikukawa, Ohue S, Naoki Matsuo, Takashi Yoshikawa, Yasutoshi Fukai, and Takahisa Sakurai

Subjects
medicine.medical_specialty, business.industry, Hepatic resection, Internal medicine, Gastroenterology, Medicine, Surgery, business
Abstract

腫瘍径が5cm以下の肝癌11切除例の臨床的検討結果を報告するとともに, これら症例の腫瘍の浸潤の状態, 腫瘍の組織型, 非腫瘍部の病変を教室でこれまでに経験した腫瘍径5cm以上の肝癌と腫瘍径別に病理組織学的に対比検討した. 腫瘍径別の組織像は径3～5cm, 3cm以下では全例に被膜形成があるも門脈内腫瘍塞栓は腫瘍径と関係なく75～93%に認めた. 被膜への浸潤の程度も腫瘍径と関係なく50%以上の症例に認めた. 腫瘍部の組織型は3cm以下では高分化型のものが多く, 肝硬変の合併は5cm以上の60%に比べて, 5cm以下では88～100%と高率にみられた. 腫瘍径が3cm以下の肝癌でも早期癌といえる所見ではなく, さらに小型の肝癌を発見し検討する必要がある.

Published
1984

24. Anomaly of the inferior vena cava observed by CT

Author

Kazuo Hara, Jun Ueda, Yasuo Kobayashi, Hideo Uchida, and Ohue S

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Vena Cava, Inferior, Computed tomography, Inferior vena cava, medicine.anatomical_structure, medicine.vein, Azygos Vein, cardiovascular system, medicine, Humans, Retroperitoneal space, Radiology, Nuclear Medicine and imaging, Radiology, Tomography, Tomography, X-Ray Computed, business, Azygos continuation, Retrospective Studies
Abstract

Computed tomography (CT) is a good modality for diagnosing diseases of the retroperitoneal space and capable of showing the abnormality of inferior vena cava (IVC) without using invasive technique. To determine the incidence of the anomaly of IVC, the computed tomograms were investigated retrospectively. The incidence were 0.69% in left side IVC, 1.03% in double IVC and 0.08% in azygos continuation.

Published
1983

25. Diagnostic values and therapeutic effects of transcatheter arterial embolization using Lipiodol (Lp-TAE) for hepatocellular carcinoma. Comparison of medical images and resected specimens

Author

Tetsuya Yoshioka, Naoki Matsuo, Yasutoshi Fukai, Takeshi Matsumori, Hideaki Yoshida, Hideo Uchida, Tadasu Tsujii, Yasuhiro Hosogi, Ohue S, and Hajime Ohishi

Subjects
medicine.medical_specialty, Hepatology, business.industry, Arterial Embolization, Hepatocellular carcinoma, Therapeutic effect, Lipiodol, medicine, Radiology, medicine.disease, business, medicine.drug
Abstract

抗癌剤混入Lipiodolを併用した肝動脈塞栓術(Lp-TAE)後に肝切除を施行した12例の肝細胞癌を対象にして,手術前のLp-TAE後のCT (Lp-CT)像,切除肝連続切片の軟線X線像ならびに組織像を各々対比し,Lipiodolの主腫瘍と娘結節への集積状態とTAE効果を検討した.Lp-CT像は主腫瘍ならびに娘結節へのLipiodolの集積状態を反映し,小肝細胞癌と娘結節の診断に有効であった.主腫瘍の完全壊死を示した4例と95%以上壊死の認められた5例には,腫瘍内にLipiodolが密に集積し,これらのTAE成績は従来のgelatin sponge単独TAE群のそれを上回っていた.また,娘結節へのLipiodolの集積とTAE効果が組織学的に確認でき,Lp-TAEが娘結節の診断と治療に有効であることが実証できた.Lp-TAEならびに引き続き施行するLp-CTは,肝細胞癌に対する必須の術前検査法として評価されるべきである.

Published
1986

26. Computed tomography detection of small daughter nodules in hepatocellular carcinoma after iodized oil infusion into the hepatic artery

Author

Hajime Ohishi, Yasutoshi Fukai, Yoshioka T, Hideaki Yoshida, Naoki Matsuo, Hideo Uchida, Ohue S, and Hitoshi Yoshimura

Subjects
medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, media_common.quotation_subject, Bioengineering, Neoplasms, Multiple Primary, Hepatic arterial infusion, medicine, Humans, Radiology, Nuclear Medicine and imaging, Embolization, media_common, Daughter, business.industry, Liver Neoplasms, Angiography, Iodized Oil, Nodule (medicine), medicine.disease, Embolization, Therapeutic, Primary tumor, Hepatocellular carcinoma, Lipiodol, Radiology, medicine.symptom, Tomography, X-Ray Computed, business, Nuclear medicine, Perfusion, medicine.drug
Abstract

The detectability of small daughter nodules of hepatocellular carcinoma by computed tomography after hepatic arterial infusion of Lipiodol (iodized oil) and by infusion hepatic angiography was studied in 102 cases. The Lipiodol was selectively accumulated by the tumor. Tumors and small daughter nodules appeared as high-density areas on computed tomography. In 24 cases daughter nodules were identified only by computed tomography. In 50 cases computed tomography demonstrated superior ability to detect the daughter nodules when compared with infusion hepatic angiography. In 21 cases the daughter nodules were detected for the first time in areas other than the main site of the primary tumor. Lipiodol-computed tomography is very effective in the diagnosis of daughter nodules of hepatocellular carcinoma.

Published
1988

30. Stenting Procedure for Sinus Stenosis with Transverse-Sigmoid Dural Arteriovenous Fistulas: A Case Report

Author

Fukumoto, S., Ueda, T., Igase, K., Ohue, S., Kumon, Y., and Ohnishi, T.

Abstract

We reported the dural AVF case with sinus stenosis, that was entirely treated through the stenting procedure. 61-year-old male had been realizing the attack which causes bilateral visual problem. He would have suffered from the intracranial hypertension caused by dural AVF in the right transverse sinus and left transverse sinus stenosis. We performed TVE and sinus stenting, then used the antiplatelet and the anticoagulant. However, six months later, he suffered from SAH due to recurrence of dural AVF. We performed TVE again, denser packing than usual. Two years later, he have no symptom, angiographically, there was no recurrence of dural AVF and patency of stented sinus.We think denser embolizations should have performed in case of dural AVF with sinus stenting.

Published
1995
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31. Transcatheter arterial embolization using iodized oil (lipiodol) mixed with an anticancer drug for the treatment of hepatocellular carcinoma

Author

Hitoshi Yoshimura, Ohue S, Yoshioka T, Akira Takaya, Hiroshi Sakaguchi, Tadasu Tsujii, Hideo Uchida, Hajime Ohishi, and Tsutomu Matsui

Subjects
Cancer Research, medicine.medical_specialty, Carcinoma, Hepatocellular, Iodized oil, Mitomycin, Toxicology, Gastroenterology, Mitomycins, Hepatic Artery, Internal medicine, Catheterization, Peripheral, medicine, Humans, Pharmacology (medical), Histological examination, Pharmacology, business.industry, Arterial Embolization, Therapeutic effect, Liver Neoplasms, Iodized Oil, medicine.disease, Anticancer drug, Embolization, Therapeutic, medicine.anatomical_structure, Oncology, Doxorubicin, Hepatocellular carcinoma, Lipiodol, Radiology, business, Artery, medicine.drug
Abstract

The therapeutic results of Lp-TAE (transcatheter arterial embolization with Gelfoam particles preceded by the infusion of a mixture of lipiodol and an anticancer drug via the proper hepatic artery) were evaluated in hepatocellular carcinomas (523 non-resected and 24 resected cases). Excellent therapeutic effects were confirmed not only for the main tumor but also for the the daughter nodules by a histological examination of the liver tissues resected after Lp-TAE. The cumulative 1-year, 2-year and 3-year survival rates in the 523 non-resected cases were 60.4%, 42.9% and 28.0% respectively. These survival rates were all higher than those achieved by Gelfoam TAE. The above results suggest the usefulness of Lp-TAE in the treatment of hepatocellular carcinoma.

Published
1989

32. Evaluation by ultrasonography of arterial embolization therapy for hepatocellular carcinoma

Author

Hideo Uchida, Yoshihisa Kurosaki, Hitoshi Yoshimura, Hajime Ohishi, Yasuhiro Hosogi, Masami Katsuragi, Ohue S, and Naoki Matsuo

Subjects
Male, medicine.medical_specialty, Carcinoma, Hepatocellular, business.industry, Arterial Embolization, Ultrasound, Liver Neoplasms, Middle Aged, medicine.disease, Acoustic shadow, Embolization, Therapeutic, Hepatocellular carcinoma, Ultra sonography, medicine, Humans, Radiology, Nuclear Medicine and imaging, Female, Radiology, Ultrasonography, Cardiology and Cardiovascular Medicine, business, Aged
Abstract

Twelve cases of hepatocellular carcinoma treated by arterial embolization were followed with ultrasonography. Shrinkage of the tumor after the therapy was confirmed in all cases. Echo level reduction in the tumor occurred in 10 cases. High-level reverberation echoes with acoustic shadows emerged in seven cases; however, these echoes were not detected in any cases 3 weeks after the procedure. Echoes were considered either as the consequence of gas produced in the tumor or air trapped in the embolic substance. Ultrasonography, therefore, is an effective technique for the posttherapeutic evaluation of arterial embolization therapy for hepatocellular carcinoma.

Published
1983

35. Visualization of gastric varices using angiographic C-arm CT during retrograde transvenous sclerotherapy

Author

Iwazawa Jin, Ohue Shoichi, Abe Hisashi, and Mitani Takashi

Subjects
C-arm CT, gastric varix, sclerotherapy, venography, Medical physics. Medical radiology. Nuclear medicine, R895-920
Abstract

During retrograde transvenous sclerotherapy for gastric varices, sufficient opacification of the target varices on venography is essential for successful treatment. However, venography sometimes cannot identify target varices due to overlapping adjacent collateral vessels or leakage of contrast medium to other outflow veins. We report how C-arm CT images acquired using a flat-panel detector angiography system helped to identify target varices and predict the distribution of a sclerosant, which resulted in safer sclerotherapy and increased operator confidence.

Published
2010

38. Correction: Neuroradiological, genetic and clinical characteristics of histone H3 K27-mutant diffuse midline gliomas in the Kansai Molecular Diagnosis Network for CNS Tumors (Kansai Network): multicenter retrospective cohort.

Author

Hayashi N, Fukai J, Nakatogawa H, Kawaji H, Yoshioka E, Kodama Y, Nakajo K, Uda T, Naito K, Kijima N, Okita Y, Kagawa N, Takahashi Y, Hashimoto N, Arita H, Takano K, Sakamoto D, Iida T, Arakawa Y, Kawauchi T, Sonoda Y, Mitobe Y, Ishibashi K, Matsuda M, Achiha T, Tomita T, Nonaka M, Hara K, Takebe N, Tsuzuki T, Nakajima Y, Ohue S, Nakajima N, Watanabe A, Inoue A, Umegaki M, Kanematsu D, Katsuma A, Sumida M, Shofuda T, Mano M, Kinoshita M, Mori K, Nakao N, and Kanemura Y

Published
2024
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39. Neuroradiological, genetic and clinical characteristics of histone H3 K27-mutant diffuse midline gliomas in the Kansai Molecular Diagnosis Network for CNS Tumors (Kansai Network): multicenter retrospective cohort.

Author

Hayashi N, Fukai J, Nakatogawa H, Kawaji H, Yoshioka E, Kodama Y, Nakajo K, Uda T, Naito K, Kijima N, Okita Y, Kagawa N, Takahashi Y, Hashimoto N, Arita H, Takano K, Sakamoto D, Iida T, Arakawa Y, Kawauchi T, Sonoda Y, Mitobe Y, Ishibashi K, Matsuda M, Achiha T, Tomita T, Nonaka M, Hara K, Takebe N, Tsuzuki T, Nakajima Y, Ohue S, Nakajima N, Watanabe A, Inoue A, Umegaki M, Kanematsu D, Katsuma A, Sumida M, Shofuda T, Mano M, Kinoshita M, Mori K, Nakao N, and Kanemura Y

Subjects
Humans, Female, Male, Middle Aged, Adult, Aged, Adolescent, Retrospective Studies, Young Adult, Child, Child, Preschool, Brain Neoplasms genetics, Brain Neoplasms pathology, Brain Neoplasms therapy, Cohort Studies, Central Nervous System Neoplasms genetics, Central Nervous System Neoplasms therapy, Central Nervous System Neoplasms pathology, Central Nervous System Neoplasms diagnosis, Glioma genetics, Glioma pathology, Glioma therapy, Histones genetics, Mutation
Abstract

This study aims to elucidate the clinical and molecular characteristics, treatment outcomes and prognostic factors of patients with histone H3 K27-mutant diffuse midline glioma. We retrospectively analyzed 93 patients with diffuse midline glioma (47 thalamus, 24 brainstem, 12 spinal cord and 10 other midline locations) treated at 24 affiliated hospitals in the Kansai Molecular Diagnosis Network for CNS Tumors. Considering the term "midline" areas, which had been confused in previous reports, we classified four midline locations based on previous reports and anatomical findings. Clinical and molecular characteristics of the study cohort included: age 4-78 years, female sex (41%), lower-grade histology (56%), preoperative Karnofsky performance status (KPS) scores ≥ 80 (49%), resection (36%), adjuvant radiation plus chemotherapy (83%), temozolomide therapy (76%), bevacizumab therapy (42%), HIST1H3B p.K27M mutation (2%), TERT promoter mutation (3%), MGMT promoter methylation (9%), BRAF p.V600E mutation (1%), FGFR1 mutation (14%) and EGFR mutation (3%). Median progression-free and overall survival time was 9.9 ± 1.0 (7.9-11.9, 95% CI) and 16.6 ± 1.4 (13.9-19.3, 95% CI) months, respectively. Female sex, preoperative KPS score ≥ 80, adjuvant radiation + temozolomide and radiation ≥ 50 Gy were associated with favorable prognosis. Female sex and preoperative KPS score ≥ 80 were identified as independent good prognostic factors. This study demonstrated the current state of clinical practice for patients with diffuse midline glioma and molecular analyses of diffuse midline glioma in real-world settings. Further investigation in a larger population would contribute to better understanding of the pathology of diffuse midline glioma., (© 2024. The Author(s).)

Published
2024
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40. Is Interstitial Chemotherapy with Carmustine (BCNU) Wafers Effective against Local Recurrence of Glioblastoma? A Pharmacokinetic Study by Measurement of BCNU in the Tumor Resection Cavity.

Author

Ohnishi T, Yamashita D, Inoue A, Suehiro S, Ohue S, and Kunieda T

Abstract

The effectiveness of carmustine (BCNU) wafers on local recurrence of glioblastoma (GBM) remains contentious. We investigated the accumulating high-dose effects of BCNU released from the wafers on the survival of GBM patients by measuring BCNU concentration in the resection cavity of GBM over time. BCNU wafers (Gliadel ® ) were implanted with an Ommaya device in 15 patients, including 12 patients with GBM. BCNU concentrations in the tumor resection cavity were measured for 30 days postoperatively. The area under the curve (AUC) all was calculated from BCNU concentration curves, and the relationships between AUC all and survival, tumor phenotypes on MRI, and recurrence patterns were analyzed. The BCNU concentration was maximal 1 h postoperatively, rapidly decreased within 24 h, and remained relatively high for 7 days. GBM patients were classified into two groups: early recurrence (ER) and late or no recurrence (LN), using median progression-free survival as the cut-off. AUC all tended to be lower in the ER group than in the LN group, but the difference was not significant. MRI revealed that all patients in the ER group had highly invasive GBMs, whereas all patients in the LN group had less-invasive GBMs. A total of 9 patients experienced recurrence, with 6 local, 2 diffuse, and 1 disseminated patterns. No differences in AUC all were seen between local and non-local recurrence groups. Total BCNU concentrations did not correlate with tumor progression or survival. However, a high concentration of BCNU may have potential to provide some survival benefit for less-invasive type GBM.

Published
2022
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41. Hypoxia-induced phenotypic transition from highly invasive to less invasive tumors in glioma stem-like cells: Significance of CD44 and osteopontin as therapeutic targets in glioblastoma.

Author

Nishikawa M, Inoue A, Ohnishi T, Yano H, Ozaki S, Kanemura Y, Suehiro S, Ohtsuka Y, Kohno S, Ohue S, Shigekawa S, Watanabe H, Kitazawa R, Tanaka J, and Kunieda T

Abstract

The poor prognosis of glioblastoma multiforme (GBM) is primarily due to highly invasive glioma stem-like cells (GSCs) in tumors. Upon GBM recurrence, GSCs with highly invasive and highly migratory activities must assume a less-motile state and proliferate to regenerate tumor mass. Elucidating the molecular mechanism underlying this transition from a highly invasive phenotype to a less-invasive, proliferative tumor could facilitate the identification of effective molecular targets for treating GBM. Here, we demonstrate that severe hypoxia (1% O 2 ) upregulates CD44 expression via activation of hypoxia-inducible factor (HIF-1α), inducing GSCs to assume a highly invasive tumor. In contrast, moderate hypoxia (5% O 2 ) upregulates osteopontin expression via activation of HIF-2α. The upregulated osteopontin inhibits CD44-promoted GSC migration and invasion and stimulates GSC proliferation, inducing GSCs to assume a less-invasive, highly proliferative tumor. These data indicate that the GSC phenotype is determined by interaction between CD44 and osteopontin. The expression of both CD44 and osteopontin is regulated by differential hypoxia levels. We found that CD44 knockdown significantly inhibited GSC migration and invasion both in vitro and in vivo. Mouse brain tumors generated from CD44-knockdown GSCs exhibited diminished invasiveness, and the mice survived significantly longer than control mice. In contrast, siRNA-mediated silencing of the osteopontin gene decreased GSC proliferation. These results suggest that interaction between CD44 and osteopontin plays a key role in tumor progression in GBM; inhibition of both CD44 and osteopontin may represent an effective therapeutic approach for suppressing tumor progression, thus resulting in a better prognosis for patients with GBM., (Copyright © 2021. Published by Elsevier Inc.)

Published
2021
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42. Intracranial anaplastic solitary fibrous tumor/hemangiopericytoma: immunohistochemical markers for definitive diagnosis.

Author

Yamashita D, Suehiro S, Kohno S, Ohue S, Nakamura Y, Kouno D, Ohtsuka Y, Nishikawa M, Matsumoto S, Bernstock JD, Harada S, Mizuno Y, Kitazawa R, Ohnishi T, and Kunieda T

Subjects
Adult, Aged, Diagnosis, Differential, Female, Follow-Up Studies, Hemangiopericytoma diagnostic imaging, Hemangiopericytoma surgery, Humans, Male, Meningeal Neoplasms diagnostic imaging, Meningeal Neoplasms surgery, Meningioma diagnostic imaging, Meningioma surgery, Middle Aged, Neoplasm Recurrence, Local diagnostic imaging, Neoplasm Recurrence, Local surgery, STAT6 Transcription Factor metabolism, Solitary Fibrous Tumors diagnostic imaging, Solitary Fibrous Tumors surgery, Biomarkers, Tumor metabolism, Hemangiopericytoma metabolism, Meningeal Neoplasms metabolism, Meningioma metabolism, Neoplasm Recurrence, Local metabolism, Solitary Fibrous Tumors metabolism
Abstract

Intracranial anaplastic hemangiopericytoma (AHPC) is a rare and malignant subset of solitary fibrous tumor/hemangiopericytoma (SFT/HPC) as per the WHO 2016 Classification of Tumors of the Central Nervous System. AHPC portends a poor prognosis and is associated with higher rates of recurrence/metastasis in comparison with SFT/HPC. Accordingly, it is critical to continue to define the clinical course of patients with AHPC and in so doing further refine clinicopathologic/immunohistochemical (IHC) criteria needed for definitive diagnosis. Herein, we describe clinical/histological characteristics of six patients with AHPC. In addition, we reviewed and analyzed the expression of various IHC markers reported within the literature (i.e., a total of 354 intracranial SFT/HPCs and 460 meningiomas). Histologically, tumors from our six patients were characterized by a staghorn-like vascular pattern, mitotic cells, and strong nuclear atypia. Immunohistochemically, all tumors displayed positive nuclear staining for STAT6; other markers, including CD34 and Bcl-2, were expressed only in three patients. Analysis of IHC expression patterns for SFT/HPC and meningioma within the literature revealed that nuclear expression of STAT6 had the highest specificity (100%) for SFT/HPC, followed by ALDH1 (97.2%) and CD34 (93.6%). Of note, SSTR2A (95.2%) and EMA (85%) displayed a high specificity for meningioma. Anaplastic SFT/HPC is a tumor with poor prognosis that is associated with higher rates of recurrence and metastasis in comparison with SFT/HPC. Given that anaplastic SFT/HPC requires more aggressive treatment than meningioma despite of a similar presentation on imaging, it is crucial to be able to distinguish between these tumors.

Published
2021
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43. CD44 expression in the tumor periphery predicts the responsiveness to bevacizumab in the treatment of recurrent glioblastoma.

Author

Nishikawa M, Inoue A, Ohnishi T, Yano H, Kanemura Y, Kohno S, Ohue S, Ozaki S, Matsumoto S, Suehiro S, Nakamura Y, Shigekawa S, Watanabe H, Kitazawa R, Tanaka J, and Kunieda T

Subjects
Adult, Aged, Aged, 80 and over, Animals, Biomarkers, Tumor metabolism, Brain Neoplasms metabolism, Brain Neoplasms mortality, Brain Neoplasms pathology, Cell Movement, Female, Glioblastoma metabolism, Glioblastoma mortality, Glioblastoma pathology, Humans, Male, Mice, Mice, Inbred NOD, Mice, SCID, Middle Aged, Neoplasm Invasiveness, Neoplasm Proteins metabolism, Neoplasm Recurrence, Local metabolism, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local pathology, Progression-Free Survival, RNA, Messenger metabolism, Treatment Outcome, Vascular Endothelial Growth Factor A antagonists & inhibitors, Vascular Endothelial Growth Factor A metabolism, Xenograft Model Antitumor Assays, Antineoplastic Agents, Immunological therapeutic use, Bevacizumab therapeutic use, Brain Neoplasms drug therapy, Glioblastoma drug therapy, Hyaluronan Receptors metabolism, Neoplasm Recurrence, Local drug therapy
Abstract

Antiangiogenic therapy with bevacizumab (Bev), a monoclonal antibody targeting vascular endothelial growth factor (VEGF), is a common treatment for recurrent glioblastoma (GBM), but its survival benefit is limited. Resistance to Bev is thought to be a major cause of ineffectiveness on Bev therapy. To optimize Bev therapy, identification of a predictive biomarker for responsiveness to Bev is required. Based on our previous study, we focused on the expression and functions of CD44 and VEGF in the Bev therapy. Here, we analyze a relationship between CD44 expression and responsiveness to Bev and elucidate the role of CD44 in anti-VEGF therapy. CD44 and VEGF expression in the tumor core and periphery of 22 GBMs was examined, and the relationship between expression of these molecules and progression-free time on Bev therapy was analyzed. The degree of CD44 expression in the tumor periphery was evaluated by the ratio of the mRNA expression in the tumor periphery to that in the tumor core (P/C ratio). VEGF expression was evaluated by the amount of the mRNA expression in the tumor periphery. To elucidate the roles of CD44 in the Bev therapy, in vitro and in vivo studies were performed using glioma stem-like cells (GSCs) and a GSC-transplanted mouse xenograft model, respectively. GBMs expressing high P/C ratio of CD44 were much more refractory to Bev than those expressing low P/C ratio of CD44, and the survival time of the former was much shorter than that of the latter. In vitro inhibition of VEGF with siRNA or Bev-activated CD44 expression and increased invasion of GSCs. Bev showed no antitumor effects in mice transplanted with CD44-overexpressing GSCs. The P/C ratio of CD44 expression may become a useful biomarker predicting responsiveness to Bev in GBM. CD44 reduces the antitumor effect of Bev, resulting in much more highly invasive tumors., (© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

Published
2021
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44. Met-PET uptake index for total tumor resection: identification of 11 C-methionine uptake index as a goal for total tumor resection including infiltrating tumor cells in glioblastoma.

Author

Inoue A, Ohnishi T, Kohno S, Ohue S, Nishikawa M, Suehiro S, Matsumoto S, Ozaki S, Fukushima M, Kurata M, Kitazawa R, Shigekawa S, Watanabe H, and Kunieda T

Subjects
Adult, Aged, Brain Neoplasms surgery, Carbon Radioisotopes, Female, Gadolinium, Glioblastoma surgery, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Tumor Burden, Brain Neoplasms diagnostic imaging, Brain Neoplasms metabolism, Glioblastoma diagnostic imaging, Glioblastoma metabolism, Methionine pharmacokinetics, Positron-Emission Tomography
Abstract

Glioblastoma multiforme (GBM) is largely due to glioma stem cells (GSCs) that escape from total resection of gadolinium (Gd)-enhanced tumor on MRI. The aim of this study is to identify the imaging requirements for maximum resection of GBM with infiltrating GSCs. We investigated the relationship of tumor imaging volume between MRI and 11 C-methionine (Met)-PET and also the relationship between Met uptake index and tumor activity. In ten patients, tumor-to-contralateral normal brain tissue ratio (TNR) was calculated to evaluate metabolic activity of Met uptake areas which were divided into five subareas by the degrees of TNR. In each GBM, tumor tissue was obtained from subareas showing the positive Met uptake. Immunohistochemistry was performed to examine the tumor proliferative activity and existence of GSCs. In all patients, the volume of Met uptake area at TNR ≦ 1.4 was larger than that of the Gd-enhanced area. The Met uptake area at TNR 1.4 beyond the Gd-enhanced tumor was much wider in high invasiveness-type GBMs than in those of low invasiveness type, and survival was much shorter in the former than the latter types. Immunohistochemistry revealed the existence of GSCs in the area showing Met uptake at TNR 1.4 and no Gd enhancement. Areas at TNR > 1.4 included active tumor cells with relatively high Ki-67 labeling index. In addition, it was demonstrated that GSCs could exist beyond the border of Gd-enhanced tumor. Therefore, to obtain maximum resection of GBMs, including infiltrating GSCs, aggressive surgical excision that includes the Met-positive area at TNR 1.4 should be considered.

Published
2021
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45. Management for a patient of moyamoya disease presenting with ischemic stroke in the first trimester of pregnancy.

Author

Watanabe M, Kohno K, Shinohara T, Seno T, Fujiwara S, Onoue S, Fukumoto S, Ichikawa H, Iwata S, Okamoto K, and Ohue S

Subjects
Adult, Brain Ischemia diagnostic imaging, Brain Ischemia physiopathology, Cerebrovascular Circulation, Female, Hemodynamics, Humans, Moyamoya Disease diagnostic imaging, Moyamoya Disease physiopathology, Pregnancy, Pregnancy Complications, Cardiovascular diagnostic imaging, Pregnancy Complications, Cardiovascular physiopathology, Pregnancy Trimester, First, Stroke diagnostic imaging, Stroke physiopathology, Treatment Outcome, Abortion, Therapeutic, Brain Ischemia therapy, Fibrinolytic Agents therapeutic use, Moyamoya Disease therapy, Pregnancy Complications, Cardiovascular therapy, Stroke therapy
Abstract

We report an extremely rare case of a 27-year-old woman presenting with ischemic stroke as an initial manifestation of moyamoya disease in the first trimester of pregnancy. We conducted an artificial abortion when her neurological symptoms rapidly became refractory to optimal antithrombotic treatments. The progression of neurologic deficits stopped immediately after abortion, resulting in recovery to independence, with slight motor aphasia and right hemiparesis due to improved cerebral flow. We highlight rapid artificial abortion combined with antithrombotic treatment for patients of moyamoya disease with pregnancy-associated ischemic stroke as an appropriate treatment to correct hemodynamic instability and suppress the progression of neurological symptoms., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Published
2020
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46. [A Case of Right Frontal Dermoid Cyst with Temporal Imaging Changes in the Desease Course].

Author

Nakamura Y, Iwata S, Inoue A, Ohue S, Fukumoto S, Ichikawa H, Onoue S, Ozaki S, and Kohno K

Subjects
Child, Craniotomy, Female, Frontal Lobe, Humans, Magnetic Resonance Imaging, Brain Neoplasms diagnostic imaging, Dermoid Cyst diagnostic imaging
Abstract

Dermoid cysts are rare benign intracranial neoplasms derived from embryonal remnant tissues. Here, we describe a case of dermoid cyst located in the right frontal lobe, which showed repeated changes on CT. An 11-year-old girl was referred to our hospital to treat a brain neoplasm. Brain CT and MRI revealed a cystic tumor in the right frontal lobe. Incidentally, brain CT had been performed 6, 2, and 1 year before the presentation, which demonstrated repeated changes in the tumor over the clinical course. Gross total resection of the tumor was achieved through right frontal craniotomy. Histological findings revealed keratin flakes, mature bones, cholesterol crystals, and granulation with macrophages. The cyst wall was composed of squamous epithelium with adnexal structures, such as hair follicles and sebaceous glands. Therefore, we diagnosed the tumor as a dermoid cyst. The postoperative course was uneventful, and she was discharged on postoperative day 10 without neurological deficits. Dermoid cysts are difficult to be diagnosed on routine neuroimaging. An accurate diagnosis requires details of the clinical course and analysis of both imaging and pathological studies.

Published
2019
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47. Prognostic significance of immunohistochemical subtypes based on the stage of B-cell differentiation in primary CNS lymphoma.

Author

Inoue A, Ohnishi T, Kohno S, Matsumoto S, Nishikawa M, Ohue S, Ozaki S, Suehiro S, Kurata M, Fukushima M, Kitazawa R, Shigekawa S, Watanabe H, and Kunieda T

Abstract

Primary central nervous system lymphoma (PCNSL) has been immunohistochemically classified into two subtypes, germinal center (GC) B-cell and non-GC B-cell, but the prognostic impact of these subtypes remains debated. We investigated clinical features and prognostic significance of immunohistochemical subtypes that were identified by expression patterns of three B-cell differentiation markers in PCNSL. We also analyzed a factor related to responsiveness to high-dose methotrexate (HD-MTX) chemotherapy. Tumors from 32 PCNSL patients were immunohistochemically evaluated for expression of cluster of differentiation (CD) 10, B-cell lymphoma-6 (BCL-6), and multiple myeloma oncogene-1 (MUM-1) and classified into subtypes according to the expression patterns of these markers. Clinical features and prognostic outcome of these subtypes were investigated. Twenty-three patients were treated with HD-MTX-based chemotherapy followed by whole-brain radiation therapy (WBRT), and nine were treated with WBRT alone. Three immunohistochemical subtypes were identified, including A-type expressing CD10, BCL-6, and MUM-1 (12 patients), B-type expressing BCL-6 and MUM-1 (12 patients) and C-type expressing MUM-1 only (8 patients). Response rate in the HD-MTX therapy group was 57.1% (4/7) in A-type, 87.5% (7/8) in B-type, and 75% (6/8) in C-type. C-type with the lowest metabolic activity showed significantly longer overall survival than A-type with the higher uptake of methionine (71.6 versus 39.6 months) (P<0.05). Immunohistochemical identification of PCNSL based on the B-cell differentiation stage revealed three types of tumors, showing different metabolic activity and survival time. Refined immunohistochemical classification of PCNSL subtypes may become a useful tool for predicting more accurate prognosis and accessing sensitivity to HD-MTX therapy., Competing Interests: None., (IJCEP Copyright © 2019.)

Published
2019

48. Enhancement of antitumor activity by using 5-ALA-mediated sonodynamic therapy to induce apoptosis in malignant gliomas: significance of high-intensity focused ultrasound on 5-ALA-SDT in a mouse glioma model.

Author

Suehiro S, Ohnishi T, Yamashita D, Kohno S, Inoue A, Nishikawa M, Ohue S, Tanaka J, and Kunieda T

Subjects
Animals, Brain Neoplasms drug therapy, Brain Neoplasms pathology, Cell Proliferation drug effects, Disease Models, Animal, Glioma drug therapy, Glioma pathology, Mice, Treatment Outcome, Aminolevulinic Acid therapeutic use, Apoptosis drug effects, Brain Neoplasms therapy, Extracorporeal Shockwave Therapy methods, Glioma therapy
Abstract

OBJECTIVEHigh invasiveness of malignant gliomas frequently causes early local recurrence of the tumor, resulting in extremely poor outcome. To control such recurrence, novel therapies targeted toward infiltrating glioma cells around the tumor border are required. Here, the authors investigated the antitumor activity of sonodynamic therapy (SDT) combined with a sonosensitizer, 5-aminolevulinic acid (5-ALA), on malignant gliomas to explore the possibility for clinical use of 5-ALA-mediated SDT (5-ALA-SDT).METHODSIn vitro cytotoxicity of 5-ALA-SDT was evaluated in U87 and U251 glioma cells and in U251Oct-3/4 glioma stemlike cells. Treatment-related apoptosis was analyzed using flow cytometry and TUNEL staining. Intracellular reactive oxygen species (ROS) were measured and the role of ROS in treatment-related cytotoxicity was examined by analysis of the effect of pretreatment with the radical scavenger edaravone. Effects of 5-ALA-SDT with high-intensity focused ultrasound (HIFU) on tumor growth, survival of glioma-transplanted mice, and histological features of the mouse brains were investigated.RESULTSThe 5-ALA-SDT inhibited cell growth and changed cell morphology, inducing cell shrinkage, vacuolization, and swelling. Flow cytometric analysis and TUNEL staining indicated that 5-ALA-SDT induced apoptotic cell death in all gliomas. The 5-ALA-SDT generated significantly higher ROS than in the control group, and inhibition of ROS generation by edaravone completely eliminated the cytotoxic effects of 5-ALA-SDT. In the in vivo study, 5-ALA-SDT with HIFU greatly prolonged survival of the tumor-bearing mice compared with that of the control group (p < 0.05). Histologically, 5-ALA-SDT produced mainly necrosis of the tumor tissue in the focus area and induced apoptosis of the tumor cells in the perifocus area around the target of the HIFU-irradiated field. The proliferative activity of the entire tumor was markedly decreased. Normal brain tissues around the ultrasonic irradiation field of HIFU remained intact.CONCLUSIONSThe 5-ALA-SDT was cytotoxic toward malignant gliomas. Generation of ROS by the SDT was thought to promote apoptosis of glioma cells. The 5-ALA-SDT with HIFU induced tumor necrosis in the focus area and apoptosis in the perifocus area of the HIFU-irradiated field, whereas the surrounding brain tissue remained normal, resulting in longer survival of the HIFU-treated mice compared with that of untreated mice. These results suggest that 5-ALA-SDT with HIFU may present a less invasive and tumor-specific therapy, not only for a tumor mass but also for infiltrating tumor cells in malignant gliomas.

Published
2018
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49. Significance of Glioma Stem-Like Cells in the Tumor Periphery That Express High Levels of CD44 in Tumor Invasion, Early Progression, and Poor Prognosis in Glioblastoma.

Author

Nishikawa M, Inoue A, Ohnishi T, Kohno S, Ohue S, Matsumoto S, Suehiro S, Yamashita D, Ozaki S, Watanabe H, Yano H, Takahashi H, Kitazawa R, Tanaka J, and Kunieda T

Abstract

Glioblastoma multiforme (GBM) is the most aggressive malignant brain tumor and a subpopulation of glioma stem-like cells (GSCs) is likely responsible for the invariable recurrence following maximum resection and chemoradiotherapy. As most GSCs that are located in the perivascular and perinecrotic niches should be removed during tumor resection, it is very important to know where surviving GSCs are localized. Here, we investigated the existence and functions of GSCs in the tumor periphery, which is considered to constitute the invasion niche for GSCs in GBM, by analyzing expression of stem cell markers and stem cell-related molecules and measuring particular activities of cultured GSCs. In addition, the relationship between GSCs expressing particular stem cell markers and pathological features on MRI and prognosis in GBM patients was analyzed. We showed that GSCs that express high levels of CD44 are present in the tumor periphery. We also found that vascular endothelial growth factor (VEGF) is characteristically expressed at a high level in the tumor periphery. Cultured GSCs obtained from the tumor periphery were highly invasive and have enhanced migration phenotype, both of which were markedly inhibited by CD44 knockdown. Higher expression of CD44 in the tumor periphery than in the core was correlated with a highly invasive feature on MRI and was associated with early tumor progression and worse survival, whereas lower expression of CD44 in the tumor periphery corresponded to low invasion and was associated with longer survival. The low invasion type on MRI tended to show high levels of VEGF expression in the tumor periphery, thus presenting the tumor with high proliferative activity. These results imply the significance of GSCs with high levels of CD44 expression in the tumor periphery compared to the core, not only in tumor invasion but also rapid tumor progression and short survival in patients with GBM.

Published
2018
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50. Effects of Surgery With Salvage Stereotactic Radiosurgery Versus Surgery With Whole-Brain Radiation Therapy in Patients With One to Four Brain Metastases (JCOG0504): A Phase III, Noninferiority, Randomized Controlled Trial.

Author

Kayama T, Sato S, Sakurada K, Mizusawa J, Nishikawa R, Narita Y, Sumi M, Miyakita Y, Kumabe T, Sonoda Y, Arakawa Y, Miyamoto S, Beppu T, Sugiyama K, Nakamura H, Nagane M, Nakasu Y, Hashimoto N, Terasaki M, Matsumura A, Ishikawa E, Wakabayashi T, Iwadate Y, Ohue S, Kobayashi H, Kinoshita M, Asano K, Mukasa A, Tanaka K, Asai A, Nakamura H, Abe T, Muragaki Y, Iwasaki K, Aoki T, Watanabe T, Sasaki H, Izumoto S, Mizoguchi M, Matsuo T, Takeshima H, Hayashi M, Jokura H, Mizowaki T, Shimizu E, Shirato H, Tago M, Katayama H, Fukuda H, and Shibui S

Abstract

Purpose Whereas whole-brain radiotherapy (WBRT) has been the standard treatment of brain metastases (BMs), stereotactic radiosurgery (SRS) is increasingly preferred to avoid cognitive dysfunction; however, it has not been clearly determined whether treatment with SRS is as effective as that with WBRT or WBRT plus SRS. We thus assessed the noninferiority of salvage SRS to WBRT in patients with BMs. Patients and Methods Patients age 20 to 79 years old with performance status scores of 0 to 2-and 3 if caused only by neurologic deficits-and with four or fewer surgically resected BMs with only one lesion > 3 cm in diameter were eligible. Patients were randomly assigned to WBRT or salvage SRS arms within 21 days of surgery. The primary end point was overall survival. A one-sided α of .05 was used. Results Between January 2006 and May 2014, 137 and 134 patients were enrolled in the WBRT and salvage SRS arms, respectively. Median overall survival was 15.6 months in both arms (hazard ratio, 1.05; 90% CI, 0.83 to 1.33; one-sided P for noninferiority = .027). Median intracranial progression-free survival of patients in the WBRT arm (10.4 months) was longer than that of patients in the salvage SRS arm (4.0 months). The proportions of patients whose Mini-Mental Status Examination and performance status scores that did not worsen at 12 months were similar in both arms; however, 16.4% of patients in the WBRT arm experienced grade 2 to 4 cognitive dysfunction after 91 days postenrollment, whereas only 7.7% of those in the SRS arm did ( P = .048). Conclusion Salvage SRS is noninferior to WBRT and can be established as a standard therapy for patients with four or fewer BMs.

Published
2018
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