Miura, Japan
Miura, Japan

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Yukawa N.,Yokohama City University | Yamamoto Y.,Ashigarakami Hospital | Akaike M.,Kanagawa Cancer Center | Shiozawa M.,Kanagawa Cancer Center | And 10 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2010

Purpose: As a project of the Kanagawa Colorectal Cancer Study Group, we performed this study to analyze the efficacy and the safety of modified FOLFIRI (irinotecan: 150 mg/m2) therapy for Japanese patients with metastatic colorectal cancer. Patients and Methods : We treated PS 0-1 Japanese patients with measurable or assessable colorectal cancer who either had not received preliminary treatment, or were postoperative with metastasis and had undergone radiation therapy or adjuvant chemotherapy before more than four weeks, and further had provided written acceptance of our proposed procedures. Twenty patients received modified FOLFIRI therapy as a 2-hour infusion of CPT-11 150 mg/m2 and I-LV 200 mg/m2 followed by a bolus 5-FU 400 mg/m2 and 46-hour infusion 5-FU 2, 400 mg/m2. Tumor response was assessed by RECIST and toxicity by NCI-CTC. Results : Thirty males and seven females underwent an average 10 courses of treatment. This therapy achieved a 50% response rate, 80% disease-control rate, and 316±40days PHS. Regarding hematological toxicity, 11 patients (55%) experienced leukemia, which developed to grade 3/4 in 5 (25%) of them. Twelve patients (65%) experienced neutropenia, which developed to grade 3/4 in 10 (50%) of them. Digestive toxicity was observed in 16 patients (80%), which developed to grade 3/4 in only one patient (5%) with gastric ulcer. Six patients (30%) experienced alopecia, which was grade 1/2 only. Conclusion : This clinical study was safely carried out. The efficacy was as good as in previous reports using a regular dose of CPT-11.


Kumazu Y.,Yokohama City University | Aoyama T.,Miura City Hospital | Yamada T.,Yokohama City University | Wada H.,Miura City Hospital | And 7 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2014

We report a case of gastric carcinoma with metastasis to the liver responding to surgery and chemotherapy. The patient was a 74-year-old man with gastric cancer, clinically diagnosed as P0H0M0T3N0. We initially planned to perform an open distal gastrectomy. However, intraoperative findings revealed metastatic tumors in the liver. Therefore, the patient underwent a D1 distal gastrectomy. After surgery, the patient received the following chemotherapy regimens: 1 course of S-1 and 8 courses of a S-1 and cisplatin (CDDP) combination. After 8 courses of S-1 plus CDDP treatment, liver metastases could not be detected by computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET). The patient was assessed to have a clinical complete response. Fifty months after surgery, the patient is alive without recurrence.


Aoyama T.,Miura City Hospital | Nishikawa K.,Osaka General Medical Center | Takiguchi N.,Chiba Cancer Center | Tanabe K.,Hiroshima University | And 7 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2014

Background: Hangeshashinto (TJ-14, a Kampo medicine), which reduces the level of prostaglandin E2 and affects the cyclooxygenase activity, alleviates chemotherapy-induced oral mucositis (COM). We conducted a randomized comparative trial to investigate whether TJ-14 prevents and controls COM in patients with gastric cancer. Methods: We randomly assigned patients with gastric cancer who developed moderate-to-severe oral mucositis (CTCAE v4.0 grade ≧1) during any cycle of chemotherapy to receive either TJ-14 or a placebo as a double-blind trial. The patients received a placebo or TJ-14 for 2-6 weeks according to the chemotherapy regimen from the beginning of the next course of chemotherapy. The primary end point was the incidence of grade ≧2 oral mucositis in the protocol treatment course, and the secondary end points were the time to disappearance of oral mucositis and the incidence of adverse events. Results: Following the key opening of the blinding protocol, we analyzed 91 eligible patients (TJ-14: 45, placebo: 46) using a "per protocol set" analysis. The incidence of ≧grade 2 COM was 40.0 % in the TJ-14 group and 41.3 % in the placebo group (p = 0.588). The median duration of ≧grade 2 COM was 14 days in the TJ-14 group and 16 days in the placebo group (p = 0.894). Meanwhile, the median duration of any grade of COM was 9 days in the TJ-14 group and 17 days in the placebo group among the patients who developed grade 1 symptoms during the screening cycle [hazard ratio 0.60; 95 % CI (0.23-1.59), p = 0.290]. Conclusions: Although TJ-14 treatment did not reduce the incidence of ≥2 COM in the patients who developed mucositis during chemotherapy for gastric cancer, a trend was observed in which TJ-14 reduced the risk of COM in the patients who developed grade 1 COM during the screening cycle. Further, phase III studies with a larger sample size are needed to clarify the protective effects of TJ-14 for COM. © 2014 The Author(s).


Arai Y.,Central Hospital | Aoyama T.,Miura City Hospital | Inaba Y.,Central Hospital | Okabe H.,Uji Takeda Hospital | And 6 more authors.
Asia-Pacific Journal of Clinical Oncology | Year: 2015

This prospective multicenter study aimed to evaluate the efficacy and adverse events of hepatic arterial infusion chemotherapy (HAIC) using percutaneous catheter placement techniques for liver metastases from colorectal cancer (CRC). Methods: We administered 5-fluorouracil at 1000mg/m2 over 5h via hepatic arterial infusion on a weekly schedule. The primary endpoint was the overall response rate (RR). The secondary endpoints were the overall survival (OS), progression-free survival (PFS) and toxicities. Results: Between February 2000 and March 2002, seventy-seven eligible patients were enrolled in this study. After a median of 26 treatment cycles, 4 patients achieved a complete response, 29 achieved a partial response, 28 had stable disease, 15 had progressive disease and the status of one patient was unknown. The overall RR was 42.9% and the disease control rate (DCR) was 79.2%. The median PFS and OS times were 203 and 560 days, respectively. The most common grade 3 or 4 hematological and non-hematological toxicities were total bilirubin level elevation (10.4%) and gamma-glutamyl transferase level elevation (10.4%). With regard to the relationship between the background factors and treatment outcomes, the DCR, RR, PFS and OS were different between patients with and without extrahepatic lesions (DCR: 86.5% vs 64%, RR: 46.2% vs 36.0%, PFS: 233 days vs 99 days, OS: 587 days vs 558 days). Conclusion: The primary endpoint of this study was not met. HAIC using percutaneous catheter placement techniques did not improve the RR for liver metastasis from CRC. © 2015 Wiley Publishing Asia Pty Ltd.

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