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Nerima-ku, Japan

Akiyama T.,Diabetes Center | Ikeya A.,Diabetes Center | Ohyama T.,Diabetes Center | Nishikawa K.-I.,Diabetes Center | And 2 more authors.
Journal of the Japan Diabetes Society | Year: 2013

It is well recognized that the prevalence of peripheral artery disease (PAD) assessed with the ankle-brachial index (ABI) is 3-29% and that diabetes is a major risk factor. It has been reported that coronary artery disease (CAD) is present in 50-70% of symptomatic and critical PAD patients. However, little is known about whether CAD is associated with asymptomatic PAD. Therefore, we examined the prevalence of PAD and its association with CAD in asymptomatic type 2 diabetic patients. Two hundred and twenty-eight asymptomatic (Fontaine 1) type 2 diabetic outpatients were recruited (males: 119; Age 66.0 ± 10.8 years; HbAlc 7.6 ± 1.0%). The ABI was examined in all patients, and those with values less than 0.9 were evaluated with contrast-enhanced CT or MRA. When PAD was suspected, lower extremity and coronary angiography was performed simultaneously. The prevalence of PAD was 7.9% among all patients, and significant coronary stenosis was demonstrated in 45% of the PAD patients. These data revealed that the prevalence of coronary stenosis in asymptomatic diabetic PAD patients is as high as that observed in critical PAD patients, as has been previously reported. The ABI is thus considered to be a useful screening test for PAD and CAD. Source


Sadahiro S.,Tokai University | Tsuchiya T.,Sendai City Medical Center | Sasaki K.,Otaru Ekisaikai Hospital | Kondo K.,National Hospital Organization | And 12 more authors.
Annals of Oncology | Year: 2015

Background: While adjuvant chemotherapy is preferable for high-risk colon cancer, treatment duration is controversial. Oral uracil and tegafur (UFT)/leucovorin (LV) is widely used as a standard adjuvant chemotherapy for colon cancer in Japan. We conducted a phase III trial to investigate the optimal duration of adjuvant chemotherapy for stage IIB/III colon cancer. Patients and methods: Patients with curatively resected stage IIB/III colon cancer were eligible for enrollment in this trial. Patients were registered within 6 weeks after surgery and were randomly assigned to receive UFT/LV for 28 of 35 days for 6 months in the control group or for 5 consecutive days per week for 18 months in the study group. The primary end point was the disease-free survival (DFS), and the secondary end points were overall survival (OS) and safety. Result: A total of 1071 patients were registered from 233 centers. A statistically significant difference in DFS was not observed between the study group and the control group; the 5-year DFS was 69% in the study group and 69% in the control group. The 5-year OS was 85% in the study group and 85% in the control group. Conclusion: Eighteen-month treatment with UFT/LV did not improve DFS or OS compared with 6-month UFT/LV treatment in patients with stage IIB/III colon cancer. The important finding from this study is that not 18 months but 6 months of treatment is enough for postoperative UFT/LV for stage IIB/III colon cancer. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. Source


Tsuchiya T.,Sendai City Medical Center | Sadahiro S.,Tokai University | Sasaki K.,Otaru Ekisaikai Hospital | Kondo K.,National Hospital Organization Nagoya Medical Hospital | And 13 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2014

Purpose: The JFMC33-0502 trial is a phase III clinical study designed to determine the most appropriate duration of postoperative adjuvant chemotherapy with uracil-tegafur (UFT) plus leucovorin in patients with stage IIB or III colon cancer. We report the interim results of preplanned safety analyses. Methods: Patients with stage IIB or III colon cancer who had undergone curative resection were randomly assigned to receive UFT (300 mg/m2) plus leucovorin (75 mg/day) for 6 months (control group, 4 weeks of treatment followed by a 1-week rest, five courses) or for 18 months (study group, 5 days of treatment followed by a 2-day rest, 15 courses). Treatment status and safety were evaluated. Results: A total of 1,071 patients were enrolled, and 1,063 were included in safety analyses. Treatment completion rate at 6 months was 74.0 % in the control group and 76.7 % in the study group. Treatment completion rate in the study group at 18 months was 56.0 %. The overall incidence of adverse events (AEs) was 75.3 % in the control group and 77.6 % in the study group. The incidences of grade 3 or higher AEs were low in both groups. During the first 6 months, the incidences of the subjective AEs were significantly lower in the study group. Conclusions: Oral UFT plus leucovorin given by either dosage schedule is a very safe regimen for adjuvant chemotherapy. In particular, 5 days of treatment followed by a 2-day rest was a useful treatment option from the viewpoint of toxicity even when given for longer than 6 months. © 2014 The Author(s). Source


Hamaguchi T.,National Cancer Center Hospital | Shirao K.,Oita University | Moriya Y.,The Surgical Center | Yoshida S.,Aomori Prefectural Central Hospital | And 2 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2011

Objective: In the latter 1990s, adjuvant chemotherapy for completely resected Stage III colorectal cancer remained controversial in Japan. We conducted two independent randomized controlled trials in patients with Stage III colon and rectal cancer. Methods: Patients were randomly assigned to receive surgery alone or surgery followed by treatment with UFT (400 mg/m 2/day), given for five consecutive days per week for 1 year. The primary endpoint was relapse-free survival (RFS), and the secondary endpoint was overall survival (OS). Results: A total of 334 patients with colon cancer and 276 with rectal cancer were enrolled. The patients' characteristics were similar between the UFT group and the Surgery-alone group. There was no significant difference in RFS or OS in colon cancer. In rectal cancer, however, RFS and OS were significantly better in the UFT group than in the Surgery-alone group. The only grade 4 toxicity in the UFT group was diarrhea, occurring in one patient with colon cancer and one patient with rectal cancer. Conclusions: Postoperative adjuvant chemotherapy with UFT is successfully tolerated and improves RFS and OS in patients with Stage III rectal cancer. In colon cancer, the expected benefits were not obtained (hazard ratio = 0.89). © 2010 Springer-Verlag. Source


Arai H.,Red Cross | Kobayashi T.,Red Cross | Izuka K.,Lsesaki Municipal Hospital | Ueno T.,Lsesaki Municipal Hospital | And 5 more authors.
Japanese Journal of Cancer and Chemotherapy | Year: 2012

The safety and efficacy of miriplatin-lipiodol suspension were investigated in 174 patients with hepatocellular carcinoma (HCC). We assessed 29 patients who underwent transarterial chemoembolization (TACE) for whole-liver multinodular HCC (mHCC), compared with 145 patients who underwent TACE for non-multinodular HCC (n-mHCC) as the controls. In the mHCC group, a treatment effect (TE) of 4 was obtained in 0%, TE3 in 38%, TE2 in 31%, and TE1 in 31%. In the n-mHCC group, TE4 was obtained in 24%, TE3 in 40%, TE2 in 32%, and TE1 in 4%. Efficacy was significantly higher in the mHCC group. In the mHCC group, Grade 3 adverse events (fever, elevated alanine aminotransferase, and thrombocytopenia) occurred in 4 patients (13.7%). In the n-mHCC group, Grade 3 adverse events (ascites, elevated serum transaminase, and cytopenia) occurred in 33 patients (22.7%). There was no significant difference in the change of Child-Pugh scores over time in 6 patients who underwent repetitive TACE for mHCC. In conclusion, TACE for whole-liver mHCC is generally safe, but its short-term therapeutic effects were not satisfactory. Variation in the TACE protocol using miriplatin, such as repetitive administration of miriplatin and a reduction in the treatment interval, can be alternative treatment choices for patients with whole-liver mHCC. Source

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