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Biomedical subjects

H Akaza

Publications and source records attributed to H Akaza.

At least 253 records · Page 14Linked to original sources
PubMed1987

Comparative analysis of short-term and long-term prophylactic intravesical chemotherapy of superficial bladder cancer. Prospective, randomized, controlled studies of the Japanese Urological Cancer Research Group.

The Japanese Urological Cancer Research Group has conducted three randomized clinical studies on intravesical chemoprophylaxis of superficial bladder cancers. This paper presents a comparative analysis of the first and second of these. The protocol used in the first study was a so-called short-term schedule in which drugs (for group A, ADM 30 mg/30 ml; group B, ADM 20 mg/40 ml; group C, MMC 20 mg/40 ml; and group D, control) were administered twice a week for 4 weeks after transurethral resection (TUR), and in the second study a long-term schedule was used, in which drugs (for group E, ADM 30 mg/30 ml; group F, ADM 20 mg/40 ml; group G, MMC 20 mg/40 ml; and group H, control) were administered twice a week for 1 week, every 2 weeks for 7 weeks, monthly for 8 months, and finally once every 3 months for 1 year. In the first study 575 patients were evaluated and followed up for 5 years. The second study started 28 months later, and 607 patients were evaluated. A generally good prophylactic effect was obtained in the second study when the patients' backgrounds were adjusted in combination with the history and number of the tumors. The second study did not reveal any promoting or inhibitory effect on the progression of the recurrent tumors. There were no significant side effects in either study. The indications and the schedule for prophylactic intravesical chemotherapy should be more carefully studied.

Administration, Intravesical↗
PubMed1987

[Significance of tumor markers in the treatment of urological malignancies].

Clinical and laboratory studies have confirmed the efficacy of alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCH) as tumor markers in the diagnosis, monitoring and assessment of prognosis in cases of testicular tumor. Serum AFP level is positive in 75% of yolk sac tumors, 70% of embryonal carcinomas and 62% of teratomas. All cases of choriocarcinoma show elevated serum hCG. In the treatment of prostatic cancer, prostatic acid phosphatase (PAP), prostatic-specific antigen (PA) and gamma-seminoprotein (gamma-Sm) are important serum markers, and the RIA method has improved their specificity and sensitivity. These markers are also correlated well with therapeutic efficacy. Especially, improvement of the serum PAP level in patients with stage C and D cancer indicates prolongation of survival time. Over 90% of the metastatic lesions of prostatic cancer are encountered in the skeletal system. Thus, serum alkaline phosphatase and urinary hydroxyproline are considered to be useful markers for indicating bone involvement. In other urological malignancies, there are no specific tumor markers. As non-specific markers for renal cell carcinoma, ESR, LDH, CEA, alpha 2-globulin, haptoglobin, fibrinogen and various hormones have been investigated. In the treatment of bladder cancer, it is important to distinguish the malignant potential of the tumor. From this viewpoint, various immunohistochemical investigations and flow cytometric analysis are now in progress. It is expected that some of the findings of the studies could prove to be of clinical use in the near future.

Acid Phosphatase↗
PubMed1987

[The evaluation of chemotherapy of relapse in prostatic cancer with new response criteria].

Effect of chemotherapy for relapse of prostatic cancer was evaluated with new response criteria, in which four objective parameters including the prostate, bone metastasis, soft tissue metastasis and the serum acid phosphatase level estimated by radioimmunoassay or enzyme immunoassay were judged separately and then summarized to evaluate the response as complete response (CR), partial response (PR), stable and progressive disease (PD). Eighty-two patients were included in the study. Rate of PR and stable were 19% and 27%, respectively, and these two groups showed longer survival than those with PD. Evaluation of prostate and bone showed tendency to be discrepant with total judgement. Evaluation of soft tissues and prostatic acid phosphatase reflected the effect of chemotherapy. Chemotherapy often improved subjective symptoms but the effect did not parallel the total judgement in many cases. Factors influencing response of chemotherapy were mode of pretreatment, performance status, age, number of affected areas and clinical stage, but the grade at initial treatment was not correlated to response. The new criteria used in this study was valid for evaluation of response in prostatic cancer.

Acid Phosphatase↗
PubMed1987

[Response criteria for prostatic cancer treated by chemotherapy or antiandrogenic therapy].

The efficacy of cytotoxic agents in the treatment of prostatic cancer is difficult to evaluate because objective, measurable lesions, such as lung, liver, skin, subcutaneous and nodal metastasis are often not found. However, most of the patients with advanced prostatic cancer have bone involvement and elevated serum acid-phosphatase in addition to the primary tumor. Exact clinical trials on such cases, especially phase II studies can not be performed without appropriate evaluations of these three parameters. The criteria of these three parameters offered by various study groups are reviewed and the relevant response criteria are proposed. A stable category was thought to be useful to evaluate the efficacy on the patients with progressing disease. In our proposal, overall assessment of response involves all objective parameters including these three parameters as well as both measurable and unmeasurable disease described in the WHO handbook for reporting results of cancer treatment.

Acid Phosphatase↗
PubMed1987

[Antiemetic effects of MS-5080 associated with cisplatin chemotherapy--an attempt in assessment based on the sample score system using multivariate analysis].

Effect of a new antiemetic drug, MS-5080 was evaluated against nausea and vomiting induced by chemotherapy including cisplatin. Fifty patients with various urological malignancies were registered into this study, which were distributed to the aliquot number with a respective dose schedule of 2, 3, 4 and 5 mg/kg body weight of MS-5080. Forty-seven patients with a total of 73 chemotherapeutic courses were eligible for evaluation of antiemetic efficacy, whereas the side effect of MS-5080 were evaluated in 48 patients with a total of 74 courses. Antiemetic efficacy was evaluated in terms of duration of nausea, duration of vomiting, duration of food intolerance, and the number of vomiting episodes. No statistically significant difference was observed in relation to the dose dependency of MS-5080. In assessment of the side effects, a relatively high incidence of diarrhea was observed compared to the other known antiemetic drugs. In the present study, we attempted an evaluation based on the sample score system using multivariate analysis. The results were correlated well with results of a grading system of efficacy that were determined by each physician who treated the patients.

Adult↗
PubMed1986

Mutual neoplastic promotion by instillation of mitomycin C and cauterization on rat bladder urothelium.

The authors studied the effect of bladder instillation of mitomycin C (MMC), a potential carcinogen, on the duration and severity of the hyperplasia induced by transurethral fulguration. This experimental system may simulate closely the intravesical chemoprophylaxis of MMC after transurethral resection of bladder cancer. Physiologic saline or MMC was instilled into the rat bladder once on the day of, or 3 or 7 days after cauterization. In all groups instilled with physiologic saline the changes were reversed by day 14. On the other hand, five of nine MMC-instilled rats developed papillary lesions, and three of these had mild dysplastic epithelium on day 84. Under the scanning electron microscope, the animals of these groups showed pleomorphic microvilli on the luminal surface of the regenerative cells on days 10 and 14 after cauterization. These results may indicate the mutual neoplastic promotion by instillation of MMC and cauterization to a certain extent.

Animals↗
PubMed1986

Species differences in regenerative hyperplasia of bladder urothelium after transurethral cauterization.

The early histological changes in bladder urothelium following transurethral cauterization were sequentially studied in female rats, mice, hamsters and guinea pigs. The changes differed markedly between species: papillary hyperplasia or papilloma in the rats and simple hyperplasia in the mice, hamsters and guinea pigs. The regenerative response to the fulgurative ulcer within a given species was similar to the early response previously observed by others following administration of known bladder carcinogens. This suggests that there may be a regulatory mechanism in the urothelium which is common to urothelial proliferations induced by both carcinogenic and non-carcinogenic stimulations, though differing between animal species.

Animals↗
PubMed1986

[Surgery and adjuvant chemotherapy of disseminated testicular cancer].

The advent of combination chemotherapy regimens including Cis-Platinum (CDDP) in the 1970s brought about revolutionary improvement of short-term as well as long-term results of disseminated testicular cancer. PVB therapy (CDDP, Vinblastine and Bleomycin) introduced by L.H. Einhorn is reported to yield a 100% response rate but in Japan combination chemotherapy incorporating CDDP has not produced its maximal effects according to our results as well as analyses carried out by a multi-center cooperative study group. This is probably due to the toxicities and side effects of the drugs used. Facilities to deal with the high toxicities, i.e., severe myelosuppression, as well as enthusiasm on the part of the physician determined to arrive at a complete cure in each patient are prerequisite for the achievement of this final goal.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1986

[Cooperative phase II study of epirubicin (EPI) in bladder cancer, renal pelvic and ureteral tumors--Urological Cooperative Study Group of EPI].

A phase II study of a new anthracycline anti-cancer antibiotics, epirubicin (EPI), was undertaken in 71 patients with urothelial malignancies; 40 with advanced urothelial malignancies and 31 with superficial bladder cancer. Out of them 32 patients with advanced stage of urothelial cancer were evaluated for the systemic use of EPI, while 30 patients with superficial bladder cancer for intravesical use. Intravenous administration of this new anticancer antibiotic, at a dosage of 60 mg/m2 every three weeks, showed the response rate of 20.0% for advanced bladder cancer and 14.3% for renal pelvic and ureteral tumors. In cases of superficial bladder cancer, at a dosage of 60 mg/30 ml X 3 day every week in principal, the response rate was 66.7%. Eight out of 30 patients showed complete disappearance of the tumor. Twelve patients also showed more than 50% tumor regression. As for adverse effects no serious cardiotoxicity was demonstrated. Anorexia and other gastrointestinal side effects, such as nausea and vomiting, were also seen. Alopecia and myelosuppression were the major adverse effects among patients with systemic EPI administration. With intravesical use of EPI, cystitis syndrome was the major toxicity. However, no systemic side effects were noted in these cases. In conclusion, EPI was assumed to be effective for the treatment of advanced urothelial tumors and superficial bladder cancer.

Aged↗
PubMed1986

[Randomized cross-over study on the effects of methylprednisolone, metoclopramide and droperidol on the control of nausea and vomiting associated with cis-platinum chemotherapy].

A randomized cross-over study on the effects of methylprednisolone (MP), metoclopramide (MT) and droperidol (DP) on the control of nausea and vomiting associated with cis-platinum chemotherapy was performed. Sixty-three patients were entered into the study; 60 patients (21 treated with MP, 18 with MT and 21 with DP) were eligible for evaluation of antiemetic efficacy, whereas the side effects of these drugs were evaluated in all of the 63 patients. Out of the above 60 patients, 36 were entered into the cross-over treatment. Antiemetic efficacy was evaluated in terms of duration of nausea, duration of vomiting, frequency of vomiting, duration of inability to take food and the amount of food first taken after cis-platinum treatment. Generally, the MP-treated group of patients showed favorable effects in these points, MP being especially more effective than other drugs with a statistically significant difference for the control of nausea and disturbed intake of food during the first 24 hours after the treatment with CDDP. Anticipatory nausea and vomiting were not observed in this study. Side-effects were minimal and all of the patients except one, who showed severe diarrhea following administration of MT and could not tolerate the treatment thereafter, were safely treated.

Adult↗
PubMed1986

[Phase II collaborative study of (2''R)-4'-0-tetrahydropyranyladriamycin (THP) for urological malignancies--Urological Co-operative THP Study Group].

A Phase II clinical trial of a new anthracycline, (2''R)-4'-0-tetrahydropyranyladriamycin (THP), was performed in 137 patients with urological malignancies. Out of them, 111 patients were evaluated for tumor responses and 125 patients were evaluated for adverse effects. In cases of intravenous administration, overall response rate was 18.5% (22.2% for bladder cancer, 30.0% for tumors of the renal pelvis and ureter, and 6.7% for prostatic cancer). In the case of intra-arterial administration, overall response rate was 42.9% (50.0% for bladder cancer). For 50 patients with superficial bladder cancer intravesical chemotherapy with THP was performed. Sixteen patients showed complete disappearance of the tumor, 2 patients showed more than 90% tumor regression and 12 patients showed more than 50% tumor regression, respectively. Overall response rate was 60%. Cardiotoxicity was minimal. Alopecia was noted in a total of 16 patients, but this was minimal. Leukocytopenia was the major adverse effect among patients undergoing systemic THP administration. In conclusion, THP was most effective against transitional cell carcinoma of the urinary tract.

Adult↗