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Biomedical subjects

H Fukuma

Publications and source records attributed to H Fukuma.

At least 55 records · Page 3Linked to original sources

[Recent status of the diagnosis and treatment of bone metastasis in patients with advanced lung cancer].

The incidence and prognosis of patients with bone metastasis in primary advanced lung cancer were studied retrospectively. Between Jan. 1980 and Dec. 1985, 289 cases entered various kinds of chemotherapy protocol studies. Patients with bone metastasis of non-small cell lung cancer (NSC) comprised 44% (86/192), and those with small cell lung cancer (SC) comprised 43% (42/97). Histologically, 48% of adenocarcinoma, 50% of large cell carcinoma and 31% of squamous cell carcinoma showed bone metastasis. 8 percent of NSC bone meta (+) cases had an initial symptom of bone metastasis. Bone scan and bone X-ray were complementary and useful for diagnosis of bone metastasis, and sequential examinations tended to reduce the incidence of false-positive cases. Vertebral column, rib, pelvis and femur were the most common sites. Over 70% of the bone metastasis were in multiple skeletal systems, and 90% showed multiple-site involvement for both NSC and SC. Radiation therapy effectively reduced severe pain but paralysis was hard to control. In very few cases surgical treatment was indicated because of multiple bone metastasis, and systemic dissemination. Bone scan in 12% of SC patients showed apparent improvement with systemic chemotherapy. Among the M1 group of adenocarcinoma, median survival was 9 months in bone (+) cases, 11 months in bone (-) cases, 2 year survival was 8%, and 24%, and 3-year survival 2% and 22%, respectively. Among the bone(+) group and bone(-) group in ED cases of SC, median survival was 10 months vs. 11 months, and 2-year survival rates were both 13%. 22 percent (8/36) of squamous cell carcinomas without bone metastasis showed hypercalcemia (5.5 mEq/l). In patients with advanced lung cancer the major goal of treatment is recovery of the performance status of the patient and the relief of pain. In the case of SC, intensive systemic chemotherapy should be conducted as an adjuvant to local therapy.

Adenocarcinoma↗

Response to antitumor agents of murine transplantable tumors implanted onto chorioallantoic membrane of chick embryo.

The chorioallantoic membrane of chick embryo was used to examine the chemosensitivity of the murine tumors, B16-F1 melanoma, B16-F10 melanoma, Meth-A fibrosarcoma, and Ehrlich carcinoma. The tumors were grown on the membrane, and the effects of 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea hydrochloride, cyclophosphamide, dacarbazine, 5-fluorouracil, methotrexate, adriamycin, mitomycin C, vincristine, and cisplatin on the growth of the tumors were tested by iv injection into a vein of the chorioallantoic membrane or injection into the yolk sac. The use of chick embryo limits the time for drug exposure to 3 or 4 days, but Ehrlich carcinoma and Meth-A fibrosarcoma needed longer for the test; the use of irradiation from a cobalt source overcame the problem by increasing the growth rate of the grafts of these two tumors. There appeared to be a good correlation between the effects of the drugs on B16 melanomas grown in the eggs and in the original animals. Many compounds, including pro-drugs such as cyclophosphamide and dacarbazine, could be assayed in this way.

Allantois↗

[Autologous bone marrow transplantation in osteosarcoma].

Four patients with osteosarcoma were treated with intensive chemotherapy and autologous bone marrow transplantation (ABMT). The patients received high-dose methotrexate (9-12 mg/m2) with citrovorum factor rescue, high-dose melphalan (60 mg/m2 X 3), actinomycin D (0.5 mg/m2 X 3), adriamycin (30 mg/m2 X 2) and high-dose cyclophosphamide (60 mg/kg X 2) during 4 weeks. Bone marrow was aspirated and cryopreserved before treatment and reinfused 48 hours after the completion of chemotherapy. Two of four patients had advanced osteosarcoma with multiple pulmonary metastasis, one of whom had responded well and achieved partial response while the other had shown no response, and both patients died of disease progression 4 and 11 months after ABMT, respectively. The other two patients who received this regimen at an earlier disease stage for prevention of pulmonary metastasis, are alive and well without any evidence of metastasis 31 and 18 months after ABMT, respectively. This regimen was tolerated well in all patients except for mild nausea and vomiting. No infectious episodes were observed during the period of aplasia which continued for 19 to 38 days after marrow infusion. These results suggest that this supralethal combination chemotherapy is safe and tolerable when used with ABMT and effective for patients with osteosarcoma, especially when applied in the non-metastatic phase.

Antineoplastic Combined Chemotherapy Protocols↗

[Treatment of rhabdomyosarcoma at the National Cancer Center Hospital].

Seventy-nine patients with rhabdomyosarcoma (RMS) received treatment at the National Cancer Center Hospital between 1962 and 1985. The patients ranged in age from 4 months to 74 years with a median age of 6 years. Forty-six patients were male and 33 were female. The primary tumor site of RMS was the same as in the previous report. The head and neck region was the most frequent site (40.5%), followed by the extremities (34.1%), genitourinary region (15.2%), trunk (5.1%) and retroperitoneum (5.1%). Histologic types were embryonal RMS in 45 patients, alveolar RMS in 23 patients, pleomorphic RMS in 8 patients and unclassified RMS in 3 patients. As of October 1985, 14 of the 79 patients were still alive. Between 1962 and 1971, 38 patients were not treated by any protocol. After 1972, 41 patients received treatment using a 3 stage-related, multiple-modality program. In the first protocol, chemotherapy consisted of Vincristine, Cyclophosphamide, and Actinomycin-D, and 1 of 18 patients have survived more than 5 years. The cumulative 5-year survival rate of the first protocol was 11.1%. In the second treatment program, which involved Adriamycin in addition to the 3 drugs cited above, 4 of 23 patients have survived more than 5 years. The cumulative 5-year survival rate, 33.2%, was very improved.

Adolescent↗

[Diagnosis and treatment of metastatic bone cancer of the extremities].

Eight hundred and thirty-six patients with metastatic cancer in the bone excluding autopsy findings, occurring between January, 1976 and December, 1985 were reviewed. The most frequent site of primary focus was the breast (33.2%), followed by lung (24.6%). Three hundred and forty-two patients (40.9%) were male and 494 (59.1%) female. Diagnosis of bone metastasis was based on abnormal accumulation in the bone scintigram and abnormal findings in the bone X-ray at the same site. Out of 836 patients, 285 had metastatic skeletal lesion including extremities and 43 had a solitary lesion of the extremity. The most frequent site of bone metastases in the extremity was proximal femur and involvement of the femur was 65.2% and that of humerus was 25.6%. The majority of the patients were treated by irradiation (24.9%), irradiation with chemotherapy and/or hormone therapy (21.1%), chemotherapy (18.6%) and chemotherapy with hormone therapy (17.2%), on the other hand, only 25(8.8%) of 285 patients were treated by surgical procedures. Cumulative survival rate after diagnosis of bone metastasis varied with site of primary focus and 5 year survival rate of all cases was 6.1%. Clinical courses after skeletal metastasis were separated into two types, and one type was breast type which was slow and other type was lung type which was rapid. The most important factor for the prognosis of the patients with bone metastasis is thought to be the primary site of origin.

Adult↗

[A case of extraorbital sebaceous carcinoma].

A case of sebaceous carcinoma of the forehead of a 77-year-old male is reported and discussed and included in a review of all such cases reported in Japan. The patient had a round erosion on the right forehead that had caused itching for 15 months. An excisional biopsy of that lesion disclosed a malignancy and a subsequent wide excision was performed. The tumor recurred several times after excision and partially effective radiation therapy. The patient finally died of aspiration pneumonia 3 years after the first operation. An autopsy revealed that he had a recurrent sebaceous carcinoma extending to the periosteum of the right temporal bone and a solitary pulmonary metastasis.

Adenocarcinoma↗

Malignant peripheral nerve tumors: a clinicopathological and electron microscopic study.

Sixteen cases of malignant peripheral nerve tumors that were recorded in the files of the Department of Orthopedics, National Cancer Center Hospital, Tokyo, between 1972-July 1983 were studied clinicopathologically. The patients' ages ranged from 24-51 years, and both sexes were affected equally. Histologically, in 13 cases of nerve sheath tumors the tumors were spindle-cell type, two of these patients had manifestation of multiple neurofibromatosis (von Recklinghausen's disease). One malignant epithelioid schwannoma was found to arise from the tibial nerve. Other two cases were of primitive neuroectodermal tumors (primary malignant peripheral neuroblastoma) which showed rosette formation. The common primary symptoms in all patients were a noticeable mass which increased in size over a variable period of time, with or without associated pain and tenderness. Ultrastructural findings of spindle-cell type (in 7 tumors examined) and epithelioid type (1 tumor) showed evidence of Schwann cell differentiation of the tumors in all cases. Immunohistochemically, by the PAP method (Sternberger), staining for S-100 protein was positive in 3 of 14 tumors. Ultrastructural findings in two S-100 protein-positive cases showed evidence of Schwann cell differentiation better than the S-100 protein-negative cases, such as pronounced interdigitation of cytoplasmic processes, presence of fibrous long-spacing collagen and well-developed basal lamina. Local recurrence occurred in nine patients, and metastasis was found in five. The total 5-year survival rate was 58.5%. Tumors associated with multiple neurofibromatosis and primary peripheral neuroblastomas had the worst prognosis. Complete removal of the tumor by means of wide excision as primary treatment seemed to be the most important factor in decreasing the morbidity and mortality rates.

Adult↗

[Adjuvant chemotherapy in the treatment of primary soft tissue sarcomas, with special reference to intra-arterial infusion chemotherapy].

Seventy-eight cases of adjuvant chemotherapy for primary soft tissue sarcoma including 51 cases of intra-arterial infusion chemotherapy were studied. The patients ranged in age from 1 to 92 years with a median age of 34 years. Thirty-nine patients were male and 39 were female. The seventy-eight cases were comprized of 17 rhabdomyosarcoma, 12 liposarcoma, 12 neurogenic sarcoma, 10 malignant fibrous histiocytoma, 8 leiomyosarcoma, 7 angiosarcoma, 8 others and 4 unclassified sarcomas. Fifty-one patients with soft tissue sarcoma of the extremities were treated by intra-arterial infusion chemotherapy with either VCQ (Vincristine and Carbazilquinone) or VCQ, A (Vincristine, Carbazilquinone and Adriamycin). Out of 42 patients with measurable lesions, 2 CR, 4 PR, 33 NC and 3 PD were obtained. Histological examinations demonstrated histological effect of GI 19, G IIa 11 and G IIb 7 by Ohboshi and Shimosato's criteria. Remarkable effects of treatment were noted in most rhabdomyosarcoma patients. After intra-arterial infusion chemotherapy, a variety of surgical procedures ranging from marginal resection and wide resection to radical amputation were employed in 44 patients. Local recurrence was 27% and distant metastasis developed in 47% of cases.

Adolescent↗

[Clinical experience with alpha and beta interferon in childhood cancer].

Alpha and beta interferon were tested for antitumor activity and clinical toxicity in 15 children suffering from cancer. The drug was administered IV, IM, IT or intralesionally daily in the majority of cases in total doses of 18 X 10(6) to 9,634 X 10(5) IU. Major toxicities were a flulike syndrome, elevation of transaminase activity and leukopenia. A minor response (less than 50%) was observed in one patient with glioblastoma, treated by intrathecal administration, and an objective local response was noted in one rhabdomyosarcoma patient with multiple subcutaneous metastases, who was treated by intralesional administration. CNS leukemia in two patients improved without hematological response. Further trials are warranted.

Adolescent↗

Antitumor effect of human leukocyte interferon on human osteosarcoma transplanted into nude mice.

We studied the effect of human leukocyte interferon (HuIFN-alpha) on a human osteosarcoma (OS-OH) transplanted and passed serially in athymic mice. The growth of OS-OH was strikingly inhibited by HuIFN-alpha (50,000 IU/mouse), regardless of whether the interferon treatment was initiated 24 hr after tumor inoculation or 2 weeks later, when tumors had grown to an appreciable size (4-6 mm). The antitumor effect of HuIFN-alpha was found to be dose-dependent and a daily administration of HuIFN-alpha (50,000 IU/mouse) all but completely arrested the tumor growth.

Adult↗

Clinical significance of abnormal accumulations found in the vertebrae on the bone scintigram of cancer patients.

From January 1975 to December 1976, 180 cancer patients were found to have abnormal accumulations in the vertebrae on their bone scintigrams. These patients were carefully surveyed through their clinical records for more than two years follow-up, x-ray pictures, and autopsy findings; and finally 115 patients were selected for this study. Abnormal accumulations were classified into two categories; significantly positive and equivocal. Among thses 115 patients, significant accumulations were found in 85, and equivocal in 17. The remaining 13 showed both significant and equivocal accumulations. In 81 out of 98 (85 + 13) patients, the significant accumulations were due to metastases; and in 15 out of 30 (17 + 13) patients, the equivocal accumulation only are taken into consideration, the true positive cases are only 3 of the 17. The major factor for false positive was degenerative changes of the vertebrae in either group of significant or equivocal accumulations. Although it is difficult to differentiate benign changes of the vertebrae from the metastases on the bases of scintigram findings only, a cushion-like pattern in disc degeneration as well as in colapse of the vertebral body, a vague concentration with indistinct margin in spondlyosis deformans, and symmetrical accumulations in the intervertebral joints due to sclerotic changes are helpful in evaluating the bone scintigram of cancer patients, together with the site of abnormal accumulation and the age of the patient.

Adult↗

Delayed hypersensitivity reaction in patients with bone and soft tissue sarcoma.

In patients with sarcoma of the extremity, the tuberculin and dinitrochlorobenzene (DNCB) skin test were performed to correlate the results with the extent and prognosis of disease. Of the tumor-bearing patients, 60.0 per cent gave a positive tuberculin test and 48.9 per cent a positive DNCB test, with a significant difference from the control group with regard to the incidence of positive results in the later test (P less than 0.03). There was no difference between the different stages in the incidence of positive reactions to tuberculin but a marked difference in that to DNCB (78.6%, 40.7% and 0%). Between survivors and those who died, there was no difference in the incidence of a positive tuberculin test but a significant difference was present in that of a positive DNCB test (P less than 0.04), a difference which may be considered to reflect that in stage of disease process at the time of first examination.

Adolescent↗