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Biomedical subjects

H Shirato

Publications and source records attributed to H Shirato.

At least 91 records · Page 5Linked to original sources
PubMed1993

[Lymphangial infusion of carboplatin and iodized-oil emulsion: phase I trial].

We examined lymphography as an interventional radiological technique for suppressing microscopic metastasis to the pelvic and paraaortic lymph nodes. There were no reports on this method in our survey of the literature. We performed a dose-escalation study as a phase I trial to determine the maximum dose that could be given without intolerable complications. From September 1991 to April 1992, carboplatin and iodized-oil emulsion was injected into both feet of 10 patients by the Kinmonth method. In the first 5 patients 5 mg of carboplatin was injected into each foot, and 10 mg was injected in the next 5 patients. When the injection of 15 mg was attempted, the injection could not be completed because carboplatin powder was deposited in the syringe. The amount of carboplatin was limited by the instability of the carboplatin-lipiodol emulsion at 15 mg in the present study. There were not intolerable complications. In one case in which 10 mg was injected into each foot, the average platinum concentration in resected pelvic lymph nodes was 0.83 microgram/gWet (maximum: 3.51 micrograms/gWet) even a week after treatment. Serum platinum was undetectable (< 50 ng/ml). These results suggest that a high concentration of carboplatin can be preserved for a long time by this novel interventional technique.

Adult↗
PubMed1993

[A clinical and pathological study of non-Hodgkin's lymphoma of the nasal cavity and paranasal sinuses].

We studied 30 patients with early stage malignant lymphomas involving the nasal cavity and/or paranasal sinus who were treated between 1972 to 1991 in Hokkaido University Hospital. The mean age of the patients was 60.6 yr, and the male-to-female ratio was 2.6. The predominant histologic type was diffuse large cell type (n = 23). Treatment policy differed depending on time: radiotherapy (RT) alone between 1972 and 1980 (n = 15), RT followed by modified CVP or CHOP between 1981 and 1988 (n = 10) and BACOP followed by RT between 1989 and 1991 (n = 5). Overall five-year survival was 53%. Better survival was observed in patients with B-cell type (72%), smaller mass (tumor limited to the unilateral nasal cavity or paranasal sinus) (76%), and patients who were treated with combination chemotherapy (BACOP) followed by RT (100%). Eleven patients experienced recurrence. Four of nine local recurrences were in patients with T-cell lymphoma. CNS relapse was observed in three patients with T-cell lymphoma. We conclude that T-cell lymphoma arising at the nasal cavity and/or paranasal sinus needs careful follow-up for its high frequency of local and CNS relapse. More intensive treatment such as prophylactic whole brain RT, intrathecal administration of MTX or third generation chemotherapy (e.g. MACOP-B) might improve survival in these patients.

Adolescent↗
PubMed1993

Is postoperative radiotherapy beneficial in the management of stage I-II squamous-cell carcinoma of the uterine cervix with negative metastatic nodes and positive parametrial involvement?: A retrospective review of 70 patients.

Seventy patients having squamous-cell carcinoma of the uterine cervix FIGO Stage I-II with negative lymph nodes and positive parametrial involvement received postoperative radiotherapy following radical hysterectomy and pelvic lymphadenectomy. In 48 patients with microscopic parametrial invasion, the 5-year survival rate was 92%. The other 22 patients with macroscopic parametrial involvement had a 5-year survival rate of 75%. The overall recurrence rate was 13% (9 of 70). The sites of failure were 3 pelvic alone, 5 distant metastases alone, and 1 combined pelvis and para-aortic lymph node. All of those with recurrence were Stage-II cases. The absolute pelvic-control rate was 94.3% (66/70). Fifty-six percent of the patients experienced mild-to-moderate lymphedema. Severe complications requiring surgical intervention were observed in 6 patients (5 bowel obstructions and 1 femoral head fracture). A review of the literature suggests that early carcinoma can be successfully treated by surgery alone. Taking into consideration the risk and benefits involved, postoperative radiotherapy is not recommended for most cases with cervical carcinoma with negative lymph nodes and positive parametrial involvement in the present form, despite excellent local control. However, no definite conclusion can be drawn from this retrospective analysis.

Adult↗
PubMed1993

Squamous cell carcinoma antigen in serum for monitoring of head and neck and uterine cervical squamous cell carcinomas after radiotherapy.

Squamous cell carcinoma antigen (SCC-A) in serum was serially measured during follow-up of 96 squamous cell carcinoma patients (75 head and neck cancers and 21 uterine cervical cancers), treated with radiotherapy. In 27 of the patients with head and neck cancer and in 12 of those with cervical cancer SCC-A had also been measured before radiotherapy. In this head and neck carcinoma group, the median level of SCC-A was 1.3 (95% CI: 1.2-1.9) ng/ml before radiotherapy and 1.4 (CI: 1.1-1.5) ng/ml after radiotherapy. In the cervical carcinoma group, the median SCC-A decreased significantly (p < 0.001) from a pretreatment value of 7.5 (CI: 3.8-26.3) ng/ml to a posttreatment value of 0.9 (CI: < 0.5-1.8) ng/ml. In the total group of 75 head and neck cancers 21 relapses occurred and in 4 of these the relapse was detected at a clinically silent stage by an elevation of serum SCC-A. The same was true for 4 of the 9 relapses that occurred in the total group of uterine cervical cancer. The study suggests that serum SCC-A may be useful for posttreatment monitoring of patients with uterine cervix cancer while its value in head and neck cancer probably is more marginal.

Adult↗
PubMed1993

Relation between preoperative CT findings in rectal cancer and local recurrence rate. A pilot study.

To identify predictive factors of local recurrence possible to use as criteria for preoperative radiotherapy, we reviewed the CT scans of 51 patients undergoing curative resection for rectal cancer. Seven patients developed local recurrence. The presence of the CT images of spicular structures or a fibrous soft tissue layer around the rectum was related to extrarectal spread with a positive predictive value of 88% (30/34) when compared with the pathology. Six out of 34 cases with these CT findings developed recurrence, compared to only one out of 17 cases without such findings. The recurrence rate was especially high, (4/14), in patients where the abnormal tissue as judged by CT was attached to the perirectal fascia or extended beyond it. CT may be a useful tool for predicting local recurrence by using the perirectal fascia as a diagnostic marker.

Adult↗
PubMed1993

[Linac-knives].

Stereotactic radiotherapy using linear accelerators (Linac-knives) is a promising approach for treatment of metastatic brain tumors, arterio-venous malformations, and benign brain tumors. The advantages of the linac-knife over the Gamma knife are its capacity for stereotactic fractionated radiotherapy and to extend the indication for head and neck tumors and cervical spinal tumors.

Arteriovenous Malformations↗
PubMed1993

[Prospective dose-escalation study in stereotactic radiotherapy utilizing a linear accelerator: report from East Hokkaido Radiosurgery Study Group (EHRSSG)].

Stereotactic radiotherapy utilizing a linear accelerator has been investigated. (1) Radiosurgery, (2) fractionated stereotactic radiotherapy, and (3) fractionated radiotherapy followed by stereotactic boost have been performed according to pathology, size, and prognosis of diseases. Accuracy in localization of the treatment center was within one millimeter using a CT simulator. From July, 1990 to December 1992, 69 lesions in 63 patients have been treated using the stereotactic radiotherapy according to prospective dose-escalation design. Five patients have experienced transient worsening of nerve palsy or headache, but these complications were self-limited. No late radiation damage was observed over a mean follow-up period of 12.5 months. Encouraging improvements were obtained in patients with metastasis, AVM, and acoustic neurinoma although the follow-up period was too short to be conclusive. Stereotactic radiotherapy utilizing a linear accelerator is thus suggested as a safe and effective approach providing that dose-volume-time relationship is well controlled.

Adolescent↗
PubMed1990

[Late adverse reactions of non-ionic intravenous contrast media].

A prospective study of late adverse reactions of non-ionic intravenous contrast media was performed. Information was collected from questionnaires returned by the patients, and also from further interviews. The incidence of adverse reactions was 8.3% in all patients, and was higher in female (11.1%) than male (5.8%). They were more frequent in the patients with age ranging from 20 to 49 than those older than 50. The most frequent symptom was headache, followed by itching, skin rashes, nausea, dizziness, and general fatigue. More than half of the reactions occurred within six hours after injection, but reactions a few days later were also reported.

Adolescent↗
PubMed1990

[Radiotherapy of carcinoma of the uterine cervix--high dose rate intracavitary irradiation using a linear source arrangement].

We analyzed the records of 339 patients with squamous cell carcinoma of the uterine cervix. The patients were treated by irradiation alone in the period of 1973-1985 with external and high-dose rate intracavitary irradiation using linear source arrangement. The reason for using the linear source arrangement was to ensure the position of source as well as to simplify the technique of intracavitary irradiation. First, external irradiation was performed mainly with a dosage of 50Gy/25f four times a week or 50.4Gy/28f five times a week. Intracavitary irradiation was then carried out mainly with a dose of 30Gy/6f two times a week or 35Gy/7f two times a week and dose was indicated at point A. The 5-year survival rate of all 330 patients were 51.4%, and 55.1% for stage I (N = 19), 66.7% for stage II (N = 88), 47.1% for stage III (N = 212), 33.7% for stage IV (N = 20). Of the patients followed up for 24 months and found to have recurrence, 21.8% (39/179) had a recurrence in the pelvis and 22.1% (39/175) were found to have a distant metastasis. Of the patients followed up for over 24 months, 21.5% 932/149) developed intestinal complications and 12.2% (18/149) developed bladder complications. However complications Grade 2-4 were 5.4% for intestinal complications and 2.0% for bladder complications. From these results high-dose-rate intracavitary irradiation using a linear source arrangement was considered to be an effective treatment of carcinoma of the uterine cervix and to produce a standard results of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Lack of late skin necrosis in man after high-dose irradiation using small field sizes: experiences of grid therapy.

Out of a total of 437 patients with superior vena caval syndrome or advanced malignancy, given single-dose grid radiotherapy, four survived to 7 years. The dose to the skin under each of the 77 holes in the grid was approximately 58 Gy. The lack of skin necrosis in the total of 308 skin circles of 1 cm diameter among these survivors, compared with known necrosis rates in larger irradiated areas, implies that there is a marked field-size effect for late necrosis in small areas of irradiated skin.

Adult↗
PubMed1990

[A randomized trial of single and multifraction radiation therapy for bone metastasis: a preliminary report].

From April, 1989 through January, 1990, a randomized trial was conducted to investigate the efficacy of single fraction radiation treatment (8, 10, 12, 15Gy) compared to a multifraction dose schedule (5Gy x 4, 5Gy x 5, 5Gy x 6) as a therapy for a bone metastasis. Both subjective and objective pain scores were used to measure the therapeutic results. A total of 31 patients participated in the trial and, for analysis, 27 of these patients were follow-up for more than 8 weeks after the start of the radiation therapy. The following statistics resulted. Of the single fraction series, symptomatic pain relief was obtained in 86% of the patients (12/14 treatment areas), and of the multifraction series, 92% (12/13). Further, a complete response was achieved in 57% (8/14) of the single fraction patients and 31% (4/13) of the multifraction patients, respectively. Between the two treatment regimens, no difference was found in the incidence of pain relief, speed of onset, or acute morbidity. Finally, no severe morbidity was seen in either arm.

Adult↗
PubMed1990

[Intrahepatic bilomas after hepatic arterial embolization of malignant hepatic neoplasms].

Reviewed and discussed are six cases of intrahepatic biloma that developed after hepatic arterial embolization therapy for malignant hepatic tumors. All six cases were administered emulsion of adriamycin and lipiodol and/or sponge gel particles, as the etiology of their disease was considered to be bile duct necrosis due to obstructions of peripheral supplying arterial branches. From the 23rd to the 76 days after embolization therapy, each lesion was detected by CT scan, and every case showed an elevation of serum alkaline phoshatase. Further, in 4 cases, hepatobiliary scintigraphy revealed a delayed bile clearance in the hepatic lobe. In one case followed up for 2 months, only one of two lesions disappeared. And in 5 cases that were followed up for more than 4 months, recovery occurred in 4 cases without any further treatment, but another case required percutaneous drainage for 3.5 months to be cured. An intrahepatic biloma, or bile duct necrosis, is a complication that can arise from hepatic arterial embolization therapy, so that careful follow-up must be given.

Aged↗
PubMed1989

Biological equivalent dose prediction in pion irradiation using pion star density and the mixed beam lesion additivity model.

The biological equivalent dose profile of the pion beam was predicted with one parameter (gamma) using physical dose and pion star density. The value of the relative biological effectiveness (RBE) at each depth was given as a linear function of pion star density (PSD): RBE = 1.0 + gamma PSD, assuming (i) the mixed beam lesion additivity model and (ii) the linear relationship between the ratio of high LET dose to total dose and pion star density. The predicted depth-survival curve fitted well with the pooled biological data of the gel technique using Chinese hamster cells (CHO). The predicted RBE were consistent with previously published results through the flat dose peak, except at the decreasing portion of the dose profile. The practical usefulness of this model in clinical treatment is stressed.

Animals↗
PubMed1989

[Relapse of the stage I & II non-Hodgkin's lymphoma of the head and neck--factors relating to the chance of long-term survival].

A review has been made of 36 patients who, after initial treatment for early non-Hodgkin's lymphoma originating in the head or neck, incurred a relapse, and factors relating to their chances of long-term survival, i.e., greater than three years, have been sought. Informatively, the overall 1-year and 5-year survival after such a relapse has been 18% and 15% respectively. The factor most significantly related to long-term survival was the site of the lymphoma and the extent of the initial relapse. For those affected in the neck region alone, four out of five survived for more than 48 months after the relapse (p less than 0.0001). The pathological subtype of the initial lymphoma was the second most significant factor (p less than 0.02). Another factor drawing our attention was the history of the prophylactic adjuvant therapy. No patient survived for more than a year after relapse if they had a history of prophylactic adjuvant therapy (0/10), whereas five long-term survivors were patients with no history of such therapy (0.1 less than p less than 0.2).

Adolescent↗
PubMed1987

[Combined chemotherapy and radiotherapy in recurrent tumors of the head and neck region].

Over the past four years, 27 patients with recurrent tumors of the head and neck region have been treated with chemotherapy. The regimens used were BCMF (bleomycin 15 mg i.v. for 3 days, cyclophosphamide 500 mg i.v., methotrexate 50 mg i.v. and 5-fluorouracil 500 mg i.v.) and CMU (cyclophosphamide 350 mg/m2 i.v., methotrexate 30 mg/m2 i.v. and UFT 600 mg p.o. for 14 days). Of the 27 patients, eight were treated with combined radiation and chemotherapy, and either CR or PR was obtained. Nineteen patients were treated with chemotherapy alone, for which the response (CR + PR) rates were 8% (1/12) for BCMF and 43% (3/7) for CMU, respectively. No serious toxicities were observed as a result of these regimens. It was thus demonstrated that the CMU regimen was of great value in terms of improved response and minor toxicity in the treatment of head and neck tumors.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

[Interstitial irradiation by 192Ir seed assemblies in fixed cervical lymph node metastases].

Eleven patients with fixed cervical lymph node metastases were treated using external irradiation followed by interstitial implants, 137Cs needles were used for one patient and 192Ir seed-assemblies for 10 patients. The local tumor responses were 4 CR, 6 PR and 1 NC. Acute tolerance was good, and there were no major late injuries except for one case of severe subcutaneous fibrosis. No morbidities such as local infection, bleeding or pulmonary injuries were encountered. Clear-cut dose control relationships were demonstrated; the local control of the nodes treated with intervals of more than one month between external and interstitial irradiation was poor. It is considered that adequate treatment is to give 40 Gy over 4 weeks by external irradiation first, then, after an interval of 2 weeks, to give 40-50 Gy over 4-5 days using 192Ir interstitial implants. The interstitial implants appeared to provide an improvement in local control and in the therapeutic ratio of fixed cervical lymph node metastases.

Aged↗