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Biomedical subjects

Kenji Eguchi

Publications and source records attributed to Kenji Eguchi.

At least 37 records · Page 2Linked to original sources
PubMed2004

Doublet regimen of cisplatin plus docetaxel for second-line chemotherapy after prior therapy with cisplatin plus irinotecan for non-small cell lung cancer: a phase II study.

BACKGROUND: To evaluate the safety and efficacy of second-line chemotherapy with docetaxel and cisplatin for non-small cell lung cancer (NSCLC), we performed a phase II study. METHODS: The subjects were 25 patients with NSCLC, 75 years or younger, without organ dysfunction (performance status [PS], 0 to 2) in whom treatment with cisplatin and irinotecan had been ineffective or had been followed by recurrence or relapse. Four weeks or more after the end of the previous therapy, 60 mg/m2 of cisplatin and 60 mg/m2 of docetaxel were administered at intervals of 3 weeks. RESULTS: Observed toxicities of grade 3 or 4 included anemia (24% of patients), leukocytopenia (48%), neutropenia (76%), thrombocytopenia (4%), hepatic dysfunction (8%), and electrolyte abnormalities (4%). However, no severe nonhematologic adverse reactions occurred. The overall response rate was 32% (95% confidence interval, 13.7-50.3). The median time to disease progression was 98 days, and the median survival time was 257 days. CONCLUSION: Our results suggest that cisplatin and docetaxel can be used as second-line chemotherapy against NSCLC. But further, comparative, study of this combination should be performed in patients with good PS and organ function who have responded to prior platinum-based chemotherapy.

Adult↗
PubMed2004

Hypercalcemia-leukocytosis syndrome associated with lung cancer.

Hypercalcemia and leukocytosis are two of the most common paraneoplastic syndromes associated with various malignancies. Of note, concomitant manifestation of hypercalcemia and leukocytosis are occasionally observed in the same cancer patients. However, the relationship between these two paraneoplastic syndromes and clinical outcome is unclear. In the present study, we retrospectively investigated the occurrence of hypercalcemia (> or = 10.2 mg/dl after adjustment for serum albumin concentration), leukocytosis (> or = 14,000/mm3 with no evidence of infection) or both in lung cancer patients (1149 cases). There were 65 cases (5.7%) of hypercalcemia, 16 cases (1.4%) of leukocytosis and six cases (0.5%) of both hypercalcemia and leukocytosis at the time of first presentation. The occurrence of these two distinct paraneoplastic syndromes in the same patients was more frequent than could have been expected by chance alone (P < 0.001). There was a significant correlation between the hypercalcemia-leukocytosis syndrome and performance status (P = 0.002). Survivals of patients with hypercalcemia alone (median survival time: MST 3.8 months, n = 59), leukocytosis alone (MST 1.9 months, n = 10), and the hypercalcemia-leukocytosis syndrome (MST 1.5 months, n = 6) were significantly shorter than those without them (MST 9.5 months, n = 1074; P < 0.001). Moreover, survival of patients with the hypercalcemia-leukocytosis syndrome was significantly shorter than that of patients with hypercalcemia alone (P = 0.013). On the other hand, there was no significant difference in survival between the hypercalcemia-leukocytosis syndrome and leukocytosis alone (P = 0.47). Multivariate analysis of prognostic factors using the Cox proportional hazards model could not demonstrate that the hypercalcemia-leukocytosis syndrome had independent prognostic significance. In conclusion, our results suggest that the hypercalcemia-leukocytosis syndrome is an additional clinical entity of paraneoplastic syndrome and is an indicator for poorer outcome in lung cancer patients, although the frequency of the combined syndrome is very rare (0.5% of cases over a 10 year interval.

Adult↗
PubMed2003

Perceptions and attitudes of clinical oncologists on complementary and alternative medicine: a nationwide survey in Japan.

BACKGROUND: The prevalence of complementary and alternative medicine (CAM) is increasing worldwide because of the growing public interest in natural or holistic therapies and because of the flow of information through the Internet. However, there is a lack of communication between cancer patients and their physicians on topics relating to CAM. The authors performed a cross-sectional survey to evaluate the perceptions and attitudes of Japanese clinical oncologists toward cancer CAM. METHODS: The CAM questionnaires were sent to 2118 clinical oncologists. The questionnaires gathered data on background (age, gender, years in practice, specialty, and knowledge of cancer CAM), perception (effectiveness/ineffectiveness, scientific evidence, and drug interactions), and attitude (experience with and response to CAM users). Questions about oncologists' perceptions and attitudes to CAM were limited to herbs and other natural products that were sold over the counter. RESULTS: One hundred sixty-six questionnaires were returned as undeliverable. Of the remaining questionnaires, 751 were returned (a response rate of 39%). Two-thirds of the responders were surgical oncologists and most of the remaining responders were medical oncologists. The majority of oncologists (82%) believed that CAM products were ineffective against cancer. The main reason for this belief was a lack of reliable information (as cited by 85% of oncologists). Only 13% of oncologists had experienced CAM-associated disease improvement in their cancer patients. Of all the oncologists, 84% considered the possibility of drug interactions between anticancer drugs and CAM products. The majority of oncologists (80%) replied that they could neither promote the use of CAM products nor recommend quitting the products, when they were asked about the use of CAM products by cancer patients. CONCLUSIONS: Negative perceptions of CAM products persist among clinical oncologists. A lack of proven effectiveness of CAM products and concerns about drug interactions with anticancer treatment suggest a need for both accurate information on CAM products and clinical trials.

Attitude of Health Personnel↗
PubMed2003

Prospective study of thoracoscopic limited resection for ground-glass opacity selected by computed tomography.

BACKGROUND: With recent advances in low-dose helical computed tomography (CT), detection of ground-glass opacity (GGO) has increased. The aim of this study was to correlate high-resolution CT (HRCT) findings with pathologic features and to evaluate the efficacy of thoracoscopic limited resection for focal GGO, which were selected based on HRCT findings. METHODS: Focal GGO lesions were classified into two subtypes based on HRCT findings: pure type and mixed type. Ninety-six patients with persistent GGO 2 cm or less in diameter underwent pulmonary resection from January 1997 to December 2001. Among these, thoracoscopic wedge resection was performed prospectively between June 2000 and December 2001 in 33 patients with pure GGO lesions that were 1 cm or less. RESULTS: Thoracoscopic wedge resection was completed with complete safety. The histologic diagnoses of these 33 lesions were adenocarcinoma in 1, bronchioloalveolar carcinoma (BAC) in 23, and atypical adenomatous hyperplasia (AAH) in 9. No patients have had any evidence of tumor recurrence to date. Of the total 96 GGO lesions, 93.0% (53/57) of pure GGO 1 cm or less were BAC or AAH, whereas 38.5% (15/39) of pure GGO larger than 1 cm or mixed GGO were adenocarcinoma. CONCLUSIONS: Pure GGO 1 cm or less was characteristic of noninvasive lesions. Thoracoscopic limited resection for small GGO lesions selected by HRCT was valid.

Adenocarcinoma↗
PubMed2003

Individually different "weights" of quality of life assessment in patients with advanced nonsmall-cell lung cancer.

BACKGROUND AND OBJECTIVE: The structure of quality of life (QOL) assessment was investigated by estimating subject-specific as well as population-averaged "weights" for four domains (functional, physical, mental, and psychosocial) relative to global QOL. METHODS: Among 583 eligible patients with advanced nonsmall-cell lung cancer in two phase III trials, 377 completed QOL questionnaires at baseline, and during treatment. A random coefficients model was applied, using the global QOL score and scores for the four domains as response and explanatory variables, respectively. RESULTS: A large diversity in subject-specific weights was found for the physical and psychosocial domains during treatment and for the psychosocial and functional domains after treatment. The population-averaged weights of all domains were significant during treatment (especially the physical domain), as well as after treatment (except the functional domain). CONCLUSION: Thus, all four domains were associated with global QOL, and the associations varied among individual patients as well as among the domains.

Aged↗
PubMed2003

Influence of clinical parameters on quality of life during chemotherapy in patients with advanced non-small cell lung cancer: application of a general linear model.

OBJECTIVE: The aim of this study was to determine the relative influence of physician-assessed clinical parameters, including non-hematological adverse events and performance status, on quality of life (QOL) during chemotherapy. METHODS: QOL questionnaires consisting of four domains (functional, physical, mental and psychosocial) were self-administered every week during chemotherapy by patients with advanced non-small cell lung cancer in two phase III clinical trials; 377 patients who completed the questionnaires at baseline and at least once during the first course of therapy were analyzed. A general linear model was applied, where the four domains and the clinical parameters (nausea/vomiting, anorexia, diarrhea, fever, peripheral neuropathy and performance status) were used as the response and explanatory variables, respectively. In this model, the multi-dimensional and longitudinal aspects of QOL data were taken into account. RESULTS: All four domains were significantly affected by the occurrence of nausea/vomiting, anorexia and diarrhea. No influence of peripheral neuropathy on the domains was detected. Performance status was significantly related to the domains (except the psychosocial domain). CONCLUSION: This study revealed, by examination of multi-dimensional repeated QOL data, that clinical parameters had significant effects on QOL in patients undergoing chemotherapy. Our findings suggest that supportive care to control non-hematological adverse events, especially gastrointestinal, could maintain overall QOL in cancer patients in an earlier phase of chemotherapy.

Aged↗
PubMed2003

Effects of bronchial intermittent constrictions on explosive flow during coughing in the dogs.

This study tested the hypothesis that intrathoracic bronchi intermittently constrict during coughing and attempted to elucidate the effect on explosive flow. The subjects were 21 dogs having undergone tracheostomy. In the first group A (n = 7), the diameter of the fifth-generation bronchus was measured with a balloon-tipped catheter and the change during coughing was analyzed. In the other group (n = 14), the dogs were vagotomized and coughing was simulated by sequential application of positive and negative airway pressures (sham cough). The effects of the bronchial constriction, elicited by the stimulation of vagus efferent fibers, on explosive flow and airway pressure of sham cough were analyzed. The bronchus was constricted in explosive phase of spontaneous coughing in all the dogs of the first group. When cough bouts were repetitively developed, bronchial constriction and phrenic burst developed simultaneously. The intermittent bronchial constrictions fused and virtually acted as tonic constriction. In the second group of dogs the explosive flow of sham cough consisted of two phases; a short bout followed by a near-constant flow. When the bronchus was constricted, the explosive flow was still biphasic in 12 dogs and an exponential decay pattern formed in 2 of them. In these 12 dogs, the peak explosive flow slightly but significantly decreased (mean +/- SD, 1.39 +/- 0.23 vs. 1.34 +/- 0.23 l/s) and airway pressure in the segmental bronchus became smaller (-1.18 +/- 0.53 vs. -0.15 +/- 0.94 cmH(2)O). We concluded that intermittent bronchial constrictions act as tonic one during coughing. Bronchial constriction slightly decreased the peak explosive flow and moved the choke point to the proximal airway.

Animals↗
PubMed2002

Parathyroid hormone-related protein measured at the time of first visit is an indicator of bone metastases and survival in lung carcinoma patients with hypercalcemia.

BACKGROUND: Parathyroid hormone-related protein (PTH-rP) is a major cause of tumor-induced hypercalcemia (TIH) and frequently is found to be elevated in serum of patients with TIH. In the current study, the authors examined the usefulness of PTH-rP measurement at the time of first presentation in the follow-up of lung carcinoma patients with TIH. METHODS: The authors retrospectively studied 23 of 1149 lung carcinoma patients who were found to have TIH at the time of first presentation for the correlation between serum PTH-rP and the development of bone metastases and survival compared with lung carcinoma patients without TIH who were matched by gender, age, Eastern Cooperative Oncology Group performance status, histological type of tumor, and stage of the disease. RESULTS: Twenty-three lung carcinoma patients with TIH demonstrated significantly increased serum levels of PTH-rP (mean +/- standard error [SE], 84.1 +/- 16.5 pmol/L) compared with control patients without TIH (mean +/- SE, 36.2 +/- 2.0 pmol/L) at the time of first presentation, (P < 0.001). In these hypercalcemic patients, patients whose serum PTH-rP was > 150 pmol/L (n = 16) were found to have a significantly increased rate of bone metastases (71.4% vs. 12.5%; P = 0.01) and decreased survival (median survival of 1.4 months vs. 5.4 months; P < 0.015) compared with patients whose serum PTH-rP was < 150 pmol/L (n = 7). CONCLUSIONS: The data from the current study suggest that serum PTH-rP as determined at the time of first presentation is a useful indicator of not only hypercalcemia but also bone metastasis and eventual survival in patients with lung carcinoma.

Adult↗
PubMed2002

Preparation of purified, sterilized, and stable adenovirus vectors using albumin.

Cesium chloride ultracentrifugation combined with dialysis is a standard method for preparing a high titer of purified recombinant adenovirus. However, it was found that sterilization of the filter membrane after dialysis led to a complete loss of adenovirus activity. A virus pellet was visualized after centrifugation shortly and electron microscopy revealed an aggregation of recombinant virus within the filter membrane following dialysis with 10% (V/V) glycerol in phosphate buffered saline. The entrapment of aggregated adenovirus by the filter membrane explains why adenovirus activity is lost following sterilization. The addition of 1% albumin prevented viral aggregation and allowed the purified virus to retain its activity after filter sterilization. Furthermore, viral activity was retained within the 1% albumin solution for at least 1 week at 37 degrees C and for 2 weeks at 4 degrees C, whereas viral activity within the albumin-free solution was quickly lost.

Adenoviridae↗
PubMed2002

Screening for lung cancer with low-dose helical computed tomography: anti-lung cancer association project.

PURPOSE: Because efficacy of lung cancer screening using chest x-ray is controversial and insufficient, other screening modalities need to be developed. To provide data on screening performance of low-dose helical computed tomography (CT) scanning and its efficacy in terms of survival, a one-arm longitudinal screening project was conducted. PATIENTS AND METHODS: A total of 1,611 asymptomatic patients aged 40 to 79 years, 86% with smoking history, were screened by low-dose helical CT scan, chest x-ray, and 3-day pooled sputum cytology with a 6-month interval. RESULTS: At initial screening, the proportions of positive tests were 11.5%, 3.4%, and 0.8% with low-dose helical CT scan, chest x-ray, and sputum cytology, respectively. In 1,611 participants, 14 (0.87%) cases of lung cancer were detected, with 71% being stage IA disease and a mean tumor diameter of 19.8 mm. At repeated screening, the proportions of positive tests were 9.1%, 2.6%, and 0.7% with low-dose helical CT, chest x-ray, and sputum cytology, respectively. In 7,891 examinations, 22 (0.28%) cases of lung cancer were detected, with 82% being stage IA disease and a mean tumor diameter of 14.6 mm. The 5-year survival rate for screen-detected lung cancer was 76.2% and 64.9% for initial and repeated screening, respectively. CONCLUSION: Screening with low-dose helical CT has potential to improve screening efficacy in terms of reducing lung cancer mortality. An evaluation of efficacy using appropriate methods is urgently required.

Adult↗
PubMed2002

A case of recurrent metastatic thymoma showing a marked response to paclitaxel monotherapy.

We describe a case of recurrent metastatic thymoma showing an excellent response to salvage paclitaxel monotherapy. The patient had undergone a series of platinum-based chemotherapy treatments during the previous 20-month period and the patient's disease was considered resistant to such therapy at the start of treatment with paclitaxel. This is the first report to suggest that paclitaxel has anti-thymoma activity.

Aged↗
PubMed2002

Measurement of localized ground-glass attenuation on thin-section computed tomography images: correlation with the progression of bronchioloalveolar carcinoma of the lung.

RATIONALE AND OBJECTIVE: This study was to measure localized ground-glass attenuation (GGA) in the peripheral lung on thin-section computed tomography (CT) and to assess any relationship between the attenuation and lesion. MATERIALS AND METHODS: Twenty-eight surgically resected tumors with localized GGA at thin-section CT were studied. The tumors were histologically diagnosed as 8 atypical adenomatous hyperplasia (AAH), 11 bronchioloalveolar carcinoma (BAC), and 9 BAC with fibrosis. We assumed three concentric circles, which were 0.8, 1.0, and 1.2 times the diameter of each tumor and measured the average CT values corresponding to inside each circle. We calculated a difference in CT value between 0.8 and 1.2 times the diameter of the tumor and defined as the contrast index. RESULTS: The contrast index for tumors with AAH, BAC, and BAC with fibrosis were 19.8 +/- 8.3, 42.5 +/- 16.0 (P < 0.05 vs. group with AAH), and 111.4 +/- 32.6 (P < 0.0001 vs. Group with BAC), respectively. The contrast index became greater in the stepwise progression from AAH to BAC and from BAC to BAC with fibrosis. CONCLUSION: The contrast index correlated histologic findings of the tumor growth in BAC. The contrast index may be a useful and objective measurement for determining surgical treatment for localized GGA in preoperative diagnosis.

Adenocarcinoma, Bronchiolo-Alveolar↗
PubMed2002

Focal ground-glass opacity detected by low-dose helical CT.

OBJECTIVE: Focal ground-glass opacity (GGO) has been detected increasingly by low-dose helical CT. Although focal GGO suggests in situ neoplastic lesion in the peripheral lung, it remains controversial how to manage these lesions. The purpose of this study was to evaluate the pathologic and radiologic characteristics of focal GGO in order to develop a standard of treatment for these lesions. PATIENTS: Forty-three patients with persistent focal GGO < or = 2 cm in size from January 1998 to September 2000 were studied. Thoracoscopic lung biopsy was performed consecutively for persistent focal GGO following a several-month observation period (mean, 3.7 months). RESULTS: The histologic diagnoses were bronchioloalveolar carcinoma (BAC) in 23 patients, adenocarcinoma with mixed subtypes in 11 patients, and atypical adenomatous hyperplasia (AAH) in 9 patients. None of 34 carcinoma patients had lymph node involvement. All of 17 lesions > or = 1 cm in size were malignant. GGO with solid components on high-resolution CT were highly associated with adenocarcinoma (malignant rate, 93.3%). CONCLUSIONS: Persistent focal GGO after observation for several months was a finding of early adenocarcinoma or its precursor. Especially, lesions > or = 1 cm in size or GGO with solid component were significant signs of malignancy. We concluded lung biopsy should be attempted for persistent focal GGO.

Adenocarcinoma↗
PubMed2002

[Combination chemotherapy with carboplatin and etoposide for elderly patients aged 76 years or older with small cell lung cancer].

Eighteen elderly patients aged 76 years or older with small cell lung cancer were treated with carboplatin (AUC = 4 mg/ml.min, i.v. day 1) and etoposide (70 mg/m2 i.v. day 1-3) and 17 patients were evaluable. The median age of the study population was 77 years (range: 76-81). Eight patients had limited disease (LD) and nine did extensive disease (ED). The overall response rate was 88% for LD patients and 67% for ED patients. Median survival time was 219 days for LD patients and 158 days for ED patients. Grade 3 and 4 leukopenia, neutropenia, thrombocytopenia and anemia occurred in 41%, 76%, 24% and 6% of patients, respectively. There was one treatment-related death due to pneumonitis.

Aged↗
PubMed2002

Expression of eukaryotic initiation factor 4E in atypical adenomatous hyperplasia and adenocarcinoma of the human peripheral lung.

The overexpression of eukaryotic initiation factor 4E (eIF4E), a key regulator of protein synthesis, is involved in the malignant progression of various human cancers. We investigated eIF4E expression in atypical adenomatous hyperplasia (AAH) and adenocarcinomas of the human peripheral lung. On the basis of the WHO criteria with minor modifications, adenocarcinomas were classified as bronchioloalveolar carcinoma (BAC), mixed subtypes with a bronchioloalveolar pattern and minor invasion (early MX), and mixed subtypes with a papillary pattern and marked invasion (overt MX). eIF4E immunohistochemistry was performed in 143 tissue samples (31 AAH, 38 BAC, 43 early MX, and 31 overt MX). Both tumoral and stromal eIF4E levels were elevated from AAH, BAC, and early MX to overt MX and significantly associated with histological grade (P < 0.001 and P < 0.001, respectively). Tumoral and stromal eIF4E staining intensities were significantly correlated (P < 0.01). Immunoblot analysis of 51 tissue samples (2 AAH, 11 BAC, 18 early MX, and 20 overt MX) demonstrated that eIF4E expression in adenocarcinomas was 3.4-7.4-fold higher than in normal lung and that its expression progressively increased in the following order: AAH (lowest expression), BAC, early MX, and overt MX (highest expression). Multiple regression analysis revealed that both tumoral and stromal eIF4E expressions were significant independent factors for the histological subtype (P < 0.01 and P < 0.01, respectively). These results suggest that translational control is dysregulated during the development of peripheral lung adenocarcinoma and that progressive increases of tumoral and stromal eIF4E may be part of a positive feedback loop for malignant progression.

Adenocarcinoma↗
PubMed2002

Impact of Fluticasone Diskhaler on health-related quality of life in asthmatic patients.

OBJECTIVE: To assess effect of a breath-actuated inhaled steroid, Fluticasone Diskhaler (Flutide) on health-related quality of life in asthmatic patients using Hyland's living with asthma questionnaire (LWAQ). SUBJECTS AND METHODS: Randomly selected asthmatic patients filled out the LWAQ (the first study). Then, the eight physicians switched inhaled steroid from pressurelized metered-dose inhaler of beclomethasone (BDI) to Flutide according to their own decision. Consequently some patients were switched their prescriptions and others were not. In 12 weeks after the first study, all the patients again filled out the LWAQ (the second study). RESULTS: The patients treated with Flutide were 87 and without were 159. The scale scores of the Flutide group (mean, 1.900) were significantly higher than those of the BDI-group (mean, 1.789). In the second study, there was no significant difference between the scale scores in the two groups (mean, 1.782 vs. 1.705). Among the 8 domains, only medication score significantly decreased by Flutide therapy. More than 80% of the patients favored easy handling of Flutide including no necessity of the spacer. CONCLUSIONS: Flutide therapy significantly improved quality of life in asthmatic patients. The possible mechanisms are the stronger effectiveness of fluticasone propionate and improvement of adherence to inhaled steroid.

Adult↗
PubMedDate not supplied

Progression of focal pure ground-glass opacity detected by low-dose helical computed tomography screening for lung cancer.

OBJECTIVE: To clarify the progression of focal pure ground-glass opacity (pGGO) detected by low-dose helical computed tomography (CT) screening for lung cancer. METHODS: A total of 15,938 low-dose helical CT examinations were performed in 2052 participants in the screening project, and 1566 of them were judged to have yielded abnormal findings requiring further examination. Patients with peripheral nodules exhibiting pGGO at the time of the first thin-section CT examination and confirmed histologically by thin-section CT after follow-up of more than 6 months were enrolled in the current study. Progression was classified based on the follow-up thin-section CT findings. RESULTS: The progression of the 8 cases was classified into 3 types: increasing size (n = 5: bronchioloalveolar carcinoma [BAC]), decreasing size and the appearance of a solid component (n = 2: BAC, n = 1; adenocarcinoma with mixed subtype [Ad], n = 1), and stable size and increasing density (n = 1: BAC). In addition, the decreasing size group was further divided into 2 subtypes: a rapid-decreasing type (Ad: n = 1) and a slow-decreasing type (BAC: n = 1). The mean period between the first thin-section CT and surgery was 18 months (range: 7-38 months). All but one of the follow-up cases of lung cancer were noninvasive whereas the remaining GGO with a solid component was minimally invasive. CONCLUSIONS: The pGGOs of lung cancer nodules do not only increase in size or density, but may also decrease rapidly or slowly with the appearance of solid components. Close follow-up until the appearance of a solid component may be a valid option for the management of pGGO.

Adenocarcinoma, Bronchiolo-Alveolar↗