Biomedical subjects

Shoji Oura

Publications and source records attributed to Shoji Oura.

8 recordsLinked to original sources

PubMed2003

Clinical efficacy of bisphosphonate therapy for bone metastasis from breast cancer.

Bisphosphonates inhibit osteoclastic bone resorption and are being used as treatment for bone metastases from breast cancer. Intravenous bisphosphonate therapy can significantly reduce skeletal related events (SREs) when administered concurrently with chemotherapy or endocrine therapy. In addition, intravenous bisphosphonate monotherapy is also able to alleviate cancer induced bone pain, and to improve bone metastases in some patients. Oral bisphosphonates are not routinely used for the treatment of bone metastases due to their low bioavailability. However, minodronate, a bisphosphonate 100-fold more potent than pamidronate, is now in phase II clinical studies in Japan, and may alter the role of oral bisphosphonates in the treatment of bone metastasis from breast cancer. The ASCO guidelines recommend that patients with osteolytic bone metastases be treated not with bisphosphonate monotherapy, but with concurrent bisphosphonate and systemic therapy. In addition, it is also recommended that current standards of care for cancer pain, analgesics and radiotherapy, should not be replaced with bisphosphonate therapy.

Administration, Oral↗

PubMed2003

Time course of carcinoembryonic antigen after resection of lung cancer: a predictor of recurrence.

UNLABELLED: We investigated whether the early postoperative time course of carcinoembryonic antigen (CEA) level after resection of lung cancer could be used to predict patients' prognosis. Fifty-three lung cancer patients were included in this study. Postoperative serum CEA levels were calculated by means of non-linear least-squares fitting to the equation C(t) = (C(0)-C(p))exp(-kt) + C(p), where C(t) is postoperative CEA level, t is days after surgery, C(0) is CEA level at postoperative time 0, C(p) is CEA level at plateau, and k is the rate constant of elimination. Postoperative CEA production (P(p)) was calculated as C(p) multiplied by k. C(p) and P(p) represent the numbers of residual tumor cells after surgery. More residual tumor cells yield higher values of C(p) and P(p), and result in earlier recurrence. RESULTS: Kinetic parameters could be obtained for 30 patients whose preoperative CEA levels were sufficiently elevated. Cutoff levels as predictors for recurrence were 1.1 ng/ml for C(p) and 0.9 ng/ml/day for P(p). The accuracy of prediction of recurrence using these cutoff levels was 79% with C(p) and 89% with P(p). A very poor prognosis was observed for patients with P(p) over 0.9 ng/ml/day. CONCLUSION: Analysis of the time course of changes in CEA levels after resection of lung cancer appears to be useful for predicting patient prognosis. C(p) and P(p) are very precise predictors of recurrence.

Adult↗

PubMed2003

[Histoculture drug response assay (HDRA) guided induction concurrent chemoradiotherapy for mediastinal node-positive non-small cell lung cancer].

To improve the response to chemotherapy for non-small cell lung cancer (NSCLC), effective drugs should be selected for each patient. In 1994 we introduced histoculture drug response assay (HDRA) for NSCLC patients. For clinical N2 patients, biopsy of mediastinal lymph node is performed both for histological diagnosis and for HDRA. Induction concurrent chemoradiotherapy is then performed using HDRA positive chemotherapy agents. We have treated three patients with this strategy. HDRA could be performed using mediastinal lymph node biopsy specimens. Tumor reduction rates of these patients were 80.4%, 85.3%, and 57.1%. Their histological responses were Ef.3, Ef.2, and Ef.1b, respectively. Complete resection was done in all patients. This strategy appeared to be useful in NSCLC patients with mediastinal lymph node metastasis.

Aged↗

PubMed2003

[Malignancy-associated hypercalcemia].

Bisphosphonates (BPs) constitute a major advance in the treatment of malignancy-associated hypercalcemia(MAH). BPs correct MAH through the mechanisms of inhibition of osteoclastic bone resorption. Although BPs are more potent agents than calcitonin in the treatment of MAH, anti-hypercalcemic effect of BPs appears more slowly than that of calcitonin. Therefore, combination therapy with BP and calcitonin is favorable in the treatment of MAH showing hypercalcemic crisis. Zoledronate, most potent bisphosphonate, is apparently superior to pamidronate, standard bisphosphonate, in the treatment of MAH. BP therapy develops no serious adverse effects (i.e. acute renal failure) in clinical practice. However, attention should be paid to BP-induced pyrexia and transient pain increase.

Diphosphonates↗

PubMed2002

MR-axillography oriented surgical sampling for assessment of nodal status in the selection of patients with breast cancer for axillary lymph nodes dissection.

BACKGROUND: We have reported that magnetic resonance axillography (MR-axillography) is the best method for assessing lymph node size and representing the relation of the lymph node to normal anatomy. METHODS: The four largest nodes on MR-axillography were sampled in 62 consecutive patients with breast cancer undergoing axillary clearance. Axillary clearance yielded a mean of 17.0 (range 5-28) nodes. RESULTS: A method of preliminary sampling of four nodes in the axilla oriented by MR-axillography was assessed in all cases, 22 of whom were histologically node positive. Based on the sampled nodes, lymph node metastases were detected in 20 of 22 (91%) of the node-positive patients. Based on the sampled nodes, of the 19 patients with macrometastatic nodes, lymph node metastases were detected in all 19 (100%), but only in 1 of the 3 (33%) patients with only one micrometastatic node. CONCLUSIONS: This experience indicates that sampling the four largest nodes by MR-axillography orientation accurately identifies patients with macrometaststic nodes. This result may be comparable to that of surgical sampling performed by the most skilled surgeons.

Adult↗

PubMed2002

A case of granulomatous mastitis mimicking breast carcinoma.

A 58-year-old woman presenting with idiopathic granulomatous mastitis mimicking breast carcinoma is described. The mass was elastic, hard and painless, and located in the upper outer quadrant of the right breast. Fine needle aspiration cytology did not provide any diagnostic information. Mammography, ultrasonography and magnetic resonance imaging (MRI) strongly suggested malignancy. Excisional biopsy was performed for definitive diagnosis, and idiopathic granulomatous mastitis was demonstrated histopathologically. Neither wound complication nor recurrence has been identified in the patient, although corticosteroids were not used post operatively. We reviewed the literature, and found that our present case is rare in older patients, and that mammography, ultrasonography and MRI provide little information for differentiating between granulomatous mastitis and carcinoma.

Biopsy, Needle↗

PubMed2002

[Advanced breast cancer with lung and pleural metastases responsive to anastrozole--a case report].

A 63-year-old postmenopausal woman was referred to our hospital for treatment of ER positive advanced breast cancer. The patient had lung and pleural metastases with pleural effusion from breast cancer. She was treated with anastrozole, a 3rd-generation aromatase inhibitor, which brought about a marked regression of the lung tumor, and disappearance of pleural effusion. The patient experienced no adverse effects with this therapy. Anastrozole therapy is a useful treatment for postmenopausal women with ER positive advanced breast cancer.

Anastrozole↗

PubMed2002

[Weekly administration of gemcitabine in outpatient clinic for non-small cell lung cancer].

We treated inoperable or recurrent non-small cell lung cancer (NSCLC) patients with weekly outpatient administration of gemcitabine. The aim of this therapy was to improve or to maintain the patients' performance status. From November 1999 to December 2001, 15 NSCLC patients were treated with gemcitabine. The patients were 12 males and 3 females, 14 with adenocarcinoma and 1 with squamous cell carcinoma, aged 57 to 81 years old. A dose of 1,000 mg/m2 of gemcitabine was administered on days 1 and 8 every 3 weeks. Patients were treated for 1 to 17 (median 3) months. Performance status was maintained in 12 of 15 patients during this treatment. Average tumor marker doubling time was 289 days. Median survival time was 8.1 months. Weekly administration of gemcitabine in an outpatient setting is a useful treatment for inoperable or recurrent non-small cell lung cancer.

Adenocarcinoma↗