Biomedical subjects

T Inomata

Publications and source records attributed to T Inomata.

173 records · Page 10Linked to original sources

PubMedDate not supplied

Conservation treatment intensified with tamoxifen and CAF chemotherapy without axillary dissection for early breast cancer patients with clinically-negative axillary nodes.

Axillary node dissection has been a routine part of breast cancer treatment for more than 100 years. As so few patients have been shown to have positive nodes, more consideration should be given to eliminating axillary node dissection for duct carcinoma in situ (DCIS) and T1a lesions. And for patients with a T1/2N0M0 cancer of the breast, lumpectomy alone without axillary dissection followed by radiation therapy to the intact breast and regional lymph nodes should be a reasonable treatment method that avoids arm morbidity. Between September 1989 and December 1998, we treated 79 breast cancer patients with this method intensified with tamoxifen and CAF chemotherapy. Before the start of the therapy, we performed a thorough evaluation using helical CT and doppler ultrasonography to exclude patients with significant swelling of axillary lymph nodes (more than 5 mm in short diameter). Through the end of December 1998, the mean follow-up period was 52.6 months. Up to this date, only one patient of the 79 showed local recurrence within 5 years after the start of the treatment. This patient received a second lumpectomy. She then experienced lung metastases 6 months later. She is currently receiving combined chemotherapy with docetaxel and cisplatin. The cause-specific survival rate of these 79 patients maintained 100% at 6 years, and no axillary failure has been experienced so far. The cosmetic results in 50 (65.8%) of the 76 patients who were alive at the end of December 1998 were rated as excellent, 26 (34.2%) as good, and none as fair or poor. Therefore, we have concluded that this method of treatment for early breast cancer could eliminate surgical damage and allow good cosmetic results, and that survival rates with this treatment are excellent.

Adult↗

PubMedDate not supplied

The immunopotentiation effects of the bifunctional radiosensitizer KIN-806 in comparison with its analogs KIN-804 and KIN-844.

KIN-806 is one of the 2-nitroimidazole derivative hypoxic cell radiosensitizers. Its radiosensitizing effects and the degree of lung metastasis detected were evaluated and compared with its analogs KIN-804 and KIN-844. The immune reactions induced by these radiosensitizers were also analyzed. Female C3H/He mice and SCCVII tumor cells were used. Seventeen days after inoculation of SCCVII tumor cells into the animals, 0.4 g/kg of KIN-806, KIN-804, and KIN-844 was administered to each radiosensitizer group 30 min before 40 Gy was delivered as local irradiation. In each group, KIN-806, KIN-804, and KIN-844 markedly suppressed tumor regrowth in comparison with animals that received irradiation alone. There was no significant difference in the radiosensitizing effects among these three radiosensitizers. A marked suppression of lung metastasis and macrophage/T-lymphocyte infiltration into the tumor were observed only in the KIN-806-administered groups, regardless of the presence or absence of radiation therapy. It therefore appears likely that the lung metastasis suppression was caused by the immune reaction elicited by KIN-806, which is an excellent immunopotentiator as well as an effective radiosensitizer.

Animals↗

PubMedDate not supplied

Conservation treatment intensified with an anti-estrogen agent and CAF chemotherapy for stage I and II breast cancer.

In order to improve both cosmetic results and survival rates, we performed breast-conservation treatment (BCT) intensified with tamoxifen and CAF chemotherapy to 218 out of 224 patients who visited our department with the desire of breast-conservation between August 1989 to December 1998. Of these patients, 68 presented with tumors of stage I, and another 122 stage II. All patients were administered tamoxifen (for pre-menopausal women) or tremifene (for post-menopausal women) orally: tamoxifen and tremifene administration was started just after confirmation of the breast cancer based on the findings of fine-needle aspiration cytology. All patients underwent lumpectomy with or without axillary dissection (level I and II). For patients with T2 tumors, the lumpectomy was performed following two to four times of CAF chemotherapy. Following conservative surgery, patients were treated with radiation therapy to the intact breast and ipsilateral axilla to a total dose of 4400 cGy with a conedown to a total median dose of 5300 cGy. At the end of March 1999, the mean follow-up time was 49.0 months. In spite of high-positivity (approximately 30%) of microscopically surgical margin, local recurrence rate is considerably low, and only 2 patients experienced local recurrence. Cause-specific survival rate for patients of stage I is 100%, and that of stage II is 91.7% at 5 years. The cosmetic results of therapy were also considered good.

Adult↗

PubMedDate not supplied

Breast-conservation treatment for patients with ductal carcinoma in situ.

Fourteen cases with symptomatic ductal carcinoma in situ (DCIS) were treated with breast-conservation treatment intensified with endocrine therapy. Nine of 14 patients with palpable mass had tumor detected on mammography. CT, ultrasonography, and MRI were able to detect linear and/or spotty lesion or enhancement suggesting DCIS. Whereas these findings were not particular to DCIS, the combination of these modalities would be useful in deciding the extent of resection for DCIS. There was no patient selection for breast-conservation treatment in our department. All patients received tangential and boost radiation, and were treated with endocrine therapy using anti-estrogen drugs. The reason that nine cases had close margins (<5 mm) might be on account of the treatment including lumpectomy with 1 cm of surgical margin. In spite of their margin status, no local or systemic failure was experienced, and the cosmetic results of most patients were rated as excellent or good. Therefore, our breast-conservation treatment intensified with systemic therapy is thought to be adequate for patients with symptomatic DCIS. Six of eight cases who received preoperative treatment containing endocrine therapy with or without CAF chemotherapy showed a decrease in tumor size. Preoperative treatment may effect the microinvasion and/or breast tissue surrounding a DCIS tumor.

Adult↗

PubMedDate not supplied

Unrecognized hepatic steatosis and non-alcoholic steatohepatitis in adjuvant tamoxifen for breast cancer patients.

Adjuvant tamoxifen has become the treatment of choice against estrogen receptor-positive breast cancer. Adverse effects are rarely observed and since symptoms of hepatic steatosis, non-alcoholic steatohepatitis and cirrhosis are usually negligible, such effects are not well characterized despite large cohort studies of adjuvant tamoxifen. This issue remains to be systematically studied. The present study consisted of 136 breast cancer patients treated with or without tamoxifen. Patients had laboratory tests once each month and underwent abdominal computed tomography (CT) annually for 5 years. The extent of hepatic steatosis was assessed by CT as the liver/spleen ratio. While receiving adjuvant tamoxifen, 40 of 105 patients developed hepatic steatosis (liver/spleen ratio <0.9) without obvious changes in body mass index. Twenty-one had a liver spleen ratio of <0.5, whereas none of the 31 patients treated without tamoxifen had a ratio <0.9 or <0.5 (p<0.0001 and p<0.0001, respectively). Hepatic steatosis was recognized in 35 of the 40 patients within the first 2 years of receiving adjuvant tamoxifen and 21 of the 40 had increased transaminase levels. Liver biopsy revealed NASH in 6 of 7 patients among the 21 with a liver/spleen ratio of <0.5. A subset of individuals given adjuvant tamoxifen developed progressive hepatic steatosis without significant changes in the body mass index. We suggest a liver/spleen ratio of <0.5 as a criterion upon which liver biopsy should be recommended since NASH frequently occurred in such patients.

Adult↗

PubMedDate not supplied

Serial histopathological changes in irradiated guinea pig lung receiving conventional fractionated and hyperfractionated irradiation.

PURPOSE: To determine serial histopathological differences in guinea pig lungs receiving the same total dose as clinically used between conventional fractionated and hyperfractionated irradiation. METHODS AND MATERIALS: The guinea pigs received 80 Gy in 40 daily fractions of 2 Gy each (conventional fractionation), 80 Gy in 80 fractions of 1 Gy each twice a day (hyperfractionation), 81 Gy in 27 daily fractions of 3 Gy each (conventional fractionation), or 81 Gy in 54 fractions of 1.5 Gy each twice a day (hyperfractionation). We evaluated the histopathological changes of irradiated guinea pig lungs at 1, 2, 3, 6, 9, and 12 months after irradiation. RESULTS: The guinea pig lungs that received 81 Gy in 27 daily fractions showed histopathological changes of inflammation including formation of lymph follicles after 6 months. The lungs which received 81 Gy in 54 fractions showed similar but slightly less pronounced changes than those that received 81 Gy in 27 daily fractions. The guinea pig lungs of other groups showed no histopathological changes during the observation period. CONCLUSION: In hyperfractionated irradiation the damage to the guinea pig lung is quantitatively less than that occurring as a result of conventional fractionated irradiation of the same total dose.

Animals↗

PubMedDate not supplied

Evaluation of risk and benefit of oral immunomodulation using heat-killed enterococcus faecalis FK-23 preparation in healthy dogs.

The risk and benefit of oral immunomodulation using heat-killed Enterococcus faecalis FK-23 preparation (FK-23) were evaluated in healthy dogs. Dogs were administered perorally 100 mg/kg of FK23 daily for 3 months. FK-23 did not affect the findings of complete blood count, leukocyte differential count, blood chemistry, serum electrolyte, radiography, or physical conditions of the dogs tested. Increase in myeloid/erythroid ratio and granulocytic lineage was found in bone marrow of the FK-23 treated dogs. Neutrophil function assessed by zymosan-dependent chemiluminescence was activated by treatment of the drug. FK-23 also stimulated in vitro lymphocyte blast transformation of PHA, Con A, and LPS. FK-23 thus appears to be a useful immunomodulating drug to stimulate non-specific host immune responses without adverse side effects.

Journal Article↗

PubMedDate not supplied

Early experiences of breast-conservation treatment combined with tamoxifen and CAF chemotherapy for breast cancer of stages I and II.

A total of 39 patients with breast cancer of stages I and II received breast-conservation treatment (BCT) combined with tamoxifen and systemic chemotherapy (CAF) from August 1989 to March 1993. All of these patients visited the outpatient clinic of the Department of Radiology of Kochi Medical School Hospital, with an obvious desire to undertake BCT. During this period, another two patients with the same desire were treated with modified radical mastectomy, because of obviously positive surgical margins in frozen sections obtained at surgery. The percentage of patients treated by BCT was, therefore, 95.1%. All of the patients were females, and their average age was 49.9 years. Thirty-six of these 39 patients underwent lumpectomy, and another three patients with large-sized tumor or suspected extensive intraductal component underwent quadrantectomy or wide local excision. Nineteen of these 39 patients who were over 70 years old or had no clinically detectable axillary lymph node swelling received tangential field radiotherapy to their ipsilateral axillary region instead of axillary dissection. At the end of May 1993, the mean follow-up time was 22.4 months. Until now, one patient (T2N1M0, stage IIB) has died of distant metastases of breast cancer to bone, liver, lung, and brain, and another patient, aged 81, died of pneumonia with no evidence of breast cancer progression. The overall survival rates were, therefore, 100% (30/30), 90.0% (18/20), and 75.0% (6/8) at 1 year, 2 years, and 3 years, respectively. Cause-specific survival rates were 100% (30/30), 94.7% (18/19), and 85.7% (6/7) at 1, 2, and 3 years, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Dynamic MR appearance of benign phyllodes tumor of the breast in a 20-year-old woman.

We describe a 20-year-old woman with benign phyllodes tumor of the left breast. Dynamic MRI demonstrated a multi-lobulated lesion rapidly and markedly enhanced on dynamic studies of contrast-enhanced T1-weighted imaging without washout. Histological examination of an excisional biopsy specimen obtained under local anesthesia disclosed a well-circumscribed multi-lobulated lesion, confirming the diagnosis of benign phyllodes tumor of the breast.

Adult↗

PubMedDate not supplied

CD34-positive cell yield in peripheral blood of cancer patients during radiation therapy.

For the purpose of evaluating the feasibility of inducing CD34-positive cells in peripheral blood by radiation therapy, we examined the changes in CD34-positive cells in 21 cancer patients (16 with lung cancer and five with esophageal cancer) during thoracic radiotherapy using flow cytometry and CD34 monoclonal antibody. Although assays of granulocyte-colony-forming units (G-CFU) and granulocyte-monocyte-colony-forming units (GM-CFU) were also performed for 16 of the patients during radiation therapy, in most of these cases there was approximately one G-CFU or GM-CFU for every 100 CD34-positive cells. Seven of the 21 cancer patients showed percentages of CD34-positive cells of more than 3% (more than mean + 2 S.D.; standard deviation) of mononuclear cells in peripheral blood in at least one of the examinations. However, six of these seven patients were in stage IV with distant metastases (four with lung cancer and two with esophageal cancer), and another lung cancer patient was in stage III. Therefore, CD-34 positive cells were shown to appear in peripheral blood especially in the patients with advanced stages of malignancy, and further examinations are needed to induce CD34-positive cells by radiation therapy for possible application of ultra-high dose chemotherapy supported by peripheral blood stem cell transplantation.

Antigens, CD34↗

PubMedDate not supplied

Dynamic MR appearance of adenoid cystic carcinoma of the breast in a 67-year-old female.

We describe an adenoid cystic carcinoma on the right breast of a 67-year-old woman. Dynamic magnetic resonance (MR) imaging demonstrated a well-circumscribed round lesion with rapid and marked enhancement on T1-weighted images, without washout of the contrast agent. The enhanced area extended gradually from the margin to the center of the tumor, showing very late enhancement of the tumor center. The findings suggested a tumor with rich stromal component, including adenoid cystic carcinoma of a special type of breast cancer. Histological examination of a lumpectomy disclosed a well-circumscribed tumor consisting of ovoid, trabecular, and irregularly shaped 'nests' of tumor cells, with a focally cribriform pattern. The examination confirmed the diagnosis of adenoid cystic carcinoma of the breast.

Aged↗