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Biomedical subjects

T Okawa

Publications and source records attributed to T Okawa.

At least 91 records · Page 5Linked to original sources
PubMed1990

[Radical radiotherapy of cervical cancer].

At present, surgery and radiotherapy have been employed successfully to manage carcinoma of the cervix. Generally, the choice of treatment is determined primarily by the stage of the disease. Radiotherapy for cervical cancer must be consist ed of external radiotherapy and brachytherapy. Brachytherapy is a significant and important part of the overall management of the patients with cervical cancer. The selection of a given therapeutic modality depends on the general condition of the patients, gross characteristics of the tumor and availability of expertise to offer adequate radiation therapy.

Brachytherapy↗
PubMed1989

Phase II randomized clinical trial of LC9018 concurrently used with radiation in the treatment of carcinoma of the uterine cervix. Its effect on tumor reduction and histology.

The clinical efficacy of LC9018, a biological response modifier prepared from heat-killed Lactobacillus casei YTT9018, used in combination with radiation was studied in a randomized controlled trial on 61 patients with carcinoma of the uterine cervix of Stage IIB or III. The combination therapy with LC9018 demonstrated a significant effect on tumor reduction, compared with radiation therapy alone, at the cumulative doses of 15-Gy and 30-Gy external irradiation (P less than 0.05). Histologic study confirmed that LC9018 also enhanced the therapeutic effect of the irradiation. Moreover, LC9018 seemed to be useful in protecting the patients from leukopenia during radiotherapy. This study suggests that LC9018, when used in combination with radiotherapy, will be an effective adjuvant immunotherapeutic agent. More studies in a large series of patients will, however, be needed to establish its long-term efficacy, safety, and effects on both prognosis and enhancing radiotherapy.

Adjuvants, Immunologic↗
PubMed1989

A comparative study of the JJC, AJC and UICC T classifications of squamous cell carcinoma of the maxillary sinus.

Seventy-six cases with squamous cell carcinoma of the maxillary sinus were treated with radiotherapy and surgery with or without intra arterial infusion between 1969 to 1985 at the Tokyo Women's Medical College. T classification was made of all cases using the Japan Joint Committee (JJC, 1967), American Joint Committee (AJC, 1977) and Union Internationale Contre le Cancer (UICC, 1987) classifications. 1) By the JJC classification, there were 20 cases in T2, 44 in T3 and 12 in T4. By the AJC classification, there were 9 cases in T2, 58 in T3 and 9 in T4. The classification of 14 cases were changed from JJC T2 to AJC T3, because of extension to the medial nasal meatus. By the UICC classification, there were 27 T2 cases, 32 T3 and 17 T4. 2) Cervical lymph node metastasis was detected in 14 cases (18%) at initial diagnosis and most were found in T3 and T4 cases. 3) The cumulative 5-year survival rates were 67% for T2, 32% for T3 and 25% for T4 by the JJC classification and statistical differences (p less than 0.05) were seen in T2-T3 and T2-T4. In the AJC classification, these were 71% for T2, 37% for T3 and 22% for T4 and no statistical significance was found among them. By the UICC classification, the 5-year survival was 58% for T2, 26% for T3 and 38% for T4 and marked statistical significance (p less than 0.01) was seen in T2-T3 and T2-T4. 4) The cumulative 5-year survival rate in 14 patients with tumor extension to the medial nasal meatus was 55% and it is appropriate to define this stage as T2 in the new UICC classification. These data suggested that UICC classification (1987) is useful and correlated with prognostic analysis.

Adult↗
PubMed1989

[Clinical evaluation of radiotherapy in recurrent colorectal cancer].

Eighty four patients with recurrent colorectal cancer were treated by radiotherapy at Tokyo Women's Medical College from January 1969 to September 1987. 1) Sixty four cases (76% of all) recurred within 2 years after initial surgery. 2) the most common initial recurrent site was primary lesion alone (58%) and followed by primary lesion and distant metastasis (18%), lymph node metastasis (13%) and others (11%). 3) Over all response rate (CR + PR) was 57% (20/35). There was no relationship between response rate and total dose. By treatment procedure, response rate was 50% (12/24) in radiotherapy alone, 50% (1/2) in surgery and radiotherapy, and 70% (7/10) in radiotherapy and intra-arterial infusion. 4) Pain relief was obtained 92% of cases. 5) After initial recurrences, 50% of survival time was 12 months and 5 year cumulative survival rate was 7%. In the cases of responders (CR + PR), 5 years survival rate was 11% and there were no 3 years survivors in the cases of non responders (MR + NC). 6) There were no serious acute reaction and late complications. These data suggested that radiotherapy for recurrent colorectal cancer were effective and useful.

Adult↗
PubMed1989

Multiple primary malignant neoplasms of the head and neck.

This report analyzed the 7,763 cases treated at T.W.M.C., where radiotherapy has been mainly used, between 1968 and 1984. Of these, 258 cases (3.3%) had multiple primary malignant neoplasms, among which 88 cases involved head and neck cancer. The incidence averaged 1.6% during the first 5 years, but increased to an average of 5.7% during the last 5 years. Among head and neck cancer the incidence of multiple primary malignant neoplasms was 8.5% (88/1,033) and the incidence has been gradually increasing annually. Cancers of the head and neck were frequently combined with another primary lesion in the head and neck area or in the digestive tract, especially esophagus and stomach, followed by one in the both cases. The great majority of cancers in the head and neck occurred as the first cancer at age 60-70. The head and neck region is where the respiratory system and digestive system, including lymphatic organs originate and where the external carcinogenic factors enter into the body. These data suggested that multiple primary malignant neoplasms have been increasing in number and becoming an increasing problem. The possibility of multiple primary malignant neoplasms should not be forgotten in routine cancer related clinical work.

Adult↗
PubMed1989

Implication of activation of intraperitoneal macrophages with bio-degradable microspheres.

To estimate the possibility that biological degradable starch microspheres (DMS) activate abdominal or intraperitoneal macrophages (IMP), two sizes of DMS (Spherex, Pharmacia, Sweden) were injected into the peritoneum of the ICR mice of 4 to 8 weeks of age. Three days after the injection, peritoneal fluid was collected and incubated for one hour at 37 degrees C under 5% CO2. The cells which adhered to the petri dish were IMP, to which DMS was added for 18 hrs. The cultured IMP were observed by scanning electron microscope (SEM) and the ratio of the active type to the total number of IMP was counted as an index of the effect of DMS to IMP. The activation effect of DMS on the incubated IMP was significant in the group which was cultured with 2 microns DMS after the 45 microns DMS injection. That indicated the possible DMS function as a potential IMP activating factor (MAF).

Animals↗
PubMed1989

Scanning and transmission electron microscopy of biodegradable microspheres (DSM) in blood vessels.

A type of biodegradable microsphere (DSM), approximately 45 microns in diameter, made of polymerized potato starch (Pharmacia, Sweden) was intravenously injected into rats to observe the state of DSM in small blood vessels in the kidney and liver at the electron microscopic level. Prior to their digestion with amylase, individual DSM changed their round shape to an irregularly folded one to occupy almost the whole area of the lumen. At the transmission electron microscopic level, DSM were impregnated with colloidal iron and were easily identified. Interaction of the iron labelled DSM with the surface of endothelial cells was unexpectedly loose and no adherence or fusion of this surface was observed. The starch substance was not visible in the pinocytotic vesicles of the endothelium. These findings suggest the independent profile of DSM in situ.

Animals↗
PubMed1989

Results of radiotherapy for inoperable locally advanced esophageal cancer.

Three hundred and eleven patients with locally advanced esophageal cancer were treated by radiation therapy from 1968 to 1983 at Tokyo Women's Medical College. Of these, 288 patients with previously untreated, histologically confirmed squamous cell carcinoma but previously treated with curative intent, were eligible for analysis. The cumulative 5-year survival rate of 288 patients given radical radiotherapy was 9.0%. Sex, tumor length, and Stage (AJC) had a great influence on prognosis. The five-year survival rate in males was 5.4% and in females was 22.4%. The five-year survival rate in cases with a tumor length of 5 cm or less was 17.7% in 5-10 cm was 10.0%, and in 10 cm or above was 2.8% and they were 20.2% for Stage I, 9.9% for Stage II, and 2.6% for Stage III. There were no significant differences of survival rate among age, tumor site, and tumor type on X ray film. This data suggests that comparatively early, small-volume tumors share a significant potential for cure by radiotherapy, but potent combined therapy is necessary for the treatment of advanced cancers.

Adult↗
PubMed1989

[Radiotherapy of malignant glioma--prospective randomized clinical study of whole brain vs local irradiation].

Prospective randomized clinical study was conducted to evaluate the factor of radiation field in radiotherapy for malignant glioma from 1981 to 1988 at Tokyo Women's Medical College. Radiation methods were randomized to two groups; (I) whole brain (40 Gy) and local irradiation (18 Gy), total dose 58 Gy/29 f/6 weeks (TDF 91), (II) local irradiation, total 56 Gy/28 f/6 weeks (TDF 90). Twenty three cases were registered as group I and 26 cases as group II. Two and four years cumulative survival rate were 43% and 17% in group I and 39% and 27% in group II. There were no significant differences on response, survival, recurrent pattern, late effect and complications between whole brain and local irradiation. This study confirmed that local control was the most important in the treatment of malignant glioma.

Adult↗
PubMed1989

[Histopathological study on the safety of conservative breast surgery in terms of the degree of axillary dissection for breast cancer].

The subjects were 15 patients with primary mammary cancer who underwent radical mastectomy. Axillary dissection (level I, II and III) with an incision 7 cm below the axilla was performed. After radical mastectomy, the presence/absence of remaining lymph nodes and fatty tissue was determined. All operations were performed by the same surgeon. The number of lymph nodes dissected by means of subaxillary incision ranged from 10 to 32 (mean 20.4). The proportion of remaining lymph nodes found after radical mastectomy was 0/142 (0%) for level I, 0/113 (0%) for level II and 3/54 (5.6%) for level III. In the subclavian Halsted area, fatty tissue partially remained in 60.0% of the patients and more than half in 13.3%. It was shown that complete dissection of level III lymph nodes is difficult when this surgical technique is employed. Although fatty tissue did remain in some cases after level II dissecting, this technique presented hardly any problems in the case of level I and II dissection. Therefore, from the viewpoint of axillary dissection alone, the present technique can achieve results similar to those obtained by radical mastectomy, suggesting its applicability to mammary cancer at a relatively early stage.

Adipose Tissue↗
PubMed1988

Randomized prospective clinical study of small, large and twice-a-day fraction radiotherapy for painful bone metastases.

A prospective randomized clinical trial comparing small, large and twice-a-day fraction for the relief of painful bone metastases was performed from 1981 to 1986 at Tokyo Women's Medical College Hospital. Eighty patients with painful bone metastases (92 sites) were divided into three radiation methods which were conventional fraction scheme of 5 times/week at 2 Gy/day for a total of 30 Gy/15 fractions (Group I, TDF: 49), 2 times/week at 4.5 Gy/day for a total of 22.5 Gy/5 fractions (Group II, TDF: 50) and 3 times/week at 2 Gy/day twice a day at a minimum interval of 6 h for a total of 20 Gy/10 fractions (Group III). Pain was assessed using a score and response rate was 76% in Group I, 75% in Group II and 78% in Group III which were not statistically significant mutually. Group II and III regimes were found to have an earlier shorter onset of pain relief than Group I, but the dose of onset of pain relief was almost the same. Our data suggested that individualization of radiotherapy schedules based on to assess the patient's condition and the expected quality of life and to consider radiation site and size of field, was more important than the fractionation regime in the treatment of painful bone metastases.

Adult↗
PubMed1988

[Clinical study of controlled-release preparation of mitomycin C in the treatment of inoperable cancer patients].

The composite substance of Mitomycin C (MMC) and polymer by low temperature radiating polymerization has a characteristic of slow release, the possibility of applying it to local chemotherapy was clinically studied. Buttom-formed preparation (MMC 20 mg) and needle-formed preparation (MMC 5 mg) were applied to the lesions, respectively, by sewing and piercing in 220 cancer patients with non resectable infiltrative lesions. The treatment had a pain-relieving effect in 70 out of 117 cases (60.0%) of painful cancer in the pancreas, biliary duct, liver, etc, and improved the symptoms of digestive organs in 31 out of 93 cases (33.3%). However, the tumor-reducing effect was recognized only in minute localized lesions of hepatic cancer, etc., and the survival period was not prolonged. The treatment caused no severe side effects. From the above results, the local chemotherapy with slow-releasing MMC preparation was concluded to be a useful means of palliative therapy in non-resectable, though its formulation may to be further improved.

Clinical Trials as Topic↗
PubMed1988

[Early cancer in the head and neck].

In head and neck tumors, there is no definition of early cancer. If T1N0M0, no lymph node and distant metastasis, will be early cancer, it is difficult to detect the tumor at early phase in head and neck tumor except for tongue and laryngeal cancer. Because it is hard to define it at early stage in the tumor surrounding by bony structure or tumor growing endophytically. Although almost tumor of head and neck were easily diagnosed by inspection and palpation, total imaging examination should be done actively for detection of early stage of cancer.

Diagnosis, Differential↗
PubMed1988

[Metastatic cancer of unknown primary site].

The history, physical examination, radiographic and laboratory studies and histological diagnosis must be completely evaluated to search for the primary tumor. For diagnosis of cervical lymph node metastasis, not only whole body examination but also head and neck examination is important in which quadrascopy (nasopharyngeal, laryngeal and esophageal fiberoscopy and bronchoscopy) must be performed. If the localized lymph node metastasis of unknown primary site (TxNl-3MO); especially neck node, is presented, radiotherapy has an important role in cure. Patients with metastatic cancer of unknown primary site should be considered for early diagnosis and aggressive therapy.

Female↗
PubMed1988

[Clinical research of radiotherapy in brain metastasis].

One hundred and four patients with brain metastasis were received the conventional radiotherapy from 1980 to 1985 at 3 hospitals. Results were as follows. 1. Primary sites were lung (41 cases), breast (34) and others (29). 2. Tumor was 3.15 cm in mean size (0.6-8.2 cm) and 2.6 in number of average (1-15) 3. Radiation dose was 46.5 Gy in average (30-66 Gy) and almost of all cases were irradiated with whole brain field. 4. Over all response rate on CT findings was 65.4% (CR rate: 23.1%) and 63.4% for lung and 73.5% for breast cancer. 5. Survival rate were 25.5% in 1 year, 8.8% in 2 year, 5.4% in 3 year and 3.6% in 5 year. 6. The longer interval was between onset of brain metastasis and primary treatment, the longer survival after brain irradiation. 7. No significant differences of survival rate were seen in size and in number of brain metastasis and with on without improvement of neurological symptoms. 8. The better response was on CT, the better prognosis after radiotherapy. 9. Identification of treatment for brain metastasis according to patient's characteristics and tumor factors were important.

Adult↗
PubMed1988

Restorative activity of muroctasin on leukopenia associated with anticancer treatment.

The restorative effect of N2-[(N-acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin), a muramyl dipeptide derivative, was studied in patients with leukopenia associated with anticancer chemotherapy and radiation therapy. The drug was subcutaneously administered to 102 cancer patients in a single doses of 200 or 400 micrograms, and each dosage was given either every day for 6 days or every other day over a 5-day period. White blood cell (WBC) counts were made before, during and after treatment. MDP-Lys(L18) was most effective in patients receiving the drug every day and the 400 micrograms dose was somewhat superior to the 200 micrograms dose in augmenting the WBC population. Overall, the response to MDP-Lys(L18), in terms of the increase in number of WBCs, was good to excellent in 41.6% of patients. MDP-Lys(L18) was considerably more effective in patients with solid tumors than in those with hematological malignancies. The most common side effect was fever, which was dose-dependent, more pronounced with alternate-day dosing, and generally well controlled with antipyretics. The results of this study indicate that MDP-Lys(L18) is useful in improving the WBC count in leukopenic cancer patients treated with anticancer therapy. Considering the efficacy and side effect profiles together, it is suggested that 200 micrograms/day for 6 consecutive days is the optimal treatment regimen.

Acetylmuramyl-Alanyl-Isoglutamine↗
PubMed1988

[Prospective clinical study of twice-a-day fractionation radiotherapy in head and neck cancer].

Twenty-one patients of laryngeal cancer (T2, T3) were treated with Twice-A-Day fractionation radiotherapy (TADF) between April, 1986 and December, 1987. Tumor control and mucosal reaction were evaluated to compare with effects between TADF and Conventional fractionation radiotherapy (CF). Methods of TADF were 1.2-1.5 Gy per fraction, two fractions per day with a minimum interval of 6 Hr., 5 days a week and 66-72 Gy for total dose. In CF, they were 1.8-2.0 Gy per fraction, one fraction per day, 5 days a week and 60-70 Gy for total dose. Complete response dose were 57 Gy in average for TADF and 47 Gy for CF. There was no significant difference. Early mucosal reaction was observed slightly severe in TADF than in CF. But, there was no significant difference among them. Split time was neened 10 days in average for TADF and 7 days for CF. There was no elongation of overall time in TADF. Follow-up time was too short to discuss about late reaction. But there were no serious complications among the patients with 2 years follow-up. These data suggested that radiotherapy of TADF was effective and should be clinically studied furthermore.

Adult↗