Biomedical subjects

Taiji Kondo

Publications and source records attributed to Taiji Kondo.

3 recordsLinked to original sources

PubMed2005

Results of posterior surgery with intraoperative radiotherapy for spinal metastases.

OBJECT: Spinal cord compression from spinal metastasis represents a substantial clinical problem. Complete resection of spinal metastases is difficult in many cases, and conventional surgical decompression of the spinal cord with or without instrumentation often results in unsatisfactory neurological recovery and local recurrence, even if combined with external radiotherapy. To increase rates of local control and improve neurological recovery in such cases, we introduced decompressive surgery combined with intraoperative radiotherapy (IORT) for the treatment of spinal metastasis in 1992. We report the results of neurological recovery and local control in cases that received surgery with IORT. METHODS: Between November 1992 and December 2001, 133 cases (117 patients) were treated using IORT at Tokyo Metropolitan Komagome Hospital. The 79 cases (74 patients) that received posterior spine surgery only for spinal paresis due to spinal metastasis were reviewed. RESULTS: Improvement of at least one level according to Frankel's classification was attained in 68 cases (86%). Of the 58 patients unable to walk preoperatively, 45 patients (78%) regained walking ability postoperatively. Rate of local recurrence was 2.5%. CONCLUSIONS: IORT, combined with posterior surgery and FERT, might be one of the effective methods for local control of spinal metastasis and neurological improvement, especially in cases with progressive and multi-level lesions.

Adult↗

PubMed2004

[Ewing's sarcoma].

Ewing's sarcomas account for 6.8% of all primary malignant bone tumors and are probably a neurogenic, undifferentiated, high-grade malignancy, which usually affects the bones of children 5-15 years of age. Pain and swelling are the most common symptoms. Increase of CRP and erythrocyte sedimentation rate, leucocytosis, and anemia are frequently seen. Radiologically, they show permeative bone destruction on plain radiographs. When arising in the diaphysis of long bones, laminated, "onion-skin" periosteal reaction is seen. The tumor shows muscle density on CT, iso-signal intensity on T1-weighted MR images, and high signal intensity on T2-weighted MR images. Intramedullary invasion and skip lesions can be detected on MR images. Histologically, the tumor is uniformly composed of sheets of small round cells closely packed and without any matrix product. Glycogen granules are demonstrated in the cytoplasm by periodic acid-Schiff (PAS) and diastase reactions. Immunohistochemically, Ewing's sarcomas are positive for vimentin and MIC-2 gene product (CD99). Reciprocal translocation, i.e., t(11;22) (q24;q12), is seen in the tumor cells. EWS/FLI-1 fusion gene can be demonstrated, which can be a complementary method in diagnosing this tumor. Because Ewing's sarcomas are chemosensitive and radiosensitive, they are treated by a combination of chemotherapy, surgery, and radiotherapy. Neoadjuvant chemotherapy consists of preoperative chemotherapy and postoperative chemotherapy. Preoperative chemotherapy aims at eradicating distant micrometastasis, reducing the primary tumor volume, and evaluating the efficacy of the chemotherapeutic agents. Surgery is performed as a local treatment by excising the tumor using the wide procedure. If surgery is impractical, curative radiotherapy is performed instead of excision. When surgery is performed without complete wide procedure, adjuvant radiotherapy is carried out to eradicate the residual tumor cells. Postoperative chemotherapy aims to eradicate the distant micrometastasis. Recently, myeloablative, high-dose chemotherapy followed by autologous bone marrow transplantation is being attempted for poor-prognosis patients and good results have been reported.

Adult↗

PubMed2004

[Soft tissue sarcoma: postoperative chemotherapy].

In high-grade musculoskeletal sarcomas, adjuvant chemotherapy is often performed to prevent distant metastases. The efficacy of chemotherapy varies according to the histological type of sarcoma. Prognoses are poor in patients with osteosarcoma, Ewing's sarcoma, or rhabdomyosarcoma, when surgery alone is performed. However, because these sarcomas are chemosensitive, their prognoses are improved with adjuvant chemotherapy. On the other hand, the efficacy of chemotherapy is not statistically demonstrated in non-round cell sarcomas, e. g., malignant fibrous histiocytoma. Nowadays, several kinds of antitumor agents are usually used for adjuvant chemotherapy, and many authors have reported various kinds of regimens and their clinical results. Commonly used drugs include adriamycin, ifosfamide, cisplatin, methotrexate, cyclophosphamide, dacarbazine, vincristine, and actinomycin-D. Recently, high-dose chemotherapy combined with autologous peripheral blood or bone marrow stem cell transplantation has been begun in patients who do not respond to standard chemotherapy, and a better prognosis is expected.

Antineoplastic Combined Chemotherapy Protocols↗