Ga-67 scintigraphy in a patient with adult T-cell leukemia/lymphoma.
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Female↗
Biomedical subjects
F Endoh
Publications and source records attributed to F Endoh.
Indication for splenectomy combined with total gastrectomy for gastric cancer: analysis of data on 249 gastric cancer patients.
This study analyzed intraoperative indication for splenectomy at the time of total gastrectomy, based on 249 gastric cancer patients. Data on these patients were studied with special reference to the relationship between intraoperative gross findings such as serosal invasion, tumor size, histologic patterns and nodal metastasis to the splenic hilus. Fifty-three of the 249 patients (21.3%) had a positive metastasis. The incidence of nodal metastasis to the splenic hilus was high in patients with a primary lesion in the entire stomach (26/72: 36.1%). In case of no serosal invasion of the primary lesion, there was no nodal involvement to the splenic hilus (0/42). The low incidence of nodal metastasis occurred in case of a tumor size of less than 40 mm in the largest diameter (1/60: 1.7%) and with histological findings of signet ring cell carcinoma (1/19: 5.3%). Although site and size of the primary tumor, depth of tumor penetration, and histologic findings are interdependent variables, these factors indicate probable nodal involvement to the splenic hilus and unnecessary splenectomy can be avoided.
Female↗
Two-color flow cytometric analysis of splenic lymphocyte subpopulations in patients with gastric cancer.
Lymphocyte subpopulations of the spleen were assayed in 26 patients with gastric cancer and 5 patients with benign disease using two-color flow cytometric analysis. The ratio of Leu 2a+.Leu 15+ cells, or suppressor T cells, in the gastric cancer patients was about 6 per cent, being higher than that in the patients with benign disease (p less than 0.05). There were fewer Leu 7+.Leu 11- cells, or natural killer-NK-cells, in the gastric cancer patients in stage III or IV than in those with stages I or II (p less than 0.05). The ratio of Leu 3a+.Leu 8- cells, or helper T cells, in the stage IV patients accounted for about 15 per cent of the splenic lymphocytes, which was less than that seen in the patients in stages I or II (p less than 0.05). The ratio of Leu 2a+.Leu 15- cells, or cytotoxic T cells, was approximately twice that of suppressor T cells. The pre-operative administration of lentinan plus OK-432 increased the ratio of Leu 4+.HLA-DR+ cells, or activated T cells, and cytotoxic T cells (p less than 0.05 and p less than 0.01, respectively). The above results suggest that lymphocyte subpopulations in the spleen may have more immunosuppressive potential in proportion with the stage of gastric cancer, but that this reduced immune state may be altered when lentinan and OK-432 are given to these patients.
Adult↗
Stapled or manual suturing in esophagojejunostomy after total gastrectomy: a comparison of outcome in 379 patients.
From January 1983 to December 1989, we performed esophagojejunostomy on 379 patients who underwent total gastrectomy for gastric cancer. A mechanical EEA stapler or conventional manual suturing was used. The clinical outcomes of 199 patients in whom stapling was used (stapler group) and 180 patients in whom manual suturing was done (manual group) were compared. Two of the 199 patients in the stapler group and 3 of the 180 patients in the manual group died of causes directly related to the anastomosis. In the stapler group, 16 stapled anastomoses were formed supradiaphragmatically, and manual suturing was done for 6 patients. The highly placed anastomosis was formed without left thoracotomy or with median sternotomy in 8 of the 16 patients in whom the stapling device was used and in 1 of the 6 patients in whom manual suturing was used. The incidence of anastomotic leakage and stenosis did not differ between the groups. Thus, the mechanical stapler facilitated the construction of a rapid, reliable esophagojejunostomic anastomosis.
Aged↗
A clinical pilot study combining surgery with intraoperative pelvic hyperthermochemotherapy to prevent the local recurrence of rectal cancer.
Intraoperative pelvic hyperthermochemotherapy (IOPHC) with mitomycin C (MMC) was prescribed for 14 patients with resectable advanced rectal cancer in an attempt to prevent a postoperative local recurrence. Immediately after rectal amputation and extended lymphadenectomy, IOPHC was performed using physiologic saline containing 40 micrograms/mL of MMC at 45.5 +/- 0.6 C for 90 minutes, with an apparatus devised for IOPHC. At the end of IOPHC, the esophageal temperature was 37.2 +/- 0.8 C and cooling was not required. Antitumor efficacy and complications in the IOPHC group were compared with findings in 12 rectal cancer patients who underwent surgery only within the same period of time. Operation time was not prolonged with IOPHC treatment. In cytologic examinations of the pelvic lavage just before IOPHC treatment, viable cancer cells were detected in 6 of the 14 patients but were never detected in the postoperative exudate drained from the pelvic cavity. Of the 12 patients in the control group, 2 had a local recurrence, while in the IOPHC group there was no local recurrence for 16.9 +/- 9.7 months at this writing. Postoperative complications did not differ between the groups. This IOPHC treatment is a favorable method in eradicating cancer cells for postoperative local recurrence of rectal cancer.
Aged↗
[Clinical evaluation of intra-operative pelvic hyperthermochemotherapy combined with operation for rectal cancer].
In order to prevent local recurrence, intra-operative pelvic hyperthermochemotherapy (IOPHC) combined with surgery for rectal cancer has been performed. In this study, we evaluated the clinical effect of IOPHC in 20 patients who were given IOPHC, compared with 13 patients who underwent curative surgery without IOPHC (control group). The IOPHC procedure was as follows: After rectal amputation, the pelvic cavity was filled with a physiological saline containing 40 micrograms/ml of MMC. Then, the physiological saline was warmed and maintained by the apparatus (heater) we devised at 45 degrees C for 90 minutes. Local recurrence occurred in 2 cases of IOPHC group (2/20:10.0%), and in 3 cases in the control group (3/13:23.1%). On the other hand, distant metastases developed approximately at the same rate in the IOPHC group (4/20:20.0%) and control group (2/13:15.4%). Thus, IOPHC is a feasible approach to reduce local recurrence of rectal cancer.
Combined Modality Therapy↗
[Intra-operative pelvic hyperthermochemotherapy combined with surgery in rectal cancer].
In order to prevent local recurrence after curative surgery for rectal cancer, intra-operative pelvic hyperthermochemotherapy (IOPHC) was performed, combined with surgery. Nineteen patients with rectal cancer were given IOPHC (IOPHC group) and 25 patients who underwent curative surgery without IOPHC served as control, in the same period of time. IOPHC was done as follows: After rectal amputation or resection combined with extended lymphadenectomy, the pelvic cavity was filled with a prewarmed perfusate (physiological saline) containing 40 micrograms/ml of MMC. Then, an apparatus for IOPHC we devised was submerged in the perfusate to warm and maintain it at 45 degrees C for 90 minutes. The mean temperature of the esophagus was 37.2 degrees C, so it was not necessary to cool down the body throughout IOPHC. There was no significant postoperative morbidity between the two groups except that the total amount of exudate drained from pelvic cavity was larger in the IOPHC group. Local recurrence occurred in 3 controls, but in only one of the IOPHC group. Thus, IOPHC is a safe and reliable approach to prevent local recurrence of rectal cancer.
Adult↗
[Combination intra-arterial chemotherapy with degradable starch microspheres and mitomycin C against inoperable hepatic metastases].
Intra-arterial hepatic infusion chemotherapy combined with degradable starch microspheres (DSM) and mitomycin C (MMC) was performed for 9 patients with inoperable hepatic metastases from alimentary tract primary cancer. DSM, 45 +/- 5 micron in average diameter, produces temporary obstruction of arterial blood flow in the arterio-capillary bed and are subsequently degraded by serum amylase with T 1/2 of about 30 min. This intra-arterial treatment was repeated 2.3 times on the average. The average dose of DSM in a single infusion was 721 +/- 194 mg and the average total dose of MMC was 34.4 +/- 22.3 mg. Antitumor effects were evaluated in terms of tumor regression measured by CT scan and sonography. An objective tumor response was shown in 4/9 patients (44.4%): PR, 2/9; MR, 2/9. Elevated serum CEA levels of more than 3.0ng/ml were decreased in 7/8 patients (87.5%). Marked declines in the CEA level of more than 50% were observed in 4/8 patients (50%). Nausea and vomiting as well as abdominal pain were experienced in 8/21 treatments (38.1%) and 5/21 (23.8%), respectively. Furthermore, fever (2/21 : 9.5%), hepatic dysfunction (2/21 : 9.5%), and leukopenia (1/21 : 4.8%) were observed. All these side effects, however, were mild and transient. Thus, these results suggest that combined intra-arterial administration of DSM and MMC favorably enhances the antitumor efficacy of MMC.
Carcinoma, Hepatocellular↗
[Repeated intra-arterial chemotherapy combined with mitomycin C and degradable starch microspheres in inoperable metastatic hepatic cancer].
Intra-arterial chemotherapy combined with mitomycin C (MMC) and degradable starch microspheres (DSM) was prescribed repeatedly for 14 patients with inoperable hepatic metastasis. This intra-arterial treatment was repeated 2.7 times on the average. The average dose of DSM and MMC in a single infusion was 685 +/- 201 mg and 13.8 +/- 3.8 mg, respectively. To analyse the degradation time of DSM, MMC concentrations in the peripheral blood were measured by HPLC method. RI-angiography using 99mTc macroaggregated albumin(MAA) was performed to estimate the hemodynamic changes in the liver. Antitumor efficacy was evaluated in terms of tumor regression measured by CT scan. An objective tumor response was observed in 9/14 patients(64.2%): CR 1/14; PR 6/14; MR 2/14. Elevated CEA levels were decreased in 11/12 patients (91.7%). Based on the peripheral MMC blood levels after combined infusion with DSM and MMC, an occlusion of intrahepatic vessels with DSM continued at least for 30 minutes. Again, RI-angiography with 99mTc-MAA plus DSM revealed the increased accumulation in the tumor, compared to 99mTc-MAA only. Side effects possibly attributable to DSM were observed in 14/38 treatments, though they were slight and temporary. Thus, these results indicate that this combined intra-arterial infusion of DSM and MMC achieve, higher regional selectivity.
Combined Modality Therapy↗
Enhanced antitumor efficacy with a combination of hyperthermochemotherapy and thermosensitization with polyamine antimetabolites in nude mice.
In an attempt to enhance the antitumor effects of hyperthermochemotherapy, methylglyoxal-bis-guanylhydrazone (MGBG) and alpha-difluoromethylornithine (DFMO) were used in combination with hyperthermochemotherapy of 1-(4-amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrosoure a (ACNU) against human gastric cancer (ST-2) xenotransplanted into nude mice. After priming with DFMO and MGBG, ACNU was given ip and subsequently, a 23 minute-hyperthermia was carried out by placing the leg with the tumor into a water bath of a temperature of 43.5 +/- 0.1 degrees C. The second hyperthermic treatment was given in the same manner after 48 hours. MGBG and DFMO were administered for 4 successive days from the previous day of the first hyperthermia. In mice treated with DFMO plus MGBG, either tumor growth or tumor tripling time was much the same as in the control, while in mice given MGBG, DFMO plus heat, there was a diminution in tumor growth. Hyperthermia together with MGBG, DFMO plus ACNU brought about remarkable antiproliferative effects on ST-2 tumor growth, compared to three regimens with MGBG, DFMO plus heat, MGBG, DFMO plus ACNU, as well as ACNU plus heat. These data suggest that a combination of MGBG with DFMO leads to a favorable thermosensitization to the antitumor efficacy of ACNU.
Animals↗
[Intra-arterial chemoembolization with albumin microspheres including mitomycin C in inoperable hepatic cancer].
Intra-arterial chemoembolization using mitomycin C microsphere (MMC MS) was carried out both for VX-2 tumor-bearing rabbits and for 19 patients with inoperable hepatic cancer. MMC MSs contain 5% MMC in albumin as a biodegradable drug carrier and an average diameter is 45 +/- 8 microns. VX-2 tumor, implanted into the hind legs of the rabbits, was treated intraarterially when it grew up to 2 cm in diameter. Tumor growth was compared with the other treated groups such as control, conventional MMC or blank microsphere; and MMC concentrations in the peripheral blood, femoral vein blood and muscles of the hind legs were measured after treatment. Tumor growth in the MMC MS group was remarkably retarded, but the other groups had no retardation. MMC concentrations of blood and muscle dropped below the assay limitation within 2 hours after conventional MMC injection, but in the animals treated with MMC MS, those showed the sustained drug release over for 6 hours. Fifteen patients with unresectable hepatic malignancies received intra-arterial hepatic infusion using conventional MMC, while 19 patients were treated by MMC MS infusion. Tumor regression in the 19 patients with MMC MS was seen in 42% (8/19), while that in the 15 with conventional infusion in 33% (5/15). Serum CEA levels in 12 patients with metastatic cancer decline from 57.7 +/- 72.2 ng/ml to 16.5 +/- 21.6 ng/ml 2 weeks after MMC MS treatment. However, those in 10 patients given conventional infusion dropped from 24.0 +/- 18.1 ng/ml to 17.4 +/- 18.0 ng/ml. The survival duration for patients given conventional infusion was 6.7 +/- 2.8 months, but that with MMC MS prolonged to 14.1 +/- 8.9 months. The MMC MS treatment for metastatic hepatic cancer had superiority to the conventional infusion treatment at p = 0.0040 in survival rate.
Adult↗
[Antitumor effects of polyamine antimetabolites with polyamine-free diet].
To evaluate the antitumor efficacy of polyamine antimetabolites such as methylglyoxal-bis-guanylhydrazone (MGBG), ethylglyoxal-bis-guanylhydrazone (EGBG), and alpha-difluoromethylornithine (DFMO), the combined therapies of polyamine antimetabolites with a polyamine-free diet were studied. The combination of EGBG plus DFMO or MGBG plus DFMO showed a marked suppression of tumor growth with a polyamine-free diet; and, when compared, EGBG was slightly superior to MGBG. The inhibition of DNA biosynthesis was also parallel to the above-mentioned results. Furthermore, from an analysis for polyamine levels in tumor tissues, it was confirmed that the polyamine depletion can be maintained by polyamine antimetabolites in combination with a polyamine-free diet in vivo. Moreover, as EGBG has lesser side effects than MGBG, EGBG might be more suitable for clinical use.
Animals↗
[Radiofrequency hyperthermotherapy in cancer of the liver, bile duct and pancreas].
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Aged↗
Combined therapy of polyamine antimetabolites and antitumor drugs for human gastric cancer xenotransplanted into nude mice.
Antitumor therapies using polyamine antimetabolites combined with 1-(4-amino-2-methyl-5-pyrimidyl)methyl-3(2-chloroethyl)-3-nitrosourea (ACNU) or fluorinated pyrimidines for human gastric cancer xenotransplanted into nude mice were studied to determine inhibiting post-therapeutic regrowth of the tumor after cessation of antitumor treatments with polyamine antimetabolites alone. ACNU 20 mg/kg, fluorinated pyrimidine, 5-FU 52.8 mg/kg and 5'-deoxy-5-fluorouridine (5'-DFUR) 100 mg/kg as well as polyamine antimetabolites, alpha-difluoromethylornithine (DFMO) 1000 mg/kg and methylglyoxal-bis-guanylhydrazone (MGBG) 50 mg/kg were given intraperitoneally for 5 successive days. When DFMO and MGBG were combined with ACNU, the post-therapeutic regrowth was definitely inhibited, while combined treatments with 5-FU or 5'-DFUR did not inhibit the regrowth. Post-therapeutic DNA biosynthesis was suppressed in mice given DFMO, MGBG plus ACNU. On the contrary, in mice treated with DFMO, MGBG plus 5-FU or 5'-DFUR, suppression of DNA biosynthesis was not observed. Tumor tissue spermine levels in the DFMO, MGBG plus 5-FU or 5'-DFUR group remained unchanged, compared to those in the DFMO + MGBG group. In mice given DFMO, MGBG plus ACNU, however, spermine levels were markedly depressed; and the ACNU alone depressed also the tissue spermine levels. These different results between nitrosourea and fluorinated pyrimidines may relate to mechanisms of action of these antitumor drugs.
Animals↗
[Studies on hyperthermia by the use of a thermosensitizing drug].
Hyperthermic treatment using ACNU combined with a thermosensitizing drug, methylglyoxal-bis-guanylhydrazone (MGBG), was studied in human gastric cancer xenotransplanted into nude mice. In order to increase the intra-cellular MGBG content, intraperitoneal injection of alpha-difluoromethylornithine(DFMO) 1000 mg/kg was performed twice with an interval of 6 hours and 50 mg/kg of MGBG was given at the time of the second administration of DFMO. After 6 hours of MGBG administration, ACNU 20 mg/kg was given intraperitoneally and, subsequently a 23-minute hyperthermia was carried out in a water bath at 43.5 degrees C. After 48 hours a second hyperthermia was performed by the same method. Tumor weight was estimated using Battelle's Columbus Institute protocol and the inoculated tumors, which were extirpated 60 minutes after 3H-thymidine injection at a prescribed interval after cessation of hyperthermia, were assayed biochemically for the determination of DNA biosynthesis. In mice given ACNU, DFMO, MGBG plus heat, considerably superior results were obtained. Although the DFMO plus MGBG group was inferior in antitumor activity to the ACNU only or heat only group, the DFMO, MGBG plus heat group showed much the same antitumor effects, compared to the ACNU plus heat group. These data suggest that the thermosensitizing efficacy of MGBG may be applicable for clinical use.
Animals↗
[Combined therapy of polyamine antimetabolite and nitrosourea in human gastric cancer].
Antitumor therapy using the polyamine antimetabolites, alpha-difluoromethylornithine (DFMO) and methylglyoxal-bis-guanylhydrazone (MGBG), combined with ACNU was studied in human gastric cancer xenotransplanted into nude mice. DFMO 1,000 mg/kg (in two divided doses) and MGBG 50 mg/kg were given i.p. for 6 successive days from the time when the xenotransplanted tumor weighed about 100 mg, and ACNU 20 mg/kg was given i.p. every other day from the same time. Antitumor efficacy was assessed by the time course of tumor weight as well as of DNA biosynthesis and polyamine levels in tumor tissue. Tumor weight was estimated using Battelle's Columbus Institute protocol and DNA biosynthesis was assayed biochemically by 3H-TdR injection at a prescribed interval after termination of therapy. Furthermore, tumoral polyamine levels were assayed by HPLC. This three-drug regimen showed a favorable antitumor effect, compared to those of the other two therapies with DFMO plus MGBG as well as ACNU only. These data suggest that this combined regimen may have a synergistic efficacy judging from the action mechanisms of these three drugs.
Animals↗
[Combined efficacy of polyamine antimetabolites and cis-diamminedichloroplatinum].
The combined antitumor effects of the polyamine antimetabolites, alpha-difluoro methylornithine (DFMO) and methylglyoxal-bis-guanylhydrazone (MGBG), with CDDP were studied using human gastric cancer cells xenotransplanted into nude mice. DFMO (1000 mg/kg in two divided doses) and MGBG (50 mg/kg) were given IP for six consecutive days from the time when the xenotransplanted tumor weighted about 100 mg, and CDDP (3.0 mg/kg) was given IP every other day from the same time. Animals treated with DFMO plus MGBG with or without CDDP as well as with CDDP only displayed suppressed tumor growth, compared to untreated mice. In mice treated with these three drugs, however, tumor growth was rather rapid compared to those treated with CDDP only, although tumoral CDDP levels in animals given DFMO, MGBG and CDDP were higher than those given CDDP only. When DFMO, MGBG and CDDP or DFMO and MGBG were administered, tumoral spermidine and spermine levels decreased markedly. On the other hand, tumor DNA biosynthesis in the CDDP only group dropped markedly 24 hours after the termination of therapy. These results suggest that an alteration in the DNA structure caused by polyamine deficiency may prevent cross-link formation in DNA by CDDP.
Animals↗
[Toxic effects of cisplatin in the treatment of malignant bone and soft tissue tumors].
A total of 31 patients with malignant bone and soft tissue tumors were evaluated for toxic effects after receiving cisplatin (104 courses) at doses of 2.0-3.0 mg/kg with aggressive hydration. Nausea was common and in 86% of cisplatin courses severe vomiting was observed. Nephrotoxicity was observed in less than 10% of all courses but ototoxicity, especially tinnitis, developed in 5 of 6 patients whose total doses of cisplatin were over 500mg, and one of them showed hearing disorder in the upper frequency above 5,000 Hz. There were no other toxic effects such as severe myelosuppression, allergic reaction or peripheral neuropathy.
Adolescent↗