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Biomedical subjects

H Niibe

Publications and source records attributed to H Niibe.

At least 91 records · Page 5Linked to original sources

Palliative radiotherapy of bone metastasis.

We analyzed the effects of radiotherapy on 226 sites of metastatic bone tumors from 1981 to 1984, and on 157 sites of bone metastases of prostate cancer from 1970 to 1988. The radiation effect on pain relief was recognized in about 90% of cases within the dose of 20Gy to 30Gy, and there were not many differences in these effects according to the original tumors or histological types. In prostate cancer, the sites which needed re-irradiation were not recognized within 6 months after irradiation, and only 12 out of 80 sites (15%) that could be observed after more than 6 months needed re-irradiation due to recurring pain. As more than 60% of the patients with prostate cancer who needed irradiation to control bone metastases died within a year, to get pain relief by irradiation immediately and safely was thought to be very useful from the viewpoint of useful life. One patient was irradiated on 16 sites and 2 of these 16 sites received 4 treatments of irradiation and the shortest interval was 10 months and the longest one was 18 months.

Bone Neoplasms↗

Malignant lymphomas of the nasal cavity and paranasal sinuses. A clinicopathologic and immunohistochemical study.

The clinicopathologic and immunohistological features of 20 Japanese patients with non-Hodgkin's lymphomas (NHLs) limited to the sinonasal area were studied using a broad panel of T- and B-cell markers on paraffin-embedded and fresh frozen tissue. All cases showed a diffuse growth pattern. Nine cases were B-cell lymphomas (immunoblastic n = 4, centroblastic n = 3, immunocytoma n = 1, centrocytic n = 1), and nine were T-cell lymphomas (pleomorphic medium and large cell n = 8, angioimmunoblastic n = 1). In two cases, the cell lineage could not be determined. No morphologic features of angiocentric/angiodestructive lymphoproliferative lesions or lymphoepithelial lesions in ductal or glandular epithelium were seen in our series. Eight (89%) of the nine T-cell tumors and four (44%) of the nine B-cell neoplasms involved both the nasal cavity and paranasal sinuses. Six of the nine T-cell neoplasms showed a clinical presentation of rhinitis, whereas all of the B-cell neoplasms showed tumor masses in the nasal cavity and/or paranasal sinuses. The two-year survival rate for T-cell lymphomas was poorer than that for B-cell lymphomas. The five-year survival of patients with NHLs involving both the nasal cavity and paranasal sinuses was also poorer than that of patients in whom NHLs were limited to the nasal cavity.

Adult↗

[Clinical evaluation of lung scintigraphy with 99mTc-technegas].

The aim of this study is to evaluate the safety and clinical usefulness of lung scintigraphy using 99mTc-technegas produced by the evaporation of pertechnetate elution at 2500 degrees C. Lung images were recorded by the gamma camera-computer system after a few deep inspirations of 99mTc-technegas. One healthy volunteer and 32 patients including 10 with lung cancer, 8 with chronic obstructive lung disease, 5 with pulmonary embolism, 2 with interstitial pneumonia, 2 with bronchiectasis and 12 with other various disease were studied. Delayed images were taken at more than 1 hour later in one healthy and 13 patients to investigate the interval changes of the intrapulmonary distribution of 99mTc-technegas. Obvious differences of radioactive distribution between early and delayed image were observed in only 2/14 cases. Penetration index (P.I.) averaged 0.81 +/- 0.11 for early images and 0.85 +/- 0.12 for delayed image. There was no significant difference between P.I. for early and delayed images. More than 97 MBq of 99mTc-macroaggregated albumin (99mTc-MAA) were required to obtain the adequate perfusion images after the acquisition of lung images with about 37 MBq of 99mTc-technegas. Bronchial deposits of 99mTc-technegas were shown in 12/33 cases and pathological defects in 26/32 patients (81.3%). Twenty three of 33 cases also had a perfusion scintigraphy with 99mTc-MAA. Ventilation perfusion mismatches were presented in 5/5 patients with pulmonary embolism and 1/10 patients with lung cancer. The safety was confirmed in all cases and clinical usefulness in 30/32 patients (94%). In conclusion, the safety and clinical usefulness of lung scintigraphy with 99mTc-technegas were proven in this study.

Adolescent↗

Nodular histiocytic lymphoma, emphasizing results of stage I disease treated by radiotherapy. A report of the Japan Lymphoma Radiation Therapy Study Group (JLRTG).

The records of 49 patients with nodular histiocytic lymphomas (NH) who were treated from 1972 to 1985 in hospitals belonging to the JLRTG were retrospectively reviewed. The actuarial survival rate and relapse-free survival rate of all patients after 5 years were 55.0 and 51.3%, respectively. Twenty-one patients with stage I disease had a significantly better survival rate than did 12 patients with stage II disease (P less than 0.01). Without combination chemotherapy, all 15 patients with stage I NH treated by radiation therapy were in complete remission, and 14 of them remained alive and well. Among these 15 patients, no difference in relapse was observed between patients who received involved field irradiation (1 of 6) and those who received extended field irradiation (2 of 9). Patients with stage II or more NH should be treated with intensive chemotherapy and radiotherapy, as are patients with diffuse histiocytic lymphoma (DH). However, involved field radiotherapy with careful follow-up observation may be the treatment of choice for patients with stage I NH, provided their tumors are not bulky.

Adult↗

[Experimental studies on the combined effect of radiation and UFT: 2. fractionated treatments combining UFT and X ray radiation].

The combined effects of fractionated radiation and UFT, which is a mixture of tegafur (FT) and uracil, have been studied using C3H mouse mammary carcinoma. The tumor was implanted in the right hind legs of and irradiated with 300R daily for either 10 or 15 days. UFT (FT 15mg/kg + uracil 33.6mg/kg) was intra-gastrically administered 2 hr. before irradiation. Dose modifying factor (DMF) of UFT obtained from the tumor growth delay assay was 1.52 for 10 fractions (3,000R) and 1.27 for 15 fractions (4,500R). The continuous administrations of UFT for one month after combination treatment suppressed the tumor regrowth. It is suggested that UFT is a useful radiosensitizer for concurrent fractionated radiation and useful adjuvant agent after radiation therapy.

Animals↗

[What is cure of the tumor with radiation therapy? Clinical viewpoint].

Tumors as malignant as lung cancer can be cured by radiation therapy. Local control is the primary requirement for complete cure of the tumor, but the continued presence of the mass demonstrated by imaging techniques does not necessary mean persistence of viable tumor cells. The mass shadow persisting in the region irradiated at a cure dose may simply represent delayed absorption of dead cells so that the patient should be observed for at least 3 months after the therapy. This requires patience on the part of clinitians, but erroneous additional irradiation must be avoided, because excess irradiation can do harm but no good. Radiosensitivity, radioresponsiveness, and radiocurability are all independent characteristics of the tumor. In general, the effects of radiation therapy must be evaluated comprehensively in consideration of these three characteristics of the tumor. Understanding of the natural history of the disease is essential for the treatment of malignant tumors. Therapeutic approach cannot be determined if the natural history of tumor is disregarded.

Aged↗

[Interactions of radiation and biological response modifiers (BRMs) in the treatment of malignant tumor].

This article reports on attempt to characterize the interactions of radiation and BRMs in the treatment of malignant tumor on the basis of our some experimental results. BRMs have a high possibility to enhance radiation effects on tumor cells with in a radiation field and bring some benefits to host tumor immune system with minimizing deleterious effects of irradiation to the immune responses. But it is very difficult to determine the rational design of administration of BRMs to induce the most effective interactions on relevant immune system and other host responses in the combination with radiotherapy. We should make it clear how radiation can be useful to potentiate the tumor antigenecity or antitumor immune responses.

Animals↗

[The study of 201Tl, 123I-IMP-SPECT before and after radiation therapy of brain tumor].

201Tl, 123I-IMP-SPECT were performed in 17 patients with brain tumors before and after radiation therapy, compared with X-CT. 15 of 17 patients showed enhanced areas on X-CT and higher accumulations on 201Tl-SPECT in the same lesions before radiation therapy. There was significant correlation between enhanced lesions on X-CT and lesions of higher accumulation on 201Tl-SPECT before and after radiation therapy. But, the patients with residual enhanced lesions on X-CT did not always show higher accumulation on 201Tl-SPECT after radiation therapy. And, 2 patients with radiation injury after radiation therapy for brain tumor did not show higher accumulation on 201Tl-SPECT, though one patient showed enhanced lesion on X-CT. 201Tl-SPECT was expected to evaluate viability of brain tumor. 123I-IMP-SPECT was useful to recognize the site of higher 201Tl accumulation and evaluate blood flow around brain tumor. It is concluded that 201Tl, 123I-IMP-SPECT is useful for the evaluation of treatment effect of brain tumor and for the differentiation of cerebral radiation injury from recurrent tumor.

Adult↗

[Experimental studies concerning comparison of the effect on the intestine between antitumor agents and radiation].

Though radiotherapy combined with chemotherapy is used increasingly more frequently in the recent treatment of malignant tumors, very little is known about what dose of an antitumor agent equals what radiation dose in effect. We tried to determine those radiation doses which are required to produce the same effect as certain specific doses of antitumor agents (isoeffective dose) by studying the early effects of radiation and drugs chiefly on the intestine of dd strain mice. Parameters used were food consumption, body weight change, 3H-TdR radioactivity in the intestine and the labelling index of intestinal crypt cells. The results were as follows: 1) To determine that radiation dose which is equal to a drug dose (1/2 its LD50) in systemic effect, body weight change and food consumption were suggested to be useful parameters. 2) To determine that radiation dose which is equal to a drug dose in the effect on a specific organ, parameters suitable for the target cells must be selected. For evaluating the effect on the intestine, the labelling index of intestinal epithelium was a useful parameter. 3) The results of treatment with combined radiation and slight amounts of drugs suggested that the degree of aggravation of radiation injury due to drugs might vary with the time of drug administration. 4) Graphic representation of the severity of injury as indicated by parameters enabled us to grasp visually the characteristics of drugs.

Animals↗

Large dose fraction radiotherapy in the treatment of glioblastoma.

Twenty-four adults with glioblastoma multiforme (astrocytoma, grade 4) underwent postoperative large dose fraction radiotherapy (LDFR; 5 Gy twice weekly) with Linac X-rays. The outcome in this group was compared with that of 26 patients who received conventional fractionated radiotherapy (CFR; 2 Gy 5 times weekly). The time, dose, and fractionation (TDF) factor was about 100 in both groups. The survival rates following LDFR and CFR were, respectively, 63% vs 65% at 1 year; 36% vs 8% at 2 years; 17% vs 4% at 3 years; and 4% vs 0% at 5 years. Although the survival curve for LDFR was superior to that for CFR, the difference was not statistically significant. Autopsies of nine LDFR and 13 CFR patients showed no residual tumor in one case and no cases, respectively; small residual tumor in three cases in each group; extensive coagulation necrosis of the tumor and surrounding brain tissue in one LDFR and four CFR patients; tumor proliferation in three LDFR and four CFR cases; and mixed glioblastoma and fibrosarcoma in one LDFR and two CFR patients. These results suggest that maximum tumor removal followed by LDFR may offer a better prognosis for patients with glioblastoma than that offered by surgery plus CFR.

Adult↗

[Radiation therapy in bone metastases from lung cancer].

The record of 73 patients with 153 sites of bone metastases from a lung cancer treated by radiation have been reviewed to evaluate the effectiveness of pain relief. Radiation therapy for bone metastases was found to be very effective. Sufficient symptomatic improvement was achieved in 94% of all patients, while 63% obtained almost complete pain relief that was sustained until death. Onset of a symptomatic response to radiotherapy was within less than 20 Gy in total dose in more than 80% of all patients. There were no significant differences in the frequency of pain relief among the various histological types of primary lung tumors.

Adenocarcinoma↗

[Experimental studies on the combined effect of radiation and UFT 1. Radiosensitizing effect of UFT under single X-ray exposure].

The combined effects of X-ray and UFT, which is a mixture of tegafur (FT) and uracil, were studied using C3H mouse mammary carcinoma. Tumors were irradiated with a single dose of 1,000 R, 2,000 R one week after intramuscular transplantation. UFT (FT 15mg/kg+Uracil 33.6mg/kg) was intragastrically administered 2 hours before irradiation. In the group treated by combination of UFT and 1,000 R, the dose modifying factor (DMF) of UFT was 1.28 on the tumor growth delay and 1.64 on the survival time. A decrease in pulmonary metastases was found in the group treated by combination of UFT and radiation. It is suggested that UFT is a useful oral drug for combined treatment with radiation.

Animals↗

[The role of radiotherapy in the treatment of small-cell lung cancer].

The role of radiotherapy in the initial management of small-cell lung cancer (SCLC) is a matter of current debate. Unfortunately, compared to other cell types, radiotherapy for SCLC is limited in its use. The value of radiation therapy in palliation is unquestioned. SCLC is quite sensitive to both radiation therapy and chemotherapy. However, in extensive disease radiation therapy is secondary to combination chemotherapy. In limited disease, it is well documented that thoracic irradiation increases locoregional tumor control and improves the complete remission (CR) rate. However, the patients given high-dose thoracic irradiation concurrently with chemotherapy are the possibility of local toxicity, especially, drug induced pneumonitis. Recently, the optimal sequence of radiation therapy and chemotherapy has been discussed. We believe that it is better to start with chemotherapy. With prolongation of survival related to intensive combination chemotherapy, brain metastases become more frequent. Therefore current therapeutic regimens include prophylactic cranial irradiation (PCI) soon after the attainment of CR, but it has not prolonged survival. So there are conflicting reports about neurotoxicity after PCI. It is difficult to reach any firm conclusion in regard to the value of PCI.

Brain Neoplasms↗

[Autopsy cases of glioblastoma multiforme: treatment results of high-dose fractionated radiation therapy and CT scan findings].

Six autopsy cases of glioblastoma multiforme in cerebral hemisphere were examined by large histological preparations. They were treated by surgery and high-dose fractionated radiation therapy (5 Gy twice weekly). Their morphological changes were compared to the last CT and radiation field and total doses. Four out of six cases showed small residual tumor. One case showed extensive necrosis of the tumor and brain. The other case exhibited no tumor tissue at all. Spongy degeneration of the white matter associated with astrocytosis and macrophage infiltration extended sometimes beyond the local irradiation field. These white matter changes were easily occurred in the previous peritumoral edema where tumor cell infiltration was frequently observed. Residual tumor cells consisted of small anaplastic cells, which might be radioresistant and recur. Enhancement effect of CT scan showed tumor tissue and radiation necrosis with vascular proliferation.

Adult↗

[Histopathologic changes and tumor cell kinetics after hyperthermia and/or radiation therapy in a rat glioma model: bromodeoxyuridine (BUdR) labelling index].

Single and combined treatment of interstitial microwave hyperthermia (HT) and radiation therapy (RT) were delivered to rat glioma models. The animal model tumors were induced by intracerebral inoculation of a small piece of G-XII glioma tissue to 6-8 week-old rats. Heating to about 44 degrees C at the surface of the inserting antenna using a 2450 MHz microwave was carried on for 30 minutes. A single dose of 800 r to the whole head was delivered by deep X-ray apparatus. In combined treatment, heating immediately preceded irradiation. Following treatment, animals were sacrificed at 1, 3, 6, 12, 24, 48, 72 and 96 hours. BUdR was administered intraperitoneally 1 hour before sacrifice. Microscopically, in HT, tumor cells became eosinophilic and separated from each other. Some of them were necrotic. Macrophage infiltration in tumor tissue was recognized after 72 hours. BUdR labelling indices were less than 1% till 24 hours had passed, then became 25% at 48 hours, nearly equal to that of the control animals. In RT, ballooning of the tumor cells was prominent, and some of the tumors became necrotic. Lymphocyte infiltration of the tumor tissue was occasionally seen. BUdR labeling indices decreased slowly; less than 10% in 24 hours, but continued until 96 hours had passed. Combined treatment of HT and RT showed addictive effect of histological changes and suppression of tumor cell growth.

Animals↗

[Current status of radiation therapy in the treatment of malignant glioma:].

The patients of malignant glioma mostly consisting of anaplastic astrocytoma (AA) and glioblastoma (GM) were surveyed at the Committee for Compiling the Manual of Radiotherapy in the Treatment of Brain Tumors, organized by Japanese Association for Radiotherapy Research. Total 286 patients were treated at ten institutes during the period from January 1985 through December 1987. Numbers of cases with AA and GM were 130 and 156, respectively. Concerning the treatment volume, the medium field (50-100 cm2) was applied to 127 patients (37.4%) and the whole brain to 25 one (7.4%). The total dose was given by the range from 56 Gy to 65 Gy in 158 patients (47.6%). One-year survival ratio of AA and GM were 60-75% and 40-65%, respectively. For obtaining the improvement of local control rate, it is considered that the beam focusing onto the target lesion and the sufficient removal of the tumor are necessary and essential.

Astrocytoma↗

[The histological types and the effects of radiation on tumors].

The effects of radiation on tumors should be divided into radiosensitivity and radioresponsiveness. The local effects of radiation are not always consistent with curability. Though local control is one requirement to attain cure, the primary factor that affects long-term survival is the natural history of the tumor. The effects of irradiation can not be predicted only by determining the histological type of tumor. However, the natural history of the tumor can be understood by careful observation of the stroma in the tumor and condition of the host. As the result, radiocurability can be predicted to some extent.

Humans↗

[Experimental study of tumor detection using 131I-labeled F (ab)2 fragments of monoclonal antibodies to CA 19-9 and CEA (IMACIS-1)].

To determine if IMACIS-1 might have the capability of specifically pinpointing an adenocarcinoma in the human lung, xenografts of adenocarcinomatous nude mice that were injected with IMACIS-1 have been evaluated by scintigraphy, and the IMACIS-1 biodistribution in the tissue measured after sacrifice. Results have revealed that scintigraphic images obtained twenty-four hours after the IMACIS-1 injection showed some activity in the area of the tumor. At seventy-two hours after the IMACIS-1 injection, tumoral radioactivity was only seen in mice with a large tumor. At ninety-two hours after injection, the animals were sacrificed and a biodistribution study was performed. The IMACIS-1 uptake was expressed in counts per minute per gram of tissue. The tissue-to-blood uptake ratio in mice with a large tumor was 8.4 in the viable part of the tumor, 27.2 in the necrotic part of the tumor, 3.0 in the liver, and 1.5 in the spleen, respectively. In contrast, the ratio in mice with a small tumor was 3.4 in the viable part and 18.3 in the necrotic part. Immunoperoxidase staining with either the anti CEA or the anti CA 19-9 antibody was strongly visible in the necrotic part of the tumor.

Adenocarcinoma↗