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T Ohnoshi

Publications and source records attributed to T Ohnoshi.

At least 73 records · Page 4Linked to original sources
PubMed1990

[Progress and obstacles in chemotherapy and combined modality treatment of small cell lung cancer].

In order to assess the development of treatment of small cell lung cancer (SCLC), we analyzed a total of 183 patients who had been entered into our protocol studies since 1976. Between 1976 and 1981, 39 patients (20 LD and 19 ED) received COMP, a 4-drug combination of cyclophosphamide (CTX), vincristine (VCR), methotrexate and procarbazine. During the period, chest irradiation (RT) was optimal for those with LD. Between 1981 and 1986, 112 patients (56 each of LD and ED) were treated with a cyclic alternating chemotherapy (CT) of COMP and VAN, a 3-drug combination of etoposide (VP-16), adriamycin (ADM) and nimustine. In this study, we randomized patients with LD either to receive CT alone or CT plus RT of 40 Gy to assess the role of RT in the treatment of LD. Thereafter, a pilot study of CAV-PVP hybrid CT has been conducted in 32 patients (16 each of LD and ED), in which CTX, ADM and VCR were given on day 1 (CAV), and cisplatin on day 8 and VP-16 on days 8 and 9 (PVP). RT was administered mandatory to LD in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Small cell lung cancer; a retrospective analysis of results of chemotherapy and chemo-radiotherapy].

In order to assess the development of treatments and the curability of small cell lung cancer, we analysed a total of 239 patients entered in our protocol study since 1976. Median survival time was 68 weeks for 127 patients with limited disease and 48 weeks for 112 with extensive disease. Three-year survival rate was 18% for those with limited disease, whereas it was only 5% for extensive disease. The median survival time and long-term disease-free survival rate has been improved with an introduction of aggressive chemotherapy including new drugs such as etoposide and cisplatin. Chest irradiation in addition to intensive chemotherapy played a substantial, but not significant, role for prolonging patient survival in those with limited disease. Nevertheless, the pace of therapeutic advances has been slowed and appears to reach a plateau. In this paper, the authors try to find some obstacles in the treatment of the disease, and to indicate some strategies to gain a progress.

Aged↗
PubMed1989

[Beneficial effect of cisplatin based combination chemotherapy on adenocarcinoma of the lung].

Cisplatin (CDDP) based combination chemotherapy has improved the response rate of non-small cell lung cancer (NSCLC). However, the survival benefit of CDDP-based chemotherapy in patients with NSCLC is still controversial. In order to determine whether CDDP had a meaningful impact on the course of NSCLC, the survival of patients treated by combination chemotherapy containing CDDP (CDDP arm: PVB; CDDP + vindesine + bleomycin, VIP; vindesine + ifosfamide + CDDP) was compared with that treated by chemotherapy without CDDP (no CDDP arm: COMP; cyclophosphamide + vincristine + methotrexate + procarbazine, MVB; mitomycin C + vindesine + bleomycin), retrospectively. Survival in CDDP arm (median survival time [MST]; 10.2 months) was significantly longer than in the no-CDDP arm (MST; 6.9 months) (p less than 0.01). These results indicate that CDDP-based combination chemotherapy can not only improve response rate but also prolong survival of NSCLC.

Adenocarcinoma↗
PubMed1989

[Small cell lung cancer: a retrospective analysis of results of chemotherapy and combined modality treatment].

In order to assess the development of treatments and the curability of SCLC, we analyzed a total of 181 patients entered in our protocol studies since 1976. Between 1976 and 1981, 37 patients (20 LD and 17 ED) were treated with COMP, a 4-drug combination of cyclophosphamide (CTX), vincristine (VCR), methotrexate, and procarbazine. During the period, chest irradiation (RT) was administered optionally to those with LD. Between 1981 and 1986, 112 patients (56 each of LD and ED) were treated with a cyclic alternating chemotherapy of the COMP and VAN, a 3-drug combination of etoposide (VP-16), adriamycin (ADM), and nimustine. In this study, we randomized LD patients either to receive CT alone or CT plus chest RT of 40 Gy to assess the role of chest RT in the treatment of patients in LD. Complete responders were also randomized either to receive prophylactic cranial irradiation (PCI) or not. Thereafter, a pilot phase II study of a hybrid regimen has been conducted in 32 patients (16 each of LD and ED), in which CTX, ADM and VCR (CAV) was given on day 1, and cisplatine and VP-16 (PVP) on days 8 and 9. Chest RT was administered mandatory to LD in this study. The median survival time (MST) has been prolonged with an improvement in response rate over CT in both LD and ED: MST of LD was 10 months for COMP, 14 months for COMP-VAN, and not achieved for CAV-PVP hybrid regimen (13 of 16 patients alive between 10 and months), while that of ED was 8 months for COMP, 11 months for COMP-VAN, and 13 months for CAV-PVP hybrid regimen. The randomized study comparing CT alone and CT plus chest RT revealed that chest RT played a substantial, but not significant, for long survival in LD. Finally 13 of 149 patients treated between 1976 and 1986 were long-term, disease-free survivors beyond 2 years (12 LD and 1 ED). Two of them who had not received PCI had a relapse in the brain, but the remaining 11 patients are alive and disease-free between 28 and 84 months. These results imply that SCLC is potentially curable, but it will be difficult to achieve a cure in a substantial proportion of patients with the disease.

Adult↗
PubMed1989

[Pilot phase II study of hybrid chemotherapy of CAV-PVP in small cell lung cancer (SCLC)].

A pilot phase II study of a hybrid chemotherapy for SCLC has been conducted between October 1986 and March 1988. Dose and schedule of the regimen were as follows: CTX, 700 mg/m2, on day 1; ADM 30 mg/m2, on day 1; VCR, 1.4 mg/m2, on day 1 (CAV); and CDDP, 60 mg/m2, on day 8; VP-16, 100 mg/m2, on days 8 and 9 (PVP). Courses were repeated q. 4 weeks up to 6 cycles. Patients with LD received chest irradiation at a dose of 50 Gy when maximal response was achieved. Thirty-six patients were fully evaluated for tumor response and toxicity. All 18 patients with LD responded to the regimen including 11 CRs (61%); there were 7 CRs (39%) and 9 PRs (50%) in patients with ED. Fourteen of the 18 patients with LD have survived for 7 to 22 months, against 12.8 months in ED patients. The major toxicity was myelosuppression, but it was well tolerated. These results indicate that hybrid chemotherapy is highly effective for SCLC, and warrants further clinical trials.

Aged↗
PubMed1989

[Recent trends of chemotherapy in small cell lung cancer: a slow but steady progress].

The author reviewed some distinct findings concerning chemotherapy of small cell lung cancer (SCLC) which had appeared recently in the articles of journals and proceedings. Of new drugs, teniposide and carboplatin have a significant activity against SCLC, however, the usefulness of these drugs must be determined in the comparative fashion with their mother compounds. Cisplatin plus etoposide (PVP), which was demonstrated to have a distinct activity in previously treated SCLC and to be not fully cross-resistant to CAV, has recently been incorporated into the first-line treatment. PVP has been evaluated as either induction chemotherapy or consolidation therapy, as alternating chemotherapy with CAV and as a chemotherapy regimen in the combined modality treatment with chest irradiation. The data obtained provide results comparable or rather superior to those achieved with CAV or other conventional regimens when used as induction chemotherapy, and provide some encouraging results when used as consolidation chemotherapy and in combination with chest irradiation. Four trials have been conducted to test the usefulness of CAV-PVP alternation, however, the results is still controversial. Recently, two institutions reported the results of pilot study of an intensive weekly chemotherapy. Although the complete response rate of the weekly regimens appears superior to that of conventional regimens, the survival benefit is still obscure because of an inadequate follow-up time. The pace of therapeutic advances in SCLC has slowed and appears to reach a plateau, however, recent articles indicate a slow but steady progress in the treatment of SCLC.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1989

[Chemotherapy of aggressive non-Hodgkin's lymphomas: a retrospective analysis of a single institution].

In order to assess the curability of diffuse non-Hodgkin's lymphoma, a total of 93 patients who had entered into protocol studies in our institution was analysed retrospectively. Between 1977 and 1988, 53 large cell lymphoma (DL), 16 mixed cell lymphoma (DMx), and 24 medium-sized cell lymphoma (DM) patients with advanced disease were treated with CHOP, CHOP-Bleo, or CHOP-Bleo alternating with POEM-Bleo (5-drug combination of mitoxantrone, etoposide, vincristine, bleomycin, and prednisolone). The complete response rate was 70% for DL, 69% for DMx, and 54% for DM. The response was most durable in DL, compared with DMx and DM: the relapse-free survival rate at 5-year was 71% for DL, both 38% for DMx and DM. Almost all the relapses had occurred within 2 years in DL, DMx and DM, as well, thus responding patients over 2 years after cessation of chemotherapy appeared to have been cured. Relapse-free survival rate was almost the same for T- and B-lymphoma, however, the 5-year survival rate of T-lymphoma was lower than that of B-lymphoma, reflecting the poor complete response rate of the former. Finally, the disease-free survival rate at 5-year was 39% for all the 93 patients, with a trend favoring for DL histology with a rate of 51%. The alternating CHOP-Bleo/POEM-Bleo regimen appears beneficial compared with conventional regimens such as CHOP and CHOP-Bleo on the basis of response rate and response durability, and these results warrant further clinical trials.

Adolescent↗
PubMed1989

[Critics and proposals for the response criteria of the Japan Lung Cancer Society].

The successful conduct of cancer treatment trials is dependent upon the use of consistent criteria for response and for toxicity. In 1982, the Japan Lung Cancer Society published its own criteria which conformed to the response criteria of the Japan Society for Cancer Therapy, with some additional comments for the evaluation of tumors on the chest X-ray. Although the criteria have been used on all studies in Japan and have made a contribution to qualify clinical trials of lung cancer, these criteria must be updated by the introduction of modern techniques such as computerized axial tomography and magnetic resonance imaging. In this paper, the author dare criticized the criteria, referred to points of question and proposed some revisions in a small part of the criteria.

Antineoplastic Agents↗
PubMed1989

[Current status of chemotherapy in the treatment of malignant lymphomas].

Chemotherapy of malignant lymphomas has accomplished a significant progress during the two decades. Cure can be expected in a significant proportion of patients, even those with advanced disease. The major obstacle for cure is selection and overgrowth of a drug-resistant tumor cell population. For this reason, a number of investigators have tested the efficacy of intensive chemotherapy including non-cross-resistant alternating regimens and hybrid regimens. Today, with intensive combination chemotherapy, at least 60% of patients with advanced Hodgkin's disease and 50% of those with diffuse large cell lymphoma can be curable. The authors update the review of the chemotherapy for malignant lymphomas, and also report outcomes of chemotherapy in our own patients.

Adolescent↗
PubMed1989

[Chemotherapy of stage III-IV Hodgkin's disease. A retrospective analysis of the 53 cases collected from 9 institutions in Japan].

The clinical data of 53 patients with Stage III-IV Hodgkin's disease collected from 9 institutions in Japan were analyzed for the efficacy of chemotherapy. CR rate (78%) and five-year relapse-free survival (RFS) rate (61%) were higher in the patients treated with VEPA/CHOP regimen than those in patients with VEMP/BONP or MOPP/C-MOPP regimen, although the difference was not statistically significant because of the small number of the patients. As to 14 patients treated with CHOP regimen, CR rate was 87% and RFS curve trend toward plateau at 67% after 2 years and 3 months from the initiation of chemotherapy. Salvage therapy with adriamycin-based combination chemotherapy achieved CRs in 9 of 14 (64%) patients who had been treated with VEMP, BONP, modified MOPP or C-MOPP regimen. The CHOP regimen was effective in the treatment of III-IV Hodgkin's disease but an alternative multidrug chemotherapy with ADM, CPM, VCR, BLM, etoposide and procarbazine is recommended for achieving a higher CR rate and a better RFS. Prospective study is needed to establish the standard chemotherapy for Hodgkin's disease in Japan.

Adolescent↗
PubMed1989

[Antibody activity to Propionibacterium acnes in bronchoalveolar lavage fluid in sarcoidosis].

While increased levels of circulating antibody to various microorganisms have been reported in sarcoidosis patients, the pathogenesis of the disease is still unknown. In this report, the levels of antibody activities against Propionibacterium acnes (P. acnes) were measured in bronchoalveolar lavage fluid (BALF) in patients with sarcoidosis, using an enzyme-linked immunosorbent assay method. Each immunoglobulin class of antibody activity to P. acnes was corrected by albumin concentrations in BALF. The levels of whole immunoglobulin antibody activities to P. acnes in BALF were as follows: 412.3 +/- 443.9 O.D./albumin 1 mg (M +/- SD) in 31 untreated sarcoidosis patients, 556.6 +/- 341.8 in 10 sarcoidosis patients treated with prednisolone, and 231.5 +/- 156.8 in 16 control individuals. The levels of antibody activities were significantly elevated in untreated patients (p less than 0.05) and in treated patients (p less than 0.02) compared to those of controls. However, considering the treated vs. untreated patients, there was no significant difference in levels. The serum levels of whole immunoglobulin antibody activities were 0.484 +2- 0.191 O.D. in 38 untreated patients, 0.410 +/- 0.166 in 13 treated patients and 0.571 +/- 0.254 in 52 controls. The levels of antibody activity were significantly lower in treated patients than in the controls (p less than 0.05). However, there was no significant difference between the untreated patients and controls. To assess the site of antibody production, the secretion ratio was calculated by dividing the levels in BALF to those in serum. For this purpose, each serum level of antibody activity was also corrected by serum albumin concentration as with BALF.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Interleukin-2 production and receptor expression of alveolar lymphocytes stimulated by Propionibacterium acnes in sarcoidosis].

We previously reported that alveolar lymphocytes in patients with active sarcoidosis are sensitized to Propionibacterium acnes (P. acnes) which may play a significant role in the induction of alveolitis in these patients. However, the mechanism of lymphocyte activation is not fully understood. In this study, we further investigated the production of Interleukin-2 (IL-2), and the responsiveness to IL-2 of alveolar lymphocytes obtained from sarcoidosis patients and stimulated by P. acnes in vitro. In 21 untreated sarcoidosis patients, 7 treated patients and 13 control subjects, the mean IL-2 activity of fluid released from cultured alveolar lymphocytes was 9.8 +/- 15.7 u/ml (M +/- SD), 1.9 +/- 4.7 u/ml and 0.2 +/- 0.8 u/ml respectively. The IL-2 activity of lymphocytes from untreated patients was significantly higher than that of control subjects (p less than 0.02). The responsiveness of alveolar lymphocytes to recombinant IL-2 was evaluated by 3H-thymidine uptake in the presence and absence of P. acnes. Lymphocytes stimulated by P. acnes showed a significantly increased uptake (3766 +/- 3929 dpm) compared to unstimulated lymphocytes (1123 +/- 968 dpm) obtained from 11 untreated sarcoidosis patients (p less than 0.02). On the other hand, the responsiveness of lymphocytes obtained from 6 control subjects was low, regardless of stimulation by P. acnes. There was a significant correlation (p less than 0.05) between the P. acnes-induced production of IL-2 by alveolar lymphocytes and the blastogenesis of alveolar lymphocytes in untreated sarcoidosis patients. Our data indicate that P. acnes stimulates IL-2 production and IL-2 receptor induction in alveolar lymphocytes from patients with active sarcoidosis.

Adult↗
PubMed1989

[The response of alveolar lymphocytes induced by Propionibacterium acnes in pulmonary sarcoidosis: correlation with clinical studies, pulmonary function studies and bronchoalveolar lavage].

Current concepts of the pathogenesis of sarcoidosis suggest that the alveolitis in this disorder is related to increased numbers of helper T-cells within the lungs. However, the mechanism of this accumulation of lymphocytes is not known. We have reported that proliferation of alveolar lymphocytes induced by P. acnes is increased in patients with active sarcoidosis. To determine whether the response of alveolar lymphocytes would be useful in staging the activity of pulmonary sarcoidosis, we studied 34 untreated patients with this disorder, and correlated the response of alveolar lymphocytes with clinical, roentgenographic, physiologic, and bronchoalveolar lavage findings in these non-smoking patients. There was a significant correlation of the response in the numbers of lymphocytes (p less than 0.05) and CD4 (+) T-cells (p less than 0.01) recovered from the lungs of these patients by bronchoalveolar lavage. Furthermore, the response correlated significantly with the activity of Interleukin-2 released by alveolar lymphocytes stimulated by P. acnes (p less than 0.05). In contrast, no correlation was found between the response and the clinical, roentgenographic, or physiologic data. However, in patients who showed abnormality in all three clinical examinations, i.e. serum angiotensin converting enzyme activity, number of alveolar lymphocytes, and 67Ga scintigraphy of the lung, the response was significantly higher than in controls (p less than 0.001) or in patients with none of these abnormalities (p less than 0.01). Also, the response in patients with an abnormality in two of these three examinations was significantly elevated compared to that in normals (p less than 0.025) or in patients without an abnormal examination (p less than 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

[Phase II study of a three-drug combination of ifosfamide, cisplatin and vindesine in non-small-cell lung cancer].

Between February 1986 and April 1987, we conducted a phase II clinical trial of a three-drug combination of ifosfamide, cisplatin, and vindesine in advanced non-small-cell lung cancer. The combination consisted of ifosfamide, 1,300 mg/m2, on days 1 through 5, cisplatin, 20 mg/m2, on days 1 through 5, and vindesine, 3 mg/m2, on days 1 and 8. Courses were repeated at 4-week intervals until disease progression or unacceptable toxicity occurred. Of 21 patients evaluated, one had a complete response and 12 had partial response, with an overall response rate of 62%. The projected median response duration was 30 weeks. The median survival for all patients has not been reached: 14 of 21 patients are still alive with a median follow-up period of 41 weeks (range, 12 to 73 weeks). The major toxicity was myelosuppression. One patient died of septicemia while neutropenic, but the toxicity was well tolerated in the rest. These results indicate that this three-drug combination is active against non-small-cell lung cancer and warrants further clinical trials.

Adenocarcinoma↗