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Biomedical subjects

Y Takatsuka

Publications and source records attributed to Y Takatsuka.

At least 19 recordsLinked to original sources

[Intra-arterial infusion chemotherapy in locally recurrent breast cancer].

Intra-arterial infusion chemotherapy (IA) using implantable reservoir was performed in four locally recurrent breast cancers. The regimen consisted of several cycles of induction (1 cycle, 90-150mg: EPI) and the following maintenance infusion. The results were as follows. (1) D.F.I. of all cases were short and pre-treatment of 3 cases was not effective. (2) Clinical response was 2 CR and 1 MR. We confirmed that IA was an effective treatment for not only locally recurrence but also disseminated foci. (3) In 3 out of the four cases there was reduction of severe arm swelling. These findings suggested that IA using implantable reservoir was useful for the treatment of locally recurrent breast cancer in terms of anti-cancer effect and improved QOL.

Adult

[A prospective randomized study of intra-arterial infusion chemotherapy in the treatment of advanced breast cancer].

A prospective randomized study among 3 preoperative modalities, which consisted of intra-arterial infusion chemotherapy (I.A.), systemic chemotherapy (I.V.) and nontreated group, was carried out on 70 patients with advanced breast cancer. The results were as follows. (1) The response rate of primary lesions to I.A. (68.2%) was significantly higher than that of I.V. (37.5%). (2) The post-operative survival of responders (CR, PR) was better than those of non-responders (NC). (3) The frequency of side effects was similar in both I.A. and I.V. groups. (4) There was no difference among survival rates of 3 groups. We confirmed that I.A. was an efficacious neoadjuvant therapy in terms of down staging of advanced breast cancer.

Alopecia

[Intra-arterial infusion chemotherapy in the treatment of advanced breast cancer--doxorubicin versus epirubicin].

Doxorubicin (ADM) and epirubicin (epi-ADM) were tested at a dose of 150mg given intraarterially to 31 patients (ADM 14, epi-ADM 17) with advanced breast cancer. The clinical response rate was 78.6% in ADM (1 CR and 10 PR) and 76.5% in epi-ADM (1 CR and 12 PR). The histological response rate of 57.1% was also obtained in ADM and 56.3% in epi-ADM. No significant differences were evident between the two drugs. As for side effects, hair loss and gastrointestinal disorders were frequently documented low grade and less following administration of epi-ADM as compared to ADM. A more favorable prognosis seems possible with epi-ADM compared with ADM. Intra-arterial infusion chemotherapy with epi-ADM appears to be effective for the treatment of advanced breast cancer and is less toxic that ADM.

Alopecia

[Successful treatment of disseminated breast cancer with combination therapy of 5'-deoxy-5'-fluorouridine (5'-DFUR), medroxyprogesterone acetate (MPA) and cyclophosphamide (CPA)].

A 54 year-old female patient with disseminated breast cancer refractory to various kinds of previous therapies was treated with a combination therapy of 5'-DFUR, MPA and CPA. Partial response (PR) was obtained both against pleural and liver metastases with complete disappearance (CR) of soft tissue lesions and was still being continued for the following 7 months. No serious side effects were observed except for a mild degree of diarrhea and moon face. The patient was enjoying a favorable quality of life. We confirmed that this combination regimen was effective as the second line treatment for disseminated breast cancer.

Antineoplastic Combined Chemotherapy Protocols

[A comparative study with 5'-DFUR alone or in combination with tamoxifen (TAM) or medroxyprogesterone acetate (MPA) for advanced or recurrent breast cancer].

A comparative study of 5'-DFUR 600 mg/day alone (C-arm) or in combination with TAM 30 mg/day (A-arm) or MPA 600 mg/day (B-arm) was carried out. Thirty-four patients (aged 80 or less) with no prior treatment were evaluable, and the following results were obtained. 1) Patient characteristics were similar in each treatment group and the compliance in all groups was excellent. 2) The group B response rate (70.0%) was considerably higher than that of group A (23.1%) and C (27.3%). 3) In B, the response rates in soft tissues (80.0%) and bone (71.4%) were still good. 4) Mild side effects were encountered in about 15% of each group. We confirmed that combination chemotherapy with a low dose of 5'-DFUR and MPA was effective for first line treatment of metastatic breast cancer.

Adult

[Clinical usefulness of carcinoembryonic antigen measurement in nipple discharge as an adjunctive tool for diagnosis of breast cancer].

We measured carcinoembryonic antigen (CEA) in 43 cases with abnormal nipple discharge by means of enzyme immunoassay utilizing monoclonal anti-CEA antibodies. When the cut-off value was set at 400 ng/ml so that the cases where measured values are not less than this value may be interpreted to be positive, the sensitivity and specificity were 60% and 75% respectively. The clear relationship was virtually observed between the concentration of CEA in nipple discharge and the cytological diagnosis. 9 of 10 malignant cases showed positive in both or either of the CEA assay and the cytological examination. And we could find 1 case of the zero stage of breast cancer and 4 cases in non-invasive carcinoma (Tis) through the combined diagnosis. On the other hand, only 2 of 8 benign cases showed false positive results. The correlation between the CEA concentration in nipple discharge and intratumoral expression of CEA was also observed. In this study, we concluded that the combined use of the enzyme immunoassay and the cytological examination would be more effective in the detection of early breast cancer accompanied with abnormal nipple discharge.

Adult

[Evaluation of chest wall resection in the patients with breast cancer involving chest wall].

Twenty-three patients with advanced or recurrent breast cancer involving bony chest wall were treated by extended full-thickness chest wall resection and immediate reconstruction. The results were as follows: 1) Distant metastases were found concurrently or subsequently in more than half of the patients. Therefore, we should regard chest wall lesions as a systemic disease. 2) Long term result was encouraging, with 73.9% local control rate. 3) Post-surgical prognosis of the patients with sternal metastasis and solitary chest wall lesions were favorable, in that order. 4) Both local control rate and survival of the patients with mediastinal invasion, however, were fairly poor. 5) Disease-free interval (D.F.I.) after mastectomy longer than 5 years correlated significantly with a long survival after chest wall resection. As a result, we confirmed that chest wall resection was the treatment of choice for the patients with long D.F.I. and solitary chest wall lesion without mediastinal invasion nor metastasis, but the postoperative systemic therapy was indispensable to improve the patient's survival.

Adult

[A controlled study with medroxyprogesterone acetate (MPA) alone or in combination with cyclophosphamide (CPA) in the treatment of advanced or recurrent breast cancer unresponsive to other therapies. Osaka Study Group for the Treatment of Breast Cancer].

Forty-eight patients with advanced or recurrent breast cancer unresponsive to other therapies were treated orally with medroxyprogesterone acetate (MPA) 1,200 mg/day alone (Group A: 28 patients) or in combination with cyclophosphamide (CPA) 100 mg/day (Group B: 20 patients). Either complete response (CR) or partial response (PR) was obtained in eight (28.6%) patients of Group A and PR in five (25.0%) of Group B. The median duration of the response was 5.3 months in Group A and 4.4 months in Group B. Despite the expected better result of the combined chemo-endocrine therapy for Group B, there were no statistical difference in usefulness between the two regimens. No severe adverse reactions were observed in this study. We conclude that MPA alone is useful for treatment of patients with advanced or recurrent breast cancer unresponsive to other therapies.

Adult

[A comparative study of intra-arterial infusion chemotherapy and systemic chemotherapy in the treatment of locally advanced breast cancer].

A comparative randomized study of intra-arterial infusion chemotherapy (IA) and systemic chemotherapy (IV) was carried out on 41 patients with locally advanced breast cancer, and the following results were obtained. 1) The response rate of primary lesions to IA (63.2%) was better than that of IV (40.9%). 2) In the patients treated with IA, grade of leukopenia, as well as the percentage of gastro-intestinal disorders, was low. 3) More prolonged follow-up studies are required on the therapeutic effects on micrometastasis. The author confirmed that IA was an efficacious neoadjuvant therapy in terms of down staging of locally advanced breast cancer.

Breast Neoplasms

[Intra-arterial infusion chemotherapy with epirubicin for advanced breast cancer].

Thirty-two patients with locally advanced or disseminated breast cancer were treated with preoperative intra-arterial infusion chemotherapy with epirubicin (30 mg/m2, day 1, 4, 7). The results were as follows: 1) the response rate (CR + PR) was as high as 71.9% (23/32) in the primary lesions. Marked degenerative changes were, also, histologically observed in 22 cases (68.8%). 2) As for side effects, mild grade of leukopenia and hair loss were frequently encountered in 75.0% and 62.5%, respectively. Gastrointestinal disorders, however, was extremely rare (6.3%). 3) Follow-up time was not long enough, but considerable survival advantages were suggested. The author confirmed that intra-arterial infusion chemotherapy with epirubicin was an efficacious modality for the treatment of advanced breast cancer.

Adult

[Clinical significance of a tumor marker NCC-ST-439 in breast cancer--a comparative study with CA 15-3, CEA and TPA].

We compared a new tumor marker NCC-ST-439 (ST-439) with CA 15-3, CEA and TPA for its clinical usefulness in 600 patients with breast cancer (81, primary; 49, recurrent; 470, non-recurrent), and confirmed the following results. The sensitivity of ST-439 (41.5%) was significantly higher (p less than 0.05) than that of CA 15-3 (26.2%), CEA (28.5%) and TPA (26.9%). The specificity of ST-439 (84.5%), however, was considerably lower (p less than 0.01) than these other three markers. In primary cases, the positive rate of ST 439 (34.6%) was significantly higher (p less than 0.05) than that of the other markers, and was remarkable in the early stage. As to the positive rate at the various metastatic sites, there were a few differences among these four markers. Because of no significant correlation among these markers, combination assay with ST-439, CA 15-3 and CEA showed an excellent sensitivity (57.7%). These results suggest that ST-439 is a useful tumor marker not only in monitoring the recurrence, but also in the diagnosis of primary cancer.

Antigens, Tumor-Associated, Carbohydrate

[A case of inflammatory breast cancer successfully treated with intra-arterial infusion of high-dose epirubicin].

A 56-year-old female with extensive inflammatory breast cancer was treated with intra-arterial infusion chemotherapy using a high dose of epirubicin. One cycle consisted of epirubicin; 150 mg (day 1, 4, 7) and daily administration of tamoxifen; 40 mg. After completion of 2 cycles of the regimen, both the main tumor and the extensive inflammatory skin lesion completely disappeared (CR). Hair loss, gastrointestinal disorders and leukopenia (nadir; 1,600) were the side effects encountered, but all of them were reversible. These findings suggested that dose-escalation of epirubicin was effective, and that cases with extensive skin involvement were also candidates for this modality.

Administration, Oral

[A case of disseminated breast cancer successfully treated with medroxyprogesterone acetate].

We reported the successful treatment of disseminated breast cancer with medroxyprogesterone acetate (MPA). The patient was a 52-year-old female with brain and bone metastasis developed 1 year after surgery. The primary tumor was ER-positive, and she had been treated previously with adjuvant therapy consisting of UFT and tamoxifen. Brain metastasis was surgically removed, but the following combination chemotherapy (epirubicin and vindesine) failed to result in further improvement. Then MPA (1,200 mg/day) was administered as the second-line therapy. After 6 months, multiple bone lesions showed remarkable calcification (PR) and disappeared completely (CR) 13 months later. But the patient was forced to discontinue MPA because of uncontrollable hyperglycemia. At this writing, CR was still being continued and the patient was enjoying favorable quality of life without any treatment. We confirmed that MPA was effective as the second-line treatment for disseminated breast cancer.

Adenocarcinoma

[A long-term follow-up study of intra-arterial infusion chemotherapy in locally advanced breast cancer].

Long-term follow-up results were reported for 61 patients with locally advanced breast cancer treated by intraarterial infusion chemotherapy (IA), compared with those for 96 patients who received no such treatment. The results were as follows. (1) The response rate of the primary lesions to IA was 53.6%, and the post-surgical survival of responders (CR, PR) was significantly better than those of non-responders (NC). (2) Excellent loco-regional control was also achieved in the IA-group. The local recurrence rate was only 16.2%. (3) However, there was no difference between survival rates of each group. The author confirmed that IA was an effective initial treatment for locally advanced breast cancer in terms of loco-regional control, but definite conclusions can be made only after randomized study.

Antineoplastic Agents

Bio-adhesio-chemo (BAC) therapy for patients with malignant pleural effusion.

Eighteen patients with serious pleuritis carcinomatosa with remarkable pleural effusion were treated with a new pleurodesic therapy, and all the patients treated obtained favorable results. After removing pleural effusion, fibrinogen solution was intrapleurally instilled and then, our newly devised material, G.T.XIII and an anticancer drug, Adriamycin (ADM), were administered as chemosclerosing agents in an attempt to prevent recurrence of the effusion and also to provide locoregional antineoplastic effects. Recurrence of pleural effusion was nil in all patients treated, and subjective complaints of the patients were remarkably relieved. There were 14 patients evaluable, and all the response of these patients resulted in partial response (PR) according to the World Health Organization (WHO) criteria. Improvement of performance status (PS) was observed in 61% (11/18). Eight patients could be discharged. Three patients have remained alive. Fifteen patients died after the therapy, and their median survival was 67 days. Eight patients were autopsied. The postmortem examinations confirmed that fibrous adhesion in the pleural cavity with these materials was significant, and evidence of recurrence of pleural fluid was not seen. Topical oncolytic effects of the ADM were histologically remarkable. This pleurodesis was called "Bio-adhesio-chemo (BAC) therapy."

Adult