Measurement and Analysis of Complex Permittivity of Breast Cancer in Microwave Band.

In order to obtain the basic data of breast cancer detection by microwave imaging, the complex permittivity of tissue excised from a breast cancer surgery was measured and analyzed. The relative permittivity and the conductivity of each tissue have strong linearity. In 80% of cases the relative dielectric constant and conductivity of the cancer tissue were higher than those in the breast tissue. However, in the remaining 20% case (scirrhous carcinoma) the dielectric constant and conductivity of the mammary gland were higher in those of cancer. We found that it is necessary to examine diagnostic approach of the reconstructed image by microwave imaging.

Chemotherapy in cancer patients undergoing haemodialysis: a nationwide study in Japan.

BACKGROUND: Cancer is a major cause of death in patients undergoing haemodialysis. However, information about the actual clinical practice of chemotherapy for patients with cancer undergoing haemodialysis is lacking. We conducted a nationwide survey using questionnaires on the clinical practice of chemotherapy for such patients. PATIENTS AND METHODS: The nationwide survey included patients undergoing haemodialysis who were subsequently diagnosed with cancer in 20 hospitals in Japan from January 2010 to December 2012. We reviewed their clinical data, including cancer at the following primary sites: kidney, colorectum, stomach, lung, liver, bladder, pancreas and breast. The questionnaires consisted of the following subjects: (1) patient characteristics; (2) regimen, dosage and timing of chemotherapy; and (3) clinical outcome. RESULTS: Overall, 675 patients were registered and assessed for main primary cancer site involvement. Of 507 patients with primary site involvement, 74 patients (15%) received chemotherapy (44 as palliative chemotherapy and 30 as perioperative chemotherapy). The most commonly used cytotoxic drugs were fluoropyrimidine (15 patients), platinum (8 patients) and taxane (8 patients), and the dosage and timing of these drugs differed between institutions; however, the dosage of molecular targeted drugs (24 patients) and hormone therapy drugs (15 patients) was consistent. The median survival time of patients receiving palliative chemotherapy was 13.0 months (0.1-60.3 months). Three patients (6.8%) died from treatment-related causes and nine patients (20%) died of causes other than cancer. Of the 30 patients who received perioperative chemotherapy, 6 (20%) died of causes other than cancer within 3 years after the initiation of chemotherapy. CONCLUSION: Among the haemodialysis patients with cancer who received chemotherapy, the rates of mortality from causes other than cancer might be high for both palliative and perioperative chemotherapy. Indications for the use of chemotherapy in patients undergoing haemodialysis should be considered carefully.

First-line chemotherapy with S-1 alone or S-1 plus cisplatin for elderly patients with advanced gastric cancer: a multicenter propensity score matched study.

BACKGROUND: Fluoropyrimidine and platinum combination is the standard treatment for advanced or recurrent gastric cancer (AGC). However, fluoropyrimidine monotherapy is commonly used for elderly patients with AGC because of its good tolerability. METHODS: In this multicenter retrospective study, we collected clinical data of AGC patients aged 70 years or older, treated with S-1 alone or S-1 plus cisplatin (SP) as the first-line treatment between January 2009 and December 2011. Propensity score matched cohorts (PSMC) were used for reducing the confounding effects to compare efficacy and safety between the two treatment groups. Cox regression analysis was performed to clarify the prognostic factors. RESULTS: PSMC (n = 109 in each group) were selected from among 444 eligible patients (S-1 group, 210; SP group, 234); the S-1 group included more patients deemed unfit for intensive chemotherapy than the SP group (e.g., higher age, poorer PS, poor renal function). In the PSMC, patients' characteristics were comparable between groups, except the male ratio (S-1 group, 64.2%; SP group, 77.1%; p = 0.04). No significant differences were observed in either overall survival [hazard ratio (HR) 0.93, p = 0.63] or progression-free survival (HR 1.09, p = 0.61). Severe adverse events (AEs) and hospitalization due to AEs were more frequent in the SP group than in the S-1 group (p < 0.001 each). CONCLUSION: Our findings do not support the survival benefit of SP over S-1 in elderly patients with AGC. We are now conducting a prospective comparative study to optimize treatment strategy and explore applicability of the geriatric assessment for these patients.

Development and validation of a set of six adaptable prognosis prediction (SAP) models based on time-series real-world big data analysis for patients with cancer receiving chemotherapy: A multicenter case crossover study.

BACKGROUND: We aimed to develop an adaptable prognosis prediction model that could be applied at any time point during the treatment course for patients with cancer receiving chemotherapy, by applying time-series real-world big data. METHODS: Between April 2004 and September 2014, 4,997 patients with cancer who had received systemic chemotherapy were registered in a prospective cohort database at the Kyoto University Hospital. Of these, 2,693 patients with a death record were eligible for inclusion and divided into training (n = 1,341) and test (n = 1,352) cohorts. In total, 3,471,521 laboratory data at 115,738 time points, representing 40 laboratory items [e.g., white blood cell counts and albumin (Alb) levels] that were monitored for 1 year before the death event were applied for constructing prognosis prediction models. All possible prediction models comprising three different items from 40 laboratory items (40C3 = 9,880) were generated in the training cohort, and the model selection was performed in the test cohort. The fitness of the selected models was externally validated in the validation cohort from three independent settings. RESULTS: A prognosis prediction model utilizing Alb, lactate dehydrogenase, and neutrophils was selected based on a strong ability to predict death events within 1-6 months and a set of six prediction models corresponding to 1,2, 3, 4, 5, and 6 months was developed. The area under the curve (AUC) ranged from 0.852 for the 1 month model to 0.713 for the 6 month model. External validation supported the performance of these models. CONCLUSION: By applying time-series real-world big data, we successfully developed a set of six adaptable prognosis prediction models for patients with cancer receiving chemotherapy.

Phase II study of lanreotide autogel in Japanese patients with unresectable or metastatic well-differentiated neuroendocrine tumors.

Background Lanreotide is a long-acting somatostatin analog with demonstrated efficacy against enteropancreatic neuroendocrine tumor (NET) in the phase III (CLARINET) study. Materials and Methods In this single-arm study, Japanese patients with grade (G) 1/G2 NET received lanreotide (120 mg/4 weeks) for 48 weeks. Those who completed the study were enrolled in a long-term extension study. The primary endpoint was the clinical benefit rate (CBR) defined as a complete response, partial response (PR), or stable disease (SD) over 24-weeks. Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), safety, and pharmacokinetics. Results Thirty-two patients were recruited at 10 sites. The full analysis set (FAS) comprised 28 patients. Primary tumors were located in pancreas (12 patients), foregut (non-pancreas, lung; 1), midgut (2), hindgut (8), and unknown (5). Four patients had gastrinoma of the functional NET, and 3 had multiple endocrine neoplasia type 1. In the FAS, 39.3% had progressive disease at baseline. The CBR at 24 weeks was 64.3% (95% confidence interval; CI: 44.1-81.4), and median PFS was 36.3 weeks (95% CI: 24.1-53.1). PR was confirmed in 1 patient at 60 weeks during the extension study (ORR: 3.6%). Frequent adverse events related to lanreotide included injection site induration (28.1%), faeces pale (18.8%), flatulence (12.5%), and diabetes mellitus (12.5%). Conclusions The efficacy and safety of lanreotide in this study indicated its usefulness as a treatment option for Japanese NET patients. TRIAL REGISTRATION: JapicCTI-132,375, JapicCTI-142,698.

Successful conservative management of diffuse cavernous hemangioma of the rectum.

Diffuse cavernous hemangioma of the rectum (DCHR) is a relatively rare disease. A 40-year-old man presented with long-standing lower abdominal discomfort and hematuria. At the time of hospitalization, his vital signs and hemoglobin level were normal. Colonoscopy showed markedly dilated blood vessels in the sigmoid mucosa, which was confirmed on magnetic resonance imaging and computed tomography as cavernous hemangioma. Without surgery, there have been no signs of progression of DCHR during a 3-year follow-up period.

[Examination of a relapsing pattern of cases of completely resected non-small cell lung cancer].

PURPOSE: The purpose of this research was to understand the clinical discovery of a relapse, relapse time, and the presentation of the first relapse of non-small cell lung cancer(NSCLC)by examining cases of relapse after complete resection of NSCLC. Objective and method. Cases of relapse after complete resection of NSCLC in our hospital were examined. RESULTS: Fifteen cases were evaluated. In half of these cases, relapse was discovered owing to increased tumor marker values. Of the patients, 60%had a relapse within 2 years after resection and 20%had a relapse 5 years after resection. The first relapse was a local recurrence in 9 cases, lung metastasis in 5 cases, and distant metastasis outside the thoracic cavity in 3 cases. CONCLUSION: The effectiveness of the tumor marker as a diagnostic parameter of relapse in NSCLC was demonstrated. Discovering distant metastases at the early postoperative period and relapse 5 years after resection are important.

[Examination and care for cancer patients with difficult-to-assess pain - feed back on patients who received consultation from our palliative care team].

OBJECTIVE: The care of cancer patients whose pain is difficult to assess is examined. METHODS: Cancer patients who received a consultation because pain assessment by our palliative care team between September 2008 and November 2010 proved difficult, were evaluated retrospectively. RESULTS: The corresponding cases were five cases(5. 6% of all cases who received consultation). The cause of the difficulty in the assessment of pain was due to dementia in two cases, mental retardation in one case, the patient's personality in another case, and the patient's believing in a third case. Useful observable items have been pointed out for difficult pain evaluation are of the patient, including expression and behavior. And the importance of chose consideration of the causes of difficult assessment of pain have also been pointed out. CONCLUSION: Careful care according to the cause of the difficult assessment of pain and individual communication ability proved important.

[Analysis of the correlation with KRAS gene mutation status and the benefit of cetuximab plus irinotecan as third- line chemotherapy for the Treatment of unresectable metastatic colorectal cancer].

Mutation of the KRAS gene in patients with metastatic colorectal cancer(mCRC)has been established as a predictive marker of poor response to anti-EGFR cetuximab. The Japanese Society of Medical Oncology recommends that the KRAS mutation status at codon 12 and codon 13 should be genotyped by direct-sequencing or allele-specific PCR. In this study, we tested the point mutation of codon 12 and 13 in the KRAS gene by Luminex(xMAP)flow cytometry with sequence-specific oligonucleotide probes for 39 out of 64 unresectable mCRC patients enrolled from Sep 2008 to Oct 2009, who were administered cetuximab in combination with irinotecan(CPT-11)as third-line therapy. We retrospectively analyzed the relationship between KRAS mutation status and responses to combination therapy. Mutations in the KRAS gene were detected in 38. 5% of cases(codon12: 73%, codon 13: 27%), and the median follow-up time was 8. 2 months(range, 1. 4-15. 2 months). The response rates for patients with KRAS wild-type and patients with KRAS mutations were 33. 3%(95%CI 14. 5-52. 2%)and 0%(p=0. 015); the disease control rates were 75%(95%CI 57. 7-92. 3%)and 40%(95%CI, 15. 2-64. 8%; p=0. 044); the median TTF was 7 months(95%CI 4. 6-9. 3)and 2. 3 months(95%CI 1. 3-3. 2; p=0. 0007), and the median OS was 12. 9 months(95%CI 6. 7-19. 1)and 10. 8 months(95%CI 5. 0-16. 7; p=0. 15), respectively. Therefore, we concluded that the KRAS mutation in mCRC is a predictive factor for the lack of response to combination therapy with cetuximab plus CPT- 11, as reported in previous clinical studies.

[The anti EGFR antibody indication between the Japanese and overseas guidelines].

The revised version of the Japanese colorectal cancer treatment guidelines by the Japanese Society for Cancer of the Colon and Rectum published in July 2009 showed remarkable changes in the field of systemic chemotherapy compared with the 2005 edition. Bevacizumab was approved in 2004 in United States, in 2005 in Europe, and in 2007 in Japan. On the other hand, cetuximab was approved in 2004 in Europe and United States, and in July 2008 in Japan. Besides, capecitabine was approved in September 2009 in Japan for not only adjuvant chemotherapy but also unresectable advanced colorectal cancer. Thus, we had one more treatment option of capecitabine with Oxaliplatin as CapeOx (XELOX). Therefore, most of the standard chemotherapy regimens in Western countries then became available in Japan. There has been no major difference in the drug treatment strategy except for the approval of panitumumab in Europe and the US, but this was not true in Japan. Now KRAS testing is recommended, and the indication for cetuximab is limited to KRAS wild type. Cetuximab can not be administered as the first-line treatment in Japan because KRAS testing is not covered by health insurance. This article deals with the difference in the anti EGFR antibody indication between the Japanese and overseas guidelines.

[A case of ovarian cancer in which a remarkable effect was seen with intrathoracic administration of CDDP and CPT-11].

A-58-year-old female admitted to our hospital for abdominal fullness and dyspnea was diagnosed with malignant pleuro-peritonitis of advanced ovarian cancer. CT showed a massive right-sided pleural effusion, massive ascites, and large ovarian tumor (about 10 x 15 cm). The patient was treated with intrathoracic administration of CDDP and CPT-11. Combination chemotherapy of CDDP (10 mg/week) and CPT-11 (10 mg/week) was administered by intrapleural injection every other week. As a result (total amount; CDDP 310 mg, CPT-11 250 mg, in 9 months), pleural effusion and ascites disappeared. Moreover, marked shrinkage (about 3 x 4 cm) of the tumor was confirmed. This intrathoracic administration of CDDP and CPT-11 may be an effective loco-regional therapy for advanced ovarian cancer with malignant pleuro-peritonitis.

Peroxidase-like catalytic activity of aqueous- and immobilized-Mn(3+)-octabromo-porphyrins on ion-exchange resin supplied as mimetic of horseradish peroxidase.

In order to explore the capability of metal porphyrins as an alternative of horseradish peroxidase (HRP), HRP-like activity of three manganese-porphyrins (Mn-Ps) and three Mn-octabromo-porphyrins (Mn-OBPs) was examined in both aqueous and immobilized states. It was found that Mn(3+)-octabromotetrakis(1-methyl-pyridinium-4yl)porphine (Mn-OBTMPyP) has an activity of at least 90% of HRP in an aqueous solution. Mn-OBTMPyP exhibited a catalytic activity even in the presence of hydrogen peroxide without suicide reaction. In addition, Mn-OBTMPyP was revealed to function as an alternative to HRP in the quantitative determination of serum uric acid. These results are of great interest because they indicate that metal-octabromo-porphyrins possibly include promising candidates of artificial enzyme capable of substituting for HRP.

[A case of advanced pancreatic cancer treated successfully with self-expandable stent, PTEG and chemotherapy].

A 52-year-old male admitted to our hospital for ileus was diagnosed with advanced pancreatic cancer. He was complicated with multiple alimentary tract stenosis (duodenal third portion, ascending portion and splenic-flexure portion of colon) due to intraabdominal spread of malignancies. The self-expandable metal stent was successfully placed in each stenotic portion with being effectively decompressed of his intestinal obstruction by the procedure of percutaneous transesophageal gastro-tubing (PTEG). These treatments improved his symptoms to ingest orally in addition to the tube feeding per PTEG. Furthermore, he has been receiving adjuvant chemotherapy with GEM, S-1, and CPT-11 for 9 months at outpatient department. We concluded a combined procedure of self-expandable stent and PTEG was useful palliative treatment in malignant gastrointestinal obstruction of advanced pancreatic cancer.