2022/04/14 更新

写真a

ナガオ ショウジ
長尾 昌二
NAGAO Shoji
所属
医歯薬学域 教授(特任)
職名
教授(特任)
外部リンク

学位

  • 博士(医学) ( 岡山大学 )

  • 医学博士 ( 岡山大学 )

研究キーワード

  • 婦人科腫瘍

  • Gynecologic Oncology

研究分野

  • ライフサイエンス / 産婦人科学  / 婦人科腫瘍

学歴

  • 岡山大学   Medical School   Faculty of Medicine

    1987年4月 - 1993年3月

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    国名: 日本国

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経歴

  • 岡山大学大学院医歯薬総合研究科   周産期学講座   教授

    2021年10月 - 現在

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  • 埼玉医科大学国際医療センター   婦人科腫瘍科   客員教授

    2015年4月 - 現在

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  • 兵庫県立がんセンター   婦人科   館長

    2013年4月 - 2021年9月

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  • - 埼玉医科大学 医学部国際医療センター 産婦人科(婦人科腫瘍科) 准教授   准教授

    2009年10月 - 2013年3月

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  • 埼玉医科大学 医学部国際医療センター 産婦人科(婦人科腫瘍科) 専任講師

    2007年4月 - 2009年9月

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  • 埼玉医科大学   Obstetrics and Gynecology, Faculty of Medicine

    2006年8月 - 2007年3月

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所属学協会

  • 米国臨床腫瘍学会

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  • 婦人科悪性腫瘍化学療法研究機構

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  • 日本癌治療学会

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  • 日本婦人科腫瘍学会

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  • 日本産科婦人科学会

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  • American Sciety of Clinical Oncology

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  • Japan Gynecologic Oncology Group

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  • Japan Society of Clinical Oncology

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  • Japan Society of Gynecologic Oncology

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  • Japan Society of Obstetrics and Gynecology

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委員歴

  • 特定非営利活動法人 婦人科悪性腫瘍研究機構   支持・緩和医療委員会  

    2020年   

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  • 特定非営利活動法人 婦人科悪性腫瘍研究機構   理事  

    2020年   

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  • 日本サルコーマ治療研究学会   評議員  

    2018年   

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  • 日本婦人科腫瘍学会   評議員  

    2018年   

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  • - 子宮体がん治療ガイドライン改訂委員会委員  

    2012年   

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  • JGOG監査委員会委員  

    2010年 - 2011年   

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  • - GOG Japan監査委員会委員  

    2010年   

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論文

  • Effect of prior olaparib maintenance therapy for platinum sensitive recurrent ovarian cancer on response to subsequent platinum-based chemotherapy. 国際誌

    Hiroshi Nakazawa, Shoji Nagao, Moyu Narita, Takashi Shibutani, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Satoshi Yamaguchi

    The journal of obstetrics and gynaecology research   2022年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: Several years have passed since olaparib maintenance therapy was approved in patients with platinum sensitive recurrent ovarian cancer (PSROC). We speculated that the response to platinum-based chemotherapy (PBC) would be impaired at the time of recurrence after olaparib maintenance therapy. We conducted a noninterventional retrospective study to clarify this clinical question in a single institution. METHODS: We included all patients with PSROC who received olaparib after second or later line of PBC between April 18, 2018, and August 31, 2021. We evaluated the effect of olaparib maintenance therapy on PBC after progression. RESULTS: We identified 42 patients who received olaparib maintenance therapy after second or later line of PBC. Twenty-four patients relapsed after olaparib maintenance therapy, and 17 patients received PBC again. Four of 17 patients (complete response 2, partial response 2) responded to the PBC. The median progression-free survival was longer in patients with platinum-free interval ≥12 months than platinum-free interval of 6-12 months (9.7 vs 2.6 months, hazard ratio, 0.20: 95% confidence interval, 0.04-0.90; p = 0.04). CONCLUSIONS: In the patients with PSROC who experienced disease progression after olaparib maintenance therapy, especially in those with platinum-free interval of 6-12 months, the response to subsequent PBC was extremely poor. The efficiency of re-administration of PBC for PSROC patients with a short-term recurrence after olaparib treatment may need to be reconsidered.

    DOI: 10.1111/jog.15184

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  • Clinical practice guideline for the treatment of malignant ascites: section summary in Clinical Practice Guideline for peritoneal dissemination (2021).

    Keisuke Matsusaki, Kuniaki Aridome, Shigenobu Emoto, Hiroaki Kajiyama, Nobumasa Takagaki, Takao Takahashi, Hiroshi Tsubamoto, Shoji Nagao, Akihiro Watanabe, Hideaki Shimada, Joji Kitayama

    International journal of clinical oncology   27 ( 1 )   1 - 6   2022年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Patients with peritoneal dissemination (PD) caused by abdominal malignancies are often associated with massive ascites, which shows extremely dismal prognosis because of the discontinuation of systemic chemotherapy mostly due to poor performance status. Many treatment methods, such as simple drainage, peritoneovenous shunting (PVS) and cell-free and concentrated reinfusion therapy (CART), have been used for symptom relief. However, the clinical efficacies of these methods have not been fully investigated yet. Recently, we developed the Clinical Practice Guideline for PD caused by various malignancies according to "Minds Clinical Practice Guideline Development Guide 2017". In this guideline, we systematically reviewed information on clinical diagnosis and treatments for PD using PubMed databases (2000 - 2020), and clarified the degree of recommendation for clinical questions (CQ). The evidence level was divided into groups by study design and quality. The literature level and a body of evidence were evaluated in reference to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Based on the results of systematic review, the strength of the recommendations was evaluated at a consensus meeting of the Guideline Committee. This is the English synopsis of the part of treatment of malignant ascites in Clinical Practice Guideline for PD, 2021 in Japanese. The guidelines summarize the general aspect of the treatment of malignant ascites and statements with recommendation strengths, evidence levels, agreement rates and future perspective for four raised clinical questions.

    DOI: 10.1007/s10147-021-02077-6

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  • Olaparib plus bevacizumab as maintenance therapy in patients with newly diagnosed, advanced ovarian cancer: Japan subset from the PAOLA-1/ENGOT-ov25 trial. 国際誌

    Keiichi Fujiwara, Hiroyuki Fujiwara, Hiroyuki Yoshida, Toyomi Satoh, Kan Yonemori, Shoji Nagao, Takashi Matsumoto, Hiroaki Kobayashi, Hughes Bourgeois, Philipp Harter, Anna Maria Mosconi, Isabel Palacio Vazquez, Alexander Reinthaller, Tomoko Fujita, Philip Rowe, Eric Pujade-Lauraine, Isabelle Ray-Coquard

    Journal of gynecologic oncology   32 ( 5 )   e82   2021年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Asian Society of Gynecologic Oncology$\mathsemicolon$ Korean Society of Gynecologic Oncology and Colposcopy  

    OBJECTIVE: The addition of maintenance olaparib to bevacizumab demonstrated a significant progression-free survival (PFS) benefit in patients with newly diagnosed, advanced ovarian cancer in the PAOLA-1/ENGOT-ov25 trial (NCT02477644). We evaluated maintenance olaparib plus bevacizumab in the Japan subset of PAOLA-1. METHODS: PAOLA-1 was a randomized, double-blind, phase III trial. Patients received maintenance olaparib tablets 300 mg twice daily or placebo twice daily for up to 24 months, plus bevacizumab 15 mg/kg every 3 weeks for up to 15 months in total. This prespecified subgroup analysis evaluated investigator-assessed PFS (primary endpoint). RESULTS: Of 24 randomized Japanese patients, 15 were assigned to olaparib and 9 to placebo. After a median follow-up for PFS of 27.7 months for olaparib plus bevacizumab and 24.0 months for placebo plus bevacizumab, median PFS was 27.4 versus 19.4 months, respectively (hazard ratio [HR]=0.34; 95% confidence interval [CI]=0.11-1.00). In patients with tumors positive for homologous recombination deficiency, the HR for PFS was 0.57 (95% CI=0.16-2.09). Adverse events in the Japan subset were generally consistent with those of the PAOLA-1 overall population and with the established safety and tolerability profiles of olaparib and bevacizumab. CONCLUSION: Results in the Japan subset of PAOLA-1 support the overall conclusion of the PAOLA-1 trial demonstrating that the addition of maintenance olaparib to bevacizumab provides a PFS benefit in patients with newly diagnosed, advanced ovarian cancer. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02477644.

    DOI: 10.3802/jgo.2021.32.e82

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  • Survival impact of adjuvant concurrent chemoradiotherapy after radical hysterectomy in FIGO stage IIIC1 cervical adenocarcinoma.

    Kazuhiro Suzuki, Shoji Nagao, Moyu Narita, Hiroshi Nakazawa, Takashi Shibutani, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Satoshi Yamaguchi

    International journal of clinical oncology   26 ( 7 )   1322 - 1329   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media {LLC}  

    BACKGROUND: We evaluated the survival effect of adjuvant concurrent chemoradiotherapy after radical hysterectomy in patients with clinical pelvic node-positive cervical adenocarcinoma. METHODS: Patients with pelvic node-positive cervical adenocarcinoma diagnosed between 2000 and 2016 at our institution were identified. Survival was compared between patients who underwent radical hysterectomy alone and those who received concurrent chemoradiotherapy as an adjuvant treatment. Survival analysis using log-rank test and Cox proportional hazards model was performed. RESULTS: We identified 80 patients who underwent radical hysterectomy for clinical pelvic node-positive cervical adenocarcinoma; of these, four with pathological pelvic node-negative adenocarcinoma were excluded. Of the 76 patients, 27 underwent radical hysterectomy alone and 49 received radical hysterectomy followed by concurrent chemoradiotherapy. With a median follow-up of 53 months, the 5-year overall survival rate was 51.0% in patients who underwent radical hysterectomy alone versus 53.0% in patients who received additional concurrent chemoradiotherapy (log-rank p = 0.455). CONCLUSION: The addition of concurrent chemoradiotherapy after radical hysterectomy did not significantly improve survival among patients with pelvic node-positive cervical adenocarcinoma. More appropriate treatment strategies are needed to improve the survival outcomes of these patients.

    DOI: 10.1007/s10147-021-01904-0

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  • Treatment strategy for locally advanced squamous cell cervical cancer with clinically positive pelvic lymph nodes metastasis. 国際誌

    Takashi Shibutani, Shoji Nagao, Kazuhiro Suzuki, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Satoshi Yamaguchi

    The journal of obstetrics and gynaecology research   47 ( 7 )   2442 - 2448   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    AIM: To determine the optimal treatment for locally advanced squamous cell cervical cancer with clinical positive pelvic lymph nodes metastasis (cN1). METHODS: We enrolled patients with squamous cell cervical cancer with 2008 FIGO stages IB, IIA, or IIB diagnosed with cN1, who were treated at Hyogo Cancer Center between April 2010 and December 2016. Patients with para-aortic lymph nodes metastasis were excluded. RESULTS: Of the 69 eligible patients, 24 underwent concurrent chemoradiotherapy (CCRT), 11 underwent radical hysterectomy with pelvic lymphadenectomy (RH) with or without adjuvant RT, and 34 underwent neoadjuvant chemotherapy (NAC) followed by RH as initial treatment. The regimens of NAC included dose-dense TC (paclitaxel 80 mg/m2 , days 1, 8, 15; and carboplatin at an area under the curve = 6 on day 1, every 3 weeks) and dose-dense TP (paclitaxel 80 mg/m2 on days 1, 8, 15; and cisplatin 75 mg/m2 on day 1, every 3 weeks). The median observation period was 57 (12-107) months. The 5-year disease-free survival rates of the CCRT, RH, and NAC groups were 78.7%, 63.6%, and 88.2%, respectively (p = 0.14). The 5-year overall survival rates of the CCRT, RH, and NAC groups were 78.6%, 70.1%, and 94.1%, respectively (p = 0.11). CONCLUSIONS: We recommend avoiding RH as primary treatment for cN1 with locally advanced squamous cell cervical cancer. Although CCRT should be considered for cN1, further studies are required to determine if NAC followed by RH will serve as an effective option.

    DOI: 10.1111/jog.14816

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  • Validation of tissue factor pathway inhibitor 2 as a specific biomarker for preoperative prediction of clear cell carcinoma of the ovary.

    Etsuko Miyagi, Noriaki Arakawa, Kentaro Sakamaki, Naho Ruiz Yokota, Takeharu Yamanaka, Yuki Yamada, Satoshi Yamaguchi, Shoji Nagao, Yasuyuki Hirashima, Yuka Kasamatsu, Hisamori Kato, Tae Mogami, Yohei Miyagi, Hiroshi Kobayashi

    International journal of clinical oncology   26 ( 7 )   1336 - 1344   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Tissue factor pathway inhibitor 2 (TFPI2) is a novel serum biomarker that discriminates ovarian clear cell carcinoma (CCC) from borderline ovarian tumors (BOTs) and non-clear cell epithelial ovarian cancers (EOCs). Here, we examined the performance of TFPI2 for preoperative diagnosis of CCC. METHODS: Serum samples were obtained preoperatively from patients with ovarian masses, who needed surgical treatment at five hospitals in Japan. The diagnostic powers of TFPI2 and cancer antigen 125 (CA125) serum levels to discriminate CCC from BOTs, other EOCs, and benign lesions were compared. RESULTS: A total of 351 patients including 69 CCCs were analyzed. Serum TFPI2 levels were significantly higher in CCC patients (mean ± SD, 508.2 ± 812.0 pg/mL) than in patients with benign lesions (154.7 ± 46.5), BOTs (181 ± 95.5) and other EOCs (265.4 ± 289.1). TFPI2 had a high diagnostic specificity for CCC (79.5%). In patients with benign ovarian endometriosis, no patient was positive for TFPI2, but 71.4% (15/21) were CA125 positive. TFPI2 showed good performance in discriminating stage II-IV CCC from BOTs and other EOCs (AUC 0.815 for TFPI2 versus 0.505 for CA125) or endometriosis (AUC 0.957 for TFPI2 versus 0.748 for CA125). The diagnostic sensitivity of TFPI2 to discriminate CCC from BOTs and other EOCs was improved from 43.5 to 71.0% when combined with CA125. CONCLUSIONS: High specificity of TFPI2 for preoperative detection of CCC was verified with the defined cutoff level of TFPI2 in clinical practice. TFPI2 and CA125 may contribute substantially to precise prediction of intractable CCC.

    DOI: 10.1007/s10147-021-01914-y

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  • Docetaxel and carboplatin chemotherapy for treating patients with stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix: a phase II study.

    Muneaki Shimada, Shinya Sato, Tadahiro Shoji, Shoji Nagao, Hideki Tokunaga, Kotaro Sueoka, Kazuhiro Takehara, Keiichiro Nakamura, Satoshi Yamaguchi, Junzo Kigawa

    International journal of clinical oncology   26 ( 7 )   1314 - 1321   2021年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: This phase II study evaluated the efficacy and safety of docetaxel/carboplatin chemotherapy for treating patients with stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix. METHODS: A total of 50 patients with International Federation of Gynecology and Obstetrics stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix were enrolled and administered docetaxel at a dose of 60 mg/m2, followed by carboplatin at a dose based on the area under the receiver operating characteristic curve of 6. The treatments were repeated every 21 days until disease progression or unacceptable adverse events. Except for two patients, 48 were eligible for evaluation. Another patient withdrew consent before treatment; adverse events were evaluated in 47. RESULTS: The response rate was 47.9% with 5 patients achieving complete response, 18 partial response, 14 stable disease, and 6 progressive disease. The disease control rate was 77.1%. With a median follow-up duration of 368 days, the median progression-free survival and overall survival were 6.1 months (95% CI 5.5-8.6) and 15.8 months (95% CI 18.2-28.3), respectively. The most frequent grade 3 and grade 4 hematological toxicity was neutropenia, with 38 patients (81%) having grade 4 and 4 (9%) having grade 3 neutropenia. The non-hematological toxicities were mainly grade 1 or 2 in severity. CONCLUSION: Docetaxel/carboplatin chemotherapy was effective, with a higher disease control rate and well-tolerated chemotherapeutic regimen for patients with stage IVB or recurrent non-squamous cell carcinoma of the uterine cervix.

    DOI: 10.1007/s10147-021-01903-1

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  • Quality of life assessment of cell-free and concentrated ascites reinfusion therapy during initial treatment for advanced ovarian cancer: A prospective cohort study. 国際誌

    Kasumi Yamamoto, Shoji Nagao, Tomoharu Tsu, Taeko Matsushima, Yoshimi Ishido, Moyu Narita, Kazuhiro Suzuki, Hiroshi Nakazawa, Takashi Shibutani, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Satoshi Yamaguchi

    The journal of obstetrics and gynaecology research   47 ( 4 )   1536 - 1543   2021年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    AIM: Cell-free and concentrated ascites reinfusion therapy (CART) is applied to relieve symptoms in patients with malignant ascites. We performed a prospective cohort study to evaluate the efficacy and safety of CART performed on patients with advanced ovarian and peritoneal cancers with massive ascites during the initial treatment. METHODS: From April 2018 to July 2020, CART was performed during the initial treatment of 31 patients with advanced ovarian and peritoneal cancers with cancerous ascites. Patient characteristics and clinical information before and after CART were collected. We performed quality of life assessment using the Japanese version of the M.D. Anderson Symptom Inventory (MDASI-J) 24 h before and after CART. RESULTS: CART was performed 38 times in 24 patients before or during neoadjuvant chemotherapy and 11 times in 11 patients prior to surgery. Four patients underwent CART before primary surgery and before and/or during chemotherapy. Grade 1-2 fever was observed in 18 of 31 cases (58%), and all were controllable by nonsteroidal anti-inflammatory drugs. CART did not adversely affect the main treatment, chemotherapy, or surgery. CART significantly improved the MDASI-J symptom and interference scores within 24 h after the procedure. The symptom and interference scores decreased from 2.4 to 1.8 and from 4.8 to 3.0, respectively. CONCLUSIONS: CART can be safely performed and is useful for symptom relief and improvement of general condition prior to initial surgery and during initial chemotherapy in ovarian and peritoneal cancers. Performing CART at the time of initial treatment may facilitate initiation of the main treatment.

    DOI: 10.1111/jog.14670

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  • Phase 2 single-arm study on the safety of maintenance niraparib in Japanese patients with platinum-sensitive relapsed ovarian cancer. 国際誌

    Kazuhiro Takehara, Takashi Matsumoto, Junzo Hamanishi, Kosei Hasegawa, Motoki Matsuura, Kiyonori Miura, Shoji Nagao, Hidekatsu Nakai, Naotake Tanaka, Hideki Tokunaga, Kimio Ushijima, Hidemichi Watari, Yoshihito Yokoyama, Yoichi Kase, Shuuji Sumino, Ajit Suri, Hiroaki Itamochi, Nobuhiro Takeshima

    Journal of gynecologic oncology   32 ( 2 )   e21   2021年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Asian Society of Gynecologic Oncology$\mathsemicolon$ Korean Society of Gynecologic Oncology and Colposcopy  

    OBJECTIVE: The primary objective of this study was to evaluate the safety of niraparib 300 mg/day in Japanese patients with platinum-sensitive, relapsed ovarian cancer in a maintenance setting. METHODS: Phase 2, multicenter, open-label, single-arm study enrolled Japanese patients with platinum-sensitive, relapsed ovarian cancer who had received ≥2 platinum-based regimens. The primary endpoint (incidence of grade 3 or 4 thrombocytopenia-related events within 30 days after initial niraparib administration) was justified by the incidences of a global pivotal phase 3 study and its post-hoc safety analysis on thrombocytopenia, the major hematological adverse event of niraparib. The overall safety analysis examined other treatment-emergent adverse events (TEAEs). RESULTS: Enrolled patients (n=19) had a median (min, max) body weight of 53.9 (40.8-79.1) kg; all but one patient weighed <77 kg. Most (94.7%) patients initially received niraparib 300 mg/day but this decreased in subsequent cycles (mean±standard deviation dose intensity, 191.6±65.7 mg/day). In total, 6/19 (31.6%) patients experienced grade 3 or 4 thrombocytopenia-related events within 30 days of initial niraparib administration. Other common TEAEs included nausea, and decreased platelet or neutrophil counts. No progression-free or overall survival events occurred; only 1 of 4 response-evaluable patients had a post-baseline tumor assessment (stable disease). CONCLUSION: The incidence of grade 3 or 4 thrombocytopenia-related events in Japanese ovarian cancer patients was similar to that in the corresponding non-Japanese study. Overall, the safety profile was acceptable and consistent with the known safety profile and previous experience with niraparib. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03759587.

    DOI: 10.3802/jgo.2021.32.e21

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  • Phase II study of a new multidisciplinary therapy using once every 3 week carboplatin plus dose-dense weekly paclitaxel before and after radical hysterectomy for locally advanced cervical cancer.

    Shoji Nagao, Kasumi Yamamoto, Tetsuro Oishi, Satoshi Yamaguchi, Kazuhiro Takehara, Muneaki Shimada, Junzo Kigawa

    International journal of clinical oncology   26 ( 1 )   207 - 215   2021年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media {LLC}  

    BACKGROUND: We proposed a novel treatment strategy, consisting of triweekly cisplatin plus dose-dense weekly paclitaxel before and after radical hysterectomy without adjuvant radiation therapy to treat locally advanced cervical cancer. However, cisplatin-related severe non-hematologic toxicities were frequent during this strategy. This study aimed to assess the applicability of replacing cisplatin with carboplatin in our proposed strategy. METHODS: Women with International Federation of Gynecology and Obstetrics (FIGO) 2008 stage IB2, IIA2, or IIB cervical cancer received three cycles of carboplatin (based on an area under the curve of six), each 21 days apart, starting on day 1, and 80 mg/m2 of paclitaxel on days 1, 8, and 15 of each 21-day cycle before undergoing radical hysterectomy. Patients with one or more high-risk factors, including lymph vascular invasion, parametrial invasion, lymph-node metastasis, or positive margins, received three additional cycles of chemotherapy after hysterectomy. Concurrent chemoradiation therapy was only applied to those patients who failed to respond to neoadjuvant chemotherapy. RESULTS: Between September 2014 and July 2016, 50 women (13 women with FIGO stage IB2, 5 with stage IIA2, and 32 with stage IIB) were enrolled in this study. The overall response rate to chemotherapy was 92%, including 22% with pathological complete response. Forty-nine women (98%) completed the planned radical hysterectomy, and 11 (22%) women with one or more high-risk factors received three additional cycles of chemotherapy. Only four women (8%) received concurrent chemoradiation therapy after surgery. The 2- and 3-year progression-free survival rates were 88.0% and 83.8%, respectively, and the 2- and 3-year overall survival rates were 98.0% and 95.4%, respectively. Only two patients reported grade 3 or higher non-hematologic toxicities including grade 3 nausea in one patient and grade 3 liver dysfunction in one patient. CONCLUSIONS: Replacement the platinum agent resulted in equivalent efficacy, with reduced toxicity, in women with locally advanced cervical cancer. This strategy could considerably diminish the application of radiation therapy without reduced survival. A study to identify those patients who will benefit from this new multidisciplinary strategy is warranted.

    DOI: 10.1007/s10147-020-01787-7

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  • Propensity score-matched analysis of systemic chemotherapy versus salvage hysterectomy for persistent cervical cancer after definitive radiotherapy/concurrent chemoradiotherapy. 国際誌

    Munetaka Takekuma, Fumiaki Takahashi, Seiji Mabuchi, Wataru Kudaka, Koji Horie, Mariko Ikeda, Ayumi Shikama, Akira Mitsuhashi, Shoji Nagao, Shiro Suzuki, Mika Mizuno, Shin Nishio, Hideki Tokunaga, Yukinobu Ota, Takahiro Kasamatsu, Ryo Kitagawa, Takafumi Toita, Hiroaki Kobayashi, Mitsuya Ishikawa, Nobuo Yaegashi

    BMC cancer   20 ( 1 )   1169 - 1169   2020年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The aim of the current study was to evaluate oncologic outcomes of patients who were treated with salvage hysterectomy (HT), compared to systemic chemotherapy (CT) for persistent cervical cancer after definitive radiotherapy (RT)/ concurrent chemoradiotherapy (CCRT). METHODS: Patients with persistent cervical cancer treated with definitive RT/CCRT at 35 institutions from 2005 to 2014 were reviewed retrospectively (n = 317). Those who underwent a HT for persistent cervical cancer after definitive RT/CCRT were matched with propensity scores for patients who underwent systemic CT. Oncologic outcomes between the two groups using a propensity score matched-cohort analysis were compared. RESULTS: A total of 142 patients with persistent cervical cancer after definitive RT/CCRT were included after matching (HT: 71, systemic CT: 71). All background factors between HT and CT groups were well balanced. Median overall survival was 3.8 and 1.5 years in the HT and CT groups, respectively (p = 0.00193, hazards ratio [HR] 0.41, 95% confidence interval [CI] 0.23-0.73), Increasing residual tumor size was significantly associated with a high incomplete resection rate (p = 0.016, Odds Ratio 1.11, 95%CI 1.02-1.22). Severe late adverse events occurred in 7 patients (9.9%) in the HT cohort. CONCLUSION: The current study demonstrated that, when compared to systemic CT, the adoption of salvage HT for patients with persistent cervical cancer after definitive RT/CCRT reduced mortality rate by about 60%. This indicates that salvage HT could be curative treatment for those patients. Further prospective clinical trials with regard to salvage HT after RT/CCRT are warranted.

    DOI: 10.1186/s12885-020-07672-w

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  • Suppressive effect upon carboplatin hypersensitivity reaction via pegylated liposomal doxorubicin combination therapy.

    Kyoko Shimada, Shoji Nagao, Kazuhiro Suzuki, Takashi Shibutani, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Satoshi Yamaguchi

    International journal of clinical oncology   25 ( 9 )   1718 - 1725   2020年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media {LLC}  

    BACKGROUND: Occurrence of hypersensitivity reaction (HSR) in patients having received multiple doses of carboplatin has been reported. Several studies demonstrated reduction of carboplatin-associated HSR with in combination with pegylated liposomal doxorubicin (PLD). The objective of this study was to determine the suppressive effect on carboplatin-induced HSR via combined treatment with PLD within clinical practice. METHODS: We reviewed the medical records of women with primary or recurrent ovarian, fallopian tube, or peritoneal cancer treated with carboplatin containing regimen at our hospital between January 2009 and March 2019. We compared the incidence of carboplatin-induced HSR among patients who received more than one cycle of PLD plus carboplatin (PLD-C) therapy (i.e., PLD-C group) versus patients who never received PLD-C therapy (non-PLD-C group). RESULTS: A total of 414 women were included in this study (48: PLD-C group, 366: non-PLD-C group). Carboplatin-induced HSR occurred in 34 total patients (8.2%) [1/48 (2.1%) in the PLD-C group and 33/366 (9.0%) in the non-PLD-C group], with a median cycle number of carboplatin administration at onset of HSR being 9. Incidences of carboplatin-induced HSR within the PLD-C versus non-PLD-C group at the 8th, 12th, and 16th cycles of carboplatin administration were 2.2% vs 11.2%, 2.2% vs 28.6%, and 2.2% vs 39.1%, respectively [hazard ratio: 19.2 (95% confidence interval: 9.82-39.4), p < 0.0001]. CONCLUSION: Based on the data analyzed here, a suppressive effect on carboplatin-induced HSR via combination therapy with PLD was confirmed within clinical practice.

    DOI: 10.1007/s10147-020-01706-w

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  • Dose-dense paclitaxel and carboplatin vs. conventional paclitaxel and carboplatin as neoadjuvant chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer: a retrospective study.

    Takashi Shibutani, Shoji Nagao, Kazuhiro Suzuki, Michiko Kaneda, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Tamotsu Sudo, Satoshi Yamaguchi

    International journal of clinical oncology   25 ( 3 )   502 - 507   2020年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media {LLC}  

    BACKGROUND: The purpose of this study was to determine the optimal regimen of neoadjuvant chemotherapy (NAC) for advanced epithelial ovarian, fallopian tube, and peritoneal cancers. METHODS: A clinical information survey involving 171 patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer was conducted. These patients underwent NAC followed by interval debulking surgery at the Hyogo Cancer Center (Hyogo, Japan) between January 2006 and December 2015. RESULTS: The median observation period was 41 (range 4-138) months. Dose-dense paclitaxel and carboplatin (TC) was administered in 101 patients (59%); tri-weekly TC was administered 70 patients (41%). Median progression-free survival was 21 [95% confidence interval (CI) 18-23] months and 15 (95% CI 13-17) months in the dose-dense TC and conventional-TC group [hazard ratio (HR) = 0.69, 95% CI 0.46-0.96; p = 0.02], respectively. The median overall survival was 59 (95% CI 46-72) and 40 (95% CI 32-57) months in the dose-dense TC group and conventional-TC group (HR = 0.72, 95% CI 0.48-1.06; p = 0.09). Multivariate analysis for progression-free survival demonstrated that dose-dense TC represented an independent prognostic factor (HR = 0.70, 95% CI 0.50-0.99; p = 0.04). CONCLUSIONS: Dose-dense TC is a promising regimen of NAC for advanced epithelial ovarian cancer.

    DOI: 10.1007/s10147-019-01567-y

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  • A phase II study of the combination chemotherapy of bevacizumab and gemcitabine in women with platinum-resistant recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer. 国際誌

    Shoji Nagao, Ai Kogiku, Kazuhiro Suzuki, Takashi Shibutani, Kasumi Yamamoto, Tomoatsu Jimi, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Satoshi Yamaguchi

    Journal of ovarian research   13 ( 1 )   14 - 14   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media {LLC}  

    INTRODUCTION: Bevacizumab and gemcitabine are key drugs for treating recurrent epithelial ovarian cancer. However, information about the combination of bevacizumab and gemcitabine is insufficient. We conducted a phase II study to assess the feasibility, clinical activity, and toxicity of this combination chemotherapy. METHODS: This study included women with platinum-resistant recurrent epithelial ovarian, primary peritoneal, or fallopian tube cancer who received one to three regimens of platinum-based chemotherapy between April 1, 2015 and December 31, 2018. The patients received bevacizumab 15 mg/kg intravenously on day 1 and gemcitabine 1000 mg/m2 intravenously on days 1 and 8 every 21 days until disease progression or unacceptable toxicity. The primary endpoint was the completion rate of three cycles of chemotherapy. This study was registered in the University Medical Information Network (UMIN) Clinical Trials Registry (UMIN000016619). RESULTS: Among the 19 patients, 18 (95%) received ≥3 and 9 (47%) received ≥6 cycles of the study therapy. The objective response rate was 42% (complete response of 16% and partial response of 26%), and the clinical control rate was 84%. Hematological toxicity included neutropenia grade 3/4 in 9 patients (47%), anemia grade 3/4 in 2 (11%), and thrombocytopenia grade 3/4 in 1 (5%). One patient (5%) had grade 3 hypertension, and 1 (5%) had grade 3 protein urea. Possibly related grade 3 pulmonary toxicity was observed in 1 patient. Three patients needed dose reduction of gemcitabine to 800 mg/m2 due to treatment delay by 15 to 21 days on day1. There was no treatment delay more than 14 days on day 8. The median progression-free survival duration was 5.1 months and median overall survival duration was 21.3 months. CONCLUSION: The combination chemotherapy with gemcitabine and bevacizumab was feasible, effective and safe. This combination chemotherapy may be explored in a further randomized trial.

    DOI: 10.1186/s13048-020-0617-y

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  • Leptomeningeal metastases arising from gynecological cancers.

    Hiroko Yano, Shoji Nagao, Satoshi Yamaguchi

    International journal of clinical oncology   25 ( 2 )   391 - 395   2020年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Most cases of leptomeningeal metastasis (LM) arise from solid tumors, such as breast cancer, lung cancer, or malignant melanoma. LM arising from gynecological cancers are extremely rare. Longer survival owing to recent advances in chemotherapy and other treatments has contributed to the increased frequency of gynecological cancers metastasizing to the central nervous system (CNS). Detailed information regarding LM is scarce; therefore, we conducted a study concerning LM arising from primary gynecological cancers. METHODS: Among 24 patients with CNS metastases from gynecological cancer treated at our hospital between January 2011 and August 2018, those who were eventually diagnosed with LM were included in this retrospective study. RESULTS: Among 24 patients with CNS metastases, five patients (20.8%) were diagnosed with LM. The primary cancer was endometrial in two, cervical in one, and peritoneal in two patients. Of these five patients, three developed LM as a complication 1-11 months after the treatment of brain metastases; one patient had multiple brain metastases diagnosed at the same time as LM, and one had LM alone, without accompanying brain metastases. The median survival after the diagnosis of LM was 23 (12-69) days, while the median survival of 24 patients after the initial diagnosis of CNS metastases was 106 (13-959) days. CONCLUSION: Although LM arising from gynecological cancers is considered rare, identification of LM may be important to predict prognosis and develop new therapeutic strategies.

    DOI: 10.1007/s10147-019-01556-1

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  • [Ⅳ.Endometrial Cancer].

    Shoji Nagao

    Gan to kagaku ryoho. Cancer & chemotherapy   47 ( 2 )   247 - 251   2020年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Olaparib plus Bevacizumab as First-Line Maintenance in Ovarian Cancer. 国際誌

    Isabelle Ray-Coquard, Patricia Pautier, Sandro Pignata, David Pérol, Antonio González-Martín, Regina Berger, Keiichi Fujiwara, Ignace Vergote, Nicoletta Colombo, Johanna Mäenpää, Frédéric Selle, Jalid Sehouli, Domenica Lorusso, Eva M Guerra Alía, Alexander Reinthaller, Shoji Nagao, Claudia Lefeuvre-Plesse, Ulrich Canzler, Giovanni Scambia, Alain Lortholary, Frederik Marmé, Pierre Combe, Nikolaus de Gregorio, Manuel Rodrigues, Paul Buderath, Coraline Dubot, Alexander Burges, Benoît You, Eric Pujade-Lauraine, Philipp Harter

    The New England journal of medicine   381 ( 25 )   2416 - 2428   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: Olaparib has shown significant clinical benefit as maintenance therapy in women with newly diagnosed advanced ovarian cancer with a BRCA mutation. The effect of combining maintenance olaparib and bevacizumab in patients regardless of BRCA mutation status is unknown. METHODS: We conducted a randomized, double-blind, international phase 3 trial. Eligible patients had newly diagnosed, advanced, high-grade ovarian cancer and were having a response after first-line platinum-taxane chemotherapy plus bevacizumab. Patients were eligible regardless of surgical outcome or BRCA mutation status. Patients were randomly assigned in a 2:1 ratio to receive olaparib tablets (300 mg twice daily) or placebo for up to 24 months; all the patients received bevacizumab at a dose of 15 mg per kilogram of body weight every 3 weeks for up to 15 months in total. The primary end point was the time from randomization until investigator-assessed disease progression or death. RESULTS: Of the 806 patients who underwent randomization, 537 were assigned to receive olaparib and 269 to receive placebo. After a median follow-up of 22.9 months, the median progression-free survival was 22.1 months with olaparib plus bevacizumab and 16.6 months with placebo plus bevacizumab (hazard ratio for disease progression or death, 0.59; 95% confidence interval [CI], 0.49 to 0.72; P<0.001). The hazard ratio (olaparib group vs. placebo group) for disease progression or death was 0.33 (95% CI, 0.25 to 0.45) in patients with tumors positive for homologous-recombination deficiency (HRD), including tumors that had BRCA mutations (median progression-free survival, 37.2 vs. 17.7 months), and 0.43 (95% CI, 0.28 to 0.66) in patients with HRD-positive tumors that did not have BRCA mutations (median progression-free survival, 28.1 vs. 16.6 months). Adverse events were consistent with the established safety profiles of olaparib and bevacizumab. CONCLUSIONS: In patients with advanced ovarian cancer receiving first-line standard therapy including bevacizumab, the addition of maintenance olaparib provided a significant progression-free survival benefit, which was substantial in patients with HRD-positive tumors, including those without a BRCA mutation. (Funded by ARCAGY Research and others; PAOLA-1 ClinicalTrials.gov number, NCT02477644.).

    DOI: 10.1056/NEJMoa1911361

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  • Landscape of systemic therapy for ovarian cancer in 2019: Primary therapy. 国際誌

    Keiichi Fujiwara, Kosei Hasegawa, Shoji Nagao

    Cancer   125 Suppl 24   4582 - 4586   2019年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    According to the statement from the 5th Ovarian Cancer Consensus Conference in 2015, the primary systemic chemotherapy for advanced ovarian cancer is a combination of paclitaxel plus carboplatin administered every 3 weeks (PCq3w). Optional alternatives include weekly dose-dense paclitaxel, in combination and maintenance therapy with bevacizumab, and intraperitoneal chemotherapy. Since then, in addition to the PCq3w strategy, there has been emerging new evidence, especially for poly(adenosine diphosphate-ribose) polymerase inhibitors. Moreover, there are multiple randomized, phase 3 trials testing the addition of antiangiogenic and/or immune checkpoint inhibitors in this patient population. In this article, current and future perspectives of systemic chemotherapy for advanced ovarian cancer are discussed.

    DOI: 10.1002/cncr.32475

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  • Recurrence, death, and secondary malignancy after ovarian conservation for young women with early-stage low-grade endometrial cancer. 国際誌

    Koji Matsuo, James C Cripe, Katherine C Kurnit, Michiko Kaneda, Audrey S Garneau, Gretchen E Glaser, Aaron Nizam, Rachel M Schillinger, Michelle L Kuznicki, Akira Yabuno, Shiori Yanai, Denise M Garofalo, Jiro Suzuki, Jessica D St Laurent, Ting-Tai Yen, Annie Y Liu, Masako Shida, Mamoru Kakuda, Tetsuro Oishi, Shin Nishio, Jenna Z Marcus, Sosuke Adachi, Tetsuji Kurokawa, Malcolm S Ross, Max P Horowitz, Marian S Johnson, Min K Kim, Alexander Melamed, Karime K Machado, Kosuke Yoshihara, Yoshio Yoshida, Takayuki Enomoto, Kimio Ushijima, Shinya Satoh, Yutaka Ueda, Mikio Mikami, Bobbie J Rimel, Rebecca L Stone, Whitfield B Growdon, Aikou Okamoto, Saketh R Guntupalli, Kosei Hasegawa, Mian M K Shahzad, Dwight D Im, Marina Frimer, Bobbie S Gostout, Frederick R Ueland, Shoji Nagao, Pamela T Soliman, Premal H Thaker, Jason D Wright, Lynda D Roman

    Gynecologic oncology   155 ( 1 )   39 - 50   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: To examine the association between ovarian conservation and oncologic outcome in surgically-treated young women with early-stage, low-grade endometrial cancer. METHODS: This multicenter retrospective study examined women aged <50 with stage I grade 1-2 endometrioid endometrial cancer who underwent primary surgery with hysterectomy from 2000 to 2014 (US cohort n = 1196, and Japan cohort n = 495). Recurrence patterns, survival, and the presence of a metachronous secondary malignancy were assessed based on ovarian conservation versus oophorectomy. RESULTS: During the study period, the ovarian conservation rate significantly increased in the US cohort from 5.4% to 16.4% (P = 0.020) whereas the rate was unchanged in the Japan cohort (6.3-8.7%, P = 0.787). In the US cohort, ovarian conservation was not associated with disease-free survival (hazard ratio [HR] 0.829, 95% confidence interval [CI] 0.188-3.663, P = 0.805), overall survival (HR not estimated, P = 0.981), or metachronous secondary malignancy (HR 1.787, 95% CI 0.603-5.295, P = 0.295). In the Japan cohort, ovarian conservation was associated with decreased disease-free survival (HR 5.214, 95% CI 1.557-17.464, P = 0.007) and an increased risk of a metachronous secondary malignancy, particularly ovarian cancer (HR 7.119, 95% CI 1.349-37.554, P = 0.021), but was not associated with overall survival (HR not estimated, P = 0.987). Ovarian recurrence or metachronous secondary ovarian cancer occurred after a median time of 5.9 years, and all cases were salvaged. CONCLUSION: Our study suggests that adoption of ovarian conservation in young women with early-stage low-grade endometrial cancer varies by population. Ovarian conservation for young women with early-stage, low-grade endometrial cancer may be potentially associated with increased risks of ovarian recurrence or metachronous secondary ovarian cancer in certain populations; nevertheless, ovarian conservation did not negatively impact overall survival.

    DOI: 10.1016/j.ygyno.2019.08.007

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  • A phase II randomized controlled study of pegylated liposomal doxorubicin and carboplatin vs. gemcitabine and carboplatin for platinum-sensitive recurrent ovarian cancer (GOTIC003/intergroup study).

    Hiroyuki Fujiwara, Kimio Ushijima, Shoji Nagao, Yuji Takei, Muneaki Shimada, Masashi Takano, Kiyoshi Yoshino, Yoshiaki Kawano, Yasuyuki Hirashima, Satoru Nagase, Shin Nishio, Tadaaki Nishikawa, Kimihiko Ito, Tadahiro Shoji, Eizo Kimura, Tadao Takano, Toru Sugiyama, Junzo Kigawa, Keiichi Fujiwara, Mitsuaki Suzuki

    International journal of clinical oncology   24 ( 10 )   1284 - 1291   2019年10月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: To compare the efficacy, safety, and tolerability profiles of pegylated liposomal doxorubicin and carboplatin (PLDC) with those of gemcitabine and carboplatin (GC) for the treatment of patients with platinum-sensitive recurrent ovarian cancer. METHODS: Ovarian cancer patients with recurrence > 6 months after first-line platinum and taxane-based therapies were randomly assigned to PLDC [pegylated liposomal doxorubicin 30 mg/m2 plus carboplatin area under the curve (AUC) 5 mg/mL/min on day 1] every 4 weeks or GC (gemcitabine 1000 mg/m2 on days 1 and 8 plus carboplatin AUC 4 mg/mL/min on day 1) every 3 weeks for at least 6 cycles. The primary endpoint was progression-free survival, and overall response rate, overall survival, toxicity, and dose administration were secondary endpoints. RESULTS: One-hundred patients (49 PLDC; 51 GC) were randomly assigned. Over a median follow-up of 24 months, the median progression-free survival was 12.0 months (95% CI 9.2-15.0) for PLDC and 9.8 months (8.9-12.3) for GC [HR 0.69 (0.455-1.047)] with a difference of 2.2 months. The response rate was 57.1% (41.0-72.3) for PLDC and 56.4% (39.6-72.2) for GC. No obvious differences in toxicity (G3/4) were noted between arms. The median relative dose intensity of planned dose per week was 88.9% for pegylated liposomal doxorubicin and 53.1% for gemcitabine (p < 0.0001). CONCLUSIONS: PLDC and GC are both good treatment candidates for platinum-sensitive recurrent ovarian cancer patients; however, the dose intensity was lower for GC than for PLDC. PLDC had a more favorable risk-benefit profile than that of GC for patients.

    DOI: 10.1007/s10147-019-01471-5

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  • Phase II trial of paclitaxel, carboplatin, and bevacizumab for advanced or recurrent cervical cancer. 国際誌

    Kazuhiro Suzuki, Shoji Nagao, Takashi Shibutani, Kasumi Yamamoto, Tomoatsu Jimi, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Satoshi Yamaguchi

    Gynecologic oncology   154 ( 3 )   554 - 557   2019年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: We evaluated the efficacy and safety of the combination of paclitaxel, carboplatin, and bevacizumab in patients with advanced or recurrent cervical cancer. METHODS: Subjects included patients with advanced or recurrent cervical cancer not amenable to curative treatment with surgery or radiation therapy. Treatment consisted of paclitaxel 175 mg/m2, carboplatin area under the curve 6 mg/mL/min, and bevacizumab 15 mg/kg every 21 days until disease progression, complete remission, or limiting toxicity. The primary endpoint was the objective response. RESULTS: In total, 34 patients received a median of 6 treatment cycles (range 2-25). The median follow-up period was 18.5 months (range 2-29). The objective response was 88% (95% confidence interval: 72.5%-96.7%). Seventeen patients (50%) experienced complete response, whereas 13 patients experienced (38%) partial response with a median duration of 6 months. Grades 3 and 4 hematologic toxicities manifested as neutropenia in 14 (41.2%), leukopenia in 14 (41.2%), anemia in 11 (32.4%), and thrombocytopenia in 9 (26.5%) patients. One patient who underwent prior pelvic irradiation developed grade 2 rectovaginal fistula. CONCLUSION: The combination of paclitaxel, carboplatin, and bevacizumab is effective and safe in patients with advanced or recurrent cervical cancer.

    DOI: 10.1016/j.ygyno.2019.05.018

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  • Endometrial carcinoma in a 14-year-old: A case report. 国際誌

    Hajime Uda, Miho Kitai, Ai Kogiku, Anna Kobayashi, Toshiko Sakuma, Shoji Nagao, Satoshi Yamaguchi

    Gynecologic oncology reports   29   7 - 9   2019年8月

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    記述言語:英語  

    •We present a case of endometrial carcinoma (EC) in a 14-year-old girl with no risk factors for EC.•The patient received MPA therapy and endometrial curettage.•At 47 weeks after her last MPA treatment, she has had no recurrence.•EC should be considered in diagnosing juveniles with sustained abnormal uterine bleeding, even those without risk factors.

    DOI: 10.1016/j.gore.2019.05.006

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  • Correlation between pre-operative and final histological diagnosis on endometrial cancer. 国際誌

    Takaya Shiozaki, Maiko Miwa, Toshiko Sakuma, Kazuhiro Suzuki, Ai Kogiku, Kasumi Yamamoto, Tokihiro Senda, Hiroko Yano, Miho Kitai, Kazuko Matsuoka, Tamotsu Sudo, Shoji Nagao, Satoshi Yamaguchi

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society   29 ( 5 )   886 - 889   2019年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: We conducted a retrospective study to evaluate the correlation between pre-operative and post-operative histological diagnoses on endometrial cancer, and to describe the treatments and outcomes when post-operative diagnoses are downgraded from pre-operative histology. METHODS: Patients who underwent surgery for endometrial cancer in our facility between 2010 and 2013 were enrolled in the study. The definition of downgrade discordance is in accordance with the following criteria: 1) the pre-operative and post-operative histological diagnoses were both endometrioid and the final pathology was a lower grade than the pre-operative pathology and 2) the pre-operative diagnosis was not endometrioid, whereas the post-operative diagnosis was endometrioid grade 2 or less. RESULTS: A total of 250 patients were enrolled, and the concordance rates were 56% for endometrioid adenocarcinoma grade 1 (EMG1), 67% for EMG2, 67% for EMG3, 82% for carcinosarcoma, 71% for serous carcinoma, and 67% for clear cell carcinoma. Eighteen cases (6.6%) were identified as downgrade discordancy. Of the 18 patients, the triage for adjuvant therapy remained the same for 15 cases (83%), all of whom had no evidence of disease at their last visit. Three cases had discordances with respect to triage for adjuvant therapy; the therapies were triaged based on post-operative diagnosis. Of these patients one had a recurrence. CONCLUSIONS: Good correlation was observed between pre-operative and final histological diagnoses of endometrioid carcinoma (56%-67%) and type 2 carcinoma (67%-82%). Approximately 7% (18/250) of patients had downgrade discordancy; however, triage for adjuvant therapy did not change for approximately 80% (15/18) of the patients with downgrade discordancy. Further studies are needed to evaluate the effectiveness of triages that are based on post-operative diagnoses.

    DOI: 10.1136/ijgc-2018-000041

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  • [Ⅲ.Surgery for Platinum Sensitive Recurrent Epithelial Ovarian Cancer].

    Shoji Nagao

    Gan to kagaku ryoho. Cancer & chemotherapy   46 ( 2 )   240 - 243   2019年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Phase I Study of Multiple Epitope Peptide Vaccination in Patients With Recurrent or Persistent Cervical Cancer. 国際誌

    Kosei Hasegawa, Yuji Ikeda, Yuko Kunugi, Akira Kurosaki, Yuichi Imai, Shunsuke Kohyama, Shoji Nagao, Eito Kozawa, Koji Yoshida, Takuya Tsunoda, Yusuke Nakamura, Keiichi Fujiwara

    Journal of immunotherapy (Hagerstown, Md. : 1997)   41 ( 4 )   201 - 207   2018年5月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Cancer immunotherapy has now been established as a leading standard therapeutic option in a subset of patients with cancer. In this study, we conducted a phase I dose-escalation trial using a mixture of 5 peptides to vaccinate cervical cancer patients with HLA-A*2402. The primary endpoints were safety and determination of a recommended vaccine dose, and the secondary endpoints were evaluations of immunologic responses and clinical efficacy. All patients had recurrent or persistent disease and had failed to respond to or were intolerant to prior standard chemotherapy. Peptides derived from forkhead box protein M1 (FOXM1), maternal embryonic leucine zipper kinase (MELK), Holliday junction-recognition protein, and vascular endothelial growth factor receptors 1 and 2 were administered to 9 patients in a 3 patient-cohort design, with doses of 0.5, 1, or 2 mg of each of the individual peptides in a mixture with incomplete Freund's adjuvant. The major adverse events were anemia and injection site reactions, which were seen in 77.8% (7/9) and 66.7% (6/9) of patients, respectively. Grade 3 anemia was observed in 1 patient. No dose-limiting toxicity of the vaccine was observed. Seven (78%) patients achieved stable disease, and the median progression-free survival was 3.3 months (102 d). Interferon-γ enzyme-linked immunospot assays for each of the 5 antigens showed that 8 (89%) and 7 (78%) patients had high T-cell responses to FOXM1 and MELK, respectively. In conclusion, we demonstrated that this 5-peptide vaccine was tolerable, and that FOXM1 and MELK could be promising targets for immunotherapy in patients with cervical cancer.

    DOI: 10.1097/CJI.0000000000000214

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  • [II. Chemotherapy for Small Cell Carcinoma of the Uterus].

    Shoji Nagao

    Gan to kagaku ryoho. Cancer & chemotherapy   45 ( 2 )   239 - 242   2018年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Chemoresistance of Gastric-Type Mucinous Carcinoma of the Uterine Cervix: A Study of the Sankai Gynecology Study Group. 国際誌

    Atsumi Kojima, Muneaki Shimada, Yoshiki Mikami, Shoji Nagao, Nobuhiro Takeshima, Toru Sugiyama, Norihiro Teramoto, Takako Kiyokawa, Junzo Kigawa, Ryuichiro Nishimura

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society   28 ( 1 )   99 - 106   2018年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Gastric-type mucinous carcinoma (GAS) is a novel variant of mucinous carcinoma of the uterine cervix, characterized by aggressive clinical behavior and absence of high-risk human papillomavirus. We conducted this study to evaluate the chemosensitivity of GAS compared with that of usual-type endocervical adenocarcinoma (UEA) in patients who had been enrolled in our previous study. METHODS: Of 52 patients from our previous phase 2 study (SGSG005) of neoadjuvant chemotherapy with docetaxel and carboplatin for stage IB2 to IIB nonsquamous cervical cancer, 47 (stage IB2, 12; stage IIA2, 7; stage IIB, 28) were enrolled in this study with written informed consent. The biopsy specimens before neoadjuvant chemotherapy and surgical specimens after chemotherapy were centrally reviewed based on the updated World Health Organization classification (2014). RESULTS: Of 47 patients with nonsquamous cell carcinoma, 20 (42.6%) were diagnosed with UEA, 13 (27.7%) with GAS, 12 (25.5%) with adenosquamous carcinoma, and 1 patient each (2%) with small cell carcinoma and serous carcinoma. Consequently, 33 patients, consisting of 20 patients with UEA and 13 patients with GAS, were eligible for the current study. The response rate of GAS was significantly lower than that of UEA (46.2% vs 85.0%, P = 0.048). Of 16 cases of stage II UEA, 11 (68.8%) were downstaged on microscopic examination of postsurgical specimens, but none of the 8 patients with stage II GAS showed any response (P < 0.01). Two inoperative tumors were GAS. With a median follow-up duration of 56 months, the 5-year progression-free and overall survival rates of GAS were significantly worse than those of UEA (38.5% vs 75.0% [P = 0.011] and 36.9% vs 90.0% [P < 0.001], respectively). CONCLUSIONS: These findings suggest that GAS should be distinguished from UEA by its chemoresistance, necessitating an alternative treatment strategy established for this distinct subtype of endocervical adenocarcinoma.

    DOI: 10.1097/IGC.0000000000001145

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  • Pelvic fractures after definitive and postoperative radiotherapy for cervical cancer: A retrospective analysis of risk factors. 国際誌

    Kasumi Yamamoto, Shoji Nagao, Kazuhiro Suzuki, Ai Kogiku, Tokihiro Senda, Hiroko Yano, Miho Kitai, Takaya Shiozaki, Kazuko Matsuoka, Satoshi Yamaguchi

    Gynecologic oncology   147 ( 3 )   585 - 588   2017年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVES: This study clarified the incidence of and identified the risk factors for post-radiation pelvic insufficiency fractures (PIFs) in women who received postoperative definitive or adjuvant radiotherapy (RT) for cervical cancer. PATIENTS AND METHODS: The medical records and data of imaging studies, including computed tomography scan and magnetic resonance imaging, of women with cervical cancer who received external-beam RT for the entire pelvic area between January 2003 and December 2012 at our institution were reviewed. RESULTS: A total of 533 patients with histologically diagnosed cervical cancer who received RT (298: definitive RT, 235: adjuvant RT) were included in this study. Eighty-four patients (15.8%) developed PIF in the irradiated field. Median age at onset of PIF was 72.5years (range: 54-95years), and 82 of them (98%) were postmenopausal women. Sixty-nine patients (80%) developed PIF within 3years from the completion of RT. The median time for the development of PIF was 14months (range: 1-81months). The most commonly involved fracture site was the sacral bone. Postmenopausal state, coexistence of rheumatoid arthritis, and high-dose-rate intracavitary brachytherapy (HDR-ICBT) use were significant predisposing factors for the development of PIF, according to multivariate analysis. CONCLUSIONS: The incidence rate of PIF among patients who received RT for locally advanced cervical cancer was 15.8%. The principal predisposing factors for post-radiation PIF were postmenopausal state, rheumatoid arthritis, and HDR-ICBT use. Active interventions, including bone density screening followed by medication, should be considered during the early stage of RT for women with high-risk factors of PIF.

    DOI: 10.1016/j.ygyno.2017.09.035

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  • Cisplatin with dose-dense paclitaxel before and after radical hysterectomy for locally advanced cervical cancer: a prospective multicenter phase II trial with a dose-finding study. 国際誌

    Maki Tanioka, Satoshi Yamaguchi, Muneaki Shimada, Shoji Nagao, Kazuhiro Takehara, Masato Nishimura, Satoshi Morita, Shunichi Negoro, Kiyoshi Fujiwara, Junzo Kigawa

    Medical oncology (Northwood, London, England)   34 ( 8 )   134 - 134   2017年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    The aim of this study is to evaluate the outcome and safety of the multidisciplinary strategy using cisplatin plus dose-dense paclitaxel (dose-dense TP) before and after radical hysterectomy (RH) for stage IB2, IIA2, or IIB patients with cervical cancer. In the dose-finding phase, 12 patients received 3 cycles of cisplatin (75 mg/m2, day 1) with paclitaxel (70 or 80 mg/m2, days 1, 8, and 15) every 21 days as neoadjuvant chemotherapy (NAC). In the phase II study, 51 patients received 3 cycles of dose-dense TP at the recommended dose as NAC, and another 2 cycles of the same regimen after RH. The primary endpoint was 2-year progression-free survival (PFS). The secondary endpoints were 2-year overall survival (OS), adverse events (AEs), response rate (RR), and pathological complete response (pCR) rates. The recommended dose of paclitaxel at dose-finding phase was 80 mg/m2. In the phase II study, 34 patients (66.7%) had FIGO stage IIB disease. The RR and pCR rates were 94 and 28%. With a median follow-up duration of 58 months, each of the 2- and 5-year PFS rates was 88.2%, the 2- and 5-year OS rates were 94.1 and 88.2%, respectively. The incidence of grade 3/4 AEs was neutropenia (34%), nausea (12%), appetite loss (10%), fatigue (6%), and anemia (6%). Febrile neutropenia was uncommon (2%). Dose-dense TP before and after RH achieved a good long-term survival and was feasible for patients with locally advanced cervical cancer.

    DOI: 10.1007/s12032-017-0992-4

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  • Correlation Between Tumor Mesothelin Expression and Serum Mesothelin in Patients with Epithelial Ovarian Carcinoma: A Potential Noninvasive Biomarker for Mesothelin-targeted Therapy. 国際誌

    Tatsuya Hanaoka, Kosei Hasegawa, Tomomi Kato, Sho Sato, Akira Kurosaki, Akiko Miyara, Shoji Nagao, Hiroyuki Seki, Masanori Yasuda, Keiichi Fujiwara

    Molecular diagnosis & therapy   21 ( 2 )   187 - 198   2017年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: The cell surface glycoprotein mesothelin is highly expressed in several malignant diseases. Normal mesothelin expression is limited to mesothelial cells lining the pleura, peritoneum, and pericardium, making it a biomarker and an attractive target for cancer therapy. METHODS: We investigated tumor mesothelin expression and serum mesothelin levels in patients with epithelial ovarian cancer or borderline tumors. In total, 161 patients selected from a previous prospective study were analyzed for tumor mesothelin expression using immunohistochemistry and serum mesothelin expression using enzyme-linked immunosorbent assay. RESULTS: Eighty-eight (68.8%) epithelial ovarian cancers and eight (24.2%) borderline tumors showed high mesothelin expression, which was associated with shorter progression-free and overall survival. The tumor mesothelin expression status was moderately correlated with serum mesothelin levels in epithelial ovarian cancer patients. Based on receiver operating characteristic analysis, a serum mesothelin level above 2.20 nM predicted high tumor mesothelin expression in epithelial ovarian cancer patients (area under the curve = 0.81). In 45 patients with recurrent epithelial ovarian cancer, we observed relatively lower levels of serum mesothelin, compared to the level at the primary diagnosis. We also tracked the change in the serum mesothelin level during the course of second-line chemotherapy and found a discrepancy between the clinical response and the serum mesothelin change in some patients, which suggested tumor heterogeneity among the tumor cells with or without mesothelin expression. CONCLUSION: Serum mesothelin may be a useful noninvasive biomarker surrogate for tumor mesothelin expression in future clinical trials for mesothelin-targeted therapy.

    DOI: 10.1007/s40291-017-0255-2

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  • Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for stage IB2, IIA2, and IIB patients with non-squamous cell carcinoma of the uterine cervix.

    Muneaki Shimada, Shoji Nagao, Keiichi Fujiwara, Nobuhiro Takeshima, Ken Takizawa, Tadahiro Shoji, Toru Sugiyama, Satoshi Yamaguchi, Ryuichiro Nishimura, Junzo Kigawa

    International journal of clinical oncology   21 ( 6 )   1128 - 1135   2016年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: We conducted a phase II study to evaluate the efficacy of neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy for patients with non-squamous cell carcinoma of the uterine cervix. METHODS: Sixty-one patients with International Federation of Gynecology and Obstetrics stage IB2, IIA2, or IIB non-squamous cell carcinoma of the uterine cervix were enrolled. The patients were administered docetaxel at a dose of 60 mg/m2, followed by carboplatin at a dose based on an area under the curve of 6. The treatments were repeated every 21 days for one to three cycles. Fifty-two patients were eligible to evaluate the efficacy of neoadjuvant chemotherapy followed by radical hysterectomy. Adverse events were evaluated in 59 patients. RESULTS: The response rate was 69 % (95 % CI, 57-82 %), with 5 patients achieving complete response, 31 partial response, 15 stable disease, and 1 progressive disease. Median follow-up duration was 1913 days with a range of 145-2632 days. Of 52 patients, 50 underwent radical hysterectomy after neoadjuvant chemotherapy. The 2-year overall survival rate was 81.8 % for stage IB2, 85.7 % for stage IIA2, and 92.6 % for stage IIB. The most frequent grade 3 and 4 hematological toxicity was neutropenia, with 43 patients experiencing grade 4 and 11 with grade 3. The nonhematological toxicities were mainly grade 1 or 2 in severity. CONCLUSION: Neoadjuvant chemotherapy with docetaxel and carboplatin followed by radical hysterectomy may be a useful strategy for patients with non-squamous cell carcinoma of uterine cervix.

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  • Analysis of the effect of adjuvant radiotherapy on outcomes and complications after radical hysterectomy in FIGO stage IB1 cervical cancer patients with intermediate risk factors (GOTIC Study). 国際誌

    Kazuto Nakamura, Yoshikazu Kitahara, Toyomi Satoh, Yuji Takei, Masashi Takano, Shoji Nagao, Isao Sekiguchi, Mitsuaki Suzuki

    World journal of surgical oncology   14 ( 1 )   173 - 173   2016年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    BACKGROUND: There are no definitive criteria for identifying which patients with The International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer will benefit from adjuvant therapy after radical hysterectomy. The aims of this study were to clarify the efficacy of adjuvant therapy and assess complications after radical hysterectomy in patients with FIGO stage IB1 cervical cancer with intermediate risk factors. METHODS: Between January 2005 and December 2009, the medical records of 75 stage IB1 patients' intermediate risk factors (i.e., tumor size 2-4 cm, lymphovascular involvement, and/or deep stromal invasion >1/2) who underwent radical hysterectomy at six institutions were collected, and these patients were enrolled in this nonrandomized retrospective study. We simplified the criteria of intermediate risk factors as much as possible, as the criteria adopted in some clinical studies are complicated in practice. RESULTS: The patients were grouped according to the receipt of adjuvant therapy as follows: 46 patients, no further treatment; 19 patients, external beam radiation treatment, including 9 patients who received brachytherapy; 5 patients, concurrent chemoradiotherapy (CCRT); and 5 patients, chemotherapy (CT). The clinical outcomes and complications in each group were analyzed. After an average follow-up of 82.6 months (range, 24-135 months), only one patient with all three risk factors who received radiotherapy (RT) experienced recurrence. Excluding this patient, the remaining patients who received RT, CCRT, or CT had two or three risk factors. Lymphedema was significantly more common among patients who received RT or CCRT, whereas the incidence of ileus and ureteral obstruction was not different among the treatment groups. However, an unsutured peritoneum increased the risk of ileus. CONCLUSIONS: The findings of this study suggest that RT and CCRT after radical hysterectomy are not beneficial in patients with intermediate risk factors. In particular, RT and CCRT appeared to increase the incidence of lymphedema. A prospective randomized study is needed to verify the findings of this study.

    DOI: 10.1186/s12957-016-0931-4

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  • A preoperative low cancer antigen 125 level (≤25.8 mg/dl) is a useful criterion to determine the optimal timing of interval debulking surgery following neoadjuvant chemotherapy in epithelial ovarian cancer. 国際誌

    Akemi Morimoto, Shoji Nagao, Ai Kogiku, Kasumi Yamamoto, Maiko Miwa, Senn Wakahashi, Kotaro Ichida, Tamotsu Sudo, Satoshi Yamaguchi, Kiyoshi Fujiwara

    Japanese journal of clinical oncology   46 ( 6 )   517 - 21   2016年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The purpose of this study is to investigate the clinical characteristics to determine the optimal timing of interval debulking surgery following neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer. METHODS: We reviewed the charts of women with advanced epithelial ovarian cancer, fallopian tube cancer or primary peritoneal cancer who underwent interval debulking surgery following neoadjuvant chemotherapy at our cancer center from April 2006 to April 2014. RESULTS: There were 139 patients, including 91 with ovarian cancer [International Federation of Gynecology and Obstetrics (FIGO) Stage IIIc in 56 and IV in 35], two with fallopian tube cancers (FIGO Stage IV, both) and 46 with primary peritoneal cancer (FIGO Stage IIIc in 27 and IV in 19). After 3-6 cycles (median, 4 cycles) of platinum-based chemotherapy, interval debulking surgery was performed. Sixty-seven patients (48.2%) achieved complete resection of all macroscopic disease, while 72 did not. More patients with cancer antigen 125 levels ≤25.8 mg/dl at pre-interval debulking surgery achieved complete resection than those with higher cancer antigen 125 levels (84.7 vs. 21.3%; P< 0.0001). Patients with no ascites at pre-interval debulking surgery also achieved a higher complete resection rate (63.5 vs. 34.1%; P< 0.0001). Moreover, most patients (86.7%) with cancer antigen 125 levels ≤25.8 mg/dl and no ascites at pre-interval debulking surgery achieved complete resection. CONCLUSIONS: A low cancer antigen 125 level of ≤25.8 mg/dl and the absence of ascites at pre-interval debulking surgery are major predictive factors for complete resection during interval debulking surgery and present useful criteria to determine the optimal timing of interval debulking surgery.

    DOI: 10.1093/jjco/hyw029

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  • Diagnosis of desmoplastic small-round-cell tumor by cytogenetic analysis: a case report. 国際誌

    Senn Wakahashi, Tamotsu Sudo, Kotaro Ichida, Shintaro Sugita, Tadashi Hasegawa, Shoji Nagao, Satoshi Yamaguchi, Toshiko Sakuma, Hideto Yamada

    Clinical case reports   4 ( 5 )   520 - 3   2016年5月

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    記述言語:英語  

    We herein present atypical histologic and immunohistochemical features of DSRCT. The various differential diagnoses of DSRCT may occasionally generate confusion. Cytogenetic analysis may solve diagnostic dilemmas such as that in our case. Further studies are required to establish a standard treatment for DSRCT.

    DOI: 10.1002/ccr3.558

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  • The Efficacy of Low-Dose Paclitaxel Added to Combination Chemotherapy of Carboplatin and Gemcitabine or Pegylated Liposomal Doxorubicin. 国際誌

    Shoji Nagao, Norihiro Iwasa, Akira Kurosaki, Tadaaki Nishikawa, Tatsuya Hanaoka, Kosei Hasegawa, Keiichi Fujiwara

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society   26 ( 3 )   443 - 8   2016年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Paclitaxel is known to produce the "platelet-sparing effect" that prevents the carboplatin-induced decrease in platelet count. We conducted a pilot study to assess whether the addition of low-dose paclitaxel to carboplatin-based combination chemotherapy prevents thrombocytopenia. METHODS: Patients with platinum-sensitive recurrent ovarian cancer received intravenous (IV) paclitaxel at 60 mg/m(2) followed by IV carboplatin at an area under the curve of 6 and IV pegylated liposomal doxorubicin at 30 mg/m(2) on day 1 in a 28-day cycle (DC-LOP) or IV gemcitabine at 1000 mg/m(2) on days 1 and 8 in a 21-day cycle (GC-LOP). RESULTS: During May 2011 to December 2011, 7 patients received 29 cycles of DC-LOP; during January 2012 to May 2013, 15 patients received 88 cycles of GC-LOP. Grade 3/4 thrombocytopenia occurred in 2 (33%) of 6 and 9 (56%) of 16 patients in the DC-LOP and GC-LOP groups, respectively. No grade 3/4 nonhematological toxicity was observed. Only one patient who received GC-LOP had grade 2 sensory and motor peripheral neuropathy. Paclitaxel-related toxicities, including muscle pain, arthralgia, and peripheral neuropathy, were consistently rare and mild. The response rates of DC-LOP and GC-LOP were 33% (0, complete response; 2, partial response; 3, stable disease; 1, progression disease) and 50% (2, complete response; 6, partial response; 7, stable disease; 1, progression disease), respectively. CONCLUSIONS: Although low-dose paclitaxel addition did not alleviate thrombocytopenia in the setting of this pilot study, the results do not deny the existence of the "platelet-sparing effect" by low-dose paclitaxel. Further investigation of the carboplatin-based combination chemotherapy including a drug with mild hematological toxicity is warranted.

    DOI: 10.1097/IGC.0000000000000630

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  • [The Near-Future of Intraperitoneal Chemotherapy in Epithelial Ovarian Cancer].

    Shoji Nagao

    Gan to kagaku ryoho. Cancer & chemotherapy   43 ( 2 )   198 - 202   2016年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Clinical Features of Neuroendocrine Carcinoma of the Uterine Cervix: A Single-Institution Retrospective Review. 国際誌

    Shoji Nagao, Maiko Miwa, Naoko Maeda, Ai Kogiku, Kasumi Yamamoto, Akemi Morimoto, Senn Wakahashi, Kotaro Ichida, Tamotsu Sudo, Satoshi Yamaguchi, Toshiko Sakuma, Kiyoshi Fujiwara

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society   25 ( 7 )   1300 - 5   2015年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: Neuroendocrine carcinoma of the cervix is a rare and aggressive subtype of cervical cancer and includes small cell neuroendocrine carcinoma (SCNEC) and large cell neuroendocrine carcinoma (LCNEC). We conducted a single-institution retrospective review to explore the pattern of treatments and outcomes with the aim of defining an optimum treatment strategy for these carcinomas. METHODS: Twenty-three consecutive patients with SCNEC or LCNEC of the cervix diagnosed at the Hyogo Cancer Center between 1996 and 2013 were included in this study. Pertinent information, including clinical and pathological characteristics, and survival data were collected from clinical records and/or telephone surveys. The pathological review was conducted by a pathologist specializing in gynecologic cancer. RESULTS: Eleven patients had SCNEC and 12 had LCNEC. Eighteen patients with International Federation of Gynecology and Obstetrics (FIGO) stage I/II underwent type III radical hysterectomy with pelvic lymphadenectomy. After surgery, 9 received adjuvant chemotherapy (8, irinotecan plus cisplatin; 1, paclitaxel plus carboplatin), 7 received concurrent chemoradiation therapy (CCRT; 6, nedaplatin; 1, cisplatin), and 2 received radiation therapy (RT). Patients who received adjuvant chemotherapy had a better overall survival than did patients who received CCRT or RT (hazard ratio, 0.21; 95% confidence interval, 0.030-1.51; P = 0.12). Although the overall survival rates are not statistically significant, the 9 patients who underwent radical hysterectomy followed by adjuvant chemotherapy are all alive. Among the remaining 5 patients who did not undergo radical hysterectomy, 2 with FIGO stage III and 1 with stage IVa received CCRT, and 2 with stage IVb received palliative RT or chemotherapy. These 5 patients with FIGO stage III/IV died of disease within 36 months. CONCLUSIONS: Radical hysterectomy followed by platinum-based chemotherapy, especially the irinotecan plus cisplatin combination, is beneficial for long-term survival in patients with early-stage neuroendocrine carcinoma of the cervix.

    DOI: 10.1097/IGC.0000000000000495

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  • What is an appropriate second-line regimen for recurrent endometrial cancer? Ancillary analysis of the SGSG012/GOTIC004/Intergroup study. 国際誌

    Shoji Nagao, Shin Nishio, Satoshi Okada, Takeo Otsuki, Kiyoshi Fujiwara, Hiroshi Tanabe, Masashi Takano, Yoko Hasumi, Yuji Takei, Tetsuya Hasegawa, Takashi Matsumoto, Keiichi Fujiwara, Munetaka Takekuma, Kazuto Nakamura, Muneaki Shimada, Mitsuaki Suzuki, Junzo Kigawa

    Cancer chemotherapy and pharmacology   76 ( 2 )   335 - 42   2015年8月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: We previously reported that the concept of "platinum sensitivity" could be applied to recurrent endometrial cancer. We conducted an ancillary analysis to determine an appropriate second-line regimen for patients who received a platinum agent as first-line chemotherapy. METHODS: We extracted and reanalyzed data of patients treated with doxorubicin and cisplatin (AP), paclitaxel and carboplatin (TC), or docetaxel and carboplatin (DC) as first- and second-line chemotherapies from the SGSG012/GOTIC004/Intergroup study. RESULTS: We identified 216 patients: 38 received AP as first-line chemotherapy, of which 36 received TC or DC (Tax-C) as second-line chemotherapy; and 178 received Tax-C as first-line chemotherapy, of which 51 received AP and 127 received Tax-C as second-line chemotherapy. Median progression-free survival (PFS) and overall survival (OS) after second-line chemotherapy decreased in the order of Tax-C followed by Tax-C (10 and 48 months, respectively), AP followed by Tax-C (9 and 23 months, respectively), and Tax-C followed by AP (3 and 12 months, respectively). Median PFS and OS after second-line chemotherapy for platinum-resistant patients receiving Tax-C as first-line chemotherapy were longer in Tax-C than in AP (7 and 23 vs. 3 and 10 months, respectively) as second-line chemotherapy [hazard ratio (HR) 3.255, 95 % confidence interval (CI) 1.908-5.555, p < 0.0001; HR 3.179, 95 % CI 1.835-5.507, p < 0.0001, respectively]. Median PFS and OS after second-line chemotherapy for platinum-sensitive patients receiving Tax-C as first-line chemotherapy were almost equivalent to those receiving Tax-C or AP as second-line chemotherapy. CONCLUSIONS: For platinum-resistant recurrent endometrial cancer patients, Tax-C may be preferred over AP as second-line chemotherapy.

    DOI: 10.1007/s00280-015-2793-9

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  • Gynecologic Cancer InterGroup (GCIG) consensus review for clear cell carcinoma of the uterine corpus and cervix. 国際誌

    Kosei Hasegawa, Shoji Nagao, Masanori Yasuda, David Millan, Akila N Viswanathan, Rosalind M Glasspool, Mojgan Devouassoux-Shisheboran, Alan Covens, Domenica Lorusso, Christian Kurzeder, Jae-Weon Kim, Laurence Gladieff, Jane Bryce, Michael Friedlander, Keiichi Fujiwara

    International journal of gynecological cancer : official journal of the International Gynecological Cancer Society   24 ( 9 Suppl 3 )   S90-5   2014年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Clear cell carcinomas of the uterine corpus and cervix are rare gynecological cancers with limited information regarding the pathogenesis and biology. At present, the approach to management is the same as for patients with the more common histological subtypes of endometrioid endometrial cancer and adenocarcinoma of the cervix. Surgical resection is the standard treatment for patients with early-stage disease, but there is no evidence-based approach to direct the management of patients with more advanced-stage disease at presentation or with recurrent disease. We review the epidemiology, pathology, and what is known about both uterine corpus and cervical clear cell cancers and make management recommendations.

    DOI: 10.1097/IGC.0000000000000297

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  • Feasibility study of combination chemotherapy with paclitaxel, doxorubicin and cisplatin without prophylactic granulocyte colony-stimulating factor injection for intermediate-to-high risk or recurrent endometrial cancer. 国際誌

    Shoji Nagao, Tadaaki Nishikawa, Tatsuya Hanaoka, Akira Kurosaki, Norihiro Iwasa, Kosei Hasegawa, Keiichi Fujiwara

    Japanese journal of clinical oncology   44 ( 11 )   1040 - 4   2014年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: We evaluated the feasibility of combination chemotherapy with paclitaxel, doxorubicin and cisplatin without prophylactic granulocyte colony-stimulating factor injection for intermediate-to-high-risk or recurrent endometrial cancer. METHODS: Women with histologically confirmed FIGO Stages I-II with >1/2 myometrial invasion, Stage III/IV or recurrent endometrial cancer were enrolled. Patients received intravenous doxorubicin (45 mg/m(2)), followed by cisplatin (50 mg/m(2)) on Day 1 and intravenous paclitaxel (160 mg/m(2)) on Day 2. Granisetron (75 µg) was administered depending on neutrophil counts on Days 3 and 8. Treatment was repeated every 21 days for six cycles or until disease progression or unacceptable toxicity. The primary endpoint was the completion rate of the scheduled chemotherapy; secondary endpoints were Grade 3/4 toxicity and response rate in patients with measurable lesions. RESULTS: From September 2010 to December 2012, 35 women, including 7 with FIGO Stage I, 4 with Stage II, 13 with Stage III, 10 with Stage IV and 1 with recurrent endometrial cancer, were enrolled. There were 26 endometrial carcinomas (Grade 1, 16; Grade 2, 6; Grade 3, 4), 4 carcinosarcomas, 2 serous adenocarcinomas, 1 neuroendocrine carcinoma, 1 poorly differentiated carcinoma and 1 mixed carcinoma. Twenty-five patients (71%) completed six chemotherapy cycles. Grade 3/4 hematological toxicities included neutrocytopenia (97%), thrombocytopenia (6%) and anemia (34%). Three patients (9%) experienced neutropenic fever. Grade 3/4 non-hematological toxicities were observed in 13 patients. In 15 patients with evaluable lesions, the response rate was 80%. CONCLUSIONS: Combination chemotherapy with paclitaxel, doxorubicin and cisplatin without prophylactic granulocyte colony-stimulating factor injection is feasible.

    DOI: 10.1093/jjco/hyu124

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  • [II. Future perspectives of intraperitoneal chemotherapy for ovarian cancer].

    Keiichi Fujiwara, Shoji Nagao, Akira Kurosaki, Kosei Hasegawa

    Gan to kagaku ryoho. Cancer & chemotherapy   41 ( 2 )   184 - 7   2014年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Applicability of the concept of "platinum sensitivity" to recurrent endometrial cancer: the SGSG-012/GOTIC-004/Intergroup study. 国際誌

    Shoji Nagao, Shin Nishio, Hirofumi Michimae, Hiroshi Tanabe, Satoshi Okada, Takeo Otsuki, Maki Tanioka, Keiichi Fujiwara, Mitsuaki Suzuki, Junzo Kigawa

    Gynecologic oncology   131 ( 3 )   567 - 73   2013年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The concept of "platinum sensitivity" has been widely applied in the management of recurrent ovarian cancer. This study aimed to evaluate the applicability of this concept to recurrent endometrial cancer. PATIENTS AND METHODS: In this multicenter retrospective cohort study, the clinical data of patients with recurrent endometrial cancer, who had a history of receiving first-line platinum-based chemotherapy and who received second-line platinum-based chemotherapy at the time of recurrence between January 2005 and December 2009 were reviewed. RESULTS: A total of 262 patients from 30 centers with initial FIGO stage classifications of I (29), II (23), III (122), and IV (88) were enrolled. In total, 153 endometrioid adenocarcinomas, 34 serous adenocarcinomas, 17 clear cell adenocarcinomas, 36 carcinosarcomas, and 22 "other" tumors were documented. The response rates for patients with platinum-free intervals of <6 months, 6-11 months, 12-23 months, and ≥24 months were 25%, 38%, 61%, and 65%, respectively. The median progression-free survival after second-line platinum-based chemotherapy for patients with platinum-free intervals of <12 months and ≥12 months was 4.4 (95% confidence interval (CI)=3.7-5.8) months and 10.3 (95% CI=8.2-12.6) months, respectively (log-rank P<0.0001), and the median overall survival was 13.8 (95% CI=10.6-18.1) months and 40.9 (95% CI=25.3-54.2) months, respectively (log-rank P<0.0001). CONCLUSION: Platinum-free interval is a predictor of response and survival after second-line platinum-based chemotherapy in patients with recurrent endometrial cancer. The concept of "platinum sensitivity" could be applicable to recurrent endometrial cancer.

    DOI: 10.1016/j.ygyno.2013.09.021

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  • [Intraperitoneal chemotherapy].

    Shoji Nagao, Akira Kurosaki, Norihiro Iwasa, Keiichi Fujiwara

    Nihon rinsho. Japanese journal of clinical medicine   70 Suppl 4   610 - 6   2012年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

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  • Evidence-based guidelines for treatment of cervical cancer in Japan: Japan Society of Gynecologic Oncology (JSGO) 2007 edition.

    Satoru Nagase, Yoshiki Inoue, Naohiko Umesaki, Daisuke Aoki, Masatsugu Ueda, Hideki Sakamoto, Shigemitsu Kobayashi, Ryo Kitagawa, Takafumi Toita, Shoji Nagao, Kiyoshi Hasegawa, Ichio Fukasawa, Keiichi Fujiwara, Yoh Watanabe, Kiyoshi Ito, Hitoshi Niikura, Tsuyoshi Iwasaka, Kazunori Ochiai, Hidetaka Katabuchi, Toshiharu Kamura, Ikuo Konishi, Noriaki Sakuragi, Tadao Tanaka, Yasuo Hirai, Yuji Hiramatsu, Makio Mukai, Hiroyuki Yoshikawa, Tadao Takano, Kosuke Yoshinaga, Takeo Otsuki, Michiko Sakuma, Noriyuki Inaba, Yasuhiro Udagawa, Nobuo Yaegashi

    International journal of clinical oncology   15 ( 2 )   117 - 24   2010年4月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Clinical practice guidelines for gynecologic cancers have been published by the National Comprehensive Cancer Network and the National Cancer Institute. Whereas these guidelines form the basis for the standard of care for gynecologic malignancies in the United States, it has proven difficult to institute them in Japan due to differences in patient characteristics, health-care delivery systems, and insurance programs. Therefore, evidence-based guidelines for treating cervical cancer specifically in Japan have been under development. The Guidelines Formulation Committee and Evaluation Committee were independently established within the Committee for Treatment Guidelines for Cervical Cancer. Opinions from within and outside the Japan Society of Gynecologic Oncology (JSGO) were incorporated into the final draft, and the guidelines were published after approval by the JSGO. These guidelines are composed of ten chapters and comprise three algorithms. Each chapter consists of a clinical question, recommendations, background, objectives, explanations, and references. The objective of these guidelines is to clearly delineate the standard of care for cervical cancer treatment in Japan in order to ensure equitable care for all Japanese women diagnosed with cervical cancer.

    DOI: 10.1007/s10147-010-0061-x

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  • Splenectomy during Secondary Cytoreductive Surgery for Epithelial Ovarian Cancer 査読 国際誌

    Jitti Hanprasertpong, Rie Ohishi, Norihiro Iwasa, Shoji Nagao, Kojun Okamoto, Keiichi Fujiwara

    ASIAN PACIFIC JOURNAL OF CANCER PREVENTION   11 ( 2 )   413 - 416   2010年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:ASIAN PACIFIC ORGANIZATION CANCER PREVENTION  

    Splenic metastasis from ovarian cancer is unusual. Most splenic metastases are encountered in the setting of widespread visceral metastases. We present 6 cases of splenic metastasis of epithelial ovarian cancer. Three cases underwent a splenectomy as a part of interval debulking surgery, and the rest received a splenectomy as a surgery for recurrent disease. The splenectomies were well-tolerated in all patients and no serious morbidity or mortality resulted. Only one patient experienced a transient elevation in platelet count.

    Web of Science

    PubMed

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  • NCI issues clinical announcement for preferred method of treatment for advanced ovarian cancer 査読

    S. Nagao, K. Fujiwara, R. Ohishi, Y. Nakanishi, N. Iwasa, M. Shimizu, T. Goto, K. Shimoya

    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER   18 ( 6 )   1210 - 1214   2008年11月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Nagao S, Fujiwara K, Ohishi R, Nakanishi Y, Iwasa N, Shimizu M, Goto T, Shimoya K. Combination chemotherapy of intraperitoneal carboplatin and intravenous paclitaxel in suboptimally debulked epithelial ovarian cancer. Int J Gynecol Cancer 2008;18:1210-1214.
    The objective of this study was to retrospectively assess the efficacy and safety of combination chemotherapy of intraperitoneal (IP) carboplatin and intravenous (IV) paclitaxel in suboptimally debulked ovarian cancer. Between March 1998 and March 2006, 44 patients with histologically confirmed epithelial ovarian carcinoma or peritoneal carcinoma with a residual mass greater than 1 cm received combination chemotherapy of IV paclitaxel and IP carboplatin. Administration of IV paclitaxel at 175 mg/m(2) immediately followed by IP carboplatin at an area under the curve of 6 was scheduled every 3 weeks for at least six cycles. The diagnosis and stage were ovarian carcinoma stage II in 8, III in 25, and IV in 6 cases, and peritoneal carcinoma stage III in 5 cases. Eighty-three percent of patients completed more than six cycles of chemotherapy. The incidences of grade 3/4 hematologic toxicities were 41 (93%) for neutrocytopenia, 10 (41%) for thrombocytopenia, and 18 (23%) for anemia. Observed grade 3/4 nonhematologic toxicities were 1 (2%) for allergy, 1 (2%) for fatigue, 1 (2%) for vomiting, 1 (2%) for liver dysfunction, and 4 (9%) for peripheral neuropathy. Two patients (5%) encountered catheter problems (one obstruction and one infection). Overall response rate was 80% (16 complete response, 19 partial response, 3 stable disease, and 6 progressive disease). Median progression-free survival and overall survival were 24 and 31 months, respectively. Combination chemotherapy of IP carboplatin and IV paclitaxel is effective and safe in suboptimally debulked ovarian cancer, and further evaluation is warranted.

    DOI: 10.1111/j.1525-1438.2008.01192.x

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  • [Paclitaxel and carboplatin with or without pirarubicin (THP-ADR) as first line chemotherapy in elderly patients].

    Shoji Nagao, Naoki Okimoto, Atsushi Hongo, Yasushi Mizutani, Junichi Kodama, Mitsuo Yoshinouchi, Yuji Hiramatsu, Takafumi Kudo

    Gan to kagaku ryoho. Cancer & chemotherapy   30 ( 2 )   243 - 9   2003年2月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    To evaluate the validity of administration of paclitaxel and carboplatin with or without pirarubicin (THP-ADR) as first line chemotherapy in elderly patients with gynecologic cancer, we explored the efficacy and safety of these regimens. From October 1, 1998 to September 30, 2001, we administered paclitaxel and carboplatin with or without THP-ADR pursuant to the chart we prepared originally as first line chemotherapy in patients with gynecologic cancer. Eleven elderly patients (age > 70 years) and 62 younger patients (age < 70 years) were entered into the present study. Paclitaxel was administered as a 3-hour intravenous (i.v.) infusion at dosages of 135 to 180 mg/m2 immediately followed by carboplatin over 60 minutes at dosages of area under the curve (AUC) 3 to 5, administered intravenously or intraperitoneally. We observed grade 3/4 anemia more frequently in elderly patients receiving the regimen including paclitaxel and carboplatin without THP-ADR (9% v.s. 47%, p < 0.0001). Grade 3/4 anemia (10% v.s. 22%, p = 0.02) and grade 3/4 thrombocytopenia (7% v.s. 22%, p = 0.007), febrile neutropenia (14% v.s. 44%, p = 0.02) also occurred more frequently in elderly patients receiving the regimen including paclitaxel and carboplatin with THP-ADR. The overall response rates were equivalent among elderly and younger patients (69% and 78%), respectively. The regimen consisting of paclitaxel and carboplatin without THP-ADR was applied safely to elderly patients.

    PubMed

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  • [The effect of L-Glutamine and Shakuyaku-Kanzo-to for paclitaxel-induced myalgia/arthralgia].

    Kosei Hasegawa, Yasushi Mizutani, Hiroyuki Kuramoto, Shoji Nagao, Hisashi Masuyama, Atsuhi Hongo, Jyunichi Kodama, Mitsuo Yoshinouchi, Yuji Hiramatsu, Takafumi Kudo, Hiroyuki Okuda

    Gan to kagaku ryoho. Cancer & chemotherapy   29 ( 4 )   569 - 74   2002年4月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Myalgia/arthralgia is a crucial side effect of paclitaxel, and may become the major dose-limiting side effect. However, this is a situation where there is little effective preventive treatment. L-Glutamine was reported as a neuroprotective agent for vincristine-induced neurotoxicity. In Japan, there have been reports on steroid and Shakuyaku-Kanzou-to (a herbal medicine) for paclitaxel-induced myalgia/arthralgia. This study aimed to compare the effect of L-Glutamine and Shakuyaku-Kanzou-to, and to discuss the validity of these agents for the paclitaxel-induced myalgia/arthralgia. Our results suggested that Shakuyaku-Kanzou-to showed no remarkable effects against paclitaxel-induced myalgia/arthralgia as had been reported before; however, both L-Glutamine and Shakuyaku-Kanzou-to decreased the duration of grade 2 toxicity (CALGB Expanded Common Toxicity Criteria) in comparison with those who were not treated. L-Glutamine and Shakuyaku-Kanzou-to might therefore a preventive effect against moderate or severer myalgia/arthralgia during paclitaxel-treated chemotherapy. Further trials are needed to confirm the value of these drugs.

    PubMed

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  • Rapid and sensitive detection of physical status of human papillomavirus type 16 DNA by quantitative real-time PCR. 国際誌

    Shoji Nagao, Mitsuo Yoshinouchi, Yasunari Miyagi, Atsushi Hongo, Junichi Kodama, Sachio Itoh, Takafumi Kudo

    Journal of clinical microbiology   40 ( 3 )   863 - 7   2002年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    A rapid quantitative real-time PCR method was employed to quantify the copy number of E2 and E6 genes for analysis of the physical status of human papillomavirus type 16 (HPV-16) DNA. Significant differences with respect to both copy numbers were found when more than 40% of HPV-16 DNA was integrated with disruption of the E2 gene in an experimental model. The physical status of HPV-16 DNA in 50 clinical samples was exclusively episomal in 21 cases (42%), concomitant in 14 cases (28%), and integrated in 15 cases (30%). The prevalence of integrated and/or concomitant forms of HPV-16 DNA increased with progression of cervical disease. Four of 11 cervical intraepithelial neoplasia involved integrated forms of HPV-16 DNA partially or exclusively. This rapid, sensitive technique is useful in the analysis of the physical status of HPV DNA.

    PubMed

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  • 腹腔鏡補助下膣式子宮全摘術の難易度推定のための術前診断スコア (LAVH Score)

    松本 貴, 倉本 博行, 矢野 真理, 山本 寄人, 長尾 昌二, 兵頭 慎治, 木花 敏雅, 野田 清史, 石井 修平, 森 巍

    日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology   14 ( 1 )   121 - 124   1998年12月

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    記述言語:日本語   出版者・発行元:JAPAN SOCIETY OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY AND MINIMALLY INVASIVE THERAPY  

    DOI: 10.5180/jsgoe.14.121

    CiNii Article

    CiNii Books

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    その他リンク: http://search.jamas.or.jp/link/ui/1999188645

  • 当院における腹腔鏡補助下腟式子宮全摘術(LAVH)の検討(TVH施行例との比較とLAVHの意義について)

    松本 貴, 松岡 亮平, 今井 香里, 長尾 昌二, 片山 富博, 森 巍

    日本産科婦人科内視鏡學會雜誌 = The journal of the Japan Endoscopy Society of Obstetrics and Gynecology   12 ( 1 )   83 - 86   1996年12月

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    記述言語:日本語   出版者・発行元:JAPAN SOCIETY OF GYNECOLOGIC AND OBSTETRIC ENDOSCOPY AND MINIMALLY INVASIVE THERAPY  

    DOI: 10.5180/jsgoe.12.83

    CiNii Article

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    その他リンク: http://search.jamas.or.jp/link/ui/1997132586

▼全件表示

書籍等出版物

  • 婦人科手術 子宮摘出術

    講義録産婦人科学 メジカルビュー社(東京)  2010年1月 

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  • 婦人科腫瘍 子宮頚がん、子宮体がん

    外来がん化学療法マニュアル 文光堂(東京)  2009年8月 

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  • 腹腔内化学療法の位置づけ

    卵巣癌診療ハンドブック ヴァンメディカル(東京)  2009年8月 

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  • 卵巣癌に対する腹腔内化学療法

    「よくわかる卵巣癌のすべて」永井書店  2007年3月 

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MISC

  • 原発性腹膜癌と悪性リンパ腫との鑑別に腹腔鏡下組織生検が有用であった1例

    成田 萌, 北井 美穂, 鈴木 一弘, 中澤 浩志, 澁谷 剛志, 山本 香澄, 矢野 紘子, 長尾 昌二, 山口 聡

    産婦人科の実際   70 ( 13 )   1625 - 1631   2021年12月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

    <文献概要>症例は急速に増悪する腹部膨満症状を認めた49歳。癌性腹膜炎に類似した所見を認めるも確定診断が得られず,腹腔鏡下組織生検を行い悪性リンパ腫と診断した。リンパ腫細胞が腹膜や大網に広く浸潤した病態である腹膜リンパ腫症は稀な疾患だが,腹水や腹膜・大網播種など癌性腹膜炎によく似た所見を示すため,両者の鑑別は困難である。腹膜リンパ腫症を伴う悪性リンパ腫は侵攻性で予後不良であることが多く,早期診断と治療介入が非常に重要であり,本症例では侵襲の少ない腹腔鏡手術により早期診断ができたため報告する。

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  • 【図解 分子メカニズムから理解する婦人科がんの薬物療法】卵巣悪性腫瘍 上皮性卵巣癌 e.プラチナ不応性,プラチナ抵抗性再発,late lineでの化学療法

    長尾 昌二

    産婦人科の実際   70 ( 12 )   1466 - 1471   2021年11月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

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  • 診療 進行再発卵巣癌に対するレジメン選択 三海婦人科癌スタディグループ(SGSG)アンケート調査結果

    澁谷 剛志, 長尾 昌二, 佐藤 慎也, 竹原 和宏, 宇佐美 知香, 中村 圭一郎, 古宇 家正, 末岡 幸太郎, 紀川 純三

    産婦人科の実際   70 ( 10 )   1105 - 1108   2021年10月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

    <文献概要>目的:進行卵巣癌に対するレジメン選択は,ベバシズマブ(BEV)の使用を含め施設間で異なっている可能性がある。われわれはわが国におけるレジメン選択の現状を把握することを目的とし,三海婦人科癌スタディグループ(SGSG)参加施設へアンケート調査を実施した。方法:2019年9月にSGSG参加施設35施設に対して,初回術後治療,術前化学療法(NAC),インターバル腫瘍減量手術(IDS)後,プラチナ感受性再発,のそれぞれのタイミングで第一選択として使用するレジメンをアンケート形式で調査した。成績:全35施設中20施設から回答があった。初回術後治療としてTC+BEV療法を第一選択としている施設は15施設(75%)であった。プラチナ感受性再発に対してBEV併用レジメンを第一選択としている施設は17施設(85%)であった。NACにおける第一選択のレジメンはTC療法が8施設(40%),dose-dense TC療法が6施設(30%),TC+BEV療法が6施設(30%)であった。IDS後にレジメンを変更している施設が8施設(40%)あった。結論:初回治療とプラチナ感受性再発に対してBEV併用レジメンを使用している施設が多く,NACの治療方針は多様であった。

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  • 高用量黄体ホルモン療法によって長期生存をなしえている子宮体癌4B期の1例

    中澤 浩志, 長尾 昌二, 成田 萌, 鈴木 一弘, 澁谷 剛志, 自見 倫敦, 矢野 紘子, 北井 美穂, 塩崎 隆也, 山口 聡

    日本女性医学学会雑誌   29 ( 1 )   164 - 164   2021年10月

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    記述言語:日本語   出版者・発行元:(一社)日本女性医学学会  

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  • 進行上皮性卵巣癌における主治療前化学療法および腫瘍減量手術の適用(GOTIC019試験)

    長尾 昌二, 田村 惇, 澁谷 剛志, 三輪 真唯子, 加藤 友康, 佐藤 豊実, 竹井 裕二, 紙谷 菜津子, 井上 直樹, 中村 和人, 井上 彩, 藤原 恵一, 鈴木 光明

    日本癌治療学会学術集会抄録集   59回   O8 - 1   2021年10月

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    記述言語:英語   出版者・発行元:(一社)日本癌治療学会  

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  • 新規卵巣明細胞癌特異的腫瘍マーカーTFPI2の開発

    宮城 悦子, 荒川 憲昭, 坂巻 顕太郎, ルイズ横田 奈朋, 山田 有紀, 山口 聡, 長尾 昌二, 平嶋 泰之, 笠松 由佳, 加藤 久盛, 最上 多恵, 宮城 洋平, 小林 浩

    日本癌治療学会学術集会抄録集   59回   O7 - 4   2021年10月

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    記述言語:英語   出版者・発行元:(一社)日本癌治療学会  

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  • 血清中マイクロRNA解析による卵巣がん及び良性腫瘍診断マーカーの開発

    若尾 摂, 須藤 裕子, 山本 香澄, 須藤 保, 長尾 昌二

    日本癌治療学会学術集会抄録集   59回   O7 - 6   2021年10月

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    記述言語:英語   出版者・発行元:(一社)日本癌治療学会  

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  • 診療 子宮頸癌に対する術後補助放射線治療による水腎症の検討

    矢野 紘子, 長尾 昌二, 山口 聡

    産婦人科の実際   70 ( 8 )   887 - 891   2021年8月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

    <文献概要>当院で子宮頸癌に対する広汎子宮全摘術後に補助放射線治療を行った81例において,放射線治療が要因と思われる水腎症を8例(約10%)に認めた。半数は一過性の水腎症で自然軽快したものの,残りの半数は進行性持続性となっている。広汎子宮全摘術後早期に水腎症を認めなくてもその後の放射線治療により水腎症を発症し,腎機能を保持するために侵襲的な処置を要する場合があり,放射線治療中や治療後の注意深い腎臓評価が必要である。

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00535&link_issn=&doc_id=20210823220016&doc_link_id=10.18888%2Fsp.0000001816&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fsp.0000001816&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

  • 再発時にペムブロリズマブが著効した子宮体部脱分化癌の1例

    山本 香澄, 梶本 和義, 長尾 昌二, 山口 聡

    産婦人科の実際   70 ( 7 )   793 - 798   2021年7月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

    <文献概要>症例は53歳,主訴は不正性器出血。子宮内膜組織診は類内膜腺癌Grade 2,骨盤部MRIでは子宮体部に結節状腫瘤を認めた。子宮体癌IA期の術前診断で腹腔鏡下単純子宮全摘,両側付属器切除術を実施。術後の病理組織診断はpT1a,脱分化癌,高度のリンパ管侵襲を認めた。術後補助化学療法はTC療法を実施したが,8ヵ月後肺門部リンパ節,肺転移をきたした。TC療法を再開したが効果なく,MSI-Highを確認しペムブロリズマブを開始。2サイクル後軽度増悪傾向を示したが4サイクル後に縮小に転じ,以後奏効を維持している。

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    その他リンク: https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J00535&link_issn=&doc_id=20210727070022&doc_link_id=10.18888%2Fsp.0000001792&url=https%3A%2F%2Fdoi.org%2F10.18888%2Fsp.0000001792&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

  • Olaparib維持療法後のプラチナ製剤再投与の奏効率

    中澤 浩志, 長尾 昌二, 成田 萌, 鈴木 一弘, 澁谷 剛志, 自見 倫敦, 矢野 紘子, 北井 美穂, 塩崎 隆也, 山口 聡

    産婦人科の進歩   73 ( 2 )   146 - 146   2021年5月

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    記述言語:日本語   出版者・発行元:「産婦人科の進歩」編集室  

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  • 癌腹膜播種治療のガイドライン 大量癌性腹水に対する治療戦略

    松崎 圭祐, 有留 邦明, 江本 成伸, 梶本 広明, 北山 丈二, 高垣 伸匡, 高橋 孝郎, 鍔本 浩志, 長尾 昌二, 渡邊 昭博

    日本外科系連合学会誌   46 ( 3 )   317 - 317   2021年5月

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    記述言語:日本語   出版者・発行元:日本外科系連合学会  

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  • 早期子宮体癌に対する腹腔鏡下手術後の再発についての検討

    成田 萌, 北井 美穂, 鈴木 一弘, 中澤 浩志, 澁谷 剛志, 山本 香澄, 自見 倫敦, 矢野 紘子, 塩崎 隆也, 松岡 和子, 長尾 昌二, 山口 聡

    産婦人科の進歩   73 ( 2 )   149 - 149   2021年5月

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    記述言語:日本語   出版者・発行元:「産婦人科の進歩」編集室  

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  • HPV関連子宮頸部腫瘍に罹患した患者はHPVワクチンのインフルエンサーになり得るか

    北井 美穂, 成田 萌, 鈴木 一弘, 中澤 浩志, 澁谷 剛志, 山本 香澄, 自見 倫敦, 矢野 紘子, 塩崎 隆也, 松岡 和子, 長尾 昌二, 山口 聡

    日本産科婦人科学会雑誌   73 ( 臨増 )   S - 391   2021年3月

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    記述言語:日本語   出版者・発行元:(公社)日本産科婦人科学会  

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  • 当院におけるMSI-High固形癌に対するペムブロリズマブ投与の現状

    成田 萌, 長尾 昌二, 鈴木 一弘, 中澤 浩志, 澁谷 剛志, 山本 香澄, 自見 倫敦, 矢野 紘子, 北井 美穂, 塩崎 隆也, 松岡 和子, 山口 聡

    日本婦人科腫瘍学会雑誌   39 ( 1 )   313 - 313   2021年1月

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    記述言語:日本語   出版者・発行元:(公社)日本婦人科腫瘍学会  

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  • 進行卵巣癌に対するコンパニオン診断としてのBRCA遺伝学的検査の当院での現状

    中澤 浩志, 長尾 昌二, 成田 萌, 鈴木 一弘, 澁谷 剛志, 山本 香澄, 自見 倫敦, 矢野 紘子, 北井 美穂, 塩崎 隆也, 松岡 和子, 山口 聡

    日本婦人科腫瘍学会雑誌   39 ( 1 )   397 - 397   2021年1月

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    記述言語:日本語   出版者・発行元:(公社)日本婦人科腫瘍学会  

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  • 進行・再発婦人科癌に対する腹水濾過濃縮再静注法施行時のQOL評価 前向きコホート研究

    山本 香澄, 長尾 昌二, 成田 萌, 鈴木 一弘, 中澤 浩志, 澁谷 剛志, 自見 倫敦, 矢野 紘子, 北井 美穂, 塩崎 隆也, 松岡 和子, 山口 聡

    日本婦人科腫瘍学会雑誌   39 ( 1 )   315 - 315   2021年1月

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    記述言語:日本語   出版者・発行元:(公社)日本婦人科腫瘍学会  

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  • 子宮頸がんに対する術後補助放射線治療による水腎症の検討

    矢野 紘子, 長尾 昌二, 成田 萌, 鈴木 一弘, 中澤 浩志, 澁谷 剛志, 山本 香澄, 自見 倫敦, 北井 美穂, 塩崎 隆也, 松岡 和子, 山口 聡

    日本婦人科腫瘍学会雑誌   39 ( 1 )   348 - 348   2021年1月

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    記述言語:日本語   出版者・発行元:(公社)日本婦人科腫瘍学会  

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  • 遠隔転移を伴う進行子宮頸癌の予後因子および治療戦略

    北井 美穂, 岡本 葉留子, 成田 萌, 鈴木 一弘, 中澤 浩志, 澁谷 剛志, 山本 香澄, 自見 倫敦, 矢野 紘子, 塩崎 隆也, 松岡 和子, 長尾 昌二, 山口 聡

    日本婦人科腫瘍学会雑誌   39 ( 1 )   279 - 279   2021年1月

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    記述言語:日本語   出版者・発行元:(公社)日本婦人科腫瘍学会  

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  • 進行再発卵巣癌に対するレジメン選択 三海婦人科癌スタディグループ(SGSG)アンケート調査結果

    澁谷 剛志, 長尾 昌二, 佐藤 慎也, 竹原 和宏, 本郷 淳司, 宇佐美 知香, 中村 圭一郎, 大亀 真一, 依光 正枝, 古宇 家正, 中村 紘子, 平林 啓, 白山 裕子, 金森 康展, 末岡 幸太郎, 石橋 朋佳, 西村 正人, 金西 賢治, 中村 隆文, 漆川 敬治, 長治 誠, 入江 隆, 紀川 純三

    日本婦人科腫瘍学会雑誌   39 ( 1 )   396 - 396   2021年1月

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    記述言語:日本語   出版者・発行元:(公社)日本婦人科腫瘍学会  

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  • 術前化学療法によって硬化性苔癬が肉眼的に明らかになった外陰癌の一例

    中澤 浩志, 長尾 昌二, 折出 唯志, 成田 萌, 鈴木 一弘, 澁谷 剛志, 山本 香澄, 自見 倫敦, 矢野 紘子, 北井 美穂, 塩崎 隆也, 松岡 和子, 山口 聡

    日本女性医学学会雑誌   28 ( 1 )   139 - 139   2020年10月

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    記述言語:日本語   出版者・発行元:(一社)日本女性医学学会  

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  • Principle and evolving role of intraperitoneal chemotherapy in ovarian cancer 国際誌

    Keiichi Fujiwara, Shoji Nagao, Eriko Aotani, Kosei Hasegawa

    Expert Opinion on Pharmacotherapy   14 ( 13 )   1797 - 1806   2013年9月

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    記述言語:英語  

    Introduction: Intraperitoneal (i.p.) chemotherapy has been extensively studied in the ovarian cancer field. Despite the fact that three large randomized trials that were conducted in the United States showed survival benefit, meta-analysis also showed survival benefit and the National Cancer Institute (NCI) released a clinical announcement recommending i.p. chemotherapy for optimally debulked advanced stage ovarian cancer in 2006, i.p. chemotherapy has not been widely accepted by the gynecologic oncology community, mainly because of its toxicities. Areas covered: In this review, previously available evidence, new evidence published since the NCI clinical announcement and ongoing clinical trials will be discussed. Expert opinion: Three currently ongoing randomized Phase III trials will provide extremely important information about whether a less toxic i.p. regimen using carboplatin will be beneficial for patients with advanced ovarian cancer. They are important because it may be possible to solve many of the questions or unmet needs in i.p. chemotherapy by combining these three trials. © 2013 Informa UK, Ltd.

    DOI: 10.1517/14656566.2013.820705

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  • 婦人科がん (第5土曜特集 抗がん剤外来治療コンセプトシート2013) -- (抗がん剤の外来治療と注意点 : 各論)

    長尾 昌二

    医学のあゆみ   246 ( 9 )   657 - 661   2013年8月

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    記述言語:日本語   出版者・発行元:医歯薬出版  

    CiNii Article

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    その他リンク: http://search.jamas.or.jp/link/ui/2013306024

  • 卵巣癌に対する腹腔内化学療法 特集 播種治療の展望

    SURGERY FRONTIER   19 ( 2 )   65 - 71   2012年4月

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  • 婦人科がん最新の研究動向 腹腔内化学療法

    日本臨床   70 ( 4 )   610 - 616   2012年3月

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  • Intravenous/Intraperitoneal Paclitaxel and Intraperitoneal Carboplatin in Patients With Epithelial Ovarian, Fallopian Tube, or Peritoneal Carcinoma A Feasibility Study 国際誌

    Shoji Nagao, Norihiro Iwasa, Akira Kurosaki, Tadaaki Nishikawa, Rie Ohishi, Kosei Hasegawa, Tomoko Goto, Keiichi Fujiwara

    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER   22 ( 1 )   70 - 75   2012年1月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Objective: This study aimed to evaluate intravenous (IV)/intraperitoneal (IP) paclitaxel and IP carboplatin (TCipTip therapy) feasibility in epithelial ovarian (EOC), fallopian tube (FTC), or peritoneal carcinoma (PC) patients.
    Methods: From December 2007 to August 2010, 20 women with histologically confirmed stage IC to IV EOC, FTC, or PC received 6 TCipTip cycles after the primary cytoreductive surgery. Intravenous paclitaxel was administered at 135 mg/m(2) followed by IP carboplatin based on the area under the curve = 6 on day 1; IP paclitaxel at 60 mg/m2 was administered on day 8. The toxicity grade was determined by CTCAE version 3.0. The institutional review board requested we reduce the IP paclitaxel dose in the first cycle to ensure safety.
    Results: Twenty women, including 18 with EOC, 1 with stage IIC FTC, and 1 with stage IV primary PC, received TCipTip therapy. There were 12 serous, 5 endometrioid, 1 mucinous, 1 clear cell adenocarcinoma, and 1 mixed carcinoma (clear cell and endometrioid) cases. Eleven women achieved optimal status at primary surgery. Grade 3/4 hematologic toxicity incidence was 73% (neutrocytopenia), 9% (thrombocytopenia), and 24% (anemia). Grade 3/4 nonhematologic toxicities were observed in 5 patients (4 with grade 3 allergy and 1 with grade 3 ileus). Twelve patients (60%) completed more than 6 chemotherapy cycles. Reasons for interruption included paclitaxel allergy, grade 2 abdominal pain, carboplatin allergy during the seventh cycle, disease progression, pleural embolism, ileus, and address change.
    Conclusions: Toxicities for TCipTip therapy were acceptable; this therapy is feasible for EOC, FTC, or PC patients. Further TCipTip therapy evaluation is warranted.

    DOI: 10.1097/IGC.0b013e318234f927

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  • Phase II study of combination chemotherapy with docetaxel and carboplatin for locally advanced or recurrent cervical cancer. 国際誌

    20 ( 9 )   1563 - 8   2011年10月

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    記述言語:英語  

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  • 卵巣がんの薬物療法 腹腔内化学療法(IP療法)

    臨床腫瘍プラクティス   2011年4月

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  • がん性腹膜炎

    産科と婦人科   2011年3月

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  • A Randomized Phase II/III Trial of 3 Weekly Intraperitoneal versus Intravenous Carboplatin in Combination with Intravenous Weekly Dose-dense Paclitaxel for Newly Diagnosed Ovarian, Fallopian Tube and Primary Peritoneal Cancer 国際誌

    Keiichi Fujiwara, Eriko Aotani, Tetsutaro Hamano, Shoji Nagao, Hiroyuki Yoshikawa, Toru Sugiyama, Junzo Kigawa, Daisuke Aoki, Noriyuki Katsumata, Masahiro Takeuchi, Mitsuaki Suzuki

    JAPANESE JOURNAL OF CLINICAL ONCOLOGY   41 ( 2 )   278 - 282   2011年2月

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    記述言語:英語   出版者・発行元:OXFORD UNIV PRESS  

    Retrospective studies and a Phase II trial demonstrated the promising efficacy and safety of intraperitoneal administration of carboplatin in ovarian, fallopian tube and primary peritoneal cancer. A Japanese Gynecologic Oncology Group 3016 randomized Phase III trial for these cancers showed dose-dense weekly administration of paclitaxel significant improvement of progression-free survival and overall survival over every 3-week administration. From June 2010, we have been conducting a randomized Phase II/III trial of intravenous versus intraperitoneal administration of carboplatin every 3 week in combination with dose-dense weekly administration of paclitaxel. The purpose of this trial is to prove the superiority of intraperitoneal administration of carboplatin over intravenous administration. Primary endpoint is progression-free survival and secondary endpoints include overall survival, quality of life assessment and cost-benefit. The first 120 patients will be evaluated for the feasibility of intraperitoneal arm and a total of 746 patients will be enrolled in a Phase III study.

    DOI: 10.1093/jjco/hyq182

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  • 卵巣がんIa期および境界悪性腫瘍における妊孕能温存治療

    産婦人科の実際   2011年2月

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  • Single nedaplatin treatment as salvage chemotherapy for platinum/taxane-resistant/refractory epithelial ovarian, tubal and peritoneal cancers

    Tomoko Goto, Masashi Takano, Rie Ohishi, Norihiro Iwasa, Motohiro Shimizu, Kosei Hasegawa, Shoji Nagao, Keiichi Fujiwara

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   36 ( 4 )   764 - 768   2010年8月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL PUBLISHING, INC  

    Aim:
    To evaluate toxicity, response and progression-free survival of single nedaplatin chemotherapy in women with platinum/taxane-resistant/refractory epithelial ovarian, tubal and peritoneal cancer.
    Methods:
    Seventeen patients with platinum/taxane-resistant/refractory epithelial ovarian, fallopian tube or primary peritoneal cancer who were treated with a single nedaplatin regimen at 90 mg/m2 administration on day 1 of a 28-day cycle in our institution between 2005 and 2007 were retrospectively investigated.
    Results:
    Ten of 17 patients (59%) had measurable disease. Seven patients were evaluated according to cancer antigen (CA) 125 levels. The overall response was 24% (complete response, 2 patients; partial response, 2 patients). Two of these 4 patients had measurable disease. Stable disease and progressive disease was noted in 6 (35%) and 7 (41%) patients. Median progression-free survival was 8 months (range 3-11) in patients who responded to therapy and 4 months (range 2-6) in patients with stable disease. Mean platinum-free interval due to treatment without using platinum analogues after developing platinum-resistant/refractory disease was 11 months (range 8-12) in patients who responded to nedaplatin regimen and 3 months (range 1-11) in patients who did not (P &lt; 0.01), whereas mean treatment-free interval was 3 months (range 1-5) in responders and 1 month (range 1-3) in non-responders, which did not show a significant difference. Grade 4 hematological toxicity was observed in 2 of 17 patients (12%). No grade 3 or 4 non-hematological toxicity occurred. All toxicities were managed on an outpatient basis.
    Conclusions:
    Single nedaplatin treatment for platinum/taxane-resistant/refractory ovarian, tubal and peritoneal cancer patients is the candidate of salvage chemotherapy with comparable effectiveness and less toxicity to other approved regimens.

    DOI: 10.1111/j.1447-0756.2010.01217.x

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  • Single nedaplatin treatment as salvage chemotherapy for platinum/taxane-resistant/refractory epithelial ovarian, tubal and peritoneal cancers 国際誌

    Tomoko Goto, Masashi Takano, Rie Ohishi, Norihiro Iwasa, Motohiro Shimizu, Kosei Hasegawa, Shoji Nagao, Keiichi Fujiwara

    JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH   36 ( 4 )   764 - 768   2010年8月

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    記述言語:英語   出版者・発行元:WILEY-BLACKWELL PUBLISHING, INC  

    Aim:
    To evaluate toxicity, response and progression-free survival of single nedaplatin chemotherapy in women with platinum/taxane-resistant/refractory epithelial ovarian, tubal and peritoneal cancer.
    Methods:
    Seventeen patients with platinum/taxane-resistant/refractory epithelial ovarian, fallopian tube or primary peritoneal cancer who were treated with a single nedaplatin regimen at 90 mg/m2 administration on day 1 of a 28-day cycle in our institution between 2005 and 2007 were retrospectively investigated.
    Results:
    Ten of 17 patients (59%) had measurable disease. Seven patients were evaluated according to cancer antigen (CA) 125 levels. The overall response was 24% (complete response, 2 patients; partial response, 2 patients). Two of these 4 patients had measurable disease. Stable disease and progressive disease was noted in 6 (35%) and 7 (41%) patients. Median progression-free survival was 8 months (range 3-11) in patients who responded to therapy and 4 months (range 2-6) in patients with stable disease. Mean platinum-free interval due to treatment without using platinum analogues after developing platinum-resistant/refractory disease was 11 months (range 8-12) in patients who responded to nedaplatin regimen and 3 months (range 1-11) in patients who did not (P &lt; 0.01), whereas mean treatment-free interval was 3 months (range 1-5) in responders and 1 month (range 1-3) in non-responders, which did not show a significant difference. Grade 4 hematological toxicity was observed in 2 of 17 patients (12%). No grade 3 or 4 non-hematological toxicity occurred. All toxicities were managed on an outpatient basis.
    Conclusions:
    Single nedaplatin treatment for platinum/taxane-resistant/refractory ovarian, tubal and peritoneal cancer patients is the candidate of salvage chemotherapy with comparable effectiveness and less toxicity to other approved regimens.

    DOI: 10.1111/j.1447-0756.2010.01217.x

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  • 卵巣癌と生殖機能温存治療の実際 妊孕能の可能性と限界を考える

    長尾昌二, 仲神宏子, 塚原沙耶, 大石理恵, 岩佐紀宏, 長谷川幸清, 藤原恵一

    産婦人科の実際   2010年3月

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  • 卵巣癌の手術と妊孕能温存手術

    長尾昌二, 仲神宏子, 塚原沙耶, 大石理恵, 岩佐紀宏, 長谷川幸清, 藤原恵一

    産婦人科治療   2010年3月

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  • オープンディスカッション 卵巣がん委員会報告 iPocc試験プロトコール概要

    長尾 昌二

    第8回婦人科悪性腫瘍化学療法研究機構年次会議(総会)記録集   158 - 61   2010年1月

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  • 上皮性卵巣癌の妊孕性温存療法の適応と限界

    長尾昌二, 岩佐紀宏, 藤原恵一

    臨床婦人科産科   2009年12月

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  • Phase II Study of Intraperitoneal Carboplatin With Intravenous Paclitaxel in Patients With Suboptimal Residual Epithelial Ovarian or Primary Peritoneal Cancer A Sankai Gynecology Cancer Study Group Study 国際誌

    Keiichi Fujiwara, Shoji Nagao, Junzo Kigawa, Jun Noma, Nobuo Akamatsu, Yasunari Miyagi, Fumitaka Numa, Makoto Okada, Eriko Aotani

    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER   19 ( 5 )   834 - 837   2009年7月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Purpose: To assess the antitumor efficacy and safety of 2 treatment modalities: intraperitoneal carboplatin combined with intravenous (IV) paclitaxel.
    Patients and Methods: Eligible patients were those with epithelial ovarian carcinoma or primary peritoneal carcinoma stages 11 to IV who underwent initial surgery and had a residual tumor size of 2 cm or larger. Patients received IV paclitaxel 175 mg/m(2) followed by intraperitoneal carboplatin AUC6. The primary end point was a response. Secondary end points were toxicity, progression-free survival, and overall survival.
    Results: Twenty-six patients were enrolled, and 24 patients were eligible for assessment. The response rate was 83.3% (95% CI, 62.6%-95.3%; Table 4). The median progression-free survival was 25 months. The median overall survival had not been reached. Incidences of grade (G) 3/4 hematological toxicities were absolute neutrophil count, 96%; hemoglobin, 29%; and thrombocytopenia, 16%. Nonhematological toxicities included G2 liver function, 4%; G3 sensory neuropathy, 8%; and G3 myalgia and arthralgia, 4%.
    Conclusions: Intraperitoneal administration of carboplatin combined with IV paclitaxel was well tolerated and showed satisfactory response in the patients with bulky residual tumor. Large-scale phase III trial comparing with IV carboplatin is warranted in this patient population.

    DOI: 10.1111/IGC.0b013e3181a29dfe

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  • Phase II Study of Intraperitoneal Carboplatin With Intravenous Paclitaxel in Patients With Suboptimal Residual Epithelial Ovarian or Primary Peritoneal Cancer A Sankai Gynecology Cancer Study Group Study

    Keiichi Fujiwara, Shoji Nagao, Junzo Kigawa, Jun Noma, Nobuo Akamatsu, Yasunari Miyagi, Fumitaka Numa, Makoto Okada, Eriko Aotani

    INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER   19 ( 5 )   834 - 837   2009年7月

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    記述言語:英語   出版者・発行元:LIPPINCOTT WILLIAMS & WILKINS  

    Purpose: To assess the antitumor efficacy and safety of 2 treatment modalities: intraperitoneal carboplatin combined with intravenous (IV) paclitaxel.
    Patients and Methods: Eligible patients were those with epithelial ovarian carcinoma or primary peritoneal carcinoma stages 11 to IV who underwent initial surgery and had a residual tumor size of 2 cm or larger. Patients received IV paclitaxel 175 mg/m(2) followed by intraperitoneal carboplatin AUC6. The primary end point was a response. Secondary end points were toxicity, progression-free survival, and overall survival.
    Results: Twenty-six patients were enrolled, and 24 patients were eligible for assessment. The response rate was 83.3% (95% CI, 62.6%-95.3%; Table 4). The median progression-free survival was 25 months. The median overall survival had not been reached. Incidences of grade (G) 3/4 hematological toxicities were absolute neutrophil count, 96%; hemoglobin, 29%; and thrombocytopenia, 16%. Nonhematological toxicities included G2 liver function, 4%; G3 sensory neuropathy, 8%; and G3 myalgia and arthralgia, 4%.
    Conclusions: Intraperitoneal administration of carboplatin combined with IV paclitaxel was well tolerated and showed satisfactory response in the patients with bulky residual tumor. Large-scale phase III trial comparing with IV carboplatin is warranted in this patient population.

    DOI: 10.1111/IGC.0b013e3181a29dfe

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  • 上皮性卵巣がんの妊孕性温存手術

    長尾昌二, 大石理恵, 伊藤百合子, 岩佐紀宏, 清水基弘, 後藤友子, 藤原恵一

    産科と婦人科   76 ( 4 )   403 - 8   2009年4月

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  • An estimation of total number of cycles of chemotherapy in patients with epithelial ovarian cancer worldwide

    S. Nagao, R. Ohishi, N. Iwasa, M. Shimizu, T. Goto, K. Fujiwara

    GYNECOLOGIC ONCOLOGY   112 ( 2 )   S56 - S57   2009年2月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

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  • Is the adjustment of serum creatinine level from &lt; 0.6 mg/dl to 0.6 mg/dl justified in estimating carboplatin clearance calculated by the Jelliffe formula?

    Shoji Nagao, Rie Ohishi, Norihiro Iwasa, Motohiro Shimizu, Kosei Hasegawa, Tomoko Goto, Keiichi Fujiwara

    Clinical Ovarian Cancer   2 ( 1 )   48 - 51   2009年

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    記述言語:英語   出版者・発行元:Cancer Information Group, LP  

    In current Gynecologic Oncology Group studies, serum creatinine level is adjusted to 0.6 mg/dL in patients with levels &lt
    0.6 mg/dL (Adjusted-Jelliffe formula). The purpose of this study is to evaluate whether this adjustment is suitable. Patients and Methods: Carboplatin clearance was estimated in 115 patients with serum creatinine &lt
    0.6 mg/dL who received carboplatin-based chemotherapy for gynecologic malignancies between January 1996 and August 2004. The clearance was estimated using the Cockroft-Gault, Jelliffe, and Adjusted-Jelliffe formulae. The 3 estimations were then compared with each other using the post hoc Wilcoxon signed rank test. Bias was assessed by mean percentage error (MPE), and precision was assessed by mean absolute percentage error (MAPE). The relationships between body surface area (BSA) and ratios of estimated carboplatin clearance (Jelliffe formula/Cockroft-Gault formula and Adjusted-Jelliffe formula/Cockroft-Gault formula) were evaluated by simple regression analysis. Results: The carboplatin clearance calculated by the Jelliffe formula was significantly larger than the other 2 formulae (P &lt
    .0001). Although MPE was reduced from +20 to +6 by adjustment of serum creatinine, MAPE was barely reduced from 21 to 14. The simple regression line represents correlation between BSA and ratios of estimated carboplatin clearance was merely translated to below by adjusting the serum creatinine level, and the bias by BSA was not corrected. Conclusion: Despite adjusting the serum creatinine level, the Adjusted-Jelliffe formula overestimates the creatinine clearance when compared with the Cockcroft-Gault formula.

    DOI: 10.3816/COC.2009.n.007

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  • Is the adjustment of serum creatinine level from &lt; 0.6 mg/dl to 0.6 mg/dl justified in estimating carboplatin clearance calculated by the Jelliffe formula?

    Shoji Nagao, Rie Ohishi, Norihiro Iwasa, Motohiro Shimizu, Kosei Hasegawa, Tomoko Goto, Keiichi Fujiwara

    Clinical Ovarian Cancer   2 ( 1 )   48 - 51   2009年

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    記述言語:英語   出版者・発行元:Cancer Information Group, LP  

    In current Gynecologic Oncology Group studies, serum creatinine level is adjusted to 0.6 mg/dL in patients with levels &lt
    0.6 mg/dL (Adjusted-Jelliffe formula). The purpose of this study is to evaluate whether this adjustment is suitable. Patients and Methods: Carboplatin clearance was estimated in 115 patients with serum creatinine &lt
    0.6 mg/dL who received carboplatin-based chemotherapy for gynecologic malignancies between January 1996 and August 2004. The clearance was estimated using the Cockroft-Gault, Jelliffe, and Adjusted-Jelliffe formulae. The 3 estimations were then compared with each other using the post hoc Wilcoxon signed rank test. Bias was assessed by mean percentage error (MPE), and precision was assessed by mean absolute percentage error (MAPE). The relationships between body surface area (BSA) and ratios of estimated carboplatin clearance (Jelliffe formula/Cockroft-Gault formula and Adjusted-Jelliffe formula/Cockroft-Gault formula) were evaluated by simple regression analysis. Results: The carboplatin clearance calculated by the Jelliffe formula was significantly larger than the other 2 formulae (P &lt
    .0001). Although MPE was reduced from +20 to +6 by adjustment of serum creatinine, MAPE was barely reduced from 21 to 14. The simple regression line represents correlation between BSA and ratios of estimated carboplatin clearance was merely translated to below by adjusting the serum creatinine level, and the bias by BSA was not corrected. Conclusion: Despite adjusting the serum creatinine level, the Adjusted-Jelliffe formula overestimates the creatinine clearance when compared with the Cockcroft-Gault formula.

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  • Combination chemotherapy of intraperitoneal carboplatin and intravenous paclitaxel in suboptimally debulked epithelial ovarian cancer

    S. Nagao, K. Fujiwara, R. Ohishi, Y. Nakanishi, N. Iwasa, M. Shimizu, T. Goto, K. Shimoya

    International Journal of Gynecological Cancer   18 ( 6 )   1210 - 1214   2008年11月

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    記述言語:英語  

    The objective of this study was to retrospectively assess the efficacy and safety of combination chemotherapy of intraperitoneal (IP) carboplatin and intravenous (IV) paclitaxel in suboptimally debulked ovarian cancer. Between March 1998 and March 2006, 44 patients with histologically confirmed epithelial ovarian carcinoma or peritoneal carcinoma with a residual mass greater than 1 cm received combination chemotherapy of IV paclitaxel and IP carboplatin. Administration of IV paclitaxel at 175 mg/m2 immediately followed by IP carboplatin at an area under the curve of 6 was scheduled every 3 weeks for at least six cycles. The diagnosis and stage were ovarian carcinoma stage II in 8, III in 25, and IV in 6 cases, and peritoneal carcinoma stage III in 5 cases. Eighty-three percent of patients completed more than six cycles of chemotherapy. The incidences of grade 3/4 hematologic toxicities were 41 (93%) for neutrocytopenia, 10 (41%) for thrombocytopenia, and 18 (23%) for anemia. Observed grade 3/4 nonhematologic toxicities were 1 (2%) for allergy, 1 (2%) for fatigue, 1 (2%) for vomiting, 1 (2%) for liver dysfunction, and 4 (9%) for peripheral neuropathy. Two patients (5%) encountered catheter problems (one obstruction and one infection). Overall response rate was 80% (16 complete response, 19 partial response, 3 stable disease, and 6 progressive disease). Median progression-free survival and overall survival were 24 and 31 months, respectively. Combination chemotherapy of IP carboplatin and IV paclitaxel is effective and safe in suboptimally debulked ovarian cancer, and further evaluation is warranted. © 2008, Copyright the Authors.

    DOI: 10.1111/j.1525-1438.2008.01192.x

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  • Carboplatin dosing in obese women with ovarian cancer: A Gynecologic Oncology Group study 国際誌

    Jason D. Wright, Chunqiao Tian, David G. Mutch, Thomas J. Herzog, Shoji Nagao, Keiichi Fujiwara, Matthew A. Powell

    GYNECOLOGIC ONCOLOGY   109 ( 3 )   353 - 358   2008年6月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Background. Carboplatin dosing for gynecologic malignancies is traditionally based on the Jelliffe formula that lacks dose adjustment for weight. Obese women may therefore receive a sub-therapeutic carboplatin dose. This study assessed the association between BM I and outcome for ovarian cancer patients treated with carboplatin-based chemotherapy.
    Methods. An analysis of patients treated with carboplatin and paclitaxel on Gynecologic Oncology Group (GOG) protocol 158 was perfonned. The dose of carboplatin for each patient was based on an area under the curve of 7.5 and a glomerular filtration rate (GFR) derived from the Jelliffe formula which is derived from age and serum creatinine. Patients were stratified based on body mass index (BMI).
    Results. A total of 387 patients were included in the analysis. The patients were stratified into three groups: normal weight (BMI &lt; 25.0, 50%), overweight (BMI 25-29.9, 32%) and obese (BMI &gt;= 30.0, 18%). Compared to pretreatment values, the obese patients had a lower relative decrease in their platelet counts (- 25% for BMI &gt;= 30 vs. - 6 1% for BMI &lt; 25) (p = 0.01). Similar trends were noted for relative changes in hemoglobin (p = 0.006) and hematocrit (p = 0.002). Dose reductions were required in 34% of normal weight compared to 2 1% of the obese women (p = 0.004). There was a trend toward increased risk for disease progression in women with a BMI &gt;= 30 (RR: 1.25, 95% CI: 0.93-1.69, p = 0. 14).
    Conclusion. Obese ovarian cancer patients treated with carboplatin experience substantially less toxicity than normal weight women. The lower toxicity suggests that obese patients may be receiving a substandard drug dose. (c) 2008 Elsevier Inc. All rights reserved.

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  • 上皮性卵巣がんに対するcarboplatin腹腔内投与およびpaclitaxel静脈内点滴投与の有用性

    長尾昌二, 大石理恵, 塚本有佳子, 中西美恵, 岩佐紀宏, 清水基弘, 後藤友子, 藤原恵一, 下屋浩一郎

    癌の臨床   54 ( 5 )   1 - 7   2008年5月

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  • Combination chemotherapy of intraperitoneal carboplatin and intravenous taxane in advanced endometrial cancer: A pilot study

    S. Nagao, R. Oishi, Y. Tsukamoto, Y. Nakanishi, N. Iwasa, M. Shimizu, T. Goto, K. Fujiwara

    JOURNAL OF CLINICAL ONCOLOGY   26 ( 15 )   2008年5月

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:AMER SOC CLINICAL ONCOLOGY  

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  • 【婦人科関連抗がん剤の必修知識】 分子標的治療薬 トラスツズマブ/ベバシズマブ(解説/特集)

    藤原恵一, 清水基弘, 岩佐紀宏, 大石理恵, 中西美恵, 後藤友子, 長尾昌

    産科と婦人科   75 ( 3 )   347 - 351   2008年2月

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  • Feasibility of extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy

    Shoji Nagao, Keiichi Fujiwara

    GYNECOLOGIC ONCOLOGY   106 ( 2 )   435 - 435   2007年8月

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    記述言語:英語   掲載種別:速報,短報,研究ノート等(学術雑誌)   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    DOI: 10.1016/j.ygyno.2007.04.014

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  • 【婦人科がんに対する新しい治療法の導入】 分子標的治療の最新情報と展望(解説/特集)

    藤原恵一, 清水基弘, 尾, 後藤友子, 菊池真理子, 伊藤百合子, 三木明徳

    産婦人科の実際   56 ( 4 )   539 - 545   2007年5月

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  • 【卵巣がん患者の治療をめぐって】 新しい薬剤の開発とその展望(解説/特集)

    藤原恵一, 長尾昌二, 清水基弘

    臨床腫瘍プラクティス   3 ( 2 )   178 - 182   2007年5月

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  • 女性外来診療マニュアル】 症状・症候から診断・治療へ 婦人科編 外陰・腟腫瘍、類腫

    藤原恵一, 清水基弘, 後藤友子, 三木明徳, 長尾昌

    産婦人科治療   686 - 692   2007年4月

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  • 卵巣癌に対する妊よう性保存手術

    長尾昌二, 藤原恵一, 清水基弘

    産婦人科治療   94 ( 3 )   299 - 304   2007年3月

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  • Intraperitoneal carboplatin-based chemotherapy for ovarian cancer

    Keiichi Fujiwara, Shoji Nagao, Tomoko Goto, Motohiro Shimizu, Norihiro Iwasa

    CANCER INVESTIGATION   25   24 - 25   2007年

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    記述言語:英語   掲載種別:研究発表ペーパー・要旨(国際会議)   出版者・発行元:TAYLOR & FRANCIS INC  

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  • Feasibility of extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy 国際誌

    Shoji Nagao, Keiichi Fujiwara, Reina Kagawa, Yoshiaki Kozuka, Takashi Oda, Kenichiro Maehata, Hiroyasu Ishikawa, Hirofumi Koike, Ichiro Kohno

    GYNECOLOGIC ONCOLOGY   103 ( 2 )   732 - 735   2006年11月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objective. The aim of this study is to evaluate the feasibility of extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy for cervical and endometrial carcinoma.
    Methods. Seventy-six patients underwent extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy between February 1999 and September 2005. The lymph nodes dissected with the laparoscopic procedure included the inframesenteric para-aortic lymph nodes, the sacral lymph nodes, and the bilateral common iliac lymph nodes. The extraperitoneal laparoscopic operation was performed with pelvic open surgery using Lap Disc to ensure the safety of patients.
    Results. The number of patients with cervical and endometrial carcinoma was 36 and 40, respectively. The median age of patients was 51 years (range 24-75 years). Conversion to open surgery was necessary in 8 patients. These include 3 patients who encountered blood loss of 400, 136 and 128 ml; 2 extremely obese women; and 3 patients who had peritoneal tears causing CO2 gas leakage. Among the remaining 68 patients, the median operating time for extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy was 75 min (range 45-145 min), and the median estimated blood loss was 5 ml (range 5-138 ml). The median total number of resected nodes was 14 (range 2-31), and 4 patients had lymph node metastasis. No patient encountered postoperative complications attributable to extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy.
    Conclusions. Extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy with pelvic open surgery using Lap Disc is a feasible procedure, particularly in the surgeons learning phase. (c) 2006 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.ygyno.2006.04.026

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  • Feasibility of extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy

    Shoji Nagao, Keiichi Fujiwara, Reina Kagawa, Yoshiaki Kozuka, Takashi Oda, Kenichiro Maehata, Hiroyasu Ishikawa, Hirofumi Koike, Ichiro Kohno

    GYNECOLOGIC ONCOLOGY   103 ( 2 )   732 - 735   2006年11月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objective. The aim of this study is to evaluate the feasibility of extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy for cervical and endometrial carcinoma.
    Methods. Seventy-six patients underwent extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy between February 1999 and September 2005. The lymph nodes dissected with the laparoscopic procedure included the inframesenteric para-aortic lymph nodes, the sacral lymph nodes, and the bilateral common iliac lymph nodes. The extraperitoneal laparoscopic operation was performed with pelvic open surgery using Lap Disc to ensure the safety of patients.
    Results. The number of patients with cervical and endometrial carcinoma was 36 and 40, respectively. The median age of patients was 51 years (range 24-75 years). Conversion to open surgery was necessary in 8 patients. These include 3 patients who encountered blood loss of 400, 136 and 128 ml; 2 extremely obese women; and 3 patients who had peritoneal tears causing CO2 gas leakage. Among the remaining 68 patients, the median operating time for extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy was 75 min (range 45-145 min), and the median estimated blood loss was 5 ml (range 5-138 ml). The median total number of resected nodes was 14 (range 2-31), and 4 patients had lymph node metastasis. No patient encountered postoperative complications attributable to extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy.
    Conclusions. Extraperitoneal laparoscopic para-aortic and common iliac lymphadenectomy with pelvic open surgery using Lap Disc is a feasible procedure, particularly in the surgeons learning phase. (c) 2006 Elsevier Inc. All rights reserved.

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  • 婦人科癌診療の新たな潮流 卵巣癌に対する腹腔内化学療法の再評価

    藤原恵一, 長尾昌二

    産科と婦人科   9 ( 19 )   1091 - 7   2006年9月

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  • Hormonal function after ovarian transposition to the abdominal subcutaneous fat tissue

    S. Nagao, K. Fujiwara, H. Ishikawa, T. Oda, K. Tanaka, E. Aotani, I. Kohno

    International Journal of Gynecological Cancer   16 ( 1 )   121 - 124   2006年1月

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    記述言語:英語  

    We previously reported a new technique for ovarian transposition to the abdominal subcutaneous fat tissue (OTAFT) following hysterectomy. The purpose of this study is to assess the hormonal function after OTAFT. From 1993 to 2000, OTAFT was performed in 27 patients (group A). Forty-two women underwent hysterectomy and retained ovaries without transposition (group B). In 19 cases, bilateral oophorectomy with hysterectomy was performed, and they received a hormone replacement therapy (HRT) (group C). Serum follicle-stimulating hormone (FSH) level of patients was monitored every 2-12 months, and the time of menopause (defined as FSH &gt
    40 mIU/mL two times consecutively) was determined in groups A and B. After a median follow-up of 65 months, cumulative ovarian survival did not show significant difference between group A and group B (HR = 0.52, 95% CI = 0.17-1.16
    P= 0.10). In patients who were 40 years old or younger, ovarian function declined significantly in group A compared to group B (HR = 0.29, 95% CI = 0.02-0.91
    P= 0.04). However, FSH level of postmenopausal patients in group A was not different from FSH level of patients in group C, but FSH level of postmenopausal patients in group B was significantly higher than FSH level of patients in group C (P= 0.002). Although the procedure of OTAFT may somewhat affect the ovarian function, the transposed ovary in postmenopausal women presumably still secrete a small amount of estrogen which is equivalent to an estrogen level by HRT. © 2006, IGCS.

    DOI: 10.1111/j.1525-1438.2006.00280.x

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  • Hormonal function after ovarian transposition to the abdominal subcutaneous fat tissue

    S. Nagao, K. Fujiwara, H. Ishikawa, T. Oda, K. Tanaka, E. Aotani, I. Kohno

    International Journal of Gynecological Cancer   16 ( 1 )   121 - 124   2006年1月

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    記述言語:英語  

    We previously reported a new technique for ovarian transposition to the abdominal subcutaneous fat tissue (OTAFT) following hysterectomy. The purpose of this study is to assess the hormonal function after OTAFT. From 1993 to 2000, OTAFT was performed in 27 patients (group A). Forty-two women underwent hysterectomy and retained ovaries without transposition (group B). In 19 cases, bilateral oophorectomy with hysterectomy was performed, and they received a hormone replacement therapy (HRT) (group C). Serum follicle-stimulating hormone (FSH) level of patients was monitored every 2-12 months, and the time of menopause (defined as FSH &gt
    40 mIU/mL two times consecutively) was determined in groups A and B. After a median follow-up of 65 months, cumulative ovarian survival did not show significant difference between group A and group B (HR = 0.52, 95% CI = 0.17-1.16
    P= 0.10). In patients who were 40 years old or younger, ovarian function declined significantly in group A compared to group B (HR = 0.29, 95% CI = 0.02-0.91
    P= 0.04). However, FSH level of postmenopausal patients in group A was not different from FSH level of patients in group C, but FSH level of postmenopausal patients in group B was significantly higher than FSH level of patients in group C (P= 0.002). Although the procedure of OTAFT may somewhat affect the ovarian function, the transposed ovary in postmenopausal women presumably still secrete a small amount of estrogen which is equivalent to an estrogen level by HRT. © 2006, IGCS.

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  • Intraperitoneal carboplatin infusion may be a pharmacologically more reasonable route than intravenous administration as a systemic chemotherapy. A comparative pharmacokinetic analysis of platinum using a new mathematical model after intraperitoneal vs. intravenous infusion of carboplatin - A Sankai Gynecology Study Group (SGSG) study

    Y Miyagi, K Fujiwara, J Kigawa, H Itamochi, S Nagao, E Aotani, N Terakawa, Kohno, I

    GYNECOLOGIC ONCOLOGY   99 ( 3 )   591 - 596   2005年12月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objective. To clarify the pharmacological advantage of carboplatin-based intraperitoneal chemotherapy using the three-compartment mathematical model. Methods. Eleven consecutive patients in one institution underwent intraperitoneal administration of carboplatin, and 11 consecutive patients in another institution received intravenous administration. Carboplatin (AUC = 6 mg x min/ml) was diluted in 500 ml 5% glucose and administered either as an intraperitoneal bolus infusion or intravenous drip infusion during I h. Patients undergoing intravenous injection also received an infusion of 500 ml 5% glucose to obtain intraperitoneal samples. Intraperitoneal fluid and blood samples were obtained, immediately and 1, 2, 4, 8 12, and 24 h after administration. The mathematical model consisting of a three-compartment model was applied to analyze the pharmacokinetics. The model was created with simultaneous differential equations and was solved by the Runge-Kutta method. Results. The rate constants of platinum diffusion from the peritoneal cavity to serum, serum to peritoneal cavity, serum to peripheral space, peripheral space to serum, and elimination were 0.94 +/- 0.79 (mean +/- SD), 1.28 +/- 2.50, 16.50 +/- 9.26, 0.99 +/- 0.62, and 4.14 +/- 1.45 (h(-1)), respectively. When the theoretical pharmacological concentration of platinum was calculated using this mathematical model, 24-h platinum AUC in the serum was exactly the same regardless of intraperitoneal or intravenous administration of carboplatin. However, the 24-h platinum AUC in the peritoneal cavity was approximately 17 times higher when carboplatin was administered by the intraperitoneal route. Conclusion. The present pharmacological analysis suggests that intraperitoneal infusion of carboplatin is feasible not only as an intraperitoneal regional therapy but also as a more reasonable route for systemic chemotherapy. (c) 2005 Elsevier Inc. All rights reserved.

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  • Intraperitoneal carboplatin infusion may be a pharmacologically more reasonable route than intravenous administration as a systemic chemotherapy. A comparative pharmacokinetic analysis of platinum using a new mathematical model after intraperitoneal vs. intravenous infusion of carboplatin - A Sankai Gynecology Study Group (SGSG) study 国際誌

    Y Miyagi, K Fujiwara, J Kigawa, H Itamochi, S Nagao, E Aotani, N Terakawa, Kohno, I

    GYNECOLOGIC ONCOLOGY   99 ( 3 )   591 - 596   2005年12月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objective. To clarify the pharmacological advantage of carboplatin-based intraperitoneal chemotherapy using the three-compartment mathematical model. Methods. Eleven consecutive patients in one institution underwent intraperitoneal administration of carboplatin, and 11 consecutive patients in another institution received intravenous administration. Carboplatin (AUC = 6 mg x min/ml) was diluted in 500 ml 5% glucose and administered either as an intraperitoneal bolus infusion or intravenous drip infusion during I h. Patients undergoing intravenous injection also received an infusion of 500 ml 5% glucose to obtain intraperitoneal samples. Intraperitoneal fluid and blood samples were obtained, immediately and 1, 2, 4, 8 12, and 24 h after administration. The mathematical model consisting of a three-compartment model was applied to analyze the pharmacokinetics. The model was created with simultaneous differential equations and was solved by the Runge-Kutta method. Results. The rate constants of platinum diffusion from the peritoneal cavity to serum, serum to peritoneal cavity, serum to peripheral space, peripheral space to serum, and elimination were 0.94 +/- 0.79 (mean +/- SD), 1.28 +/- 2.50, 16.50 +/- 9.26, 0.99 +/- 0.62, and 4.14 +/- 1.45 (h(-1)), respectively. When the theoretical pharmacological concentration of platinum was calculated using this mathematical model, 24-h platinum AUC in the serum was exactly the same regardless of intraperitoneal or intravenous administration of carboplatin. However, the 24-h platinum AUC in the peritoneal cavity was approximately 17 times higher when carboplatin was administered by the intraperitoneal route. Conclusion. The present pharmacological analysis suggests that intraperitoneal infusion of carboplatin is feasible not only as an intraperitoneal regional therapy but also as a more reasonable route for systemic chemotherapy. (c) 2005 Elsevier Inc. All rights reserved.

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  • Difference of carboplatin clearance estimated by the Cockroft-Gault, Jelliffe, Modified-Jelliffe, Wright or Chatelut formula

    S Nagao, K Fujiwara, N Imafuku, R Kagawa, Y Kozuka, T Oda, K Maehata, H Ishikawa, H Koike, E Aotani, Kohno, I

    GYNECOLOGIC ONCOLOGY   99 ( 2 )   327 - 333   2005年11月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objective. Although the Calvert Formula is the standard method to calculate the dose of carboplatin, there is no consensus how to determine the glomerular filtration rate (GFR) without Using [Cr-51]-ethylenediamine tetraacetic acid (Cr-51-EDTA). Creatinine clearance (Ccr), calculated using the Cockroft-Gault, Jelliffe, Modified-Jelliffe or Wright formulae, has been used as a substitute for the GFR. In addition to these four formulae, the Chatelut formula has been proposed as a way to calculate carboplatin clearance. Among these formulae, Jelliffe formula does not include body surface area (BSA) or body weight, it to adjust the body size and thus may have greater bias than the other four formulae ill estimating carboplatin clearance. The Purpose of this Study is to evaluate if these five formulae could equally estimate the carboplatin clearance.
    Methods. Carboplatin clearance was estimated in 253 patients with gynecologic cancer who received carboplatin-based chemotherapy between January 1996 and August 2004. Ccr was estimated using the Cockroft-Gault, Jelliffe, Modified-Jelliffie or Wright formulae. Carboplatin clearance was also calculated directly by using the Chatelut formula. The five estimations of carboplatin clearance were compared with each other using the post-hoc Wilcoxon signed rank test. The median percent en-or (MPE) and the median absolute percent error (MAPE) were evaluated by comparing carboplatin clearance. The relationships between BSA and ratios of estimated carboplatin clearance (Jelliffe/Cockroft-Gault, Jelliffe/Modified-Jelliffe, Jelliffe/Wright, Jelliffe/Chatelut) were evaluated by using simple regression.
    Results. The estimated carboplatin clearances were: Cockroft-Gault formula, 109.8 +/- 28.4; Jelliffe formula, 128.5 +/- 28.2; Modified-Jelliffe formula, 110.8 +/- 25.7; Wright formula, 112.2 +/- 24.3; Chatelut formula, 114.1 +/- 33.0. A statistically significant difference was observed between carboplatin clearance Calculated using Jelliffe formula and that given by each of the other four formulae. Comparing the results of the Cockroft-Gault formula with the Jellife, Modified-Jelliffe, Wright and Chatelut formulae yielded MPEs of +19%, +2%, +3% and +3% and MAPEs of 27%, 5%, 6% and 6%, respectively. There was a significant correlation between BSA and ratio of estimated carboplatin clearance (Jellife/Cockroft-Gault, Jelliffe/Modified-Jellife, Jelliffe/Wright, Jelliffe/Chatelut), with Pearson correlation coefficients of 0.928, 0.847, 0.965 and 0.839 respectively. As the BSA of patient became smaller, the differences between the carboplatin clearance calculated by the Jelliffe formula from other four formulas became larger.
    Conclusions. Estimates of carboplatin clearance calculated by the Jelliffe formula tend to have greater positive bias compared to the other four formulae, particularly when the BSA of the patient is small. Ill order to conduct collaborative international Studies, it may be necessary to standardize the formula used to estimate carboplatin clearance to perforin international collaboration Studies. (c) 2005 Elsevier Inc. All rights reserved.

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  • Difference of carboplatin clearance estimated by the Cockroft-Gault, Jelliffe, Modified-Jelliffe, Wright or Chatelut formula 国際誌

    S Nagao, K Fujiwara, N Imafuku, R Kagawa, Y Kozuka, T Oda, K Maehata, H Ishikawa, H Koike, E Aotani, Kohno, I

    GYNECOLOGIC ONCOLOGY   99 ( 2 )   327 - 333   2005年11月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objective. Although the Calvert Formula is the standard method to calculate the dose of carboplatin, there is no consensus how to determine the glomerular filtration rate (GFR) without Using [Cr-51]-ethylenediamine tetraacetic acid (Cr-51-EDTA). Creatinine clearance (Ccr), calculated using the Cockroft-Gault, Jelliffe, Modified-Jelliffe or Wright formulae, has been used as a substitute for the GFR. In addition to these four formulae, the Chatelut formula has been proposed as a way to calculate carboplatin clearance. Among these formulae, Jelliffe formula does not include body surface area (BSA) or body weight, it to adjust the body size and thus may have greater bias than the other four formulae ill estimating carboplatin clearance. The Purpose of this Study is to evaluate if these five formulae could equally estimate the carboplatin clearance.
    Methods. Carboplatin clearance was estimated in 253 patients with gynecologic cancer who received carboplatin-based chemotherapy between January 1996 and August 2004. Ccr was estimated using the Cockroft-Gault, Jelliffe, Modified-Jelliffie or Wright formulae. Carboplatin clearance was also calculated directly by using the Chatelut formula. The five estimations of carboplatin clearance were compared with each other using the post-hoc Wilcoxon signed rank test. The median percent en-or (MPE) and the median absolute percent error (MAPE) were evaluated by comparing carboplatin clearance. The relationships between BSA and ratios of estimated carboplatin clearance (Jelliffe/Cockroft-Gault, Jelliffe/Modified-Jelliffe, Jelliffe/Wright, Jelliffe/Chatelut) were evaluated by using simple regression.
    Results. The estimated carboplatin clearances were: Cockroft-Gault formula, 109.8 +/- 28.4; Jelliffe formula, 128.5 +/- 28.2; Modified-Jelliffe formula, 110.8 +/- 25.7; Wright formula, 112.2 +/- 24.3; Chatelut formula, 114.1 +/- 33.0. A statistically significant difference was observed between carboplatin clearance Calculated using Jelliffe formula and that given by each of the other four formulae. Comparing the results of the Cockroft-Gault formula with the Jellife, Modified-Jelliffe, Wright and Chatelut formulae yielded MPEs of +19%, +2%, +3% and +3% and MAPEs of 27%, 5%, 6% and 6%, respectively. There was a significant correlation between BSA and ratio of estimated carboplatin clearance (Jellife/Cockroft-Gault, Jelliffe/Modified-Jellife, Jelliffe/Wright, Jelliffe/Chatelut), with Pearson correlation coefficients of 0.928, 0.847, 0.965 and 0.839 respectively. As the BSA of patient became smaller, the differences between the carboplatin clearance calculated by the Jelliffe formula from other four formulas became larger.
    Conclusions. Estimates of carboplatin clearance calculated by the Jelliffe formula tend to have greater positive bias compared to the other four formulae, particularly when the BSA of the patient is small. Ill order to conduct collaborative international Studies, it may be necessary to standardize the formula used to estimate carboplatin clearance to perforin international collaboration Studies. (c) 2005 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.ygyno.2005.06.003

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  • Combination chemotherapy of docetaxel and carboplatin in advanced or recurrent cervix cancer. A pilot study

    S Nagao, K Fujiwara, T Oda, H Ishikawa, H Koike, H Tanaka, Kohno, I

    GYNECOLOGIC ONCOLOGY   96 ( 3 )   805 - 809   2005年3月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objectives. This is a pilot study for a future trial to assess the efficacy and safety of combination chemotherapy with docetaxel and carboplatin in advanced or recurrent uterine cervix cancer.
    Methods. The patients eligible for this study had histologically confirmed, advanced (stage IB2-IV) or recurrent uterine cervix cancer. Eligible patients had measurable lesions and must have sufficient bone marrow, renal, and liver functions. Docetaxel was administered intravenously (IV) at 60 mg/m(2) followed by IV carboplatin administration based on AUC = 6. Chemotherapy was repeated in 1-6 courses depending on the purpose of the therapy. The response was evaluated based on RECIST criteria. The toxicity grade was determined by NCI-CTC version 2.
    Results. During January 2001 and April 2004, 17 patients were entered in this study. The distribution of stage was IB2, 3; IIB, 8; IIIB, 3; IVB, 1; recurrent, 2. There were 9 squamous cell carcinomas, 6 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 small cell carcinoma. The overall response rate was 76% (2 CR, 11 PR, and 4 SD). No progression of disease was observed. All 5 adenocarcinoma patients in the neoadjuvant chemotherapy group responded including 1 pathological CR. The incidences of grade 3/4 toxicities were 76% for neutrocytopenia, 12% for thrombocytopenia, and 6% for anemia. No grade 3/4 neurotoxicity was observed.
    Conclusions. The combination of docetaxel and carboplatin is an effective and safe treatment for uterine cervix cancer. Further evaluation particularly targeted on cervical adenocarcinoma is warranted. (c) 2004 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.ygyno.2004.11.044

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  • Combination chemotherapy of docetaxel and carboplatin in advanced or recurrent cervix cancer. A pilot study 国際誌

    S Nagao, K Fujiwara, T Oda, H Ishikawa, H Koike, H Tanaka, Kohno, I

    GYNECOLOGIC ONCOLOGY   96 ( 3 )   805 - 809   2005年3月

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    記述言語:英語   出版者・発行元:ACADEMIC PRESS INC ELSEVIER SCIENCE  

    Objectives. This is a pilot study for a future trial to assess the efficacy and safety of combination chemotherapy with docetaxel and carboplatin in advanced or recurrent uterine cervix cancer.
    Methods. The patients eligible for this study had histologically confirmed, advanced (stage IB2-IV) or recurrent uterine cervix cancer. Eligible patients had measurable lesions and must have sufficient bone marrow, renal, and liver functions. Docetaxel was administered intravenously (IV) at 60 mg/m(2) followed by IV carboplatin administration based on AUC = 6. Chemotherapy was repeated in 1-6 courses depending on the purpose of the therapy. The response was evaluated based on RECIST criteria. The toxicity grade was determined by NCI-CTC version 2.
    Results. During January 2001 and April 2004, 17 patients were entered in this study. The distribution of stage was IB2, 3; IIB, 8; IIIB, 3; IVB, 1; recurrent, 2. There were 9 squamous cell carcinomas, 6 adenocarcinomas, 1 adenosquamous cell carcinoma, and 1 small cell carcinoma. The overall response rate was 76% (2 CR, 11 PR, and 4 SD). No progression of disease was observed. All 5 adenocarcinoma patients in the neoadjuvant chemotherapy group responded including 1 pathological CR. The incidences of grade 3/4 toxicities were 76% for neutrocytopenia, 12% for thrombocytopenia, and 6% for anemia. No grade 3/4 neurotoxicity was observed.
    Conclusions. The combination of docetaxel and carboplatin is an effective and safe treatment for uterine cervix cancer. Further evaluation particularly targeted on cervical adenocarcinoma is warranted. (c) 2004 Elsevier Inc. All rights reserved.

    DOI: 10.1016/j.ygyno.2004.11.044

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講演・口頭発表等

  • Neoadjuvant chemotherapy of docetaxel and carboplatin in patients with stage Ib2 to II non-squamous cervix cancer of the uterus.

    ASCO  2012年 

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    会議種別:ポスター発表  

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  • 子宮頸がん術前化学療法の役割について見直しが必要では? SGSG studyを中心に

    婦人科腫瘍学会総会  2012年 

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  • 婦人科腫瘍 最近の話題

    はりま婦人科講演会  2012年 

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  • 早期上皮性卵巣癌に対する後腹膜リンパ節郭清省略の可能性

    関東連合産婦人科学会  2012年 

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  • 再発子宮体癌に対する化学療法の役割

    婦人科がん会議  2012年 

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  • 再発卵巣癌に対する化学療法 iPLAS概要

    TGCU総会  2011年 

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  • Intravenous (IV) / intraperitoneal (IP) paclitaxel and IP carboplatin in patients with epithelial ovarian, fallopian tube or peritoneal carcinoma. A feasibility study.

    ASCO  2011年 

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    会議種別:ポスター発表  

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  • 再発上皮性卵巣癌におけるCarboplatinおよびDoxil併用療法の位置づけ

    宮城県婦人科がん研究会  2011年 

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  • iPocc試験プロトコール概要

    第8回婦人科悪性腫瘍化学療法研究機構年次会議(総会)  2010年 

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  • IP支持の立場から クリニカルディベート 卵巣癌初回化学療法IP vs IV

    婦人科腫瘍学会総会  2010年 

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  • 子宮体癌後方視的検討概要

    GOTIC教育セミナー  2010年 

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  • A feasibility study of intravenous paclitaxel, intraperitoneal carboplatin and intraperitoneal paclitaxel in patients with epithelial ovarian carcinoma, fallopian tube carcinoma or peritoneal carcinoma.

    IGCS  2010年 

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    会議種別:ポスター発表  

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  • 上皮性卵巣癌に対するpaclitaxel静脈内/腹腔内投与+carboplatin腹腔内投与併用療法のfeasibility study(ワークショップ)

    日本婦人科腫瘍学会  2010年 

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  • 当科における深部静脈血栓症及び肺血栓塞栓症例の検討

    日本産科婦人科学会総会  2007年 

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  • 埼玉県西部地区における子宮頸部上皮内新生物症例に検出されたHPV型分析

    日本産科婦人科学会総会  2007年 

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  • 腹腔内投与における腹腔内AUC値と排泄速度定数との反比例関係について

    日本婦人科腫瘍学会  2007年 

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  • 子宮内膜癌1a期G1で術後二年目に癌性腹膜炎を併発した1例

    日本産科婦人科学会関東連合地方部会  2007年 

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  • 当院におけるDVTおよびPTEの現状について

    日本新生児血液学会  2007年 

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  • 抗癌剤腹腔内投与療法の現状 上皮性卵巣癌に対するIVパクリタキセル併用IP対IVカルボプラチン比較第II相試験

    日本癌治療学会  2007年 

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  • 前治療抵抗性卵巣癌に対するsecond line以降の化学療法の治療成績についての検討

    日本癌治療学会  2007年 

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受賞

  • 岡山県医師会学術奨励賞

    2005年  

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    受賞国:日本国

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共同研究・競争的資金等の研究

  • 白金製剤感受性再発上皮性卵巣癌に対するジェムザール®+カルボプラチン+少量パクリタキセル併用療法のFeasibility試験

    2012年

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    資金種別:競争的資金

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  • 再発子宮体癌におけるプラチナ製剤フリー期間と予後の研究

    2011年

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    資金種別:競争的資金

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  • プラチナ製剤抵抗性再発・再燃卵巣癌に対するPLD40mg/m2対50mg/m2の第III相比較試験

    2010年

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    資金種別:競争的資金

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  • 再発上皮性卵巣癌に対するCLD+low dose paclitaxelのfeasibility study

    2010年

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    資金種別:競争的資金

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  • 進行子宮体癌に対するTAP療法のfeasibility study

    2010年

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    資金種別:競争的資金

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  • 上皮性卵巣癌に対するpaclitaxel静脈内隔週投与+carboplatin静脈内3週間毎投与併用療法対paclitaxel静脈内隔週投与+carboplatin静脈内3週間毎投与併用療法の第II/III相試験

    2010年

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    資金種別:競争的資金

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  • 局所進行子宮頚癌に対する縮小手術の可能性

    2008年

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    資金種別:競争的資金

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  • IP chemotherapy for patients with endometrial cancer

    2008年

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    資金種別:競争的資金

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  • Less radical operation for invasive cervical cancer

    2008年

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    資金種別:競争的資金

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  • 進行子宮内膜癌に対する腹腔内化学療法の有効性、安全性に関する検討

    2008年

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    資金種別:競争的資金

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  • Combination chemotherapy of intravenous paclitaxel and intraperitoneal carboplatin in suboptimally debulked ovarian cancer.

    2007年

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    資金種別:競争的資金

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  • 残存腫瘍を有する上皮性卵巣癌患者に対するパクリタキセル静脈内点滴投与およびカルボプラチン腹腔内投与の安全性および有効性について

    2007年

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    資金種別:競争的資金

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