Faculty Profiles - NAGAO Shoji

Papers - NAGAO Shoji

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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 2018.2

Chemoresistance of Gastric-Type Mucinous Carcinoma of the Uterine Cervix: A Study of the Sankai Gynecology Study Group. Reviewed International journal

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 2018.1

Language：English Publishing type：Research paper (scientific journal)

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. Reviewed International journal

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 2017.12

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

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. Reviewed International journal

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 2017.8

Language：English Publishing type：Research paper (scientific journal)

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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子宮頸癌において治療開始前の白血球増加症並びに血小板増加症は予後予測因子となる

村田友香, 宮原義也, 鈴木嘉穂, 若橋宣, 市田耕太郎, 蝦名康彦, 山田秀人, 須藤保, 長尾昌二, 山口聡

日本婦人科腫瘍学会雑誌 35 ( 3 ) 663 - 663 2017.6

子宮頸癌における治療開始前の白血球増加症ならびに血小板増加症は予後予測因子となる

村田友香, 宮原義也, 鈴木嘉穂, 若橋宣, 市田耕太郎, 蝦名康彦, 山田秀人, 須藤保, 長尾昌二, 山口聡

産婦人科の進歩 69 ( 2 ) 234 - 234 2017.5

Correlation Between Tumor Mesothelin Expression and Serum Mesothelin in Patients with Epithelial Ovarian Carcinoma: A Potential Noninvasive Biomarker for Mesothelin-targeted Therapy. Reviewed International journal

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 2017.4

Language：English Publishing type：Research paper (scientific journal)

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. Reviewed

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 2016.12

Language：English Publishing type：Research paper (scientific journal)

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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MPA療法が奏効せず腹腔鏡下子宮全摘出となった子宮体癌の1例治療中の子宮内膜組織診の変化の検討

若橋宣, 須藤保, 浮田真沙世, 市田耕太郎, 長尾昌二, 山口聡, 山田秀人

産婦人科の進歩 68 ( 3 ) 237 - 242 2016.8

Language：Japanese Publisher：「産婦人科の進歩」編集室

症例は39歳(1経妊0経産)で、近医で不妊治療中に子宮内膜細胞異常を指摘され紹介受診した。子宮内膜掻爬で類内膜腺癌G1と診断され、妊孕性温存希望のため高用量プロゲスチン(MPA)療法を開始した。6ヵ月後の内膜組織診で効果ありと判断し、2ヵ月間の追加治療後に経過観察としたが、初回治療終了6ヵ月後に類内膜腺癌G1の再発を認め、2回目のMPA療法を行った。8ヵ月後に腺癌は消失し、MPA療法を2ヵ月間追加して経過観察とした。2回目終了8ヵ月後に複雑型子宮内膜異型増殖症を認め、治療抵抗性の判断で子宮全摘術を勧めたが、妊孕性温存希望で3回目MPA療法となったが、4ヵ月後に増殖症の遺残を認め、患者・家族の了解のもと腹腔鏡下子宮全摘術、両側卵管切除術を行った。病理診断は複雑型子宮内膜異型増殖症を背景とした類内膜腺癌G1であった。術後1年経過で再発は認めていない。全経過を通じプロゲステロン受容体は陰性、エストロゲン受容体は陽性であった。

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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). Reviewed International journal

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 2016.6

Language：English Publishing type：Research paper (scientific journal)

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. Reviewed International journal

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 2016.6

Authorship：Corresponding author Language：English Publishing type：Research paper (scientific journal)

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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子宮頸癌における治療開始前の白血球増加症は予後予測因子となる

宮原義也, 鈴木嘉穂, 若橋宣, 蝦名康彦, 森田宏紀, 須藤保, 長尾昌二, 山口聡, 山田秀人

日本婦人科腫瘍学会雑誌 34 ( 3 ) 491 - 491 2016.6

Diagnosis of desmoplastic small-round-cell tumor by cytogenetic analysis: a case report. Reviewed International journal

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 2016.5

The Efficacy of Low-Dose Paclitaxel Added to Combination Chemotherapy of Carboplatin and Gemcitabine or Pegylated Liposomal Doxorubicin. Reviewed International journal

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 2016.3

Authorship：Lead author Language：English Publishing type：Research paper (scientific journal)

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 2016.2

子宮腺筋症の術前診断で腹腔鏡下子宮全摘出術を施行し子宮体癌と判明した1例

市田耕太郎, 若橋宣, 長尾昌二

日本産科婦人科内視鏡学会雑誌 31 ( 1 ) 244 - 248 2015.11

Language：Japanese Publisher：(一社)日本産科婦人科内視鏡学会

症例は45歳(3経妊3経産)で、過多月経と腹部腫瘍が指摘され、近医にて過多月経と貧血に対し子宮内膜全面掻爬とGnRHa投与が行われ、約半年後に不正性器出血を認め、内膜細胞診class IIIで紹介受診した。エコーで後壁が有意に肥厚した境界明瞭で内部不均一な腫瘤を認め、MRIで子宮体部後壁に35mmのT2で低信号を呈し、内部に点状の高信号を認め、子宮腺筋症を疑い腹腔鏡下子宮全摘出術を行った。摘出子宮を経腟的に回収し、腟断端を吸収糸で連続縫合し閉鎖した。病理所見では、子宮腺筋症は子宮筋層に限局し、子宮底層に淡赤色のごく一部で内膜側に連続する類内膜腺癌の病変を認め、類内膜腺癌G2と診断した。切除断端は陰性、左右付属器に浸潤・転移は認めなかったが、CT・PET-CTによる全身検索で傍大動脈リンパ節に腫大を認め、子宮体癌IIIC2期の診断で開腹による傍大動脈リンパ節、骨盤リンパ節郭清術を追加した。術後化学療法を行い、1年経過で再発は認めていない。

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Clinical Features of Neuroendocrine Carcinoma of the Uterine Cervix: A Single-Institution Retrospective Review. Reviewed International journal

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 2015.9

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

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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子宮子宮頸がんの放射線療法・化学療法子宮頸癌に対する放射線治療後の骨障害に関する後方視的検討

山本香澄, 長尾昌二, 小菊愛, 三輪真唯子, 森本明美, 松村聡子, 若橋宣, 市田耕太郎, 須藤保, 山口聡, 藤原潔

日本癌治療学会誌 50 ( 3 ) 1341 - 1341 2015.9

術前検査を用いた子宮体癌後腹膜リンパ節転移の予測

三輪真唯子, 長尾昌二, 小菊愛, 山本香澄, 森本明美, 松村聡子, 若橋宣, 市田耕太郎, 須藤保, 山口聡, 藤原潔

日本癌治療学会誌 50 ( 3 ) 1798 - 1798 2015.9

What is an appropriate second-line regimen for recurrent endometrial cancer? Ancillary analysis of the SGSG012/GOTIC004/Intergroup study. Reviewed International journal

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 2015.8

Authorship：Lead author,　Corresponding author Language：English Publishing type：Research paper (scientific journal)

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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