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論文

論文
Kawano, Masaya ; Taki, Junichi ; Tsuchiya, Hiroyuki ; Tomita, Katsuro ; Tonami, Norihisa
出版情報: Journal of Nuclear Medicine.  44  pp.369-374,  2003-03-01.  THE SOCIETY OF NUCLEAR MEDICINE INC
URL: http://hdl.handle.net/2297/2794
概要: 金沢大学大学院医学系研究科<br />Distraction osteogenesis is an effective method for lengthening long bones and filling bone defects t hat result from bone resection. Insufficiency of bone consolidation in the distraction segment is problematic. In this study, we examined whether 3-phase bone scintigraphy can predict the outcome of distraction osteogenesis. We also investigated the effects of chemotherapy and surgical treatment on distraction osteogenesis. Methods: We performed 3-phase bone scintigraphy on 60 patients (9 high-grade malignant bone tumors as group A, 11 low-grade malignant or benign tumors as group B, 40 nontumoral conditions as group C) with distraction osteogenesis at the lengthening phase of the long bones. By setting the region of interest on the distraction segment and contralateral normal area, we calculated the perfusion index (PI), the uptake ratio of the blood-pool image (BPR), and the uptake ratio of the delayed image (DR). Patients were classified into poor and good consolidation groups from the radiographic findings of the distraction segment. Results: Good to fair correlations were obtained between the PI and BPR, the PI and DR, and the BPR and DR (r = 0.65, 0.45, and 0.57, respectively). The PI and BPR indicated no significant differences among group A-C (1.7 ± 0.6, 2.1 ± 0.7, and 1.8 ± 0.8 in PI, respectively; 1.8 ± 1.1, 1.9 ± 0.5, and 2.0 ± 0.7, in BPR, respectively). The DR of group A (2.4 ± 1.2) was significantly lower than that of group B (6.3 ± 1.8; P = 0.001) and group C (5.9 ± 2.8; P < 0.001). Eleven patients were classified in the poor consolidation group. The other 49 patients showed good consolidation. The poor consolidation group showed lower values in all indices obtained by 3-phase bone scintigraphy than the good consolidation group. The optimal cutoff levels, sensitivity, specificity, and accuracy of each index for detection of patients with poor consolidation were as follows: 1.1, 36%, 90%, and 80% in the PI, respectively; 1.2, 55%, 94%, and 87% in the BPR, respectively; and 2.2, 82%, 96%, and 93% in the DR, respectively. Conclusion: Three-phase bone scintigraphy is a promising method for the assessment of distraction osteogenesis. The delayed image of 3-phase bone scintigraphy, especially, is an excellent modality for predicting the outcome of distraction osteogenesis. 続きを見る
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論文

論文
Karita, Michiaki ; Tsuchiya, Hiroyuki ; Yamamoto, Norio ; Shirai, Toshiharu ; Hayashi, Katsuhiro ; Nishida, Hideji
出版情報: International Journal of Clinical Oncology.  18  pp.33-37,  2013-02-01.  Japan Society of Clinical Oncology = 日本癌治療学会 / Springer Verlag (Germany)
URL: http://hdl.handle.net/2297/29570
概要: Background: Clear cell sarcoma is a rare malignant tumor of soft tissue which is most commonly encountered in the extrem ities, especially in the foot and ankle. This tumor is slow-growing and looks like a benign tumor; it is therefore often treated inadequately and its high rate of recurrence and metastases results in a poor prognosis. Caffeine has been used as a chemotherapy potentiator that inhibits DNA damage repair and enhances the cytocidal effects of anti-cancer drugs. This study reports the effect of caffeine-potentiated chemotherapy for clear cell sarcoma in five patients. Methods: Caffeine-potentiated chemotherapy was administered to five patients with clear cell sarcoma. Three to five courses of intra-arterial chemotherapy using cisplatin, doxorubicin and caffeine were administered preoperatively, at 3-week intervals. Conservatively, wide margin surgery was performed following the preoperative chemotherapy. Intravenous cisplatin and doxorubicin with caffeine were administered three to six times to the patients who responded to the preoperative chemotherapy. This study evaluated the response to chemotherapy, recurrence, metastasis and the overall prognosis in these five patients. Results: Four of the eligible patients responded to preoperative chemotherapy. Local recurrence occurred in only one of the five patients. Distant metastasis newly developed in one patient. All five patients survive. Conclusion: Caffeine-potentiated chemotherapy can be effective treatment for clear cell sarcoma not only as initial therapy, but also as salvage therapy. © 2011 Japan Society of Clinical Oncology. 続きを見る
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論文

論文
Wakabayashi, Hiroshi ; Taki, Junichi ; Inaki, Anri ; Sumiya, Hisashi ; Zen, Yoh ; Tsuchiya, Hiroyuki ; Kinuya, Seigo
出版情報: Clinical Nuclear Medicine.  37  pp.1-8,  2012-01-01.  Lippincott, Williams & Wilkins
URL: http://hdl.handle.net/2297/30311
概要: Purpose: This study was aimed to determine whether Tc-99m-hexakis-2- methoxyisobutylisonitrile (MIBI) scintigraphy perfo rmed in the middle of preoperative chemotherapy has a prognostic value in patients with malignant bone and soft tissue tumors (MBST). Materials and Methods: In 90 patients with MBST, Tc-99m-MIBI scintigraphy was performed 15 minutes after tracer injection before the first and after the third chemotherapy cycles. After 5 cycles of chemotherapy and tumor resection, therapeutic effect was assessed by histopathology. The percent reduction of uptake ratio (AUR) was calculated according to the following equation: 100 × ([prechemotherapy UR - post-middle course of chemotherapy UR]/prechemotherapy UR). Results: The average follow-up for the entire population was 52 months. Twenty-one patients had clinically detectable metastases at initial presentation (primary metastasis). Kaplan-Meier analysis demonstrated that absence of metastasis was associated with good survival in all patients, in patients with bone tumor, and those with soft tissue tumor (P < 0.0001, P < 0.0001, and P = 0.0003, respectively), and AUR ≥30% was also associated with survival in all patients and patients with bone tumor (P = 0.011 and P = 0.047, respectively), but was marginal in those with soft tissue tumor (P = 0.091). Multivariate analysis showed that primary metastasis was the most powerful independent predictor of a lethal clinical outcome in all patients, in both patients with bone and soft tissue tumors (hazard ratio [HR]: 4.9, 95% confidence interval [CI]: 2.61-9.08, P < 0.0001; HR: 15.1, CI: 4.86-52.7, P < 0.0001; HR: 3.7, CI: 1.45-8.94, P = 0.0069, respectively) and showed that Tc-99m-MIBI scintigraphy had a good independent long-term prognostic value in all patients and patients with bone tumor (HR: 2.2, CI: 1.14-4.43, P = 0.017; HR: 6.0, CI: 2.01-21.6, P = 0.0009, respectively) but not in those with soft tissue tumor (HR: 1.5, CI: 0.61-4.09, P = 0.38). Good disease-free survival was associated with ΔUR §30% in all patients and patients with soft tissue tumor (P = 0.0093 and P = 0.017, respectively) but not in those with bone tumor (P = 0.19). Conclusions: Tc-99m-MIBI scintigraphy at the middle course of preoperative chemotherapy could be used as a prognostic indicator in patients with MBST. Copyright © 2012 by Lippincott Williams & Wilkins.<br />Thesis of Hiroshi Wakabayashi / 博士学位論文 若林 大志 続きを見る