Publications by authors named "Susumu Nakahara"
Chronic graft-versus-host disease (cGVHD) is a serious complication after allogeneic stem cell transplantation. There are no well-established treatment options for cGVHD after primary steroid-based treatment. Ibrutinib showed clinical benefit with an acceptable safety profile in steroid-dependent/refractory cGVHD patients in a Phase 1b/2 study (PCYC-1129-CA, NCT02195869), with which it was approved in the United States for adult cGVHD patients after failure of ≥1 systemic treatments.
View Article and Find Full Text PDFBackground/aim: To retrospectively evaluate the efficacy and safety of modified TPEx (docetaxel 60 mg/m on day 1, cisplatin 60 mg/m on day 1, and weekly cetuximab 250 mg/m with loading dose of 400 mg/m) followed by maintenance cetuximab as first-line treatment for inoperable recurrent and/or metastatic squamous cell carcinoma of the head and neck.
Patients And Methods: We analyzed 22 Japanese patients receiving modified TPEx every 21 days for four cycles with or without prophylactic granulocyte colony-stimulating factor (G-CSF).
Results: The best overall response rate was 55% [95% confidence interval (CI)=35-73].
Article Synopsis
- HPV-related oropharyngeal squamous cell carcinoma (OPSCC) is sensitive to radiation but traditional treatments can lead to long-term side effects, prompting a need for less toxic therapy while still ensuring effective outcomes.
- A phase 2 trial tested intensity modulated radiation therapy (IMRT) without chemotherapy on newly diagnosed OPSCC patients who were HPV-positive, focusing on their complete response 10 weeks post-treatment.
- The trial included 39 patients, 90% achieved a complete response, and showed high survival rates with very few severe side effects, suggesting IMRT could be a safer alternative for treating HPV-related OPSCC.
Dacogen, the formulated product of the pharmaceutically active agent decitabine (5 aza-2'-deoxycytidine), is approved for treatment of myelodysplastic syndromes (MDSs) and acute myeloid leukemia (AML). The current analysis was performed to characterize the pharmacokinetics of decitabine in pediatric patients with AML and evaluate their consistency with the PK in adult patients. A population pharmacokinetic model was developed by pooling decitabine concentration-time data from 5 adult (AML and MDS) and 2 pediatric (AML) studies.
View Article and Find Full Text PDFBackground: In the LYM-3002 study, the efficacy and safety of frontline bortezomib plus rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP) and rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) were compared in transplant-ineligible patients with untreated, newly diagnosed, mantle cell lymphoma. We report the final overall survival and safety outcomes for patients in the long-term follow-up phase after the primary progression-free-survival endpoint was met.
Methods: LYM-3002 was a randomised, open-label, phase 3 study done at 128 clinical centres in 28 countries in Asia, Europe, North America, and South America.
We aimed to determine whether pretreatment metabolic tumor volume of the primary tumor (T-MTV) or T classification would be a better predictor of laryngectomy-free survival (LFS) and overall survival (OS) after chemoradiotherapy in patients with locally advanced laryngeal or hypopharyngeal cancer requiring total laryngectomy. We analyzed 85 patients using a Cox proportional hazards model and evaluated its usefulness by Akaike's information criterion. A T-MTV cut-off value was determined by time-dependent receiver operating characteristic curve analysis.
View Article and Find Full Text PDFWe present an autopsy case of repetitive stroke due to tumor emboli, indistinguishable from thromboembolism with a hypercoagulable state in its clinical course. A 72-year-old man diagnosed with stage IVA oropharyngeal squamous cell carcinoma received chemoradiotherapy. Follow-up imaging revealed mediastinal lymph nodes and pulmonary metastasis.
View Article and Find Full Text PDFConclusion: The age-adjusted Charlson comorbidity index (ACCI) was associated with overall survival, disease-specific survival, and non-cancer death in patients treated with chemoradiation therapy (CRT) for hypopharyngeal cancer (HPC). Further studies using other CRT regimens are required.
Objective: To investigate the impact of the ACCI on survival in patients with HPC.
Various serum biomarkers have been developed for predicting head and neck squamous cell carcinoma (HNSCC) prognosis. However, none of them have been proven to be clinically significant. A recent study reported that the ratio of aspartate aminotransaminase (AST) to alanine aminotransaminase (ALT) had a prognostic effect on non-metastatic cancers.
View Article and Find Full Text PDFArticle Synopsis
- The study evaluated the use of concurrent chemoradiotherapy with low-dose docetaxel and cisplatin in patients with locally advanced nasopharyngeal carcinoma over a period from 2001 to 2014.
- Out of 31 patients, 90% completed the treatment, achieving a complete response rate of 42% and a partial response rate of 52%.
- The results indicated acceptable safety with significant adverse events like mucositis and neutropenia, highlighting the need for revised treatment strategies to enhance outcomes for Stage IV patients.
Article Synopsis
- A Phase II study tested the efficacy and safety of low-dose docetaxel/cisplatin with radiotherapy for patients with technically unresectable head and neck squamous cell carcinoma.
- Out of 33 patients enrolled, 31 were analyzable, and results showed a 45% complete response rate, with some patients undergoing successful surgical salvage.
- While the treatment demonstrated effectiveness, high toxicity levels and low compliance in adjuvant chemotherapy suggested the need for improvements.
Article Synopsis
- - A 55-year-old man with nasopharyngeal carcinoma underwent successful initial treatment but later died due to severe complications during adjuvant chemotherapy (TPF therapy).
- - He developed febrile neutropenia, shock, and ultimately succumbed to multiple infections, including MRSA pneumonia, after 43 days of treatment.
- - The autopsy indicated acute respiratory distress syndrome as the primary cause of death, highlighting the need for thorough patient education and consent regarding the risks of TPF therapy, which has a mortality rate of 2-4%.
Conclusions: The head and neck cancer patients with more co-morbidities and those dependent on tube feeding are at a high risk of severe infections during chemotherapy. Therefore, prophylaxis with colony-stimulating factors and/or antibiotics should be considered for those patients.
Objectives: To investigate the risk factors for severe infection during chemotherapy in head and neck cancer patients.
Article Synopsis
- The study evaluated the effectiveness and safety of low-dose docetaxel and cisplatin combined with radiation therapy in patients with stage III-IV squamous cell carcinoma of the head and neck, involving 116 patients over seven years.
- Results showed a 71% complete response rate post-treatment, with median follow-up indicating 82% and 68% survival rates at 2 and 4 years, respectively, though local and distant failure rates were also reported.
- Despite some acute toxicities like mucositis, severe side effects were minimal, and no patients died from treatment-related toxicity, demonstrating the regimen's acceptability for managing this type of cancer.
Objective: The first-line treatment for inoperable recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) has long been the combination of cisplatin and fluorouracil (PF). Recently, cetuximab has been shown to provide an additional survival benefit to PF. It remains unknown whether docetaxel adds additional benefits to PF.
View Article and Find Full Text PDFConclusions: Serum squamous cell carcinoma antigen (SCC-Ag) level was an independent prognostic factor for survival in patients with head and neck squamous cell carcinoma (HNSCC), and the prognostic value depended on the carcinoma site.
Objectives: To assess the value of SCC-Ag as a prognostic indicator in patients with HNSCC and to determine the effect of primary tumor site on prognosis.
Methods: We reviewed 493 patients with HNSCC between 2004 and 2012.
The incidence of severe mucositis in the oral cavity, pharynx and larynx is high among patients with head and neck cancer (HNC) receiving chemoradiotherapy (CRT), resulting in significant pain and impairment of quality of life. The present study investigated whether L-glutamine (glutamine) decreases the severity of mucositis in the oral cavity, pharynx and larynx induced by CRT. This double-blind, randomized, placebo-controlled trial included 40 untreated patients with squamous cell carcinoma of the nasopharynx, oropharynx, hypopharynx or larynx.
View Article and Find Full Text PDFConclusions: Comorbidities as well as T classification were the primary determinants for the nutritional status of patients with head and neck cancer.
Objectives: We aimed to elucidate the underlying conditions of malnutrition in patients with head and neck cancer.
Methods: We retrospectively reviewed 726 patients diagnosed with head and neck cancer between 2004 and 2013.
It is not well established whether pretreatment (18) F-FDG PET/CT can predict local response of head and neck squamous cell carcinoma (HNSCC) to chemoradiotherapy (CRT). We examined 118 patients: 11 with nasopharyngeal cancer (NPC), 30 with oropharyngeal cancer (OPC), and 77 with laryngohypopharyngeal cancer (LHC) who had completed CRT. PET/CT parameters of primary tumor, including metabolic tumor volume (MTV), total lesion glycolysis (TLG), and maximum and mean standardized uptake value (SUVmax and SUVmean ), were correlated with local response, according to primary site and human papillomavirus (HPV) status.
View Article and Find Full Text PDFThe olfactory neuroblastoma, first described in 1924, is a rare tumor arising from the olfactory epithelium. Because of its rarity, it is difficult to accrue a large individual series. To elucidate the characteristics of olfactory neuroblastomas in Japan, we report herein on our institutional experience of 14 cases and reviewed 104 cases reported from Japan.
View Article and Find Full Text PDFBackground: Patients with head and neck cancer frequently experience malnutrition. The purpose of this study was to examine the impact of nutritional status on prognosis and its association with treatment modalities.
Methods: This retrospective study included 706 patients with head and neck cancer diagnosed between 2004 and 2012.
Article Synopsis
- The study investigates the role of human papillomavirus (HPV) in neck node metastasis related to cancers of unknown primary (CUP) and compares HPV status in both node metastases and primary tumors in head and neck cancers.
- HPV DNA analysis was done on 68 matched pairs of node metastases and primary tumors, while a correlation was also established between cystic node metastasis on CT scans and HPV status in a larger sample of 255 cases.
- Results indicated that HPV positivity was common in oropharyngeal squamous cell carcinoma (51%) and CUPs (37%), highlighting the potential for HPV status to guide diagnosis and treatment in cases with cystic node metastasis.
Background: The standard treatment for advanced external auditory canal squamous cell carcinoma (SCC) is subtotal temporal bone resection and postoperative radiation therapy (RT), whereas chemoradiation therapy (CRT) is used in some institutions to improve patient prognosis. The purpose of this study was to evaluate the efficacy of CRT in external auditory canal SCC treatment.
Methods: Meta-analyses of external auditory canal SCC studies were performed.
Article Synopsis
- The study examined HPV infection and p53 mutations in 493 Japanese head and neck squamous cell carcinoma (HNSCC) patients, focusing specifically on oropharyngeal vs. non-oropharyngeal cancers.
- Oropharyngeal carcinoma showed a higher HPV positivity rate (34.4%) compared to non-oropharyngeal (3.6%), with HPV16 being the most common type found.
- The presence of HPV was negatively correlated with tobacco and alcohol use as well as p53 mutations; whereas in virus-unrelated HNSCC, p53 mutations were more common and connected to lifestyle factors like smoking.