Publications by authors named "Yakushijin T"
Initial adjustments in the dosage and rest period of gemcitabine plus cisplatin therapy for patients with incurable biliary tract cancer based on baseline estimated glomerular filtration rate (eGFR) values may be crucial for treatment outcomes and the preservation of renal function.
J Gastrointest Oncol
October 2024
Background: Gemcitabine (GEM) and cisplatin (CDDP) combination therapy (GC therapy) is the standard 1st-line regimen for incurable biliary tract cancers (BTCs). However, the correlation between dynamic changes in renal function and the outcomes of GC therapy remains unclear. This study aimed to clarify the association between renal function alterations and treatment outcomes after GC therapy.
View Article and Find Full Text PDFAlthough several reports have compared the outcomes of self-expandable metallic stent (SEMSs) and transanal decompression tube (TDT) placement for malignant colorectal obstruction (MCO), few studies have compared the radiation exposure (RE) associated with these two procedures. Consequently, we aimed to compare the RE of SEMS and TDT placements for MCO using propensity score matching (PSM) in a multi-center, prospective observational study. This study investigated the clinical data of 236 patients who underwent SEMS or TDT placement.
View Article and Find Full Text PDFAim: To investigate the current treatment for liver metastasis and clarify the indications for percutaneous thermal ablation for liver metastasis.
Methods: Ninety-two patients were enrolled and retrospectively analyzed. The patients underwent hepatectomy and/or percutaneous thermal ablation for liver metastases between January 2012 and December 2018.
Article Synopsis
- - This study evaluated the effectiveness and safety of atezolizumab plus bevacizumab in treating unresectable hepatocellular carcinoma in real-world settings, involving 222 patients from 19 hospitals.
- - The findings revealed an objective response rate of 22.0% and a median progression-free survival of 5.7 months, with certain factors (like younger age, more tumors, and macrovascular invasion) linked to shorter progression-free survival.
- - Despite a median overall survival not being reached, key risk factors for reduced survival included absence of hyperlipidemia, multiple intrahepatic tumors, macrovascular invasion, and elevated neutrophil-to-lymphocyte ratios, with 36.0% of
Background And Aim: Recently, the use of various endoscopic procedures performed under X-ray fluoroscopy guidance has increased. With the popularization of such procedures, diagnostic reference levels (DRLs) have been widely accepted as the global standard for various procedures with ionizing radiation. The Radiation Exposure from Gastrointestinal Fluoroscopic Procedures (REX-GI) study aimed to prospectively collect actual radiation exposure (RE) data and establish DRLs in gastrointestinal endoscopy units.
View Article and Find Full Text PDFArticle Synopsis
- This study investigated the radiation exposure to the lens of the eyes for medical staff during endoscopic retrograde cholangiopancreatography (ERCP) procedures.
- It found that the median annual radiation doses to the eyes were 3.7 mSv for operators, 2.2 mSv for assistants, and 2.4 mSv for nurses, indicating varying levels of exposure among staff.
- The research also showed a strong link between patient radiation exposure and occupational exposure for medical staff, underscoring the necessity of protective eyewear, which provided varying degrees of shielding effectiveness.
Article Synopsis
- The study aimed to identify factors that contribute to radiation exposure exceeding the diagnostic reference level (DRL) during transnasal ileus tube placement.
- Data from 496 patients was analyzed, including endoscope and procedure times, fluoroscopy duration, and radiation measurements.
- Findings indicated that longer procedure times and longer tube insertion lengths are linked to higher radiation exposure, leading to the establishment of a DRL for this procedure in Japan.
Article Synopsis
- A follow-up survey conducted in 2022 assessed radiation protection practices among medical staff in endoscopy-fluoroscopy departments in Japan, following a 2020 study that reported low protective equipment usage and insufficient knowledge.
- The survey included 464 participants, with high lead apron usage (98%) but much lower rates for other gear like thyroid collars (27%) and lead glasses (35%), indicating limited improvement since the 2020 survey.
- While many staff attended radiation protection lectures (76%) and were aware of key concepts such as cancer risk related to radiation exposure, knowledge about specific dosage limits and diagnostic reference levels remained low, signaling further educational needs.
Aim: Alterations in microbial composition of gut microbiota due to antibiotics (ATB) may lead to resistance to immune checkpoint inhibitors (ICIs). This study aimed to assess the impact of ATB use on therapeutic response in patients with hepatocellular carcinoma (HCC) receiving atezolizumab plus bevacizumab.
Methods: This study retrospectively analyzed 105 patients with HCC treated with atezolizumab plus bevacizumab as a primary systemic therapy from prospectively-registered, multicenter, cohorts.
We evaluated the value of secreted glycoprotein thrombospondin-2 (TSP-2) to predict hepatocellular carcinoma (HCC) occurrence in chronic hepatitis C (CHC) patients after Hepatitis C virus (HCV) elimination by direct-acting antiviral agents (DAAs). A total of 786 CHC patients without an HCC history who achieved a sustained virological response (SVR) with DAAs were randomly assigned 2:1, with 524 patients as the derivation cohort and 262 patients as the validation cohort. Serum TSP-2 levels at the end of treatment were measured by enzyme-linked immunosorbent assay (ELISA).
View Article and Find Full Text PDFBackground And Aim: Liver function can be improved in patients with chronic hepatitis C virus (HCV) infection who achieved sustained virologic response (SVR) with direct-acting antiviral (DAA) treatment. However, to our knowledge, the impact of liver function improvement after SVR on prognosis has not been investigated.
Methods: A total of 716 patients with chronic HCV infection and compensated advanced liver fibrosis who began receiving DAA treatment between September 2014 and August 2018 in 25 Japanese hospitals and achieved SVR were enrolled.
Article Synopsis
- The study aimed to evaluate how direct-acting antiviral therapy affects the long-term health outcomes of patients with decompensated cirrhosis caused by hepatitis C virus.
- It compared 37 patients undergoing treatment with sofosbuvir and velpatasvir (SOF/VEL) to a historical control group of 65 untreated patients, focusing on rates of liver decompensation, hospitalization, and survival.
- Results showed that the treatment group had significantly fewer decompensated events and better survival rates over two years, but the risk of developing hepatocellular carcinoma (HCC) was still high in both groups.
Article Synopsis
- Combination immunotherapy using anti-PD-L1 and anti-VEGF antibodies is the standard treatment for patients with unresectable HCC, but it doesn’t benefit all patients equally.
- A study involving 85 HCC patients showed that high levels of cell-free DNA (cfDNA) in the blood correlate with poorer treatment responses and shorter survival outcomes.
- Specific mutations in ctDNA, particularly in the TERT gene, can indicate worse prognosis and may help doctors assess treatment effectiveness for patients receiving this therapy.
Aim: Hepatocellular carcinoma (HCC) after sustained virologic response (SVR) has been observed even in hepatitis C virus (HCV) patients without advanced liver fibrosis. Identifying predictors for HCC incidence in patients without advanced liver fibrosis will enable efficient post-SVR HCC surveillance. This study aimed to develop a scoring system to predict the incidence of HCC after SVR in HCV patients without advanced liver fibrosis.
View Article and Find Full Text PDFArticle Synopsis
- A study compared the effectiveness of two cancer treatments, atezolizumab plus bevacizumab and lenvatinib, for patients with hepatocellular carcinoma (HCC), involving 272 patients in total.
- After analyzing the data, the combination of atezolizumab and bevacizumab resulted in a significantly longer median progression-free survival (8.8 months) compared to lenvatinib (5.2 months), although overall survival rates were similar.
- Additionally, the atezolizumab plus bevacizumab group maintained better liver function and had fewer severe side effects than the lenvatinib group, suggesting it may be a preferable option for HCC treatment.*
Background: Intrahepatic hepatocellular carcinoma (HCC) has a high recurrence rate after radiofrequency ablation (RFA). However, to date, no standalone predictive factors for intrahepatic distant recurrence after curative ablation have been reported.
Aims: The aim of this study was to investigate predictive factors for intrahepatic distant recurrence after curative treatment with RFA for HCCs.
Article Synopsis
- * A questionnaire survey conducted with 282 participants revealed that while most staff wore lead aprons, very few used other protective gear like thyroid collars (32%) and lead glasses (21%), and only 69% wore radiation dosimeters.
- * The findings suggest that knowledge about radiation exposure correlates with better adherence to protective measures, emphasizing the need for improved education and training on radiation safety for medical professionals.
Article Synopsis
- * Researchers looked at blood biomarkers to see if they could predict which patients would be nonresponders, finding that high levels of IL-6 and interferon alpha (IFNα) were significant predictors.
- * Patients with high IL-6 levels had worse outcomes, such as shorter progression-free survival and overall survival, making IL-6 a potential new prognostic biomarker for those receiving this therapy.
Article Synopsis
- The study examines radiation exposure levels during fluoroscopic gastrointestinal procedures in Japan to establish national diagnostic reference levels (DRLs), as current data is limited.
- A total of 12,959 procedures were analyzed from 23 hospitals, measuring various radiation dose metrics including air kerma and fluoroscopy time.
- The findings reveal specific median radiation doses and times for different procedures, highlighting significant variations across institutions, which can help optimize patient safety and treatment standards.
Article Synopsis
- - Atezolizumab plus bevacizumab, approved for hepatocellular carcinoma (HCC) in 2020, showed a 10.2% occurrence of hyperprogressive disease (HPD) in Japanese patients, defined by rapid tumor growth despite treatment.
- - Among 88 patients studied, 13.6% had partial responses, while 58% experienced stable disease; the median progression-free survival for the group was 5.0 months.
- - Higher baseline levels of α-fetoprotein, lactate dehydrogenase, and a neutrophil-to-lymphocyte ratio (NLR) ≥3 were linked to HPD, with NLR serving as a significant independent
Background: After hepatitis C virus (HCV) elimination, patients should be followed up due to risk of hepatocellular carcinoma (HCC). Growth differentiation factor 15 (GDF15) is a cytokine induced by mitochondrial dysfunction or oxidative stress. Aim To evaluate the prognostic value of GDF15 for HCC occurrence after HCV elimination.
View Article and Find Full Text PDFBackground: Several factors associated with hepatocellular carcinoma (HCC) occurrence after sustained virological response (SVR) in patients with hepatitis C have been reported. However, few validation studies have been performed in the era of direct-acting anti-virals (DAAs).
Aims: To develop a prediction model for HCC occurrence after DAA-mediated SVR and validate its usefulness.
Article Synopsis
- The study aimed to compare the effectiveness of ramucirumab versus sorafenib as treatments for patients with hepatocellular carcinoma (HCC) and high serum α-fetoprotein (AFP) levels (≥400 ng/ml).
- In the analysis of 24 patients (13 on ramucirumab and 11 on sorafenib), progression-free survival (PFS) was significantly longer for those receiving ramucirumab, with median PFS of 2.7 months compared to 0.9 months for sorafenib.
- Overall, ramucirumab demonstrated a better ability to control tumor progression in HCC patients, despite similar response rates between the two treatments.