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Japan's cancer survivorship guidelines for exercise and physical activity. 日本癌症幸存者运动和体育锻炼指南。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-19 DOI: 10.1093/jjco/hyae126
Katsunori Tsuji, Hiroyuki Sasai, Kosuke Kiyohara, Yoshio Nakata, Hiroki Nishiwaki, Takahisa Ohta, Eisuke Ochi, Toshimi Takano, Noriatsu Tatematsu, Yutaka J Matsuoka

Objective: This research aimed to establish the inaugural evidence-based cancer survivorship guidelines for Japan, with a particular focus on exercise and physical activity, in order to enhance health outcomes for cancer survivors.

Methods: A panel of experts, including oncologists, physicians, exercise scientists, epidemiologists and patient advocates, utilized a modified Delphi process and systematic reviews to establish consensus on exercise recommendations for cancer survivors. The panel focused on setting the objectives of the Clinical Practice Guidelines and addressing crucial clinical issues in Japan. Recommendations were formulated based on the strength and certainty of evidence, the benefit-harm balance and patient values and preferences.

Results: The panel formulated exercise recommendations for cancer survivors of two age groups: 18-64 years and ≥65 years. The recommendations for both age groups are consistent, emphasizing the importance of regular exercise and physical activity tailored to individual capabilities and health conditions. The guidelines underline the benefits of exercise in improving the overall health and quality of life of cancer survivors. This consensus on exercise recommendations marks a significant step in the development of comprehensive cancer survivorship guidelines in Japan, with potential implications for improving clinical outcomes and advancing research in cancer survivorship.

Conclusions: These guidelines will serve as a critical resource for cancer survivors, highlighting exercise as a key component of survivorship care, and for clinicians, in recommending appropriate physical activities to improve survivor health and well-being.

研究目的这项研究旨在为日本制定首份以证据为基础的癌症幸存者指南,其中特别关注运动和体育锻炼,以提高癌症幸存者的健康状况:一个由肿瘤学家、医生、运动科学家、流行病学家和患者权益倡导者组成的专家小组利用修改过的德尔菲程序和系统性回顾,就癌症幸存者的运动建议达成了共识。小组的工作重点是制定《临床实践指南》的目标,并解决日本的关键临床问题。建议是根据证据的强度和确定性、益处与危害的平衡以及患者的价值观和偏好制定的:专家组为两个年龄组的癌症幸存者制定了运动建议:18-64 岁和≥65 岁。针对这两个年龄组的建议是一致的,都强调了定期锻炼和根据个人能力和健康状况进行体育锻炼的重要性。指南强调了运动对改善癌症幸存者整体健康和生活质量的益处。就运动建议达成的共识标志着日本在制定全面的癌症幸存者指南方面迈出了重要一步,对改善临床结果和推进癌症幸存者研究具有潜在影响:这些指南将成为癌症幸存者和临床医生的重要资源,前者强调运动是幸存者护理的重要组成部分,后者则推荐适当的体育活动,以改善幸存者的健康和福祉。
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引用次数: 0
A single-institution retrospective study of comprehensive genomic profiling tests based on C-CAT findings for advanced solid cancers. 基于 C-CAT 检测结果的晚期实体瘤综合基因组分析测试的单一机构回顾性研究。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-19 DOI: 10.1093/jjco/hyae128
Susumu Takeuchi, Akinobu Yoshimura, Atsushi Sofuni, Yuri Ueda, Tomohiro Umezu, Masahiko Kuroda, Aoi Sukeda, Jun Matsubayashi, Toshitaka Nagao, Masato Bingo, Natsuko Inagaki, Tatsuo Ohira, Masahiro Seike, Norihiko Ikeda

Background: In recent years, as the availability of precision therapies expands, there is increasing reliance on genomic profiling assays to help identify the most appropriate treatment options for patients with advanced cancers. We retrospectively investigated the results of comprehensive genomic profiling tests from the time insurance coverage began until recently and examined the status of genetic analysis.

Methods: We retrospectively reviewed the analysis results of 300 patients with advanced solid tumors who consented to comprehensive genomic profiling tests from October 2019 to December 2022.

Results: Of the 300 patients who underwent comprehensive genomic profiling tests, analysis results for 274 patients were obtained, and were reviewed by the Clinical Genome Expert Panel. Six specimens (2%) were discontinued due to patient deaths and deteriorations in general condition. The three most frequently occurring actionable genomic alterations observed were TP53 (47.4%), KRAS (28.1%) and CDKN2A (20.4%). The most common druggable variant was CDKN2A, which was noted in 52 (19%) of 274 patients. The next most common were PIK3CA, BRAF, KRAS and PTEN. The cancer types that showed a greater median number of actionable alterations comprised thyroid cancer, pancreatic cancer and colorectal cancer.

Conclusions: In conclusion, comprehensive genomic profiling tests have the potential to be valuable in identifying genomic abnormalities. Even if there is no effective treatment at present, it may lead to a treatment in the future. Comprehensive genomic profiling tests should be considered for any cancer.

背景:近年来,随着精准疗法的普及,人们越来越依赖基因组分析检测来帮助晚期癌症患者确定最合适的治疗方案。我们回顾性地调查了从保险覆盖开始到最近的全面基因组分析测试结果,并研究了基因分析的现状:我们回顾性地查看了2019年10月至2022年12月期间同意接受综合基因组图谱检测的300名晚期实体瘤患者的分析结果:在接受全面基因组图谱检测的300名患者中,有274名患者的分析结果已获得临床基因组专家小组的审核。6份样本(2%)因患者死亡或病情恶化而中止。观察到的三种最常见的可操作基因组改变是 TP53(47.4%)、KRAS(28.1%)和 CDKN2A(20.4%)。最常见的可药用变异是 CDKN2A,274 例患者中有 52 例(19%)出现了这种变异。其次是 PIK3CA、BRAF、KRAS 和 PTEN。显示可操作变异中位数较多的癌症类型包括甲状腺癌、胰腺癌和结直肠癌:总之,综合基因组分析测试在识别基因组异常方面具有重要价值。即使目前没有有效的治疗方法,将来也有可能找到治疗方法。任何癌症都应考虑进行全面的基因组分析测试。
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引用次数: 0
Protocol digest of a phase III randomized trial of gross total resection versus possible resection of fluid-attenuated inversion recovery-hyperintense lesion on MRI for newly diagnosed supratentorial glioblastoma: JCOG2209 (FLAMINGO). 对新诊断的脑室上部胶质母细胞瘤进行全切除与可能切除磁共振成像上液体增强反转恢复高密度病灶的 III 期随机试验的方案摘要:JCOG2209 (FLAMINGO)。
IF 2.4 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-17 DOI: 10.1093/jjco/hyae130
Yuta Sekino,Yukihiko Sonoda,Ichiyo Shibahara,Junki Mizusawa,Keita Sasaki,Tetsuya Sekita,Mayumi Ichikawa,Hiroshi Igaki,Manabu Kinoshita,Toshihiro Kumabe,Junji Shibahara,Koichi Ichimura,Yoshiki Arakawa,Haruhiko Fukuda,,Yoshitaka Narita
The goal of surgery for patients with newly diagnosed glioblastoma (GBM) is maximum safe resection of the contrast-enhancing (CE) lesion on magnetic resonance imaging. However, there is no consensus on the efficacy of FLAIRectomy, which is defined as the possible resection of fluid-attenuated inversion recovery (FLAIR)-hyperintense lesions surrounding the CE lesion. Although retrospective analyses suggested the potential benefits of FLAIRectomy, such outcomes have not been confirmed by prospective studies. Therefore, we planned a multicenter, open-label, randomized controlled phase III trial to evaluate the efficacy of FLAIRectomy compared with gross total resection of CE lesions in patients with newly diagnosed GBM. The primary endpoint is overall survival. In total, 130 patients will be enrolled from 47 institutions over 5 years. This trial has been registered at the Japan Registry of Clinical Trials (study number jRCT1031230245).
对新诊断的胶质母细胞瘤(GBM)患者进行手术的目的是最大限度地安全切除磁共振成像中的对比度增强(CE)病灶。然而,FLAIR切除术的疗效尚未达成共识,FLAIR切除术的定义是可能切除CE病灶周围的流体增强反转恢复(FLAIR)高密度病灶。虽然回顾性分析表明了FLAIR切除术的潜在益处,但前瞻性研究尚未证实这种结果。因此,我们计划进行一项多中心、开放标签、随机对照的 III 期试验,以评估在新诊断的 GBM 患者中,FLAIR 切除术与 CE 病灶全切术相比的疗效。主要终点是总生存期。共有来自 47 家机构的 130 名患者将在 5 年内入组。该试验已在日本临床试验注册中心注册(研究编号为 jRCT1031230245)。
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引用次数: 0
COVID-19 in patients receiving treatment at an outpatient chemotherapy unit. 在门诊化疗病房接受治疗的患者中使用 COVID-19。
IF 2.4 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-17 DOI: 10.1093/jjco/hyae129
Shiori Kinoshita,Masashi Takemoto,Minami Asaoka,Yoko Haraguchi,Tamami Adachi,Shinsuke Iida,Hirokazu Komatsu
During the COVID-19 pandemic period, many patients who required outpatient chemotherapy developed COVID-19, requiring chemotherapy interruption. However, there are no clear guidelines regarding the safe timing for restarting chemotherapy. We conducted a retrospective study to assess when such patients can safely recommence chemotherapy. Of the 40 patients included in this study, 34 restarted anticancer drug therapy after COVID-19 infection. Six patients, four with multiple myeloma, and one each with follicular lymphoma and glioma, remained SARS-CoV-2 antigen positive >20 days after COVID-19 onset. Multiple myeloma patients recorded significantly higher frequencies of SARS-CoV-2 antigen positivity >20 days after COVID-19 onset compared with solid tumor patients, with no significant differences in the frequency of SARS-CoV-2 positivity during 5-20 days from COVID-19 onset between them. According to our data, most solid tumor patients achieved SARS-CoV-2 antigen negativity after 20 days from COVID-19 onset. On the other hand, multiple myeloma patients might need serial antigen tests before restarting anticancer therapy in the outpatient chemotherapy setting.
在 COVID-19 大流行期间,许多需要门诊化疗的患者出现了 COVID-19,需要中断化疗。然而,关于重新开始化疗的安全时机,目前还没有明确的指导方针。我们开展了一项回顾性研究,以评估此类患者何时可以安全地重新开始化疗。在纳入本研究的 40 名患者中,有 34 人在感染 COVID-19 后重新开始了抗癌药物治疗。有六名患者(多发性骨髓瘤患者四名,滤泡性淋巴瘤和胶质瘤患者各一名)在 COVID-19 感染后 20 天以上仍为 SARS-CoV-2 抗原阳性。与实体瘤患者相比,多发性骨髓瘤患者在 COVID-19 发病后 20 天内 SARS-CoV-2 抗原阳性的频率明显更高,而他们在 COVID-19 发病后 5-20 天内 SARS-CoV-2 抗原阳性的频率没有明显差异。根据我们的数据,大多数实体瘤患者在 COVID-19 发病 20 天后 SARS-CoV-2 抗原呈阴性。另一方面,多发性骨髓瘤患者在门诊化疗环境中重新开始抗癌治疗前可能需要进行连续的抗原检测。
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引用次数: 0
The effect of epidermal growth factor receptor mutation on adjuvant chemotherapy with tegafur/uracil for patients with completely resected, non-lymph node metastatic non-small cell lung cancer (> 2 cm): a multicenter, retrospective, observational study as exploratory analysis of the CSPOR-LC03 study. 表皮生长因子受体突变对完全切除、非淋巴结转移性非小细胞肺癌(> 2 cm)患者替加氟/脲嘧啶辅助化疗的影响:作为 CSPOR-LC03 研究探索性分析的一项多中心、回顾性、观察性研究。
IF 2.4 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-11 DOI: 10.1093/jjco/hyae073
Tomohiro Miyoshi,Keiju Aokage,Shun-Ichi Watanabe,Hiroyuki Ito,Noriaki Sakakura,Mingyon Mun,Motohiro Yamashita,Yasuhisa Ohde,Tadashi Aoki,Wataru Nishio,Masataka Taguri,Masahiro Tsuboi
BACKGROUNDThe use of adjuvant osimertinib for epidermal growth factor receptor (EGFR) mutants is expected to expand to earlier stage I in the future, potentially competing with the current standard of care, oral tegafur/uracil (UFT), in Japan. However, the effect of EGFR mutation status on the therapeutic effect of UFT remains unclear. This study was conducted as an exploratory analysis of a retrospective observational study that investigated the real-world data of postoperative adjuvant chemotherapy in Japan (CSPOR-LC03).METHODSBetween 2008 and 2013, 1812 patients with completely resected adenocarcinoma diagnosed as pathologic stage I (T1 > 2 cm, TNM classification, sixth edition) who have maintained organ function, and no history of other cancers were included. The primary endpoint was the 5-year disease-free survival (DFS) rate, and we compared this rate between four groups classified based on the administration of adjuvant UFT and EGFR mutation status.RESULTSOf the 933 (51%) patients with EGFR mutations, 394 underwent adjuvant UFT therapy. Of the 879 (49%) patients without EGFR mutations, 393 underwent adjuvant UFT therapy. The 5-year DFS of UFT+/EGFR+ and UFT-/EGFR+ patients were 82.0 and 87.1%, respectively, and those of UFT+/EGFR- and UFT-/EGFR- patients were 80.0 and 86.9%, respectively. DFS was significantly worse in the UFT+ group than in the UFT- group (P = 0.015). Adjuvant UFT therapy was not an independent prognostic factor for DFS, regardless of the EGFR mutation status.CONCLUSIONIn pathologic stage I (>2 cm) lung adenocarcinomas with EGFR mutation, the survival benefit of adjuvant UFT was not observed.
背景在日本,奥希替尼辅助治疗表皮生长因子受体(EGFR)突变体有望扩展到早期I期,有可能与目前的治疗标准--口服替加氟/脲嘧啶(UFT)--形成竞争。然而,表皮生长因子受体突变状态对 UFT 治疗效果的影响仍不清楚。本研究是一项回顾性观察研究的探索性分析,该研究调查了日本术后辅助化疗的真实世界数据(CSPOR-LC03)。方法在2008年至2013年间,纳入了1812例完全切除的腺癌患者,这些患者被诊断为病理分期I期(T1 > 2 cm,TNM分类,第六版),器官功能保持良好,且无其他癌症病史。主要终点是 5 年无病生存率(DFS),我们根据 UFT 辅助治疗和表皮生长因子受体(EGFR)突变状态划分了四个组别,并对这一比率进行了比较。结果 在 933 例(51%)EGFR 突变患者中,394 例接受了 UFT 辅助治疗。在 879 例(49%)未发生表皮生长因子受体突变的患者中,393 例接受了 UFT 辅助治疗。UFT+/EGFR+和UFT-/EGFR+患者的5年DFS分别为82.0%和87.1%,UFT+/EGFR-和UFT-/EGFR-患者的5年DFS分别为80.0%和86.9%。UFT+组的DFS明显差于UFT-组(P = 0.015)。无论EGFR突变状态如何,UFT辅助治疗都不是DFS的独立预后因素。
{"title":"The effect of epidermal growth factor receptor mutation on adjuvant chemotherapy with tegafur/uracil for patients with completely resected, non-lymph node metastatic non-small cell lung cancer (> 2 cm): a multicenter, retrospective, observational study as exploratory analysis of the CSPOR-LC03 study.","authors":"Tomohiro Miyoshi,Keiju Aokage,Shun-Ichi Watanabe,Hiroyuki Ito,Noriaki Sakakura,Mingyon Mun,Motohiro Yamashita,Yasuhisa Ohde,Tadashi Aoki,Wataru Nishio,Masataka Taguri,Masahiro Tsuboi","doi":"10.1093/jjco/hyae073","DOIUrl":"https://doi.org/10.1093/jjco/hyae073","url":null,"abstract":"BACKGROUNDThe use of adjuvant osimertinib for epidermal growth factor receptor (EGFR) mutants is expected to expand to earlier stage I in the future, potentially competing with the current standard of care, oral tegafur/uracil (UFT), in Japan. However, the effect of EGFR mutation status on the therapeutic effect of UFT remains unclear. This study was conducted as an exploratory analysis of a retrospective observational study that investigated the real-world data of postoperative adjuvant chemotherapy in Japan (CSPOR-LC03).METHODSBetween 2008 and 2013, 1812 patients with completely resected adenocarcinoma diagnosed as pathologic stage I (T1 > 2 cm, TNM classification, sixth edition) who have maintained organ function, and no history of other cancers were included. The primary endpoint was the 5-year disease-free survival (DFS) rate, and we compared this rate between four groups classified based on the administration of adjuvant UFT and EGFR mutation status.RESULTSOf the 933 (51%) patients with EGFR mutations, 394 underwent adjuvant UFT therapy. Of the 879 (49%) patients without EGFR mutations, 393 underwent adjuvant UFT therapy. The 5-year DFS of UFT+/EGFR+ and UFT-/EGFR+ patients were 82.0 and 87.1%, respectively, and those of UFT+/EGFR- and UFT-/EGFR- patients were 80.0 and 86.9%, respectively. DFS was significantly worse in the UFT+ group than in the UFT- group (P = 0.015). Adjuvant UFT therapy was not an independent prognostic factor for DFS, regardless of the EGFR mutation status.CONCLUSIONIn pathologic stage I (>2 cm) lung adenocarcinomas with EGFR mutation, the survival benefit of adjuvant UFT was not observed.","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Preoperative prediction of early mortality after surgery for spinal metastases. 脊柱转移手术后早期死亡率的术前预测。
IF 2.4 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-09 DOI: 10.1093/jjco/hyae125
Hiroto Kamoda,Toshinori Tsukanishi,Hideyuki Kinoshita,Yoko Hagiwara,Yuji Endo,Hiroki Takahashi,Kosuke Takeda,Tetsuya Hirashima,Takeshi Ishii,Tsukasa Yonemoto
OBJECTIVEThe objective of this study was to provide a convenient preoperative prediction of the risk of early postoperative mortality.MATERIALS AND METHODSThis retrospective study included patients who underwent surgery for spinal metastasis at our hospital between 2009 and 2021. Preoperative blood test data of all patients were collected, and the survival time was calculated by dividing the blood data. A multivariate analysis was conducted using a Cox proportional hazards model to identify prognostic factors.RESULTSThe study population included 83 patients (average: 64.5 years), 22 of whom died within 3 months. The most common lesion was the thoracic spine, and incomplete paralysis was observed in 57 patients. The surgical methods included posterior implant fixation (n = 17), posterior decompression (n = 31), and posterior decompression with fixation (n = 35). In the univariate analysis, the presence of abnormal values was significantly associated with postoperative survival in six preoperative blood collection items (hemoglobin, C-reactive protein, albumin, white blood cell, gamma-glutamyl transpeptidase, and lactate dehydrogenase). In a multivariate analysis, four test items (hemoglobin, C-reactive protein, white blood cell, and lactate dehydrogenase) were identified as independent prognostic factors.Comparing cases with ≥3 abnormal values among the above four items (high-risk group; n = 23) and those with ≤2 (low-risk group; n = 60), there was a significant difference in survival time. In addition, it was possible to predict cases of early death within 3 months after surgery with 73% sensitivity and 89% specificity.CONCLUSIONSThe study showed that four preoperative blood test abnormalities (hemoglobin, C-reactive protein white blood cell, and lactate dehydrogenase) indicated the possibility of early death within 3 months after surgery.
材料与方法这项回顾性研究纳入了 2009 年至 2021 年期间在我院接受脊柱转移手术的患者。收集所有患者的术前血液检测数据,并通过除以血液数据计算生存时间。结果研究对象包括 83 名患者(平均 64.5 岁),其中 22 人在 3 个月内死亡。最常见的病变部位是胸椎,57名患者出现不完全瘫痪。手术方法包括后路植入固定术(17 例)、后路减压术(31 例)和后路减压加固定术(35 例)。在单变量分析中,术前六项采血指标(血红蛋白、C 反应蛋白、白蛋白、白细胞、γ-谷氨酰转肽酶和乳酸脱氢酶)的异常值与术后存活率显著相关。在多变量分析中,四个检测项目(血红蛋白、C反应蛋白、白细胞和乳酸脱氢酶)被确定为独立的预后因素。将上述四个项目中异常值≥3个的病例(高危组,n = 23)与异常值≤2个的病例(低危组,n = 60)进行比较,生存时间有显著差异。结论该研究表明,术前血液检测的四项异常(血红蛋白、C 反应蛋白白细胞和乳酸脱氢酶)预示着术后 3 个月内早期死亡的可能性。
{"title":"Preoperative prediction of early mortality after surgery for spinal metastases.","authors":"Hiroto Kamoda,Toshinori Tsukanishi,Hideyuki Kinoshita,Yoko Hagiwara,Yuji Endo,Hiroki Takahashi,Kosuke Takeda,Tetsuya Hirashima,Takeshi Ishii,Tsukasa Yonemoto","doi":"10.1093/jjco/hyae125","DOIUrl":"https://doi.org/10.1093/jjco/hyae125","url":null,"abstract":"OBJECTIVEThe objective of this study was to provide a convenient preoperative prediction of the risk of early postoperative mortality.MATERIALS AND METHODSThis retrospective study included patients who underwent surgery for spinal metastasis at our hospital between 2009 and 2021. Preoperative blood test data of all patients were collected, and the survival time was calculated by dividing the blood data. A multivariate analysis was conducted using a Cox proportional hazards model to identify prognostic factors.RESULTSThe study population included 83 patients (average: 64.5 years), 22 of whom died within 3 months. The most common lesion was the thoracic spine, and incomplete paralysis was observed in 57 patients. The surgical methods included posterior implant fixation (n = 17), posterior decompression (n = 31), and posterior decompression with fixation (n = 35). In the univariate analysis, the presence of abnormal values was significantly associated with postoperative survival in six preoperative blood collection items (hemoglobin, C-reactive protein, albumin, white blood cell, gamma-glutamyl transpeptidase, and lactate dehydrogenase). In a multivariate analysis, four test items (hemoglobin, C-reactive protein, white blood cell, and lactate dehydrogenase) were identified as independent prognostic factors.Comparing cases with ≥3 abnormal values among the above four items (high-risk group; n = 23) and those with ≤2 (low-risk group; n = 60), there was a significant difference in survival time. In addition, it was possible to predict cases of early death within 3 months after surgery with 73% sensitivity and 89% specificity.CONCLUSIONSThe study showed that four preoperative blood test abnormalities (hemoglobin, C-reactive protein white blood cell, and lactate dehydrogenase) indicated the possibility of early death within 3 months after surgery.","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142175941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Salvage radiotherapy for locoregional recurrence of esophageal cancer after surgery. 食管癌术后局部复发的挽救性放射治疗。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-06 DOI: 10.1093/jjco/hyae124
Akira Torii, Natsuo Tomita, Taiki Takaoka, Takuhito Kondo, Shintaro Yamamoto, Chikao Sugie, Aiko Nagai, Akifumi Miyakawa, Mayu Kuno, Kaoru Uchiyama, Shinya Otsuka, Yasutaka Ogawa, Seiya Takano, Nozomi Kita, Tatsuya Tanaka, Ryo Ogawa, Eiji Kubota, Shuji Takiguchi, Hiromi Kataoka, Akio Hiwatashi

Objective: There is no consensus on the optimal treatment for patients with locoregional recurrence of esophageal cancer after surgery. The objective of this study was to investigate the outcomes and prognostic factors associated with salvage radiotherapy in patients with locoregional recurrence of esophageal cancer after surgery.

Methods: We reviewed 80 patients with locoregional recurrence of esophageal cancer after surgery who were treated with radiotherapy. The median dose was 60 Gy, and 29 patients (36%) received elective nodal irradiation. Fifty-three patients (66%) received concurrent chemotherapy (mostly 5-fluorouracil and cisplatin) during radiotherapy. Overall survival, progression-free survival and in-field recurrence rate were assessed.

Results: The median follow-up period was 17 months. Two-year overall survival, progression-free survival and in-field recurrence rate were 50.3%, 23.5% and 41.3%, respectively. On multivariate analysis, a maximum diameter of locoregional recurrence lesions <30 mm was associated with higher overall survival (P = 0.044). Disease-free interval between surgery and locoregional recurrence >14 months was associated with higher PFS (P = 0.003). Late grade 3 toxicities occurred in three patients (3.8%). No grade 4 or higher toxicity was observed.

Conclusions: Salvage radiotherapy demonstrated efficacy in achieving in-field control with acceptable toxicity. However, the high rate of out-of-field metastases led to poor progression-free survival and overall survival, particularly in cases involving large lesions and a short disease-free interval. A prospective study is warranted to establish a treatment strategy, particularly considering the combined use of effective anti-cancer drugs.

目的:对于食管癌术后局部复发患者的最佳治疗方法尚未达成共识。本研究旨在探讨食管癌术后局部复发患者接受挽救性放疗的疗效及相关预后因素:我们对80例术后局部复发并接受放疗的食管癌患者进行了回顾性研究。中位剂量为 60 Gy,29 名患者(36%)接受了选择性结节照射。53名患者(66%)在放疗期间同时接受了化疗(主要是5-氟尿嘧啶和顺铂)。对总生存期、无进展生存期和现场复发率进行了评估:中位随访期为 17 个月。结果:中位随访期为 17 个月,两年总生存率、无进展生存率和现场复发率分别为 50.3%、23.5% 和 41.3%。多变量分析显示,局部复发病灶最大直径为14个月与较高的PFS相关(P = 0.003)。3名患者(3.8%)出现了晚期3级毒性反应。未观察到4级或以上毒性:抢救性放疗在实现场内控制和可接受毒性方面表现出疗效。然而,场外转移率较高,导致无进展生存期和总生存期较差,尤其是在涉及大病灶和无病间隔期较短的病例中。有必要进行前瞻性研究,以确定治疗策略,特别是考虑联合使用有效的抗癌药物。
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引用次数: 0
Protocol for a prospective multicenter randomized controlled trial to evaluate the efficacy of texture and color enhancement imaging (TXI) observation in the detection of colorectal lesions (deTXIon study). 评估纹理和颜色增强成像(TXI)观察对检测结直肠病变的疗效的前瞻性多中心随机对照试验(deTXIon 研究)方案。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae063
Yutaka Saito, Naoya Toyoshima, Yasuhiko Mizuguchi, Taku Sakamoto, Toshio Uraoka, Hiroaki Ikematsu, Naoto Tamai, Takahisa Matsuda, Masashi Misawa, Kinichi Hotta, Taro Shibata

Colonoscopy is the gold standard for detecting and resecting adenomas or early stage cancers to reduce the incidence and mortality rates of colorectal cancer. In a recent observational study, texture and color enhancement imaging (TXI) was reported to improve polyp detection during colonoscopy. This randomized controlled trial involving six Japanese institutions aims to confirm the superiority of TXI over standard white-light imaging (WLI) in detecting colorectal lesions during colonoscopy. During the 1-year study period, 960 patients will be enrolled, with 480 patients in the TXI and WLI groups. The primary endpoint is the mean number of adenomas detected per procedure. The secondary endpoints include adenoma detection rate, advanced adenoma detection rate, polyp detection rate, flat polyp detection rate, depressed lesion detection rate, mean polyps detected per procedure, sessile serrated lesion (SSL) detection rate, mean SSLs detected per procedure and adverse events.

结肠镜检查是检测和切除腺瘤或早期癌症以降低结肠直肠癌发病率和死亡率的黄金标准。最近的一项观察性研究显示,纹理和颜色增强成像(TXI)可提高结肠镜检查中息肉的检出率。这项随机对照试验有六家日本医疗机构参与,旨在证实在结肠镜检查期间,纹理和颜色增强成像(TXI)在检测结肠直肠病变方面优于标准白光成像(WLI)。在为期一年的研究期间,将有 960 名患者参加试验,其中 TXI 组和 WLI 组各有 480 名患者。主要终点是每次手术检测到腺瘤的平均数量。次要终点包括腺瘤检出率、晚期腺瘤检出率、息肉检出率、扁平息肉检出率、凹陷病变检出率、每次手术检出的平均息肉数、无柄锯齿状病变(SSL)检出率、每次手术检出的平均锯齿状病变数和不良事件。
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引用次数: 0
Changes in the trends of initial treatment for newly diagnosed prostate cancer in Japan: a nationwide multi-institutional study. 日本新诊断前列腺癌初始治疗趋势的变化:一项全国性多机构研究。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae079
Taketo Kawai, Mizuki Onozawa, Satoru Taguchi, Masaki Shiota, Shinichi Sakamoto, Yoshiyuki Yamamoto, Yasuhide Kitagawa, Tohru Nakagawa, Shiro Hinotsu, Haruki Kume

Background: In previous large-scale studies conducted through 2010, androgen deprivation therapy (ADT) was the most common initial treatment for prostate cancer patients in Japan. However, recent advancements in treatment technologies have significantly affected the management of prostate cancer in Japan. This study analyzed the trends in initial treatments for prostate cancer based on two nationwide surveys.

Methods: Two Japan-wide multi-institutional surveys, J-CaP2010 and J-CaP2016, were conducted to enroll patients newly histologically diagnosed with prostate cancer in 2010 and 2016-18, respectively. Both surveys included age at diagnosis, initial PSA level, ISUP Grade Group, TNM classification, and initial treatment for prostate cancer.

Results: J-CaP2010 included data from 8192 patients across 140 institutions, whereas J-CaP2016 included data from 21 841 patients across 186 institutions. In J-CaP2016, the proportion of radical prostatectomy (RP) and radiation therapy (RT) in the initial treatment increased (from 32% to 36% and 21% to 26%, respectively), whereas the proportion of ADT decreased (from 40% to 29%) compared with those in J-CaP2010. The increase in RP or RT was noticeable in patients aged 75 years and older (from 20% to 38%) and those with high-risk localized cancer (from 58% to 74%) or locally advanced cancer (from 38% to 56%). The proportion of active surveillance or watchful waiting increased in patients with low-risk localized cancer (from 21% to 41%). The proportion of robot-assisted RP within all RPs and the proportion of intensity-modulated RT within all RTs increased remarkably (from 2.3% to 78% and 20% to 50%, respectively).

Conclusions: In Japan, RP and RT have increased as initial treatments for prostate cancer, whereas ADT has decreased. Consequently, RP has emerged as the most commonly selected initial treatment, replacing ADT.

研究背景在 2010 年之前进行的大规模研究中,雄激素剥夺疗法(ADT)是日本前列腺癌患者最常见的初始治疗方法。然而,最近治疗技术的进步对日本前列腺癌的治疗产生了重大影响。本研究根据两项全国性调查分析了前列腺癌初始治疗的趋势:方法:分别于 2010 年和 2016-18 年对新近组织学诊断为前列腺癌的患者进行了两次日本全国多机构调查,即 J-CaP2010 和 J-CaP2016。两项调查均包括诊断时的年龄、初始 PSA 水平、ISUP 分级组、TNM 分类和前列腺癌的初始治疗:J-CaP2010包括来自140家机构的8192名患者的数据,而J-CaP2016包括来自186家机构的21841名患者的数据。与J-CaP2010相比,在J-CaP2016中,初始治疗中根治性前列腺切除术(RP)和放射治疗(RT)的比例有所增加(分别从32%增至36%和21%增至26%),而ADT的比例有所下降(从40%降至29%)。在 75 岁及以上患者(从 20% 增加到 38%)和高危局部癌症患者(从 58% 增加到 74%)或局部晚期癌症患者(从 38% 增加到 56%)中,RP 或 RT 的比例明显增加。在低风险局部癌症患者中,主动监测或观察等待的比例有所增加(从21%增至41%)。在所有 RP 中,机器人辅助 RP 的比例显著增加,在所有 RT 中,强度调节 RT 的比例显著增加(分别从 2.3% 增加到 78%,从 20% 增加到 50%):在日本,RP 和 RT 作为前列腺癌初始治疗方法的比例有所上升,而 ADT 则有所下降。因此,RP已取代ADT,成为最常选择的初始治疗方法。
{"title":"Changes in the trends of initial treatment for newly diagnosed prostate cancer in Japan: a nationwide multi-institutional study.","authors":"Taketo Kawai, Mizuki Onozawa, Satoru Taguchi, Masaki Shiota, Shinichi Sakamoto, Yoshiyuki Yamamoto, Yasuhide Kitagawa, Tohru Nakagawa, Shiro Hinotsu, Haruki Kume","doi":"10.1093/jjco/hyae079","DOIUrl":"10.1093/jjco/hyae079","url":null,"abstract":"<p><strong>Background: </strong>In previous large-scale studies conducted through 2010, androgen deprivation therapy (ADT) was the most common initial treatment for prostate cancer patients in Japan. However, recent advancements in treatment technologies have significantly affected the management of prostate cancer in Japan. This study analyzed the trends in initial treatments for prostate cancer based on two nationwide surveys.</p><p><strong>Methods: </strong>Two Japan-wide multi-institutional surveys, J-CaP2010 and J-CaP2016, were conducted to enroll patients newly histologically diagnosed with prostate cancer in 2010 and 2016-18, respectively. Both surveys included age at diagnosis, initial PSA level, ISUP Grade Group, TNM classification, and initial treatment for prostate cancer.</p><p><strong>Results: </strong>J-CaP2010 included data from 8192 patients across 140 institutions, whereas J-CaP2016 included data from 21 841 patients across 186 institutions. In J-CaP2016, the proportion of radical prostatectomy (RP) and radiation therapy (RT) in the initial treatment increased (from 32% to 36% and 21% to 26%, respectively), whereas the proportion of ADT decreased (from 40% to 29%) compared with those in J-CaP2010. The increase in RP or RT was noticeable in patients aged 75 years and older (from 20% to 38%) and those with high-risk localized cancer (from 58% to 74%) or locally advanced cancer (from 38% to 56%). The proportion of active surveillance or watchful waiting increased in patients with low-risk localized cancer (from 21% to 41%). The proportion of robot-assisted RP within all RPs and the proportion of intensity-modulated RT within all RTs increased remarkably (from 2.3% to 78% and 20% to 50%, respectively).</p><p><strong>Conclusions: </strong>In Japan, RP and RT have increased as initial treatments for prostate cancer, whereas ADT has decreased. Consequently, RP has emerged as the most commonly selected initial treatment, replacing ADT.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cholinesterase as a predictor of skeletal muscle loss after gastrectomy for gastric cancer. 胆碱酯酶是胃癌胃切除术后骨骼肌损失的预测指标。
IF 1.9 4区 医学 Q3 ONCOLOGY Pub Date : 2024-09-04 DOI: 10.1093/jjco/hyae065
Yasuhiro Takano, Wataru Kai, Hironori Kanno, Nobuyoshi Hanyu

Background: Cholinesterase is a classical nutritional and inflammatory marker. The aim of the present study was to evaluate the value of cholinesterase as a predictive marker for postoperative skeletal muscle loss after gastrectomy for gastric cancer.

Methods: The study comprised 68 patients who had undergone gastrectomy for gastric cancer. Skeletal muscle mass was evaluated using skeletal mass index, and major skeletal muscle loss was defined as less than or equal to the median change rate (1-year postoperative/preoperative) of skeletal mass index in all patients. We explored the relationship between postoperative major skeletal muscle loss and disease-free survival and overall survival. Then we investigated the relationship between change rate of skeletal muscle index and serum cholinesterase levels after gastrectomy.

Results: The median value of change rate of skeletal mass index was 0.93. Postoperative major skeletal muscle loss was significantly associated with disease-free survival after gastrectomy (P = 0.003). Although major skeletal muscle loss had worse overall survival, it was not significant (P = 0.058). The change rate of skeletal mass index and cholinesterase had a stronger positive correlation compared with other nutritional indices according to Spearman's rank correlation coefficient (r = 0.438, P ≤ 0.001).

Conclusion: Evaluation of serum cholinesterase levels may be valuable for predicting postoperative skeletal muscle loss after gastrectomy, suggesting the importance of cholinesterase in postoperative nutritional management of patients with gastric cancer.

背景:胆碱酯酶是一种经典的营养和炎症标志物。本研究旨在评估胆碱酯酶作为胃癌胃切除术后骨骼肌损失的预测指标的价值:研究对象包括 68 名接受胃癌胃切除术的患者。使用骨骼质量指数评估骨骼肌质量,所有患者的骨骼质量指数变化率(术后1年/术前)小于或等于中位数即为主要骨骼肌损失。我们探讨了术后主要骨骼肌损失与无病生存率和总生存率之间的关系。然后,我们研究了胃切除术后骨骼肌指数变化率与血清胆碱酯酶水平之间的关系:结果:骨骼肌指数变化率的中位值为 0.93。术后主要骨骼肌损失与胃切除术后无病生存率显著相关(P = 0.003)。虽然大块骨骼肌缺失会降低总生存率,但并不显著(P = 0.058)。根据斯皮尔曼秩相关系数(r = 0.438,P ≤ 0.001),骨骼质量指数和胆碱酯酶的变化率与其他营养指标相比具有更强的正相关性:结论:评估血清胆碱酯酶水平可能对预测胃切除术后骨骼肌损失有价值,这表明胆碱酯酶在胃癌患者术后营养管理中的重要性。
{"title":"Cholinesterase as a predictor of skeletal muscle loss after gastrectomy for gastric cancer.","authors":"Yasuhiro Takano, Wataru Kai, Hironori Kanno, Nobuyoshi Hanyu","doi":"10.1093/jjco/hyae065","DOIUrl":"10.1093/jjco/hyae065","url":null,"abstract":"<p><strong>Background: </strong>Cholinesterase is a classical nutritional and inflammatory marker. The aim of the present study was to evaluate the value of cholinesterase as a predictive marker for postoperative skeletal muscle loss after gastrectomy for gastric cancer.</p><p><strong>Methods: </strong>The study comprised 68 patients who had undergone gastrectomy for gastric cancer. Skeletal muscle mass was evaluated using skeletal mass index, and major skeletal muscle loss was defined as less than or equal to the median change rate (1-year postoperative/preoperative) of skeletal mass index in all patients. We explored the relationship between postoperative major skeletal muscle loss and disease-free survival and overall survival. Then we investigated the relationship between change rate of skeletal muscle index and serum cholinesterase levels after gastrectomy.</p><p><strong>Results: </strong>The median value of change rate of skeletal mass index was 0.93. Postoperative major skeletal muscle loss was significantly associated with disease-free survival after gastrectomy (P = 0.003). Although major skeletal muscle loss had worse overall survival, it was not significant (P = 0.058). The change rate of skeletal mass index and cholinesterase had a stronger positive correlation compared with other nutritional indices according to Spearman's rank correlation coefficient (r = 0.438, P ≤ 0.001).</p><p><strong>Conclusion: </strong>Evaluation of serum cholinesterase levels may be valuable for predicting postoperative skeletal muscle loss after gastrectomy, suggesting the importance of cholinesterase in postoperative nutritional management of patients with gastric cancer.</p>","PeriodicalId":14656,"journal":{"name":"Japanese journal of clinical oncology","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Japanese journal of clinical oncology
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