研究者詳細 - 田中　信悟

論文 - 田中　信悟

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Phase II study of S-1, docetaxel and cisplatin combination chemotherapy in patients with unresectable metastatic gastric cancer

Yasushi Sato, Tetsuji Takayama, Tamotsu Sagawa, Yasuo Takahashi, Hiroyuki Ohnuma, Syunichi Okubo, Naoaki Shintani, Shingo Tanaka, Masaya Kida, Yasuhiro Sato, Hidetoshi Ohta, Koji Miyanishi, Tsutomu Sato, Rishu Takimoto, Masayoshi Kobune, Koji Yamaguchi, Koichi Hirata, Yoshiro Niitsu, Junji Kato

CANCER CHEMOTHERAPY AND PHARMACOLOGY ( SPRINGER ) 66 ( 4 ) 721 - 728 2010年09月 [査読有り] [国際誌]

We evaluated the activity and toxicity of docetaxel, cisplatin, and S-1 (DCS) combination chemotherapy in patients with unresectable metastatic gastric cancer. Patients with histologically proven, unresectable metastatic gastric adenocarcinoma, performance status (PS) 0-2, and no prior chemotherapy were eligible. Patients received oral S-1 (40 mg/m(2) b.i.d.) on days 1-14 and intravenous cisplatin (60 mg/m(2)) and docetaxel (60 mg/m(2)) on day 8 every 3 weeks. Thirty-four patients were enrolled between March 2005 and April 2007. Three patients were considered ineligible and did not receive the DSC therapy. Clinical characteristics were as follows: median age, 63 years (range, 44-77); PS, 0/1/2: 23/8/0; women/men, 8/23; and well-differentiated/undifferentiated adenocarcinoma, 10/21. The objective response rate was 87.1% with 1 complete response (3.2%) and 26 partial responses (83.9%) in 31 assessable patients. Four had stable disease (12.9%) but none had progressive disease. Of these 27 responders, 8 (25.8%) achieved downstaging and 7 (22.6%) underwent curative surgery. The median survival time and progression-free survival were 687 days [confidence interval (95% CI), 600.0-1,138.1] and 226 days (95% CI, 182.5-379.3), respectively. Most common grade 3/4 hematologic toxicity was neutropenia (77.4%). Most common grade 3 nonhematologic toxicities included anorexia (35.5%) and nausea (32.3%). All treatment-related toxicities resolved, and no toxic deaths were observed. DCS combination chemotherapy is highly active against unresectable metastatic gastric cancer and can be given safely with proper management of adverse events. Further studies of this combination are warranted.

DOI PubMed

脂肪性肝疾患の頻度に及ぼすアルコール摂取の影響

土居忠, 田中信悟, 佐藤康裕, 太田英敏, 南伸弥, 藤見章仁, 蟹澤祐司, 田村文人, 平川昌宏, 小野薫

肝臓 ( (一社)日本肝臓学会 ) 51 ( 9 ) 501 - 507 2010年

脂肪性肝疾患(FLD)の発生に及ぼすアルコール摂取の影響には不明な点が残されている。今回我々は2008年1月から12月までに腹部超音波検査を含む健康診断を受診した3185名を対象に脂肪肝の頻度に対するアルコール摂取の影響を多重ロジスティック回帰分析により解析した。内臓脂肪性肥満、空腹時高血糖、脂質異常症はいずれも脂肪肝頻度の増加と関連していた。1日アルコール摂取量20g未満(少量飲酒群)、20g以上から40g未満(軽度飲酒群)および40g以上から60g未満(中等度飲酒群)では脂肪肝のオッズ比は有意に低下した。男女別に飲酒の影響を検討したところ、男性では軽度飲酒群から中等度飲酒群におけるFLDの調整オッズ比は非飲酒群および1日アルコール摂取量60g以上の多量飲酒群より低かった。一方、女性ではアルコール摂取の影響は明らかでなかった。以上の結果からFLDに及ぼす飲酒の影響には性差があり、男性では軽度ないし中等度までのアルコール摂取は過栄養性FLDの発生を抑制する可能性が示唆された。(著者抄録)

DOI

Adenocarcinoma of Meckel's diverticulum diagnosed by capsule endoscopy and single-balloon enteroscopy

Yasuhiro Sato, Shingo Tanaka, Yutaku Ko, Toshinori Okuda, Fumito Tamura, Akihito Fujimi, Tadashi Doi, Yuji Kanisawa, Hidetoshi Ohta

Clinical Journal of Gastroenterology 2 ( 6 ) 388 - 393 2009年12月 [査読有り] [国内誌]

A case of adenocarcinoma arising in Meckel's diverticulum in a 58-year-old man is reported. Abdominal computed tomography and ultrasonography showed a solid tumor in the middle of abdomen. Capsule endoscopy (CE) showed tumorous lesion in the distal ileum. Single-balloon enteroscopy (SBE) subsequently showed the tumor in Meckel's diverticulum. Furthermore, biopsy specimen obtained from the lesion revealed it as adenocarcinoma. At laparotomy, we found the tumor at the blind end of the diverticulum and enlarged lymph node about 7 cm in diameter in the small intestinal mesentery. Segmental resection of the ileum, including the tumor-bearing diverticulum, was performed along with regional lymph node dissection. Histologically, origin of the tumor was assumed to be ectopic gastric mucosa. Although neoplasm in Meckel's diverticulum is difficult to diagnose preoperatively, the combination of CE and SBE was useful. Based on our search, this is thought to be the first case of neoplasm in Meckel's diverticulum diagnosed endoscopically. © 2009 Springer.

DOI PubMed

A case of early esophageal adenocarcinoma arising from esophageal cardiac glands

Yutaku Ko, Yasuhiro Sato, Shingo Tanaka, Toshinori Okuda, Akihito Fujimi, Tadashi Doi, Yuji Kanisawa, Kazuhiro Iwai, Hidetoshi Ohta

Journal of Japanese Society of Gastroenterology 106 ( 9 ) 1327 - 1333 2009年09月 [査読有り]

A 54-year-old man was referred to our hospital with an esophageal lesion. On esophagogastroduodenoscopy a pedunculated elevated lesion about 15mm in diameter was identified in the abdominal esophagus. The surface of the lesion had irregular nodules with white coating. We found no Barrett's mucosa around the lesion. A biopsy specimen of this tumor showed well-differentiated adenocarcinoma. A lower esophagus-proximal gastrectomy was performed because this tumor was suspected to invade the submucosal layer. Eventually, the histological diagnosis after resection was esophageal adenocarcinoma arising from cardiac glands, limited to the mucosal layer (M2). This origin of the esophageal adenocarcinoma is rare. Furthermore, this form of the tumor is especially unusual, and there have been few reports of similar cases.

DOI PubMed

[Spontaneous pneumothorax, an unusual manifestation of imatinib-resistant chronic eosinophilic leukemia: an autopsy study].

Fujimi A, Kanisawa Y, Tanaka S, Okuda T, Sato Y, Doi T, Ohta H, Iwasaki S, Ishizu A, Huang Y

Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine ( The Japanese Society of Internal Medicine ) 98 ( 4 ) 862 - 865 2009年04月 [査読有り]

近年，FIP1L1/PDGFRα融合遺伝子（FP遺伝子）陽性の慢性好酸球性白血病（chronic eosinophilic leukemia；CEL）に対するimatinib（IM）の有効性が示され，治療成績は著しく改善しているが長期予後には不明な点も多い．今回，我々はIMに耐性化し終末期に自然気胸を併発したCEL症例を経験した．剖検で好酸球の肺胞への高度の浸潤およびその近傍の線維化，気腫化が確認され，CELの進行が肺実質の破壊をきたし気胸の原因となったと推定された．

DOI PubMed CiNii

ダブルバルーン小腸内視鏡にて除去しえた小腸内異物の3例

佐川保, 高山哲治, 佐藤康史, 高橋祥, 田中信悟, 小笹里砂, 井山諭, 黒田裕行, 加藤淳二, 新津洋司郎

Gastroenterological Endoscopy ( (一社)日本消化器内視鏡学会 ) 50 ( 10 ) 2684 - 2690 2008年10月

症例1(60歳男性)。日曜大工で釘を誤飲し受診となった。X線では胃内に釘が確認され、内視鏡で摘出を試みたが、釘は胃内になく空腸以降に移動しており、経口的ダブルバルーン小腸内視鏡(DBE)で下部空腸に釘を認め、回収した。症例2(35歳男性)。10年前に過敏性腸症候群の診断を受け、4年前より腸閉塞症状を繰り返し、前医で慢性特発性偽性腸閉塞(CIIP)と診断された。腸管内圧減圧目的に胃瘻の造設、イレウス管の留置がされたものの、今回、イレウス管が断裂し内視鏡での摘出が困難なため、著者らの施設へ紹介受診となった。X線およびCTでは小腸内に断裂したイレウス管が認められ、経口的DBEにて下部空腸内のイレウス管を回収した。症例3(78歳女性)。11年前に回腸狭窄による腸閉塞で回腸部分切除術が行われ、数年前より腹部膨満感が続いていた。著者らの施設へ紹介受診となり、内視鏡ならびにガストログラフィン造影を行なったところ回腸に7cmの狭窄が認められた。更にこの狭窄部を経口的DBEで調べたところPTPが見つかり、これを回収ネットにて回収した。

DOI

[Two cases of advanced gastric cancer in which paclitaxel proved effective after resistance to docetaxel].

Tsushima T, Tsuji Y, Abe S, Tanaka S, Tamura F, Mizushima T, Makino K, Oura K, Honda K, Sumiyoshi T, Yoshizaki N, Kondo H

Gan to kagaku ryoho. Cancer & chemotherapy 34 ( 10 ) 1647 - 1650 2007年10月 [査読有り] [国内誌]

Docetaxel and paclitaxel are demonstrated to be effective for use as salvage therapy for advanced gastric cancer. Both drugs are taxane derivatives but there is only partial cross-resistance between them. For breast cancer and ovarian cancer, there have been several reports that showed docetaxel is effective for paclitaxel-resistant cancer, and vice versa. We experienced two cases of advanced gastric cancer effectively treated by sequential therapy of docetaxel and paclitaxel. One patient was a 43-year-old woman with a type 4 gastric carcinoma, and the other a 51-year-old woman who had suffered a recurrence of the gastric cancer after a total gastrectomy. At first, chemotherapy failed, so we chose docetaxel/high-dose 5-FU (HDFU) for the second-line therapy. After resistance to Docetaxel/HDFU, paclitaxel was effective for third-line treatment of both patients.

PubMed

[Feasibility of modified FOLFIRI regimen for patients with refractory advanced or recurrent colorectal cancer].

Takahari D, Tsuji Y, Tanaka S, Tsushima T, Ohura K, Honda K, Sumiyoshi T, Yoshizaki N, Kondo H

Gan to kagaku ryoho. Cancer & chemotherapy 34 ( 2 ) 207 - 211 2007年02月 [査読有り]

PubMed

[Gastric relapse of stage I ocular adnexal mucosa-associated lymphoid tissue lymphoma].

Sato T, Takimoto R, Iyama S, Ono K, Tanaka S, Araki N, Nishiie K, Murase K, Sato Y, Kobune M, Matsunaga T, Kato J, Niitsu Y

[Rinsho ketsueki] The Japanese journal of clinical hematology ( 一般社団法人日本血液学会 ) 48 ( 1 ) 56 - 60 2007年01月 [査読有り] [国内誌]

症例は57歳，男性。右涙腺に原発するmucosa-associated lymphoid tissue lymphoma (MALT lymphoma)に対し，局所への放射線照射が施行された。その際の胃内視鏡検査では胃粘膜に軽度の炎症性変化が指摘され，ウレアーゼテストが陽性であったため，ピロリ菌の除菌療法が施行された。その2年後，再び胃内視鏡検査を施行したところ，MALTリンパ腫病変が検出された。涙腺病変と胃病変のIgH遺伝子をサザン法で検索したところ，全く同一の再構成パターンが得られた。このため，ピロリ菌感染による慢性炎症を母地とした異所性発癌ではなく，原発巣の胃転移と考えた。また，涙腺MALTリンパ腫のリンパ腫細胞は，リンパ球が消化管粘膜へ接着する際に必須であるintegrin α4β7を高発現していたため，この接着分子が胃転移に重要な働きをした可能性があると考えられた。

DOI PubMed CiNii

[Present status of home therapy cancer patients using an infusor].

Tsuji Y, Tsushima T, Tanaka S, Mizushima T, Tamura F, Chiba H, Honda K, Makino K, Ohura K, Sumiyoshi T, Yoshizaki N, Kondo H

Gan to kagaku ryoho. Cancer & chemotherapy 33 Suppl 2 260 - 263 2006年12月 [査読有り] [国内誌]

We started a department of medical oncology and the risk management system of cancer chemotherapy since April in 2004. After that, chemotherapy administration increased steadily in numbers, especially on an outpatient basis. For reliable venous access, we made active use of a central venous Port (more than 60% of cases) as a rout of administration. Fifty five patients with advanced colorectal cancer were treated by FOLFIRI or FOLFOX regimen from April 2005 to June 2006. Two hundred sixty four cycles of FOLFIRI and 276 cycles of FOLFOX were administered. One hundred sixteen cycles (44%) and 117 cycles (42%) were performed through home therapy, respectively. Twenty five out of 55 patients could shift to home therapy using an infusor. Nine out of 30 patients wanted to continue on an inpatient basis, because their private insurance for medical care did not support the outpatient chemotherapy.

PubMed

[Peripheral T-cell lymphoma presenting with eosinophilia due to interleukin-5 produced by lymphoma cells].

Matsunaga T, Sato T, Iyama S, Tanaka S, Murase K, Sato Y, Kobune M, Takimoto R, Kato J, Kuroda H, Niitsu Y

[Rinsho ketsueki] The Japanese journal of clinical hematology ( The Japanese Society of Hematology ) 47 ( 11 ) 1457 - 1462 2006年11月 [査読有り] [国内誌]

症例は72歳, 男性。頸部リンパ節腫脹の精査を目的に入院し, リンパ節生検の結果から, 末梢性T細胞性リンパ腫 (peripheral T cell lymphoma; PTCL) と診断した。著明な好酸球増多を認めたため, 血清Interleukin-5 (IL-5) を測定したところ高値を示した。また, 生検したリンパ節組織の免疫染色ではIL-5陽性の細胞が散見された。CHOP療法を2クール施行したところ, 腫大したリンパ節は消失し, 好酸球数は正常となった。また, これにともない血清IL-5も正常化した。PTCLでは稀に好酸球増多を合併すると報告されているが, 本症例では腫瘍細胞由来のIL-5が原因と推測された。

DOI PubMed CiNii

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