Public Library of Science (PLoS)Acta Medica Okayama1932-62032132026Incidence of pelvic fractures after definitive radiotherapy for cervical cancer: A retrospective multicenter cohort study (The IPFAR study)e0344384ENShinsukeShirakawaDepartment of Obstetrics and Gynecology, Okayama UniversityShojiNagaoDepartment of Obstetrics and Gynecology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityKotaroYoshioDepartment of Radiology, Okayama UniversityToshiharuMitsuhashiCenter for Innovative Clinical Medicine, Okayama UniversityNoriakiImafukuDepartment of Obstetrics and Gynecology, Fukuyama Medical CenterDanYamamotoDepartment of Obstetrics and Gynecology, Fukuyama Medical CenterMasaeYorimitsuDepartment of Obstetrics and Gynecology, Hiroshima City Hiroshima Citizens HospitalJunichiKodamaDepartment of Obstetrics and Gynecology, Hiroshima City Hiroshima Citizens HospitalHisakoNagasakaDepartment of Obstetrics and Gynecology, Kagawa Prefectural Central HospitalYoshieNakanishiDepartment of Obstetrics and Gynecology, Kagawa Prefectural Central HospitalHisashiMasuyamaDepartment of Obstetrics and Gynecology, Okayama UniversityObjective<br>
This multicenter study aimed to identify the risk factors for pelvic insufficiency fractures (PIFs) in women who received definitive radiotherapy (RT) as the initial treatment for cervical cancer and to examine the differences in the incidence of PIFs across institutions.<br>
Patients and Methods
The medical records of 208 women were reviewed. These women received definitive RT as an initial treatment for cervical cancer at four institutions between January 2016 and December 2018.<br>
Results<br>
The median age was 61.5 years (range: 29–93 years). Overall, 59 patients (28.4%) developed PIF, with 48 (81.4%) of them developing it within two years after completion of RT. Multivariate analysis identified postmenopausal status and treating institution as independent risk factors. The incidence of PIF varied significantly among institutions, ranging from 18.9% to 50.0%, despite no significant differences in patient demographics or RT protocols.<br>
Conclusion<br>
Substantial inter-institutional variation in PIF incidence was observed, even under standardized treatment conditions. These findings underscore the need for individualized risk assessment and institutional quality control in the long-term management of cervical cancer survivors.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6612012The Pretreatment of Maximum Standardized Uptake Values (SUVmax) of the Primary Tumor Is Predictor for Poor Prognosis for Patients with Epithelial Ovarian Cancer5360ENKeiichiroNakamuraAtsushiHongoJunichiKodamaYujiHiramatsuOriginal Article10.18926/AMO/48081The purpose of this study was to evaluate prognostic factors for epithelial ovarian cancer. We found that the pretreatment values of maximum standardized uptake (SUVmax) of the primary tumor by positron emission tomography/computed tomography (PET/CT), tumor marker CA125 and C-reactive protein (CRP) were correlated with clinical characteristics and prognosis for such patients. The clinical parameters and prognoses and their correlations with SUVmax of primary tumor, CA125 and CRP were examined for 51 patients with primary ovarian cancer. The SUVmax of the primary tumor had a statistically significant association with stage (p＝0.010) and histology (p＝0.001). CA125 was significant associated with stage (p＝0.011), histology (p＝0.005) and lymph node metastasis (p＝0.025). CRP was also significantly associated with stage (p＝0.049). Disease-free survival rates of patients exhibiting a high SUVmax, CA125 and CRP were significantly lower than those exhibiting a low SUVmax, CA125 and CRP levels (p＝0.008, 0.034, and 0.037, respectively). Furthermore, overall survival rates of patients exhibiting a high SUVmax were significantly lower than those exhibiting a low SUVmax (p＝0.049).The high SUVmax of primary tumor is an important factor for identifying ovarian cancer patients with a predictor for poor prognosis.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5612002Neoadjuvant treatment with docetaxel and the effects of irradiation for human ovarian adenocarcinoma and cervical squamous cell carcinoma in vitro.1318ENShinakoArakiYasunariMiyagiKunihiroKawanishiJunkoYamamotoAtsushiHongoJunichiKodamaMitsuoYoshinouchiTakafumiKudoArticle10.18926/AMO/31723<p>The in vitro radiosensitizing effects of docetaxel have been reported, but the DNA damage caused by the irradiation after docetaxel exposure has not been investigated. In this study, the authors attempted to evaluate the radiosensitizing effects in terms of cell survival and DNA single-strand breaks in a human ovarian adenocarcinoma cell line (known as line BG-1) and a human cervical squamous cell carcinoma cell line (known as line SiHa). The cell lines were exposed to various concentrations of docetaxel (from 2.27 x 10(-3) to 2.27 microg/ml) to investigate the cytocidal effects by colony-formation assay. DNA single-strand breaks after exposure to 2.27 microg/ml of docetaxel for 30 min or 100 min were measured by the alkaline-elution assay. The remarkable cytotoxicity of docetaxel followed by irradiation was observed when concentrations were greater than 2.27 x 10(-2) microg/ml in both cell lines. The combination of docetaxel and irradiation appears to be supraadditive. The DNA single-strand breaks induced by the irradiation were enhanced in both cell lines (BG-1; P < 0.01, SiHa; P < 0.05). The synergistic cytocidal effect cannot be explained quantitatively only by the single-strand breaks.
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No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5351999Effect of cisplatin on cell death and DNA crosslinking in rat mammary. Adenocarcinoma in vitro.201208ENJunkoYamamotoYasunariMiyagiKunihiroKawanishiShinakoYamadaYujiMiyagiJunichiKodamaMitsuoYoshinouchiTakafumiKudoArticle10.18926/AMO/31635<p>The pharmacodynamic effects of cisdiamminedichloroplatinum(II) (CDDP) in vitro have been reported, but the dosage and exposure time in vitro have not been based on clinical observations of the drug's actions in vivo. In this study, the authors attempted to evaluate the pharmacodynamic effects of CDDP in vitro in terms of cell survival and DNA crosslinking by simulating unbound CDDP administration at varying concentrations to a rat mammary adenocarcinoma line (known as line 66). CDDP exposure was conducted by both constant concentration procedures and a simulated in vivo procedure. Colony formation assay for the surviving fraction and alkaline elution assay for DNA crosslink measurement were performed in order to evaluate the pharmacodynamics of CDDP. Cell survival was a function of the area under the drug concentration time curve (AUC) of unbound CDDP (R2 = 0.77, P < 0.002) for all drug exposure procedures as analyzed by the analysis of covariance test. There was a strong correlation between the surviving fraction and the crosslink index of the total amount of DNA crosslinks (R2 = 0.85, P < 0.0005). Both the total amount of DNA-DNA crosslinks and the DNA-protein crosslinks, of which the latter were dominant, were affected not by the exposure procedures, but by the AUC value (P < 0.002). The thresholds of cytocidal effect were 1.59 mg.h/l for the AUC and 0.008 for the crosslink index. The pharmacodynamic effects in vitro by simulated in vivo exposure were identical to those of constant.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X4851994Immunohistochemical analysis of P-glycoprotein expression in diverse histological types of epithelial ovarian tumors.249255ENJunichiKodamaRyojiHayaseMitsuoYoshinouchiHiroyukiOkudaTakafumiKudoArticle10.18926/AMO/31116<p>P-glycoprotein is a transmembrane protein which acts as an energy-dependent drug efflux pump for a variety of anti-cancer drugs. The mdr-1 gene which encodes P-glycoprotein was successfully cloned in 1986. To investigate P-glycoprotein expression in diverse ovarian tumors, including benign, low malignant potential and malignant, immunohistochemical study was done using a monoclonal antibody (C 219). Overall, 8 out of the 59 epithelial ovarian tumors (13.6%) expressed P-glycoprotein. It was noted that 5 of the 12 mucinous tumors were found to express P-glycoprotein, while none of the 31 serous tumors were immunohistochemically positive. In 10 malignant ovarian tumors, P-glycoprotein immunostaining was examined both prior to and after chemotherapy. Nine of them did not express any P-glycoprotein before or after chemotherapy. However, one tumor expressed P-glycoprotein after six courses of multidrug resistance-related drug administration. These findings indicate that P-glycoprotein expression is not so common in ovarian tumors, regardless of their malignant potential. Nevertheless, the results suggest a strong association between P-glycoprotein expression and certain histological cell types in epithelial ovarian tumors. It is also possible that P-glycoprotein appears as a result of chemotherapy, but such a phenomenon can not occur unless chemotherapy is administered at high doses for a long period of time.</p>
No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X6242008Immunohistochemical Evaluation of Insulin-like Growth Factor I Receptor Status in Cervical Cancer Specimens251259ENHiroyukiKuramotoAtsushiHongoYi-xuanLiuYojiroOjimaKeiichiroNakamuraNorikoSekiJunichiKodamaYujiHiramatsuOriginal Article10.18926/AMO/30944<p>The insulin-like growth factor I receptor (IGF-IR) is exceptionally overexpressed in many cervicalcancer-derived cell lines. It is postulated that a decrease of p53 protein levels due to human papillomavirus (HPV) infection may contribute to the up-regulation of IGF-IR expression in cervical cancer cells because transcription of IGF-IR is strictly down-regulated by p53. To evaluate this fact in clinical cervical cancer specimens, we checked the expression levels and activated status of IGF-IR by immunohistochemistry. Formalin-fixed and paraffin-embedded specimens obtained by conization or hysterectomy were stained with anti-IGF-IR and with an antibody recognizing phosphorylated tyrosine at its c-terminus. The expression levels of IGF-IR were significantly high in cervical intraepithelial neoplasia (CIN) III and invasive cancer specimens. Phosphorylation of IGF-IR was promoted in all CIN and invasive cancer specimens, and its intensity was related to the promotion of lesions. Interestingly, IGF-IR overexpression was missing in the basal layer of CIN I and II lesions, whereas it was evenly distributed in CIN III and invasive cancer lesions. This IGF-IR overexpression pattern may be utilized in the diagnosis of HPV infection status in CIN lesions.</p>No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030155812012008Ⅶ 卵巣癌・子宮体癌・子宮頸癌の標準的治療6975ENJunichiKodamaNo potential conflict of interest relevant to this article was reported.Acta Medica Okayama1995婦人科腫瘍におけるP糖蛋白質の発現とその意義ENNo potential conflict of interest relevant to this article was reported.