Albumin-Bilirubin Score Predicts Tolerability to Adjuvant S-1 Monotherapy after Curative Gastrectomy

Miwa, Takashi,Kanda, Mitsuro,Tanaka, Chie,Kobayashi, Daisuke,Hayashi, Masamichi,Yamada, Suguru,Nakayama, Goro,Koike, Masahiko,Kodera, Yasuhiro The Korean Gastric Cancer Association 2019 Journal of gastric cancer Vol.19 No.2

Purpose: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. Materials and Methods: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. Results: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08-20.1; cutoff value, -2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69-7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33-45.8; P=0.002). Conclusions: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.

Albumin-Bilirubin Score Predicts Tolerability to Adjuvant S-1 Monotherapy after Curative Gastrectomy

Takashi Miwa,Mitsuro Kanda,Chie Tanaka,Daisuke Kobayashi,Masamichi Hayashi,Suguru Yamada,Goro Nakayama,Masahiko Koike,Yasuhiro Kodera 대한위암학회 2019 Journal of gastric cancer Vol.19 No.2

Purpose: Due to adverse events, dose reduction or withdrawal of adjuvant chemotherapy is required for some patients. To identify the predictive factors for tolerability to postoperative adjuvant S-1 monotherapy in gastric cancer (GC) patients, we evaluated the predictive values of blood indicators. Materials and Methods: We analyzed 98 patients with pStage II/III GC who underwent postoperative adjuvant S-1 monotherapy. We retrospectively analyzed correlations between 14 parameters obtained from perioperative routine blood tests to assess their influence on the withdrawal of postoperative adjuvant S-1 monotherapy, within 6 months after discontinuation. Results: Postoperative adjuvant chemotherapy was discontinued in 21 patients (21.4%) within 6 months. Univariable analysis revealed that high preoperative albumin-bilirubin (ALBI) scores had the highest odds ratio (OR) for predicting the failure of adjuvant S-1 chemotherapy (OR, 6.47; 95% confidence interval [CI], 2.08–20.1; cutoff value, –2.696). The high ALBI group had a significantly shorter time to failure of postoperative adjuvant S-1monotherapy (hazard ratio, 3.48; 95% CI, 1.69–7.25; P=0.001). Multivariable analysis identified high preoperative ALBI score as an independent prognostic factor for tolerability (OR, 10.3; 95% CI, 2.33–45.8; P=0.002). Conclusions: Preoperative ALBI shows promise as an indicator associated with the tolerability of adjuvant S-1 monotherapy in patients with pStage II/III GC.

Halitosis Patients at a Newly Established Satellite Dental Hospital: Analysis of Patients and the Role of Dental Hygienists

Masahiro Yoneda,Miwa Yamada,Nao Suzuki,Rie Uemura,Akie Fujimoto,Yosuke Masuo,Hirofumi Fukuchi,Hiromitsu Morita,Kazuhiko Yamada,Tadayuki Matsuo,Ayako Ishii,Chihiro Koga,Takao Hirofuji 대한예방치과학회 2015 International Journal of Clinical Preventive Denti Vol.11 No.1

Objective: Fukuoka Dental College established a satellite clinic, the Center for Oral Diseases (COD), in December 2011. In this study, we analyzed halitosis patients and the role of dental hygienists. Methods: Approximately 70% of the patients were female and most were in their 40s. We analyzed the possible causes of halitosis. Results: More than half of the patients exhibited a thick tongue coating. Low salivary flow was present in 23.6% of males and in 39.4% of females. Pocket depth ≥6 mm was found in 44.2% of males and in 16.7% of females. We also analyzed treatment provided after breath odor measurement. Most of the patients with physiological halitosis and pseudohalitosis did not receive further treatment, but some were treated at the COD with scaling and professional tooth cleaning. Many of the patients with genuine halitosis received dental treatment at the COD. We referred patients from other clinics and from distant locations to their local doctors for treatment. Conclusion: Halitosis had various causes, and the role of dental hygienists, including scaling, root planing, and tooth brushing instruction, are important in decreasing breath odor. Dental hygienists play an important role in communication with halitosis patients.

Impact of rituximab and half-dose CHOP as primary therapy for untreated symptomatic Waldenström Macroglobulinemia: review of a combined regimen of rituximab with an alkylating agent

Naohiro Sekiguchi,Airi Hamano,Tomoko Kitagawa,Yuya Kurihara,Kenichi Ito,Miwa Kurimoto,Kozo Watanabe,Kazuhiko Hirano,Satoshi Noto,Kazuaki Yamada,Naoki Takezako 대한혈액학회 2018 Blood Research Vol.53 No.2

Background Waldenström Macroglobulinemia (WM) is a rare subtype of indolent B-cell lymphoma, and prospective randomized studies on WM are scarce. The R-CHOP therapy [rituximab (R), cyclophosphamide, hydroxy-doxorubicin, vincristine, and prednisone] is a popular and recommended regimen for primary therapy, prescribed by several treatment guide-lines for WM. However, treatment with R-CHOP is accompanied by severe myelosup-pression and high rates of peripheral neuropathy. Therefore, we retrospectively evaluated the efficacy and toxicity of half-dose CHOP combined with R as a primary therapy for WM. Methods Patients with untreated symptomatic WM, treated at the Disaster Medical Center be-tween April 2011 and September 2016, were retrospectively analyzed after admin-istration of 6 cycles of half-dose R-CHOP for every 3 weeks. The response, median time to response, best response, progression-free survival, overall survival, and toxicities were evaluated. Results Of the 20 WM patients analyzed, 16 (80%) received half-dose R-CHOP without vincris-tine, and 13 (65%) responded to the treatment. With a median follow-up duration of 26.3 months, the 2-year progression-free survival and 2-year overall survival rates were 70 and 93.3%, respectively. The median time to response and best response were 6 and 9.9 weeks, respectively. Grade 3/4 leukocytopenia, neutropenia, febrile neutropenia, and Grade 1 peripheral neuropathy developed in 32, 37, 0, and 21% of patients, respectively. Conclusion The half-dose R-CHOP is an effective and well-tolerated primary therapy for WM. To the best of our knowledge, this is the first study reporting the use of a reduced-dose R-CHOP regimen for the primary treatment of WM.

Impact of rituximab and half-dose CHOP as primary therapy for untreated symptomatic Waldenström Macroglobulinemia: review of a combined regimen of rituximab with an alkylating agent

Naohiro Sekiguchi,Airi Hamano,Tomoko Kitagawa,Yuya Kurihara,Kenichi Ito,Miwa Kurimoto,Kozo Watanabe,Kazuhiko Hirano,Satoshi Noto,Kazuaki Yamada,Naoki Takezako 대한혈액학회 2018 Blood Research Vol.53 No.2

Background Waldenström Macroglobulinemia (WM) is a rare subtype of indolent B-cell lymphoma, and prospective randomized studies on WM are scarce. The R-CHOP therapy [rituximab (R), cyclophosphamide, hydroxy-doxorubicin, vincristine, and prednisone] is a popular and recommended regimen for primary therapy, prescribed by several treatment guide-lines for WM. However, treatment with R-CHOP is accompanied by severe myelosup-pression and high rates of peripheral neuropathy. Therefore, we retrospectively evaluated the efficacy and toxicity of half-dose CHOP combined with R as a primary therapy for WM. Methods Patients with untreated symptomatic WM, treated at the Disaster Medical Center be-tween April 2011 and September 2016, were retrospectively analyzed after admin-istration of 6 cycles of half-dose R-CHOP for every 3 weeks. The response, median time to response, best response, progression-free survival, overall survival, and toxicities were evaluated. Results Of the 20 WM patients analyzed, 16 (80%) received half-dose R-CHOP without vincris-tine, and 13 (65%) responded to the treatment. With a median follow-up duration of 26.3 months, the 2-year progression-free survival and 2-year overall survival rates were 70 and 93.3%, respectively. The median time to response and best response were 6 and 9.9 weeks, respectively. Grade 3/4 leukocytopenia, neutropenia, febrile neutropenia, and Grade 1 peripheral neuropathy developed in 32, 37, 0, and 21% of patients, respectively. Conclusion The half-dose R-CHOP is an effective and well-tolerated primary therapy for WM. To the best of our knowledge, this is the first study reporting the use of a reduced-dose R-CHOP regimen for the primary treatment of WM.