It is a big problem to cope with elderly patients who are increasing in a community in Niigata which has already been heavily populated by those people over 65 years of age. Aging is not a disease. However, the actual situation of patients with hematological and solid tumors in the aging community is little known. In this communication, we analyzed 293 patients (AML/ALL: 52, NHL: 112, MDS: 75, MM: 40, and others: 14) and 127 dead with hematological malignancies treated in our hospital for the past 10 years or 80 to clarify the actual changes in the trend of patients with hematological malignancies and compared them with those of patients who died of solid tumors. The population movements over the last 20 years in the Kashiwazaki area were also studied.Our analysis showed that the number of patients who died of solid tumors increased (1.6 times) in step with the increases in the aged population for there 20 years in the Kashiwazaki area. In addition, the incidence of gastric cancer markedly decreased for the past 20 years, while that of colorectal cancer rapidly increased (5 times). The incidence of hematological malignancies also increased with its peak shiftted to the latter haf of the 7th decade of age for the past 10 years. In addition to the increased incidence, patients with NHL and MDS increased in number by 1.5 times over the last 10 years. Especially, patients with MM showed an increase of 3 times, while the incidence of AML was not changed, even decreasing in number.In conclusion, the incidence of hematological malignancies as well as solid tumors has steadily been increasing with the increases in the aged population in the Kashiwazaki area, and the number of the aged patients over 70 years of age also increased. Such aged patients, however, are not available for hematopoietic stem cell transplantation. Therefore, it is urgently necessary for us to cope with the increases in the number of aged patients with hematological malignancies.
Malignant Neoplasms ; incidence of cases ; seconds ; Solid tumor ; Aging

PURPOSE: Renal cell carcinoma (RCC) and melanoma have been considered ‘radioresistant’ due to the fact that they do not respond to conventionally fractionated radiation therapy. Stereotactic radiosurgery (SRS) provides high-dose radiation to a defined target volume and a limited number of studies have suggested the potential effectiveness of SRS in radioresistant histologies. We sought to determine the effectiveness of SRS for the treatment of patients with radioresistant brain metastases.MATERIALS AND METHODS: We performed a retrospective review of our institutional database to identify patients with RCC or melanoma brain metastases treated with SRS. Treatment response were determined in accordance with the Response Evaluation Criteria in Solid Tumors.RESULTS: We identified 53 radioresistant brain metastases (28% RCC and 72% melanoma) treated in 18 patients. The mean target volume and coverage was 6.2 ± 9.5 mL and 95.5% ± 2.9%, respectively. The mean prescription dose was 20 ± 4.9 Gy. Forty lesions (75%) demonstrated a complete/partial response and 13 lesions (24%) with progressive/stable disease. Smaller target volume (p < 0.001), larger SRS dose (p < 0.001), and coverage (p = 0.008) were found to be positive predictors of complete response to SRS.CONCLUSION: SRS is an effective management option with up to 75% response rate for radioresistant brain metastases. Tumor volume and radiation dose are predictors of response and can be used to guide the decision-making for patients with radioresistant brain metastases.
Brain ; Carcinoma, Renal Cell ; Humans ; Melanoma ; Neoplasm Metastasis ; Prescriptions ; Radiosurgery ; Response Evaluation Criteria in Solid Tumors ; Retrospective Studies ; Tumor Burden

Oncology is a rapidly evolving field with a shift toward personalized cancer treatment. The use of therapies targeted to the molecular features of individual tumors and the tumor microenvironment has become much more common. In this review, anti-angiogenic and other molecular targeted therapies are discussed, with a focus on typical and atypical response patterns and imaging manifestations of drug toxicities.
Drug-Related Side Effects and Adverse Reactions ; Humans ; Molecular Targeted Therapy* ; Receptor, Epidermal Growth Factor ; Response Evaluation Criteria in Solid Tumors ; Tumor Microenvironment ; Vascular Endothelial Growth Factor A

Buschke-Lowenstein tumor(BLT) is a rare sexually transmitted disease triggered by human papillomavirus type 6 or 11. It presents as an anogenital exophytic tumor characterized by its size, local infiltration, high recurrence rate and risk of malignant transformation to squamous cell carcinoma. A 45-year-old heterosexual male presented with a 22-year history of slow-growing, multiple, dark brown, verrucous, exophytic nodules and plaques over the trunk, extremities, inguinal and gluteal areas. Two years prior to consult, there was coalescence of lower abdominal plaques with rapid growth of a pinkish cauliflower-like tumor. Pelvic MRI showed that the tumor was limited to the skin. Biopsy of the lower abdominal mass was consistent with BLT and positive for HPV DNA. There was no internal organ involvement or metastasis. Pulsed dye and erbium:YAG lasers were done on the gluteal area test sites followed by wide excision and split-thickness skin graft of the lower abdominal and pubic area.

Human ; Male ; Middle Aged ; Biopsy ; Brassica ; Buschke-lowenstein Tumor ; Carcinoma, Squamous Cell ; Dna ; Erbium ; Heterosexuality ; Human Papillomavirus 6 ; Lasers, Solid-state ; Papillomavirus Infections ; Torso

PURPOSE: To explore the feasibility of maximum diameter as a response assessment method for vestibular schwannomas (VS) after stereotactic radiosurgery or fractionated stereotactic radiotherapy (RT), we analyzed the concordance of RT responses between maximum diameters and volumetric measurements. MATERIALS AND METHODS: Forty-two patients receiving curative stereotactic radiosurgery or fractionated stereotactic RT for VS were analyzed retrospectively. Twelve patients were excluded: 4 did not receive follow-up magnetic resonance imaging (MRI) scans and 8 had initial MRI scans with a slice thickness >3 mm. The maximum diameter, tumor volume (TV), and enhanced tumor volume (ETV) were measured in each MRI study. The percent change after RT was evaluated according to the measurement methods and their concordances were calculated with the Pearson correlation. The response classifications were determined by the assessment modalities, and their agreement was analyzed with Cohen kappa statistics. RESULTS: Median follow-up was 31.0 months (range, 3.5 to 86.5 months), and 90 follow-up MRI studies were analyzed. The percent change of maximum diameter correlated strongly with TV and ETV (r(p) = 0.85, 0.63, p = 0.000, respectively). Concordance of responses between the Response Evaluation Criteria in Solid Tumors (RECIST) using the maximum diameters and either TV or ETV were moderate (kappa = 0.58; 95% confidence interval, 0.32-0.85) or fair (kappa = 0.32; 95% confidence interval, 0.05-0.59), respectively. CONCLUSION: The percent changes in maximum diameter and the responses in RECIST were significantly concordant with those in the volumetric measurements. Therefore, the maximum diameters can be used for the response evaluation of VS following stereotactic RT.
Classification ; Follow-Up Studies ; Humans ; Magnetic Resonance Imaging ; Methods ; Neuroma, Acoustic ; Radiosurgery ; Radiotherapy ; Response Evaluation Criteria in Solid Tumors ; Retrospective Studies ; Tumor Burden

Since sorafenib was introduced in 2007 for treating advanced hepatocellular carcinoma (HCC), 15 patients have achieved a complete response (CR) in advanced HCC. However, only four of these reports can be regarded as real CRs involving adequate assessments including imaging, serum tumor markers, and histologic examinations of completely resected specimens. A 54-year-old man with hepatitis C virus (HCV)-related liver cirrhosis (LC) presented to our unit. A CT scan demonstrated a 3.8-cm arterial hypervascular/portal-washout mass in the right lobe and invasion in the right portal vein. Twelve weeks after beginning sorafenib therapy, the AFP level was normalized and a CT scan showed a prominent decrease in the hepatic mass and a significant decrease in the volume of portal vein thrombosis (PVT). The patient received a right liver hemihepatectomy after 12 months. No viable tumor cells were found in the resected specimen, and there was no thrombotic obstruction of the portal vein. Twelve months later the patient showed no clinical evidence of HCC recurrence. This is the first case of CR in HCC treatment following sorafenib with histologically confirmed HCV-related HCC without LC evidence, HCC with PVT, and a follow-up of longer than 12 months. This case seems to be an extremely unusual clinical outcome in advanced HCC.
Biomarkers, Tumor ; Carcinoma, Hepatocellular* ; Follow-Up Studies ; Hepacivirus ; Hepatitis C ; Humans ; Liver ; Liver Cirrhosis ; Middle Aged ; Portal Vein ; Recurrence ; Response Evaluation Criteria in Solid Tumors ; Tomography, X-Ray Computed ; Venous Thrombosis

OBJECTIVETo synthesize a tumor-targeting cell-penetrating peptide (CPP) and evaluate its biological activity and cytotoxicity in vitro.

METHODSWith fluorenylmethyloxycarbonyl (Fmoc) as the protective group of α-amino acid, the tumor-targeting CPP were synthesized with stepwise amino acid extension using solid-phase synthesis method. 5-carboxytetramethylrhodamine was added for fluorescence labeling in the presence of the coupling agents HATU and DMF. The purity of the CPP was measured by high-performance liquid chromatography and its molecular weight measured by mass spectrometry. Fluorescence microscope was used to assess the cell-penetrating activity?of the CPP in hepatocellular carcinoma cell lines SMMC-7721 and normal hepatocellular cell lines LO2. The growth activity of CPP-treated SMMC-7721 cells was measured by MTT assay.

RESULTSWith a purity of 96.05% and a relative molecular mass of 3504.9, the synthesized CPP showed no translocation activity in normal hepatocellular cell lines LO2, but showed strong ability to translocate into SMMC-7721 cells without affecting the biological activity of the cells.

CONCLUSIONUsing Fmoc solid-phase synthesis method, we have successfully synthesized the CPP with tumor-targeting activity.

Cell Line, Tumor ; Cell-Penetrating Peptides ; chemical synthesis ; pharmacology ; Drug Delivery Systems ; Drug Design ; Humans ; Liver Neoplasms ; drug therapy ; metabolism ; pathology ; Matrix Metalloproteinase 2 ; metabolism ; Rhodamines ; chemistry ; Solid-Phase Synthesis Techniques

To investigate the angiotensin I-converting enzyme (ACE) inhibitory activity of beta-chain hemoglobin fragments, 17 fragments were synthesized by microwave-assisted solid-phase synthesis method. Wang resin or Trt(2-Cl) resin, Fmoc and HBTU-HOBt were used as solid carrier, N-terminal amino acid protecting groups and coupling reagents, respectively. The ACE inhibitory, alpha-glucosidase inhibitory, antibacterial and antitumor activities of the synthesized fragments were assayed. In vitro, Val-Val-Tyr-Pro-Trp-Thr showed high ACE inhibitory activity (IC50 = 7.42 micromol x L(-1)). The results indicate that there are two active sites in Val-Val-Tyr-Pro-Trp-Thr-Gln-Arg-Phe, one consists of Val-Val-, and the other -Gln-Arg-Phe. Peptides showed high ACE inhibitory activity when the N-terminal was hydrophobic amino acid such as Val and C-terminal tripeptide contained Phe, Trp or Arg. Some of the fragments showed low a-glucosidase inhibitory activity. No antibacterial activity or antitumor activity was detected in vitro. The results indicate that these peptides have a potential antihypertensive effect and possible application in the treatment of hypertension.
Amino Acid Sequence ; Angiotensin-Converting Enzyme Inhibitors ; pharmacology ; Anti-Bacterial Agents ; pharmacology ; Antihypertensive Agents ; pharmacology ; Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Glycoside Hydrolase Inhibitors ; Humans ; Peptide Fragments ; chemical synthesis ; chemistry ; pharmacology ; Peptidyl-Dipeptidase A ; drug effects ; Solid-Phase Synthesis Techniques ; methods ; alpha-Glucosidases ; drug effects ; beta-Globins ; chemical synthesis ; chemistry ; pharmacology