1.The feasibility of women in medicine and acupuncture
Journal of the Japan Society of Acupuncture and Moxibustion 2019;69(4):246-253
Japan has faced problems of declining birth rate and aging. Acupuncture has gained popularity among the various complementary medicines available and many go privately to have acupuncture while undergoing in vitro fertilization(IVF). Although acupuncture has gained increasing popularity in the management of infertility, its effectiveness has remained controversial.Whether it is benetifical in terms of improvimg the live birth rate in IVF still remains subject to further well constructed randomized controlled studies. Obesity, defined as an excess of body fat, is a growing public health crisis that is associated with the development of many disorders, including type 2 diabetes and cardiovascular disease . Menopause causes a deterioration of lipid metabolism and increases the tendency to obesity. Ovariectomized mice have been used to study changes in postmenopause metabolism and reported to gain weight due to changes in lipid metabolism, as do menopausal women. Alzheimer's disease is associated with the unprecedented aging tendency in our world population and has become a significant health issue. In addition to a rapid acceleration of the aging progress, Alzheimer's disease is a severe affliction in patients and a heavy burden on their families and society. Prevention of obesity and Alzheimer's disease becomes a largest matter of concern not only for medicine but also for health economics.We conclude that the partnership between acupuncture and conventional medicine is an effective treatment for obesity and Alzheimer's disease.
2.A phase II, open-labeled, single-arm study of dose-dense paclitaxel plus carboplatin in advanced or recurrent uterine endometrial cancer treatment: a KCOG-G1303, DOENCA trial
Kensuke HORI ; Shin NISHIO ; Kimio USHIJIMA ; Yuka KASAMATSU ; Eiji KONDO ; Kazuhiro TAKEHARA ; Kimihiko ITO
Journal of Gynecologic Oncology 2021;32(4):e64-
Objective:
To determine the safety and efficacy of dose-dense (dd) paclitaxel (PTX) and carboplatin (CBDCA) in treating advanced or recurrent endometrial cancer.
Methods:
Women aged 20–75 years with histologically confirmed endometrial cancer, the International Federation of Gynecology and Obstetrics (FIGO) stage III disease with some residual tumor, FIGO stage IV disease, recurrence after front-line curative treatment, or recurrence after second-line chemotherapy or radiotherapy were enrolled in this study. PTX (80 mg/m2) was administered intravenously (IV) to every participant on days 1, 8, and 15, and CBDCA (area under the curve of 5) was administered IV on day 1 once every 3 weeks until the disease progressed, unacceptable adverse events occurred, or consent was withdrawn. The primary endpoint was the response rate (RR), while the secondary endpoints were progression-free survival, overall survival, and adverse effects.
Results:
Forty-eight participants were enrolled, and 46 were eligible to receive treatment. The patients' median age was 61 years (range, 43–76 years). Twenty-two participants had experienced recurrence, and the remaining patients had primary advanced endometrial cancer. There were 10 cases of serous carcinoma, 3 cases of endometrioid carcinoma G3, 2 cases of carcinosarcoma, and 2 cases of clear-cell carcinoma according to histology. Twenty-nine participants (63.0%) received ≥6 cycles of chemotherapy. The RR (complete, 13 cases; partial, 20 cases) was 71.3% (95% confidence interval: 59.0%–84.5%).
Conclusion
The dd PTX with CBDCA is feasible and available as a treatment option for advanced or recurrent endometrial cancer.
3.Randomized phase III trial comparing pegylated liposomal doxorubicin (PLD) at 50 mg/m2 versus 40 mg/m2 in patients with platinum-refractory and -resistant ovarian carcinoma:the JGOG 3018 Trial
Takashi MOTOHASHI ; Akira YABUNO ; Hiroshi MICHIMAE ; Tetsuro OHISHI ; Miwa NONAKA ; Masashi TAKANO ; Shin NISHIO ; Hiroyuki FUJIWARA ; Keiichi KEIICHI ; Eiji KONDO ; Toru SUGIYAMA ; Tsutomu TABATA
Journal of Gynecologic Oncology 2021;32(1):e9-
Objective:
The standard dose for pegylated liposomal doxorubicin (PLD) is 50 mg/m2 every 4 weeks. While 40 mg/m2 has recently been used in clinical practice, evidence supporting this use remains lacking.
Methods:
This phase III randomized, non-inferiority study compared progressionfree survival (PFS) for patients with platinum-resistant ovarian carcinoma between an experimental arm (40 mg/m2 PLD) and a standard arm (50 mg/m2 PLD) until 10 courses, disease progression or unacceptable toxicity. Eligible patients had received ≤2 prior lines.Stratification was by performance status and PFS of prior chemotherapy (<3 months versus ≥3 months). The primary endpoint was PFS and secondary endpoints were overall survival (OS), toxicity profile, clinical response and tolerability. The total number of patients was 470.
Results:
The trial was prematurely closed due to slow recruitment, with 272 patients randomized to the experimental arm (n=137) and standard arm (n=135). Final analysis was performed with 234 deaths and 269 events for PFS. In the experimental arm vs. standard arm, median PFS was 4.0 months vs. 4.0 months (hazard ratio [HR]=1.065; 95% confidence interval [CI]=0.830–1.366) and median OS was 14.0 months vs. 14.0 months (HR=1.078; 95% CI=0.831–1.397). Hematologic toxicity and oral cavity mucositis (≥grade 2) were more frequent in the standard arm than in the experimental arm, but no difference was seen in ≥grade 2 hand-foot skin reaction.
Conclusion
Non-inferiority of 2 PLD dosing schedule was not confirmed because the trial was closed prematurely. However, recommendation of dose reduction of PLD should be based both on efficacy and safety.