Showing papers by "Tadahiro Takada published in 1996"

[Prospective randomized trial comparing 1/2 FAM (5-fluorouracil (5-FU) + adriamycin + mitomycin C) versus palliative therapy for the treatment of unresectable pancreatic and biliary tract carcinomas (the 2nd trial in non-resectable patients). Japanese Study Group of Surgical Adjuvant Therapy for Carcinomas of the Pancreas and Biliary Tract].

Abstract: The efficacy of 1/2 FAM, which consists of 5-fluorouracil (5-FU), adriamycin (ADM) and mitomycin C (MMC), was compared with that of palliative treatment in patients with unresectable pancreatic and biliary tract carcinomas in a multicenter randomized trial. The patients assigned to 1/2 FAM group were treated with 5-FU 200 mg/m2/day IV, ADM 15 mg/m2/day IV and MMC 5 mg/m2/day IV. These 3 drugs were given concurrently as the initial dose within a week after palliative operation, and this regimen was repeated for at least 2 whole courses, at 4-week intervals before the next course of therapy. Those randomized to the control group were subjected to palliative treatment alone. Completely eligible for analysis were 42 cases of the 1/2 FAM group and 41 of the control group. There was no significant difference between the groups with respect to the overall and differentiated survival times according to the tumor sites and the clinical efficacy. As for the duration of 50% inhibition of tumor progression, a significantly better outcome was obtained in 1/2 FAM group. Tumor progression was most significantly inhibited in patients with gallbladder carcinoma. In 1/2 FAM group, tumor reduction was achieved in 1 CR and 2 PR patients. The most frequent adverse reaction was gastrointestinal manifestations, along with diarrhea and alopecia. 1/2 FAM did not contribute to the life prolongation, but inhibited the tumor progression for a significantly longer duration and, to a lesser extent, reduced the tumor size in unresectable pancreatic and biliary tract carcinomas. This regimen is suggested to be useful particularly in the treatment of the latter carcinoma.

Postprandial plasma secretin response in Whipple‐treated patients

Abstract: We hypothesize that the presence of a few secretin-releasing cells sited in the upper jejunum may provoke a postprandial secretin response to meal loading in patients who have undergone the Whipple procedure. This procedure involves gastrectomy and total duodenectomy and requires gastrointestinal tract reconstruction by one of three methods: (i) choledocho-pancreatico-gastro alignment (PD-1), (ii) pancreatico-choledocho-gastro alignment (PD-2) (both these methods excluding the upper jejunum from the route of food passage), or (iii) gastro-pancreatico-choledocho alignment (PD-3), in which food passes through the upper jejunum. Fasting and postprandial plasma secretin and gastrin response were measured in 47 Whipple-treated patients, 16 given a PD-1, 15 given a PD-2, and 16 given a PD-3, and in 15 healthy controls. Plasma secretin response and integrated secretin release were higher, but not significantly, in the PD-3 group, and lower in all three Whipple-treated groups than in the control (P<0.05). Plasma gastrin concentration showed no significant increase in any of the three treated groups and was significantly lower than in the controls (P<0.05). The integrated gastrin release also did not differ among the treated groups and was lower than in the controls (P<0.05). Twenty-four-h monitoring showed that the gastric pH was neutral or alkaline in all three treated groups. The failure to prove our hypothesis may be due to the presence of too few secretin-releasing cells in the upper jejunum to respond to the meal loading and/or to the intragastric pH not being sufficiently acidic to stimulate those secretin-releasing cells present in the upper jejunum.