Browsing by Author "Inoue, T."

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Narrow-band Imaging for Detection of Neoplasia at Colonoscopy: a Meta-analysis of Data From Individual Patients in Randomized Controlled Trials
    (Elsevier, 2019) Atkinson, N. S. S.; Ket, S.; Bassett, P.; Aponte, D.; De Aguiar, S.; Gupta, N.; Horimatsu, T.; Ikematsu, H.; Inoue, T.; Kaltenbach, T.; Leung, W. K.; Matsuda, T.; Paggi, S.; Radaelli, F.; Rastogi, A.; Rex, D. K.; Sabbagh, L. C.; Saito, Y.; Sano, Y.; Saracco, G. M.; Saunders, B. P.; Senore, C.; Soetiko, R.; Vemulapalli, K. C.; Jairath, V.; East, J. E.; Medicine, School of Medicine
    Background & Aims Adenoma detection rate (ADR) is an important quality assurance measure for colonoscopy. Some studies suggest that narrow band imaging (NBI) may be more effective at detection of adenomas than white-light endoscopy (WLE) when bowel preparation is optimal. We conducted a meta-analysis of data from individual patients in randomized controlled trials that compared the efficacy of NBI to WLE in detection of adenomas. Methods We searched MEDLINE, EMBASE, and Cochrane library databases, through April 2017, for randomized controlled trials that assessed detection of colon polyps by high-definition WLE vs NBI and from which data on individual patients was available. The primary outcome measure was ADR adjusted for bowel preparation quality. Multilevel regression models were used with patients nested within trials, and trial included as a random effect. Results We collected data from 11 trials, comprising 4491 patients and 6636 polyps detected. Adenomas were detected in 952/2251 (42.3%) participants examined by WLE vs 1011/2239 (45.2%) participants examined by NBI (unadjusted odds ratio [OR] for detection of adenoma by WLE vs NBI, 1.14; 95% CI, 1.01–1.29; P=.04). NBI outperformed WLE only when bowel preparation was best: adequate preparation OR, 1.07 (95% CI, 0.92–1.24; P=.38) vs best preparation OR, 1.30 (95% CI, 1.04–1.62; P=.02). Second-generation bright NBI had a better ADR than WLE (second-generation NBI OR, 1.28; 95% CI, 1.05–1.56; P=.02), whereas first-generation NBI did not. NBI detected more non-adenomatous polyps than WLE (OR, 1.24; 95% CI, 1.06–1.44; P=.008) and flat polyps than WLE (OR, 1.24; 95% CI, 1.02–1.51; P=.03). Conclusions In a meta-analysis of data from individual patients in randomized controlled trials, we found NBI to have a higher ADR than WLE, and that this effect is greater when bowel preparation is optimal.
  • Thumbnail Image
    Item
    Objective tumor response to denosumab in patients with giant cell tumor of bone: a multicenter phase II trial
    (Oxford University Press, 2015-10) Ueda, T.; Morioka, H.; Kakunaga, S.; Tsuchiya, H.; Matsumoto, Y.; Asami, Y.; Inoue, T.; Yoneda, T.; Department of Medicine, IU School of Medicine
    BACKGROUND: Giant cell tumor of bone (GCTB) is a rare primary bone tumor, characterized by osteoclast-like giant cells that express receptor activator of nuclear factor-kappa B (RANK), and stromal cells that express RANK ligand (RANKL), a key mediator of osteoclast activation. A RANKL-specific inhibitor, denosumab, was predicted to reduce osteolysis and control disease progression in patients with GCTB. PATIENTS AND METHODS: Seventeen patients with GCTB were enrolled. Patients were treated with denosumab at 120 mg every 4 weeks, with a loading dose of 120 mg on days 8 and 15. To evaluate efficacy, objective tumor response was evaluated prospectively by an independent imaging facility on the basis of prespecified criteria. RESULTS: The proportion of patients with an objective tumor response was 88% based on best response using any tumor response criteria. The proportion of patients with an objective tumor response using individual response criteria was 35% based on the modified Response Evaluation Criteria in Solid Tumors (RECIST) criteria, 82% based on the modified European Organization for Research and Treatment of Cancer (EORTC) criteria, and 71% based on inverse Choi criteria. The median time of study treatment was 13.1 months. CONCLUSION: The findings demonstrate that denosumab has robust clinical efficacy in the treatment of GCTB.