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• Efficacy and Safety of Sitafloxacin in Treating Low-risk Febrile Neutropenia in Patients with Lung Cancer.

  On R, Matsumoto T, Ebi N, Doi S, Ishii H, Furugen M, Fujita J, Ide M, Kishimoto J, Okamoto I, Fujita M, Lung Oncology Group in Kyushu (LOGIK)

  JMA journal ( 公益社団法人 日本医師会 / 日本医学会 )  5 ( 3 ) 334 - 340   2022.07 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  <p><b>Introduction:</b> Febrile episodes in patients with cancer and chemotherapy-induced neutropenia can be life-threatening and generally require prompt administration of broad-spectrum antimicrobials. However, little evidence exists for treating patients with solid tumors and febrile neutropenia (FN) with oral antimicrobials.</p><p><b>Methods:</b> In this prospective study, we aimed to determine the efficacy and safety of sitafloxacin (STFX) for treating FN in lung cancer patients. In this prospective study, low-risk FN patients with lung cancer received STFX. The primary endpoint was response rate, defined as 5 sequential days of absence of fever without adverse events. The study was registered as UMIN000010911.</p><p><b>Results:</b> As a result, STFX was administered to 26 patients, all of whom survived during its administration. Of the 26, 14 completed primary endpoint (53.85%). The low response rate was attributed to occurrence of fevers of unknown cause rather than failure of FN treatment. Only two patients received antibacterial agents other than STFX. If response rate omitted absence of fever and been defined only as recovery from FN without changing microbial agents or serious complications, the response rate would have been 91.67%. Adverse events occurred in eight patients, none of which were serious.</p><p><b>Conclusions:</b> In conclusion, STFX might be used to treat low-risk FN in patients with lung cancer; however, a more detailed study will be required in future.</p>

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• A long-term survivor keeping in a complete response without treatment after pemetrexed maintenance therapy for advanced non-squamous non-small cell lung cancer.

  Makoto Furugen, Daisuke Shibahara, Tomo Kiyuna, Wakaki Kami, Kazuya Miyagi, Shusaku Haranaga, Toru Kubota, Hirofumi Matsumoto, Naoki Yoshimi, Jiro Fujita

  Clinical case reports   9 ( 2 ) 927 - 931   2021.02 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Pemetrexed has significant efficacy for some non-squamous non-small cell lung cancer cases, as demonstrated in the current case. For those patients, pemetrexed administration should be carefully considered.

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• Hypertrophic pulmonary osteoarthropathy due to lung cancer: A case report and literature review.

  Shinzato A, Kinjo T, Miyagi T, Yamazato S, Kaneku K, Nishiyama M, Miyagi K, Furugen M, Fujita J

  Clinical case reports ( Clinical Case Reports )  8 ( 12 ) 3510 - 3514   2020.12 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Hypertrophic pulmonary osteoarthropathy (HPOA) is a rare paraneoplastic syndrome. Our literature review shows the location of arthralgia and existence of edema are referable information for the differential diagnosis in paraneoplastic arthralgia.

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• Radiation-induced sarcoma in a 10-year survivor with stage IV EGFR-mutated lung adenocarcinoma.

  Shibahara D, Furugen M, Kasashima S, Kaneku K, Yamashiro T, Arakaki W, Ariga T, Atsumi E, Aoyama H, Matsumoto H, Maehara H, Fujita J

  Respiratory medicine case reports ( Respiratory Medicine Case Reports )  28   100889 - 100889   2019 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  A 70-year-old Japanese man with stage IV EGFR-mutated lung adenocarcinoma complained of right mild back pain. The patient had been heavily treated with several cytotoxic or molecular targeted agents for 10 years and received a palliative radiation therapy of 2nd sacral vertebra 5 years ago. Computed tomography showed the abnormal lesion in right iliopsoas muscle. A pathological examination confirmed undifferentiated pleomorphic sarcoma, consistent with the diagnosis of radiation-induced sarcoma (RIS). Since RIS is a rare late-onset complication of radiation therapy, to our knowledge, this is the first report of RIS that was associated with advanced lung cancer and detected after palliative radiation therapy. The careful long-term follow-up is thus necessary even after palliative radiation therapy and we have to be aware of the existence of RIS.

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• Do infections with disseminated <i>Mycobacterium avium</i> complex precede sweet's syndrome? A case report and literature review.

  Hibiya K, Miyagi K, Tamayose M, Nabeya D, Kinjo T, Takeshima S, Ikemiyagi N, Yamada K, Fujita A, Hashioka H, Kami W, Inamine M, Shibahara D, Nakamura H, Furugen M, Haranaga S, Higa F, Tateyama M, Fujita J

  International journal of mycobacteriology   6 ( 4 ) 336 - 343   2017.10 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Sweet's syndrome is reportedly associated with preceding nontuberculous mycobacterial infections (NTMIs). Here, we report on a systemic Mycobacterium intracellulare infection in a patient on corticoid therapy for Sweet's syndrome. Literature searches show that 69.1% of patients with Sweet's syndrome and NTMIs developed this syndrome later than NTMIs and 89.3% of them developed during the clinical course of a rapidly growing mycobacterial infection. The residual cases were associated with slow-growing mycobacteria (14.3%), but only three cases of Mycobacterium avium complex (MAC) infections before the onset of Sweet's syndrome have been reported, and all of them were caused by disseminated MAC disease. One of these cases developed during corticoid therapy for Sweet's syndrome, while another case had underlying diabetes mellitus. Hence, the occurrence of systemic MAC disease may be an inevitable consequence of long-term steroid use and underlying diseases. Literature searches also show that cervical lymphadenitis was a predominant symptom in NTMIs (90.5%). The present case did not have cervical lymphadenitis although the previously reported MAC cases did experience it. Therefore, lymphadenitis from NTMIs may be related to the pathogenesis of Sweet's syndrome. Hence, should a patient have systemic infection without lymphadenitis, it will be more difficult to clinically confirm that MAC disease is a predisposing factor for Sweet's syndrome.

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