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Nishioka K, Takahashi S, Mori T, Uchinami Y, Yamaguchi S, Kinoshita M, Yamashina M, Higaki H, Maebayashi K, Aoyama H. The need of radiotherapy optimization for glioblastomas considering immune responses. Jpn J Radiol 2023; 41:1062-1071. [PMID: 37071249 PMCID: PMC10543135 DOI: 10.1007/s11604-023-01434-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/10/2023] [Indexed: 04/19/2023]
Abstract
Glioblastoma is the most common of malignant primary brain tumors and one of the tumors with the poorest prognosis for which the overall survival rate has not significantly improved despite recent advances in treatment techniques and therapeutic drugs. Since the emergence of immune checkpoint inhibitors, the immune response to tumors has attracted increasing attention. Treatments affecting the immune system have been attempted for various tumors, including glioblastomas, but little has been shown to be effective. It has been found that the reason for this is that glioblastomas have a high ability to evade attacks from the immune system, and that the lymphocyte depletion associated with treatment can reduce its immune function. Currently, research to elucidate the resistance of glioblastomas to the immune system and development of new immunotherapies are being vigorously carried out. Targeting of radiation therapy for glioblastomas varies among guidelines and clinical trials. Based on early reports, target definitions with wide margins are common, but there are also reports that narrowing the margins does not make a significant difference in treatment outcome. It has also been suggested that a large number of lymphocytes in the blood are irradiated by the irradiation treatment to a wide area in a large number of fractionations, which may reduce the immune function, and the blood is being recognized as an organ at risk. Recently, a randomized phase II trial comparing two types of target definition in radiotherapy for glioblastomas was conducted, and it was reported that the overall survival and progression-free survival were significantly better in a small irradiation field group. We review recent findings on the immune response and the immunotherapy to glioblastomas and the novel role of radiotherapy and propose the need to develop an optimal radiotherapy that takes radiation effects on the immune function into account.
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Affiliation(s)
- Kentaro Nishioka
- Department of Radiation Oncology, Hokkaido University Hospital, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan.
| | - Shuhei Takahashi
- Department of Radiation Oncology, Hokkaido University Hospital, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Takashi Mori
- Department of Radiation Oncology, Hokkaido University Hospital, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Yusuke Uchinami
- Department of Radiation Oncology, Hokkaido University Hospital, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Shigeru Yamaguchi
- Department of Neurosurgery, Hokkaido University Hospital, Sapporo, Hokkaido, Japan
| | - Manabu Kinoshita
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Masaaki Yamashina
- Department of Radiology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Hajime Higaki
- Department of Radiation Oncology, Hokkaido University Hospital, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
| | - Katsuya Maebayashi
- Division of Radiation Oncology, Nippon Medical School Hospital, Tokyo, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Hokkaido University Hospital, North-15, West-7, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan
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Mikami E, Nakamichi S, Nagano A, Misawa K, Hayashi A, Tozuka T, Takano N, Noro R, Maebayashi K, Kubokura H, Terasaki Y, Kubota K, Seike M. Successful Treatment with Definitive Concurrent Chemoradiotherapy Followed by Durvalumab Maintenance Therapy in a Patient with Tracheal Adenoid Cystic Carcinoma. Intern Med 2023; 62:2731-2735. [PMID: 36642523 PMCID: PMC10569923 DOI: 10.2169/internalmedicine.1142-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/04/2022] [Indexed: 01/15/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare type of malignant tracheal tumor originating from the secretory glands. Complete surgical resection is the current standard of care for tracheal ACC. However, there have been few case reports of chemoradiotherapy for unresectable tracheal ACC. We herein report a 28-year-old man with unresectable tracheal ACC who received concurrent chemoradiotherapy (CCRT) followed by maintenance therapy with durvalumab. CCRT was completed with a good response and safety, and the patient is currently receiving durvalumab as maintenance therapy. Durvalumab after CCRT can be a treatment option for patients with unresectable tracheal ACC.
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Affiliation(s)
- Erika Mikami
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Shinji Nakamichi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Atsuhiro Nagano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Kazuhito Misawa
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Anna Hayashi
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Takehiro Tozuka
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Natsuki Takano
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Rintaro Noro
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Katsuya Maebayashi
- Department of Radiology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Hirotoshi Kubokura
- Department of Thoracic Surgery, Graduate School of Medicine, Nippon Medical School Musashikosugi Hospital, Japan
| | - Yasuhiro Terasaki
- Department of Analytic Human Pathology, Nippon Medical School, Japan
| | - Kaoru Kubota
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
| | - Masahiro Seike
- Department of Pulmonary Medicine and Oncology, Graduate School of Medicine, Nippon Medical School, Japan
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Muragaki Y, Ishikawa E, Maruyama T, Nitta M, Saito T, Ikuta S, Komori T, Kawamata T, Yamamoto T, Tsuboi K, Matsumura A, Nakamura H, Kuroda J, Abe T, Momii Y, Saito R, Tominaga T, Tabei Y, Suzuki I, Arakawa Y, Miyamoto S, Matsutani M, Karasawa K, Nakazato Y, Maebayashi K, Hashimoto K, Ohno T. A multicenter, randomized, placebo-controlled phase IIb trial of an autologous formalin-fixed tumor vaccine for newly diagnosed glioblastomas. J Neurosurg 2023:1-11. [PMID: 36670529 DOI: 10.3171/2022.12.jns221221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/07/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE An autologous formalin-fixed tumor vaccine (AFTV) derived from resected glioblastoma (GBM) tissue can be used against unidentified tumor antigens. Thus, the authors conducted a multicenter double-blind phase IIb trial to investigate the efficacy of an AFTV. METHODS Eligible patients were adults with supratentorial GBMs, 16-75 years of age, with Karnofsky Performance Scale (KPS) scores ≥ 60%, and no long-term steroid administration. An AFTV comprising fixed paraffin-embedded tumor tissue with immune adjuvants or an identical placebo without fixed tumor tissue was injected intradermally over three courses before and after chemoradiotherapy. The primary and secondary end points were overall survival (OS), progression-free survival (PFS), and 3-year survival rate. RESULTS Sixty-three patients were enrolled. The average patient age was 61 years. The median KPS score was 80%, and the median resection rate was 95%. The full analysis set of 57 patients indicated no significant difference in OS (p = 0.64) for the AFTV group (median OS 25.6 months, 3-year OS rate 38%) compared with the placebo group (31.5 months and 41%, respectively) and no difference in PFS (median PFS 13.3 months in both groups, p = 0.98). For patients with imaging-based total tumor removal, the 3-year PFS rate was 81% in the AFTV group versus 46% in the placebo group (p = 0.067), whereas the 3-year OS rate was 80% versus 54% (p = 0.16), respectively. Similar results were obtained in the p53-negative subgroups. Severe adverse effects were not observed. CONCLUSIONS The AFTV may have potential effects in certain patient subgroups. A phase III study for patients with total tumor removal remains warranted to confirm these findings. Clinical trial registration no.: UMIN000010602 (UMIN Clinical Trials Registry).
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Affiliation(s)
- Yoshihiro Muragaki
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
- 2Center for Advanced Medical Engineering Research and Development, Kobe University, Hyogo
| | | | - Takashi Maruyama
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Masayuki Nitta
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Taiichi Saito
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Soko Ikuta
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Takashi Komori
- 2Center for Advanced Medical Engineering Research and Development, Kobe University, Hyogo
- 4Tokyo Metropolitan Neurological Hospital, Tokyo
| | - Takakazu Kawamata
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | | | - Koji Tsuboi
- 6Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, Ibaraki
| | | | - Hideo Nakamura
- 7Department of Neurosurgery, Kumamoto University, Kumamoto
| | | | - Tatsuya Abe
- 8Department of Neurosurgery, Oita University, Oita
| | | | - Ryuta Saito
- 9Department of Neurosurgery, Tohoku University, Miyagi
| | | | - Yusuke Tabei
- 10Department of Neurosurgery, Japan Red Cross Medical Center, Tokyo
| | - Ichiro Suzuki
- 10Department of Neurosurgery, Japan Red Cross Medical Center, Tokyo
| | - Yoshiki Arakawa
- 11Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto
| | - Susumu Miyamoto
- 11Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto
| | | | | | | | | | - Koichi Hashimoto
- 16Tsukuba Clinical Research and Development Organization, University of Tsukuba, Ibaraki; and
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Arakawa Y, Takami H, Isobe K, Yamasaki K, Maebayashi K, Hashimo T, Tarashima K, Ichimura K, Yoshioka T, Takimoto T, Kato M, Yoshimura K, Nishikawa R, Hara J, Kumabe T. PEDT-6 A RANDOMIZED CONTROLLED CLINICAL STUDY OF RADIOTHERAPY COMBINED WITH CHEMOTHERAPY IN PATIENTS WITH NEWLY DIAGNOSED CENTRAL NERVOUS SYSTEM GERM CELL TUMOR, JCCG CNSGCT2021. Neurooncol Adv 2022. [PMCID: PMC9719330 DOI: 10.1093/noajnl/vdac167.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
Abstract
Background
Central nervous system (CNS) germ cell tumors account for 15.3% of all CNS tumors in children and adolescents and young adults. Five histologic types and mixed types exist and can be classified into the following clinical risk groups: germinomas, malignant germ cell tumors, and other germ cell tumors. In germinomas, platinum-based chemotherapy and whole ventricle/brain irradiations 23.4 Gy/13 fraction are the standard of care, but late adverse events related to radiation therapy are a problem. In malignant germ cell tumors, chemotherapy with alkylating agents and platinum, craniospinal irradiation (CSI), and local radiation therapy (local dose 50-59.4 Gy/25-33 fractions) have become the standard of care, but the 10-year OS is poor at about 60% and late radiation therapy-related adverse events are an issue. For various reasons, it is not easy to establish a standard of care for mature teratomas and immature teratomas, which constitute the other germ cell tumors, but it is essential to collect knowledge on tumor characteristics and prognosis.
Methods and Patients
The Japan Children's Cancer Group Brain Tumor Committee has planned a study to validate the classification by histological diagnosis and ancillary tumor markers, a phase III study to test the non-inferiority of radiation dose reduction to standard therapy for germinomas, a phase II study to test the superiority of high-dose chemoradiation with methotrexate intrathecal injection excluding CSI to standard therapy for malignant germ cell tumors, observational studies to elucidate pathogenesis of other germ cell tumors.
Discussion
If these hypotheses are proven, it is expected to reduce late adverse events and prolong survival with radiotherapy in children and adolescent/young adult generation patients.
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Affiliation(s)
- Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University of Graduate School of Medicine
| | - Hirokazu Takami
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo
| | - Kiyotaka Isobe
- Department of Pediatrics, Kyoto University of Graduate School of Medicine
| | - Kai Yamasaki
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital
| | | | - Takayuki Hashimo
- Department of Radiation Medical Science and Engineering, Faculty of Medicine, Hokkaido University
| | - Keita Tarashima
- Division of Neuro-Oncology, Children's Cancer Center, National Center for Child Health and Development
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Graduate School of Medicine, Juntendo University
| | - Takako Yoshioka
- Department of Pathology, National Center for Child Health and Development
| | - Tetsuya Takimoto
- Children's Cancer Center, National Center for Child Health and Development
| | - Miho Kato
- Children's Cancer Center, National Center for Child Health and Development
| | - Kenichi Yoshimura
- Medical Center for Clinical and Translational Research, Hiroshima University Hospital
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
| | - Junichi Hara
- Department of Pediatric Hematology/Oncology, Osaka City General Hospital
| | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University School of Medicine
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Nakano T, Aoyama H, Onodera S, Igaki H, Matsumoto Y, Kanemoto A, Shimamoto S, Matsuo M, Tanaka H, Oya N, Matsuyama T, Ohta A, Maruyama K, Tanaka T, Kitamura N, Akazawa K, Maebayashi K. Reduced-dose WBRT combined with SRS for 1–4 brain metastases aiming at minimizing neurocognitive function deterioration without compromising brain tumor control. Clin Transl Radiat Oncol 2022; 37:116-129. [PMID: 36199814 PMCID: PMC9529504 DOI: 10.1016/j.ctro.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
The addition of whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) reduces the risk of brain tumor recurrence but standard-dose WBRT (SD-WBRT) accompanies the risk of neurocognitive decline. Reduced-dose WBRT (RD-WBRT) combined with SRS provides intracranial tumor control rate comparable to that after SD-WBRT + SRS. RD-WBRT could reduce the risk of neurocognitive decline compared to that after SD-WBRT.
Background and purpose To minimize cognitive decline without increasing brain tumor recurrence (BTR) by reduced-dose whole-brain radiotherapy (RD-WBRT) (25 Gy, 10 fractions) + stereotactic radiosurgery (SRS) in patients with ≤ 4 brain metastases. Materials and methods Eligible patients with ≤ 4 brain metastases on contrast-enhanced MRI and Karnofsky Performance Status ≥ 70. The primary endpoint was the non-inferiority of BTR at distant sites in the brain (BTR-distant)-free survival at 6 months compared to that of the standard dose (SD)-WBRT (30 Gy, 10 fractions) + SRS arm in a randomized clinical trial (JROSG99-1) of SRS with/without SD-WBRT. Secondary endpoints included BTR at any brain sites (BTR-all) and neurocognitive function assessed by a six-test standardized battery. Results Forty patients from seven institutions were enrolled (median age 69 years). The primary tumor site was a lung in 28 patients; 20 patients had a solitary brain metastasis. The median survival time was 19.0 months (95 %CI: 13.8 %–27.5 %). The BTR-distant-free survival at 6 months was 76.9 % (59.5 %–87.7 %), which is comparable to that of historical control although predetermined non-inferiority (>71 %) could not be confirmed (p = 0.16). The cumulative incidence of BTR-all at 6 months accounting for the competing risk of death was 23.0 % (11.4–37.1), which was not worse than that of historical control (p = 0.774). The frequency of the cumulative incidence of persistent cognitive decline at 6 months was 48.6 % under the [>2.0 SD in ≥ 1 test] definition. Conclusions RD-WBRT may yield comparable intracranial tumor control when combined with SRS, and may reduce the risk of neurocognitive decline compared to that after SD-WBRT.
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Affiliation(s)
- Toshimichi Nakano
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine, Sapporo, Japan
- Corresponding authors at: Department of Radiation Oncology, Hokkaido University Faculty of Medicine, North 15, West 7, Sapporo 060-8638, Japan
| | - Shunsuke Onodera
- Department of Radiation Oncology, Hokkaido Cancer Center, Sapporo, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasuo Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Ayae Kanemoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | | | - Masayuki Matsuo
- Department of Radiology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hidekazu Tanaka
- Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Natsuo Oya
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tomohiko Matsuyama
- Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Atsushi Ohta
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Katsuya Maruyama
- Department of Radiology and Radiation Oncology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Takahiro Tanaka
- Clinical and Translational Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Nobutaka Kitamura
- Clinical and Translational Research Center, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kohei Akazawa
- Department of Medical Informatics, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Katsuya Maebayashi
- Division of Radiation Oncology, Nippon Medical School Hospital, Tokyo, Japan
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Hirata T, Harada K, Shimamoto S, Kawaguchi H, Igaki H, Ito Y, Yamada K, Kakuhara H, Maebayashi K, Aoyama H. RT-04 Stereotactic irradiation for 2 - 3 cm brain metastases: A multicenter retrospective cohort study. Neurooncol Adv 2020. [PMCID: PMC7699079 DOI: 10.1093/noajnl/vdaa143.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: We retrospectively analyzed the treatment outcomes of Stereotactic irradiation (STI) for large size (2–3 cm) brain metastasis. Materials and methods: One hundred and sixty-nine lesions with 156 patients who underwent STI from January 1, 2013 to December 31, 2015 at 21 institutions participating in the Japanese Radiation Oncology Study Group were included in the study. Patients who had a history of whole-brain irradiation in the past and those who received whole-brain irradiation sequentially with STI were excluded. RANO-BM was used to evaluate the effect on each lesion, and the survival time or time to occurrence of local failure was defined as the number of months from the initial day of STI to the day of the events. Results: The median age was 66 (33–87) years. The median follow-up time was 14 (1–52) months. Male/female = 95/61 cases. The number of brain metastases was 1/2/3/4 or more = 93/35/14/14 cases. The median doses and fraction size were 30 Gy in 3 fractions. The primary site was lung/breast/colon or rectum/others = 95/14/14/33 cases. The median survival time was 16 months. A 1-year overall survival rate was 62% and a 1-year local control rate was 77%. Comparing the 1-year local control rate by the fraction size, single/3 or 4 /5 or more = 66/86/75%, the rate was better in the 3–4 fractions group (Log-rank test, p = 0.069). Cerebral necrosis (Grade 1/2/3/unknown = 9/10/8/3 cases) was observed in 30 lesions (18%), and the median time to diagnosis of brain necrosis was 9 (1–41) months. The incidence of necrosis in the single fraction cases was 29%, which was significantly higher than that in the fractionated irradiation cases (15%) (p = 0.039). Conclusion: Fractionated STI seems to be more favorable than single fraction STI for large brain metastases.
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Affiliation(s)
- Takero Hirata
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | - Ken Harada
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | | | - Hiroki Kawaguchi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | - Hiroshi Igaki
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | - Yusuke Ito
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | - Kazunari Yamada
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | - Hisao Kakuhara
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | - Katsuya Maebayashi
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Osaka University Graduate School of Medicine
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Nakano T, Aoyama H, Onodera S, Matsumo Y, Shimamoto S, Igaki H, Matsuo M, Oya N, Ohta A, Saito H, Maruyama K, Kanemoto A, Sakurai T, Tanaka T, Kitamura N, Akazawa K, Maebayashi K. Reduced-Dose Whole Brain Radiation Therapy Combined With Stereotactic Irradiation For Solitary Or Oligo Brain Metastases Aiming At Minimizing Deterioration Of Neurocognitive Function Without Compromising Intracranial Tumor Control: Preliminary Results. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Ishihara T, Soejima T, Maebayashi K, Yamamoto T, Kohzuki H, Okada K, Hara J, Nishikawa R. Investigation of Recurrence Factors in Patients Who Received Radiotherapy for Ependymoma: A Retrospective Multicenter Analysis Conducted by the Japan Children’s Cancer Group. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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Obayashi K, Kimura G, Kuribayashi S, Shibayama K, Sano M, Tanabe K, Akatsuka J, Hayashi T, Toyama Y, Hamasaki T, Maebayashi K, Kumita S, Kondo Y. Secondary malignancies following low-dose-rate brachytherapy for prostate cancer in a single institution. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.6_suppl.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
142 Background: Low-dose-rate brachytherapy (BT) is the internal radiation therapy for non-metastatic prostate cancer by implanting radioactive isotope Iodine 125 into the prostate. The carcinogenetic effect of radiation for the treatment of cancer has been proven during the last decades. However, few studies have been reported about brachytherapy-induced secondary malignancies. In this study, we assessed the BT-induced secondary malignancies in our institution. Methods: We reviewed 487 patients treated with low-dose-rate BT from 2006 to 2016 in our hospital. We checked the occurrence of metachronous malignancies (MM) in all the patients and examined the features of MM including the number, organ sites, histology, period from BT to the occurrence, and analyzed whether the features meet the criteria of radiation-induced malignancies. We also examined the relationship between the BT-related radiation doses and the occurrence of MM. We adopted the criteria of radiation-induced cancer proposed by Sakai et al in 1981; different pathological feature from the organ of origin, the follow-up duration after radiation therapy (over 5 years), and whether the lesion is located in the irradiated field. Results: After a median follow-up period of 57 months (range 10-125 months), 23 MM occurred, which were bladder cancer in 4 cases (0.8%), esophageal in 2 (0.4%), gastric in 5 (1.0%), colon in 4 (0.8%), rectal in 3 (0.6%), pancreatic in 1 (0.2%), lung in 3 (0.6%), and brain in 1 (0.2%). Time from initial treatment to MM was 36 months (range 1-85 months). None of the cases had experienced biochemical recurrence. Average radiation dose to the urethra and the rectum including UD90, UD5, U200, R100, R150 showed no significant difference compared to the patients without occurrence of MM. According to the Sakai’s criteria, one bladder and one rectal cancer were judged as radiation-induced secondary malignancies (0.2%). Conclusions: The risk of secondary malignancies in patients undergoing BT was very low. Further studies with longer follow-up are required because it has been only about 10 years since low-dose-rate brachytherapy started in Japan.
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Affiliation(s)
| | - Go Kimura
- Nippon Medical School Hospital, Tokyo, Japan
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Muragaki Y, Maruyama T, Ishikawa E, Nitta M, Ikuta S, Tsuboi K, Matsumura A, Nakamura H, Abe T, Saito R, Tabei Y, Arakawa Y, Momii Y, Karasawa K, Matsutani M, Ohno T, Nakazato Y, Maebayashi K. LTBK-03 MULTICENTER RANDOMIZED PLACEBO CONTROLLED TRIAL OF AUTOLOGOUS FORMALIN FIXED TUMOR VACCINE FOR NEWLY DIAGNOSED GLIOBLASTOMAS. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hashimoto Y, Akimoto T, Ishii Y, Kono S, Izumi S, Maebayashi K, Iizuka J, Tanabe K, Kiyozuka M, Mitsuhashi N, Karasawa K. EP-1646: HDR brachytherapy with hypofractionated EBRT for high risk prostate cancerSPAN STYLE="font-style:italic">. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)32897-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ikuta S, Maruyama T, Maebayashi K, Nitta M, Saito T, Tamura M, Fukui A, Okamoto S, Iseki H, Kawamata T, Muragaki Y. ATPS-38ASSESSMENT OF OPTIMIZED THERAPEUTIC TERM WITH TEMOZOLOMIDE FOR NEWLY DIAGNOSED GLIOBLASTOMA. Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov204.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Nitta M, Muragaki Y, Maruyama T, Ikuta S, Komori T, Maebayashi K, Iseki H, Tamura M, Saito T, Okamoto S, Chernov M, Hayashi M, Okada Y. Proposed therapeutic strategy for adult low-grade glioma based on aggressive tumor resection. Neurosurg Focus 2015; 38:E7. [PMID: 25599276 DOI: 10.3171/2014.10.focus14651] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT There is no standard therapeutic strategy for low-grade glioma (LGG). The authors hypothesized that adjuvant therapy might not be necessary for LGG cases in which total radiological resection was achieved. Accordingly, they established a treatment strategy based on the extent of resection (EOR) and the MIB-1 index: patients with a high EOR and low MIB-1 index were observed without postoperative treatment, whereas those with a low EOR and/or high MIB-1 index received radiotherapy (RT) and/or chemotherapy. In the present retrospective study, the authors reviewed clinical data on patients with primarily diagnosed LGGs who had been treated according to the above-mentioned strategy, and they validated the treatment policy. Given their results, they will establish a new treatment strategy for LGGs stratified by EOR, histological subtype, and molecular status. METHODS One hundred fifty-three patients with diagnosed LGG who had undergone resection or biopsy at Tokyo Women's Medical University between January 2000 and August 2010 were analyzed. The patients consisted of 84 men and 69 women, all with ages ≥ 15 years. A total of 146 patients underwent surgical removal of the tumor, and 7 patients underwent biopsy. RESULTS Postoperative RT and nitrosourea-based chemotherapy were administered in 48 and 35 patients, respectively. Extent of resection was significantly associated with both overall survival (OS; p = 0.0096) and progression-free survival (PFS; p = 0.0007) in patients with diffuse astrocytoma but not in those with oligodendroglial subtypes. Chemotherapy significantly prolonged PFS, especially in patients with oligodendroglial subtypes (p = 0.0009). Patients with a mutant IDH1 gene had significantly longer OS (p = 0.034). Multivariate analysis did not identify MIB-1 index or RT as prognostic factors, but it did identify chemotherapy as a prognostic factor for PFS and EOR as a prognostic factor for OS and PFS. CONCLUSIONS The findings demonstrated that EOR was significantly correlated with patient survival; thus, one should aim for maximum tumor resection. In addition, patients with a higher EOR can be safely observed without adjuvant therapy. For patients with partial resection, postoperative chemotherapy should be administered for those with oligodendroglial subtypes, and repeat resection should be considered for those with astrocytic tumors. More aggressive treatment with RT and chemotherapy may be required for patients with a poor prognosis, such as those with diffuse astrocytoma, 1p/19q nondeleted tumors, or IDH1 wild-type oligodendroglial tumors with partial resection.
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Hashimoto Y, Akimoto T, Motegi A, Yuka I, Sawa K, Nakamura K, Izumi S, Maebayashi K, Iizuka J, Tanabe K, Kiyozuka M, Mitsuhashi N. Hypofractionated Image-Guided IMRT for Clinically Localized Prostate Cancer: A Total Dose of 66Gy Delivered to 3 Gy per Fraction Three Times per Week. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nitta M, Muragaki Y, Maruyama T, Iseki H, Ikuta S, Konishi Y, Saito T, Tamura M, Chernov M, Watanabe A, Okamoto S, Maebayashi K, Mitsuhashi N, Okada Y. Updated therapeutic strategy for adult low-grade glioma stratified by resection and tumor subtype. Neurol Med Chir (Tokyo) 2014; 53:447-54. [PMID: 23883555 DOI: 10.2176/nmc.53.447] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The importance of surgical resection for patients with supratentorial low-grade glioma (LGG) remains controversial. This retrospective study of patients (n = 153) treated between 2000 to 2010 at a single institution assessed whether increasing the extent of resection (EOR) was associated with improved progression-free survival (PFS) and overall survival (OS). Histological subtypes of World Health Organization grade II tumors were as follows: diffuse astrocytoma in 49 patients (32.0%), oligoastrocytoma in 45 patients (29.4%), and oligodendroglioma in 59 patients (38.6%). Median pre- and postoperative tumor volumes and median EOR were 29.0 cm(3) (range 0.7-162 cm(3)) and 1.7 cm(3) (range 0-135.7 cm(3)) and 95%, respectively. Five- and 10-year OS for all LGG patients were 95.1% and 85.4%, respectively. Eight-year OS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 70.7%, 91.2%, and 98.3%, respectively. Five-year PFS for diffuse astrocytoma, oligoastrocytoma, and oligodendroglioma were 42.6%, 71.3%, and 62.7%, respectively. Patients were divided into two groups by EOR ≥90% and <90%, and OS and PFS were analyzed. Both OS and PFS were significantly longer in patients with ≥90% EOR. Increased EOR resulted in better PFS for diffuse astrocytoma but not for oligodendroglioma. Multivariate analysis identified age and EOR as parameters significantly associated with OS. The only parameter associated with PFS was EOR. Based on these findings, we established updated therapeutic strategies for LGG. If surgery resulted in EOR <90%, patients with astrocytoma will require second-look surgery, whereas patients with oligodendroglioma or oligoastrocytoma, which are sensitive to chemotherapy, will be treated with chemotherapy.
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Affiliation(s)
- Masayuki Nitta
- Department of Neurosurgery, Graduate School of Medicine, Tokyo Women's Medical University, Kawada-cho, Shinjuku-ku, Tokyo, Japan.
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Ahmed I, Biswas A, Krishnamurthy S, Julka P, Rath G, Back M, Huang D, Gzell C, Chen J, Kastelan M, Gaur P, Wheeler H, Badiyan SN, Robinson CG, Simpson JR, Tran DD, Rich KM, Dowling JL, Chicoine MR, Leuthardt EC, Kim AH, Huang J, Michaelsen SR, Christensen IJ, Grunnet K, Stockhausen MT, Broholm H, Kosteljanetz M, Poulsen HS, Tieu M, Lovblom E, Macnamara M, Mason W, Rodin D, Tai E, Ubhi K, Laperriere N, Millar BA, Menard C, Perkins B, Chung C, Clarke J, Molinaro A, Phillips J, Butowski N, Chang S, Perry A, Costello J, DeSilva A, Rabbitt J, Prados M, Cohen AL, Anker C, Shrieve D, Hall B, Salzman K, Jensen R, Colman H, Farber O, Weinberg U, Palti Y, Fisher B, Chen H, Macdonald D, Lesser G, Coons S, Brachman D, Ryu S, Werner-Wasik M, Bahary JP, Chakravarti A, Mehta M, Gupta T, Nair V, Epari S, Godasastri J, Moiyadi A, Shetty P, Juvekar S, Jalali R, Herrlinger U, Schafer N, Steinbach J, Weyerbrock A, Hau P, Goldbrunner R, Kohnen R, Urbach H, Stummer W, Glas M, Houillier C, Ghesquieres H, Chabrot C, Soussain C, Ahle G, Choquet S, Faurie P, Bay JO, Vargaftig J, Gaultier C, Nicolas-Virelizier E, Hoang-Xuan K, Iskanderani O, Izar F, Benouaich-Amiel A, Filleron T, Moyal E, Iweha C, Jain S, Melian E, Sethi A, Albain K, Shafer D, Emami B, Kong XT, Green S, Filka E, Green R, Yong W, Nghiemphu P, Cloughesy T, Lai A, Mallick S, Biswas A, Roy S, Purkait S, Gupta S, Julka PK, Rath GK, Marosi C, Thaler J, Ay C, Kaider A, Reitter EM, Haselbock J, Preusser M, Flechl B, Zielinski C, Pabinger I, Miyatake SI, Furuse M, Miyata T, Yoritsune E, Kawabata S, Kuroiwa T, Muragaki Y, Maruyama T, Iseki H, Akimoto J, Ikuta S, Nitta M, Maebayashi K, Saito T, Okada Y, Kaneko S, Matsumura A, Kuroiwa T, Karasawa K, Nakazato Y, Kayama T, Nabors LB, Fink KL, Mikkelsen T, Grujicic D, Tarnawski R, Nam DH, Mazurkiewicz M, Salacz M, Ashby L, Thurzo L, Zagonel V, Depenni R, Perry JR, Henslee-Downey J, Picard M, Reardon DA, Nambudiri N, Nayak L, LaFrankie D, Wen P, Ney D, Carlson J, Damek D, Blatchford P, Gaspar L, Kavanagh B, Waziri A, Lillehei K, Reddy K, Chen C, Rashed I, Melian E, Sethi A, Barton K, Anderson D, Prabhu V, Rusch R, Belongia M, Maheshwari M, Firat S, Schiff D, Desjardins A, Cloughesy T, Mikkelsen T, Glantz M, Chamberlain M, Reardon DA, Wen P, Shapiro W, Gopal S, Judy K, Patel S, Mahapatra A, Shan J, Gupta D, Shih K, Bacha JA, Brown D, Garner WJ, Steino A, Schwart R, Kanekal S, Li M, Lopez L, Burris HA, Soderberg-Naucler C, Rahbar A, Stragliotto G, Song AJ, Kumar AMS, Murphy ES, Tekautz T, Suh JH, Recinos V, Chao ST, Spoor J, Korami K, Kloezeman J, Balvers R, Dirven C, Lamfers M, Leenstra S, Sumrall A, Haggstrom D, Crimaldi A, Symanowski J, Giglio P, Asher A, Burri S, Sunkersett G, Khatib Z, Prajapati CM, Magalona EE, Mariano M, Sih IM, Torcuator R, Taal W, Oosterkamp H, Walenkamp A, Beerenpoot L, Hanse M, Buter J, Honkoop A, Boerman D, de Vos F, Jansen R, van der Berkmortel F, Brandsma D, Enting R, Kros J, Bromberg J, van Heuvel I, Smits M, van der Holt R, Vernhout R, van den Bent M, Weinberg U, Farber O, Palti Y, Wick W, Suarez C, Rodon J, Desjardins A, Forsyth P, Gueorguieva I, Cleverly A, Burkholder T, Desaiah D, Lahn M, Zach L, Guez D, Last D, Daniels D, Nissim O, Grober Y, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Mardor Y. MEDICAL RADIATION THERAPIES. Neuro Oncol 2013; 15:iii75-iii84. [PMCID: PMC3823894 DOI: 10.1093/neuonc/not179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
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Muragaki Y, Akimoto J, Maruyama T, Iseki H, Ikuta S, Nitta M, Maebayashi K, Saito T, Okada Y, Kaneko S, Matsumura A, Kuroiwa T, Karasawa K, Nakazato Y, Kayama T. Phase II clinical study on intraoperative photodynamic therapy with talaporfin sodium and semiconductor laser in patients with malignant brain tumors. J Neurosurg 2013; 119:845-52. [PMID: 23952800 DOI: 10.3171/2013.7.jns13415] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The objective of the present study was to perform a prospective evaluation of the potential efficacy and safety of intraoperative photodynamic therapy (PDT) using talaporfin sodium and irradiation using a 664-nm semiconductor laser in patients with primary malignant parenchymal brain tumors. METHODS In 27 patients with suspected newly diagnosed or recurrent primary malignant parenchymal brain tumors, a single intravenous injection of talaporfin sodium (40 mg/m(2)) was administered 1 day before resection of the neoplasm. The next day after completion of the tumor removal, the residual lesion and/or resection cavity were irradiated using a 664-nm semiconductor laser with a radiation power density of 150 mW/cm(2) and a radiation energy density of 27 J/cm(2). The procedure was performed 22-27 hours after drug administration. The study cohort included 22 patients with a histopathologically confirmed diagnosis of primary malignant parenchymal brain tumor. Thirteen of these neoplasms (59.1%) were newly diagnosed glioblastomas multiforme (GBM). RESULTS Among all 22 patients included in the study cohort, the 12-month overall survival (OS), 6-month progression-free survival (PFS), and 6-month local PFS rates after surgery and PDT were 95.5%, 91%, and 91%, respectively. Among patients with newly diagnosed GBMs, all these parameters were 100%. Side effects on the skin, which could be attributable to the administration of talaporfin sodium, were noted in 7.4% of patients and included rash (2 cases), blister (1 case), and erythema (1 case). Skin photosensitivity test results were relatively mild and fully disappeared within 15 days after administration of photosensitizer in all patients. CONCLUSIONS Intraoperative PDT using talaporfin sodium and a semiconductor laser may be considered as a potentially effective and sufficiently safe option for adjuvant management of primary malignant parenchymal brain tumors. The inclusion of intraoperative PDT in a combined treatment strategy may have a positive impact on OS and local tumor control, particularly in patients with newly diagnosed GBMs. Clinical trial registration no.: JMA-IIA00026 (https://dbcentre3.jmacct.med.or.jp/jmactr/App/JMACTRS06/JMACTRS06.aspx?seqno=862).
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Affiliation(s)
- Yoshihiro Muragaki
- Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, and
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Kaneyasu Y, Kita M, Okawa T, Maebayashi K, Kohno M, Sonoda T, Hirabayashi H, Nagata Y, Mitsuhashi N. In reply to Coza. Int J Radiat Oncol Biol Phys 2013; 86:4-5. [PMID: 23582241 DOI: 10.1016/j.ijrobp.2013.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Accepted: 01/11/2013] [Indexed: 11/30/2022]
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Matsuoka T, Yoshino T, Fukuhara Y, Miyanaga N, Oka K, Nagayama R, Sekido N, Maebayashi K. Mucosa-associated lymphoid tissue lymphoma of the urinary bladder. Int Cancer Conf J 2012. [DOI: 10.1007/s13691-012-0041-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Hashimoto Y, Maebayashi K, Izumi S, Motegi A, Mitsuhashi N. Dropped Head Syndrome Induced by Chemoradiotherapy for Nasopharyngeal Carcinoma: A Case Report. Jpn J Clin Oncol 2012; 42:1091-3. [DOI: 10.1093/jjco/hys135] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Hida K, Hashimoto K, Ishitani K, Maebayashi K, Mitsuhashi N, Matsui H. [A case of malignant peritoneal mesothelioma successfully treated with concurrent chemoradiotherapy]. Gan To Kagaku Ryoho 2011; 38:2639-2641. [PMID: 22189233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Malignant peritoneal mesothelioma is extremely rare, and its prognosis is poor. The median survival period is said to be approximately one year after diagnosis. We report a case of recurrent malignant peritoneal mesothelioma treated with concurrent chemoradiotherapy (CCRT). The patient has been alive for six years without recurrence. This report seems to be the first that indicates CCRT to be useful for peritoneal mesothelioma. The patient was a 21-year-old woman who underwent emergency surgery of the in acute abdomen at another hospital. The resected tumor was 18 cm in size and pathological examination revealed that it was a malignant mesothelioma of the epithelioid type. CAP therapy (cyclophosphamide+adriamycine+cisplatin)+CPT-11 administration was given only one course, and the patient was then transferred to our hospital. She underwent resection of the residual disease and six courses of TC therapy (paclitaxel+carboplatin) as adjuvant chemotherapy. Twelve months after chemotherapy, pelvic recurrence occurred. We attempted surgery but only biopsy could be performed because of a pelvic wall invasion. The patient underwent CCRT with weekly cisplatin. The tumor was reduced by irradiation of 50. 4 Gy and disappeared after 6 months. No recurrence has been found six years since the last treatment. CCRT might be effective against malignant peritoneal mesothelioma of the epithelioid type.
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Affiliation(s)
- Kazuhide Hida
- Dept. of Obstetrics and Gynecology, Tokyo Women's University
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Akimoto T, Hashimoto Y, Motegi A, Seki-Nakamura K, Izumi-Nasu S, Maebayashi K, Iizuka J, Mitsuhashi N. Correlation between the Changes in the EPIC QOL Score and the DVH Parameters in High Dose Rate Brachytherapy combined with Hypofractionated EBRT for Prostate Cancer. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Seki-Nakamura K, Maebayashi K, Nasu-Izumi S, Akimoto T, Mitsuhashi N. Evaluation of anxiety and salivary chromogranin a secretion in women receiving breast conserving surgery followed by radiation therapy. J Radiat Res 2011; 52:351-359. [PMID: 21467738 DOI: 10.1269/jrr.10160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
We conducted a prospective study to assess the anxiety and salivary Chromogranin A (CgA), which is considered to be a biomarker of the stress response, in outpatients receiving breast conserving surgery followed by radiation therapy (RT) to the whole breast. Fifty consecutive patients who received whole-breast RT were enrolled in this study. The anxiety levels were measured by the State-Trait Anxiety Inventory (STAI) at the beginning of RT (baseline), 30 Gy, completion of RT, and 1 and 3 months after RT. Salivary CgA levels were also measured at the same time. The mean state anxiety score for all patients was 46.16 with a standard error (SE) of 1.57 at the beginning of RT (baseline) which continued to decline during and after RT. It reached its lowest score with 36.34 ± 1.56 at 3 months after RT (p < 0.0001). The mean trait anxiety score for all patients was 43.10 ± 1.54 at baseline and remained constant during RT but began to decline after completion of RT and reached a low level at 3 months after RT (p = 0.0021). The mean salivary CgA concentration for all patients demonstrated no consistent trends over time, but at 30 Gy the concentration showed a significant decreasing pattern (p = 0.0473). Salivary CgA concentrations and state anxiety and trait anxiety scores at all time points showed no correlation. The mean anxiety scores measured by STAI showed no positive correlation with salivary CgA concentration for breast cancer patients undergoing radiation therapy following breast conserving surgery.
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Affiliation(s)
- Kaori Seki-Nakamura
- Department of Radiation Oncology, Tokyo Women's Medical University School of Medicine.
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Akimoto T, Kiyozuka M, Nasu S, Motegi A, Nakamura K, Hashimoto Y, Maebayashi K, Hanyu Y, Tanabe K, Mitsuhashi N. Acute and Late Toxicity after Hypofractionated Intensity-modulated Radiotherapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Motegi A, Akimoto T, Kiyozuka M, Izumi S, Hashimoto Y, Nakamura K, Maebayashi K, Iizuka J, Tanabe K, Mitsuhashi N. Correlation between the Changes in the Epic QOL Score and the Severity of Acute Genitourinary Toxicity after Permanent Brachytherapy with I-125 Alone for Prostate Cancer. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Muramatsu H, Akimoto T, Maebayashi K, Kita M, Mitsuhashi N. Prognostic significance of dysadherin and E-cadherin expression in patients with head and neck cancer treated by radiation therapy. Anticancer Res 2008; 28:3859-3864. [PMID: 19192641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the impact of dysadherin and E-cadherin expression on the clinical outcomes, including the treatment outcomes and recurrence pattern, in patients with head and neck cancer. PATIENTS AND METHODS Tumor specimens were obtained from 48 head and neck cancer patients who were treated by radiation therapy and the specimens were immunohistochemically stained for dysadherin and E-cadherin. The expressions were graded according to the percentage area occupied by cancer cells showing positive staining for E-cadherin and dysadherin as follows: grade 0, less than 10%; grade 1, 10-50%; grade 2, more than 50%. The correlations between the expression of E-cadherin and dysadherin and the clinical outcomes, including the treatment outcomes and recurrence pattern, were analyzed. RESULTS The complete response (CR) rate in the patients with a dysadherin expression grade of 0 or 1 was 70% and that in the patients with dysadherin expression grade of 2 was 38%; the difference was significant (p < 0.05). Regarding the pattern of recurrence, the expression grade of dysadherin or E-cadherin alone was not correlated with the recurrence pattern; however, patients with a difference in the expression grade between dysadherin and E-cadherin (Dys-Ecad value) of 1 or 2 showed a significantly higher rate of lymph node and/or distant metastasis (55%) as compared with those with a Dys-Ecad value of < 1 (22%) (p < 0.05). CONCLUSION Dysadherin and E-cadherin expression might serve as useful prognostic factors in patients with head and neck cancer treated by definitive radiation therapy.
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Affiliation(s)
- Hiroyuki Muramatsu
- Department of Radiology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo 162-8666, Japan
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Akimoto T, Kiyoduka M, Nasu S, Motegi A, Hashimoto Y, Nakamura K, Maebayashi K, Ishikawa H, Mitsuhashi N. Acute Genitourinary Toxicity after Real-time Planning High Dose Rate (HDR) Brachytherapy for Prostate Cancer: Comparison of the Incidence of Grade 2 or Worse Acute GU Toxicity between Intra-operative Real-time and Post-operative CT-based Planning. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fukutome M, Maebayashi K, Nasu S, Seki K, Mitsuhashi N. Enhancement of radiosensitivity by dual inhibition of the HER family with ZD1839 ("Iressa") and trastuzumab ("Herceptin"). Int J Radiat Oncol Biol Phys 2006; 66:528-36. [PMID: 16965995 DOI: 10.1016/j.ijrobp.2006.05.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2006] [Revised: 05/19/2006] [Accepted: 05/23/2006] [Indexed: 11/21/2022]
Abstract
PURPOSE The aims of this study were twofold: (1) to examine the effects of dual inhibition of 2 members of the HER family, the epidermoid growth factor receptor (EGFR) and HER2/neu, by gefitinib (ZD1839) and trastuzumab on radiosensitivity; and (2) to explore the molecular mechanism of radiosensitization especially focusing on the survival signal transduction pathways by using A431 human vulvar squamous carcinoma cells expressing EGFR and HER2/neu. METHODS AND MATERIALS The effects of inhibitors on the radiation-induced activation of EGFR and/or HER2/neu, and the intracellular proteins that are involved in their downstream signaling, were quantified by the Western blot. Radiosensitizing effects by the blockage of EGFR and/or HER2/neu were determined by a clonogenic assay. RESULTS Radiation-induced activation of the EGFR and HER2/neu was inhibited with ZD1839 and/or trastuzumab. ZD1839 also inhibited the radiation-induced phosphorylation of HER2/neu. Radiation in combination with the HER family inhibitors inhibited the activation of Akt and MEK1/2, the downstream survival signaling of the HER family. ZD1839 enhanced radiosensitivity with a dose-modifying factor (DMF) (SF3) of 1.45 and trastuzumab did so with a DMF (SF3) of 1.11. Simultaneous blockade of EGFR and HER2/neu induced a synergistic radiosensitizing effect with a DMF (SF3) of 2.29. CONCLUSIONS The present data suggest that a dual EGFR and HER2/neu targeting may have potential for radiosensitization in tumors in which both of these pathways are active.
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Affiliation(s)
- Mika Fukutome
- Department of Radiology, Tokyo Women's Medical University, School of Medicine, Tokyo, Japan.
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Maebayashi K, Nasu S, Seki K, Kiyoduka M, Hashimoto Y, Mitsuhashi N. [Intensity Modulated Radiation Therapy (IMRT)]. Gan To Kagaku Ryoho 2006; 33:436-43. [PMID: 16612150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Radiotherapy plays an important role in the management of cancer patients, and half of the patients with malignant tumors are treated with radiotherapy in the United States. In Japan, the necessity of radiation therapy has come to be widely acknowledged in cancer treatment, and more and more cancer patients are being treated with radiation. External beam radiation is the most-used radiotherapy at the present time. The advantage is that this treatment modality can be used in a short time, although the problem is that not only the cancer lesion but also the surrounding normal tissue is irradiated,causing an adverse effect on normal tissue. In order to solve this problem,treatments such as 3D-Conformal Radiation Therapy (3D-CRT), Intensity Modulated Radiation Therapy (IMRT), Stereotactic Radiation Surgery (SRS) and Stereotactic Radiation Therapy (SRT) are clinically used as an extremely precise radiotherapy, thanks to the advances in computer technology in recent years. Therefore, the purpose of these extremely precise radiation therapies is to administer a high dose to the tumor intensively, and to suppress quantities of magnetism to normal tissues. IMRT treatment results for prostate cancer patients and head and neck cancer patients are reportedly better than with other irradiation methods. In this chapter,we explain the external irradiation method with the focus on IMRT and the extremely precise radiotherapy preformed in the Tokyo Women's Medical University Hospital.
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Affiliation(s)
- Katsuya Maebayashi
- Dept. of Radiology and Radiation Oncology, School of Medicine, Tokyo Women's Medical University
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Karasawa K, Horikawa N, Kawase E, Seki K, Kohno M, Shinoda H, Nasu S, Muramatsu H, Maebayashi K, Mitsuhashi N. Assessment of psychological responses in patients about to receive radiotherapy. Radiat Med 2005; 23:478-84. [PMID: 16485538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE Radiotherapy is considered to be associated with psychological distress. We assessed the mental status, anxiety, and the factors associated with these in cancer patients about to receive radiotherapy. MATERIALS AND METHODS Hospitalized patients about to receive radiotherapy participated. Psychological status was assessed by a psychiatrist, based on interview about the type of anxiety related to cancer or radiotherapy as well as self-rating questionnaires. RESULTS Eligible data were collected from 94 patients. The incidence of mental disorders was 20%. The total mood disturbance scores were significantly higher in patients with poor performance status. The most common type of anxiety regarding radiotherapy was acute adverse effect, and the predictors were palliative treatment and living alone. CONCLUSION Mental disorders, mood disturbance, and anxiety in patients cannot be neglected in radiation oncology practice. Especially careful attention should be paid to patients with these predictive factors.
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Affiliation(s)
- Kumiko Karasawa
- Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan
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Toita T, Nakamura K, Uno T, Kodaira T, Shinoda A, Ogawa K, Mitsuhashi N, Maebayashi K, Kawaguchi A, Inoue T, Teshima T. Radiotherapy for Uterine Cervical Cancer: Results of the 1995-1997 Patterns of Care Process Survey in Japan. Jpn J Clin Oncol 2005; 35:139-48. [PMID: 15741304 DOI: 10.1093/jjco/hyi047] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study is to establish Japanese national practice patterns for uterine cervical cancer patients who received radiotherapy without surgery. METHODS The Japanese Patterns of Care Study (JPCS) conducted a national survey of 73 institutions using two-stage cluster sampling, and collected specific information on 591 patients with uterine cervical cancer treated by radiotherapy without planned surgery between 1995 and 1997. RESULTS The median age of the patients was 70 years. Karnofsky performance status (KPS) was >/=90 for 37%. Most patients (95%) had histology of squamous cell carcinoma. Ten percent were stage I, 29% stage II, 48% stage III and 13% stage IVA. Photon beams of 10-14 MV were the most used for external beam radiotherapy (EBRT). The beam energy utilized varied significantly by institution strata. Midline block was used in approximately 70% of institutions. Intracavitary brachytherapy (ICBT) was performed in 77%. Institution strata correlated significantly with the ICBT application. The majority of patients (89%) were treated with high-dose-rate (HDR) ICBT. The median single point A dose of HDR-ICBT was 600 cGy. The median summated point A dose from EBRT and HDR-ICBT was 5800 cGy (range: 1196-8600). The median overall treatment time including ICBT was 49 days. Twenty-four percent of the patients received chemotherapy. Concurrent chemoradiation was performed in 5%. CONCLUSIONS The JPCS established the Japanese national practice patterns of care for uterine cervical cancer patients treated with radiotherapy without planned surgery between 1995 and 1997. This survey demonstrated that the institutional strata significantly affected several practice patterns.
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Affiliation(s)
- Takafumi Toita
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, 207 Uehara, Nishihara-cho, Okinawa, 903-0215 Japan.
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Toita T, Mitsuhashi N, Teshima T, Maebayashi K, Nakamura K, Takahashi Y, Inoue T. Postoperative radiotherapy for uterine cervical cancer: results of the 1995-1997 patterns of care process survey in Japan. Jpn J Clin Oncol 2004; 34:99-103. [PMID: 15067104 DOI: 10.1093/jjco/hyh014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine the average national practice of postoperative radiotherapy for uterine cervical cancer in Japan. METHODS The Japanese Patterns of Care Study (PCS) reviewed the process of care employed for 455 uterine cervical cancer patients who were treated with surgery followed by postoperative radiotherapy (RT) during 1995-1997. Cases with missing data were excluded from calculations of percentage and significance for each of the surveyed items. RESULTS According to FIGO stages, 198 patients (45%) were in stage I, 52 patients (12%) were in stage IIA, 146 patients (33%) were in stage IIB and 46 patients (10%) were in stage III/IVA. The most common surgical procedure among the patients was radical hysterectomy (73%). Three hundred and seventy patients (82%) were treated with external beam RT (ERT) alone, and 74 patients (17%) were treated with a combination of ERT and intracavitary RT (ICRT). A midline block was used for the pelvic field in 63 patients (14%). Only seven patients (2%) were treated with extended field ERT. Pelvic ERT was most often performed using AP-PA opposed fields for 431 patients (97%). A majority of the patients (312 patients, 70%) were treated with a total dose of 45.0-50.4 Gy for ERT. Chemotherapy (CT) was administered to 178 patients (40%), neoadjuvant preoperative CT was administered to 80 patients (22%) and concurrent CT with postoperative RT was administered to 29 patients (8%). CONCLUSION This PCS established the national practice average of postoperative RT for uterine cervical cancer. Follow-up studies need to be conducted to determine whether the observed differences in treatment processes affect outcomes.
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Affiliation(s)
- Takafumi Toita
- Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa, Japan.
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Karasawa K, Katsui K, Seki K, Kohno M, Hanyu N, Nasu S, Muramatsu H, Maebayashi K, Mitsuhashi N, Haga S, Kimura T, Takahashi I. Radiotherapy with concurrent docetaxel for advanced and recurrent breast cancer. Breast Cancer 2004; 10:268-74. [PMID: 12955041 DOI: 10.1007/bf02966728] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Docetaxel has shown remarkable radiosensitizing properties in vitro. In this study we investigated whether the addition of docetaxel to radiotherapy enhanced tumor response in patients with advanced or recurrent breast cancer. METHODS A total of 35 patients were enrolled in this study. Docetaxel was administered concurrently during radiotherapy. Radiation doses were 54 to 69 Gy (median 60 Gy). In those enrolled through January 2000, docetaxel 40 mg/m2 was administered biweekly (once every two weeks), with subsequent dose adjustments based on tolerance and bone marrow and liver function. Beginning in February 2000, a weekly docetaxel schedule was used instead. This new regimen was based on data suggesting reduced myelosuppression with this regimen. The weekly dose rate was 20 mg/m2, with dose reductions for impaired organ function. RESULTS All patients were evaluated for toxicity and response and a total of 40 irradiated sites were evaluated for local response. The overall response rate of irradiated sites was 95% and the CR rate was 68%. CR and PR were achieved in 40%, 37% of patients, respectively. Acute toxicities were tolerated by most patients: 17% had Grade 3-4 neutropenia, 6% had Grade 3-4 radiation dermatitis, and 3% had Grade 3-4 pneumonitis. CONCLUSION The combination of docetaxel with radiotherapy is an active and safe regimen in patients with inoperable advanced or recurrent breast cancer. We determined the recommended dose of docetaxel with concomitant radiotherapy to be 20 mg/m2 weekly for a Phase II study. Further study is necessary to assess the impact of this treatment on long-term outcome.
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Affiliation(s)
- Kumiko Karasawa
- Department of Radiology, Tokyo Women's Medical University School of Medicine, Japan.
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Karasawa K, Shinoda H, Katsui K, Seki K, Kohno M, Hanyu N, Nasu S, Muramatsu H, Maebayashi K, Mitsuhashi N, Yoshihara T. Induction chemotherapy followed by hyperfractionated radiotherapy with concurrent chemotherapy for locally advanced head and neck cancer. Anticancer Res 2003; 23:5031-6. [PMID: 14981963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
BACKGROUND The aim of this study was to improve tumor control, the survival rate and organ preservation for locally advanced head and neck cancer by using induction chemotherapy followed by hyperfractionated radiotherapy and concurrent chemotherapy. MATERIALS AND METHODS Thirty-five patients with stage III-IVB head and neck cancer were treated with this protocol. Induction chemotherapy consisted of cisplatin and fluorouracil and concurrent chemotherapy consisted of carboplatin and doxifluridin. Radiotherapy was administered twice a day until a dose of 72 Gy was reached. RESULTS Twenty-two (63%) and 13 patients (37%) achieved complete responses and partial responses, respectively. In terms of non-hematological toxicities, grade 3 mucositis was observed in 49% of the patients. The overall 5-year survival was 53.5% and the progression-free survival was 40.6%. CONCLUSION Response to induction chemotherapy was useful as a predictive factor for ultimate outcome and organ conservation. More intensive regimen or other combination chemotherapy is needed to improve treatment outcome with hyperfractionated radiotherapy.
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Affiliation(s)
- Kumiko Karasawa
- Department of Radiology, School of Medicine, Juntendo University, Tokyo Women's Medical University, Tokyo, Japan.
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Karasawa K, Seki K, Kohno M, Shinoda H, Nasu S, Muramatsu H, Maebayashi K, Mitsuhashi N. 120 Long time treatment outcome of accelerated hyperfractionated radiotherapy for stage II laryngeal cancer. EJC Suppl 2003. [DOI: 10.1016/s1359-6349(03)90153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Karasawa K, Shinoda H, Katsui K, Seki K, Kohno M, Hanyu N, Nasu S, Muramatsu H, Maebayashi K, Mitsuhashi N, Yoshihara T. Radiotherapy with concurrent docetaxel and carboplatin for head and neck cancer. Anticancer Res 2002; 22:3785-8. [PMID: 12552993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND This study was designed to evaluate the concomitant use of docetaxel and carboplatin for radiosensitization in head and neck cancer. MATERIALS AND METHODS One dose of docetaxel at 10 mg/m2 and five doses of carboplatin at AUC of 0.4 per week were administered to patients during the first two weeks of radiotherapy. Sixteen patients were treated with this regimen. Radiotherapy was given to a total dose of 64.8 to 82.0 Gy. Altered fractionation radiotherapy was performed in 12 patients with untreated advanced tumors. RESULTS The complete response (CR) rate was 81%, with a partial response (PR) rate of 19%. Toxicities included grade 3 mucositis in 69% of patients and grade 2 dermatitis in 56% of patients. CONCLUSION This schedule of docetaxel and carboplatin combined with radiotherapy may become a useful approach for the management of head and neck cancer with proper management of mucositis.
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Affiliation(s)
- K Karasawa
- Department of Radiology, School of Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo 162-8666, Japan.
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Kohno M, Karasawa K, Suzuki K, Ueda M, Umeda M, Seki K, Nasu S, Muramatsu H, Maebayashi K, Mitsuhashi N, Saitou M, Kimura T, Aruga E. [A case of recurrent breast cancer with chronic renal failure treated on an outpatient basis]. Gan To Kagaku Ryoho 2002; 29:1611-4. [PMID: 12355947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
We report a case of recurrent breast cancer with chronic renal failure in a 58-year-old female. She could be treated on an outpatient basis under good general condition for most of her remaining life by chemoradiotherapy in combination with hemodialysis. Modification of the chemoradiotherapy procedures and collaboration of medical staff including the doctor in charge of home medical care and her family was indispensable in keeping her hospital stay as short as possible.
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Affiliation(s)
- Mari Kohno
- Dept. of Radiology, Tokyo Women's Medical University
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Imai R, Akimoto T, Maebayashi K, Ishikawa H, Sakurai H, Saitoh JI, Hasegawa M, Mitsuhashi N, Nakano T. Signal transduction pathway to low-dose radiation-induced apoptosis in peripheral PNET cells. Anticancer Res 2002; 22:2741-7. [PMID: 12529990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
We investigated the signal transduction pathway to low-dose radiation-induced apoptosis in vitro in the human peripheral primitive neuroectodermal tumor (pPNET) cell line with wild-type p53 established in our laboratory. Apoptosis was induced by 2Gy irradiation in an almost p53-dependent manner in this model except for a deficiency of the cleavage of caspase-9. It was detected 3 hours after irradiation by fragmentation assay. The expressions of p53, p21WAF-1 and Bax increased, in contrast to the gradually decreasing expression of Bcl-2, as observed by immunoblotting. Following this, cleavages of caspase-3 and PARP reached peak levels. There were no detectable increases in ERK expression and caspase-9 cleavage. In respect of the probability of other pathways to apoptosis, this cell line will provide a useful model both for investigating low-dose radiation-induced signal transduction pathway and for analyzing the biological characteristics of pPNET.
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Affiliation(s)
- Reiko Imai
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8111, Japan
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Maebayashi K, Mitsuhashi N, Toita T, Ogawa K, Teshima T, Takahashi Y, Inoue T. The patterns of care study for cancer of the uterine cervix in Japan: effects of dose rate on outcome. Int J Radiat Oncol Biol Phys 2001. [DOI: 10.1016/s0360-3016(01)02441-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ishikawa H, Mitsuhashi N, Sakurai H, Maebayashi K, Niibe H. The effects of p53 status and human papillomavirus infection on the clinical outcome of patients with stage IIIB cervical carcinoma treated with radiation therapy alone. Cancer 2001; 91:80-9. [PMID: 11148563 DOI: 10.1002/1097-0142(20010101)91:1<80::aid-cncr11>3.0.co;2-e] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND It has been suggested that the p53 tumor suppressor gene regulates the radiosensitivity in human malignancies after irradiation; however, in cervical carcinoma, the role of the p53 gene is still unclear because of inactivation of functional p53 by infection with human papillomavirus (HPV). The objective of this study was to clarify the effects of p53 status and HPV infection on the clinical outcome of patients with cervical carcinoma after undergoing radiation therapy. METHODS Fifty-two patients with International Federation of Gynecology and Obstetrics Stage IIIB squamous cell carcinoma of the cervix who received radiation therapy alone were reviewed. The combination of external beam irradiation therapy and three sessions of intracavity brachytherapy irradiation was performed for all patients. Genomic DNA extracted from paraffin embedded tissues was examined for HPV types 16, 18 and 33 by the polymerase chain reaction (PCR) method and for p53 status by PCR-single-strand conformation polymorphism (PCR-SSCP) technique. The effects of HPV infection, p53 status, and other parameters on clinical outcome were investigated by univariate analysis. RESULTS HPV-DNA was detected in 40 patients (76.9%), and 14 patients (26.9%) had mutations of the p53 gene in the study. There was a significant correlation between the existence of HPV and p53 status (P < 0.001). Mutations of the p53 gene were detected in 6 of 12 patients (50%) who had local recurrent tumors, whereas p53 were wild type in 32 of 40 patients (80%) who achieved local control. The p53 mutation had a significant correlations with local tumor recurrence. Furthermore, p53 status caused statistical significant differences in the curves of the recurrence free survival rate and local control rate as determined by the log rank test (P = 0.02 and P = 0.03, respectively). Conversely, no obvious correlation with any clinical outcome for patients with cervical carcinoma was found concerning HPV infection. CONCLUSIONS It is possible that the p53 gene may be used as a predictive factor in radiation therapy for patients with Stage IIIB squamous cell carcinoma of the cervix.
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Affiliation(s)
- H Ishikawa
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Gunma, Japan.
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Ebara T, Karasawa K, Maebayashi K, Kurosaki H, Ishikawa H, Kaizu T, Tanaka Y, Akagi K, Masuda G. Radiation therapy for Kaposi's sarcoma associated with acquired immunodeficiency syndrome: Tokyo Metropolitan Komagome Hospital experience. Int J Clin Oncol 2000. [DOI: 10.1007/pl00012069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Suzuki Y, Tamaki Y, Hasegawa M, Maebayashi K, Mitsuhashi N. Magnetic resonance images of primary malignant lymphoma of the uterine body: a case report. Jpn J Clin Oncol 2000; 30:519-21. [PMID: 11155924 DOI: 10.1093/jjco/hyd125] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Primary malignant lymphoma of the uterine body is extremely rare. There are few reports concerning magnetic resonance images (MR) of uterine body lymphoma although there are several reports concerning uterine cervical lymphoma. The MR images of a 66-year-old woman with primary malignant lymphoma of the uterine body showed that the myometrium was diffusely involved, exhibiting an almost homogeneous character, and the normal zonal anatomy of the uterine cervix was preserved, with the endometrium being partly recognized near the center of the tumor. We report suggestive findings on MR images of primary malignant lymphoma of the uterine body.
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Affiliation(s)
- Y Suzuki
- Department of Radiology, Gunma Cancer Center, Ota, Japan
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Higuchi K, Mitsuhashi N, Saitoh J, Maebayashi K, Sakurai H, Akimoto T, Niibe H. Caffeine enhanced radiosensitivity of rat tumor cells with a mutant-type p53 by inducing apoptosis in a p53-independent manner. Cancer Lett 2000; 152:157-62. [PMID: 10773407 DOI: 10.1016/s0304-3835(99)00449-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The radiosensitizing effects of caffeine on two rat yolk sac tumor cell lines with a different p53 status were investigated. A reduction of radiation-induced G(2) arrest was caused by caffeine at a concentration of 2 mM in both cell lines. The reduction of survival was observed in a combination of radiation and 2 mM caffeine only in a lower radiation dose range, but not in a higher dose range in NMT-1 with a wild type p53. Radiosensitization of caffeine was recognized even in a higher dose range for cells with a mutant-type p53. Apoptosis, which was not prominent after irradiation alone or caffeine treatment alone, was induced by irradiation in combination with caffeine in cells with a mutant-type p53 through a p53-independent pathway.
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Affiliation(s)
- K Higuchi
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, Japan.
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Akimoto T, Mitsuhashi N, Matsumoto H, Sakurai H, Maebayashi K, Higuchi K, Nozaki M, Niibe H. Potentially lethal damage repair and its inhibitory effect of caffeine in two yolk sac tumor cell lines with different radiosensitivities. Cancer Lett 1999; 147:199-206. [PMID: 10660107 DOI: 10.1016/s0304-3835(99)00308-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE In order to investigate the role of potentially lethal damage repair (PLDR) in cellular radiosensitivity, PLDR and its inhibitory effect by caffeine was examined. In addition, cell cycle distribution was also examined. MATERIALS AND METHODS Two rat yolk sac tumor cell lines, NMT-1 and NMT-1R, with different radiosensitivities in vitro were used. The capacity for PLDR was examined using confluent-phase cells, and evaluated by calculating the recovery ratio. Inhibitory effect of caffeine on PLDR was examined with doses of 1, 5 and 10 mM. RESULTS The capacity of PLDR in two cell lines reflected radiosensitivity. The recovery ratio after irradiation of 5 Gy was 2.8 in the radiosensitive NMT-1 and 5.2 in the radioresistant NMT-1R, and recovery reached its peak level at 6 h in both cell lines. The degree of inhibition of PLDR was weaker in NMT-1R than that in NMT-1 at the same dose level, and was correlated with reduction of G2-arrested cells by caffeine. CONCLUSIONS The results of this study suggest that the capacity of PLDR may be one of the determinant factors for radiosensitivity in the two cell lines used, and the inhibitory effect of caffeine on PLDR was in part attributable to the modification of the cell cycle progression.
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Affiliation(s)
- T Akimoto
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi, Japan.
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Mitsuhashi N, Islam MS, Sakurai H, Takahashi T, Murata O, Maebayashi K, Nozaki M, Akimoto T, Muramatsu H, Niibe H. Is radiosensitive cell line cross-sensitive to heat?: Effect of heat on two rat yolk sac tumor cell lines with different radiosensitivity. Cancer Lett 1999; 142:195-200. [PMID: 10463776 DOI: 10.1016/s0304-3835(99)00168-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The differences between two rat yolk sac tumor cell lines, which are of the same origin but differ in their response to irradiation, in thermal sensitivity and development of thermotolerance were investigated. A radiosensitive cell line NMT-1 is consistently less heat sensitive than the radioresistant cell line NMT-1R. The thermotolerances in NMT-1 and in NMT-1R preheated at 43 degrees C for 30 min, respectively, reached peaks at 6 h and at 12 h, but did not completely disappear at 48 h. Thermotolerance with a good correlation between both cell lines with HSP70 accumulation was observed in a different time course after a primary heating.
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Affiliation(s)
- N Mitsuhashi
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi, Japan.
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Sakurai H, Mitsuhashi N, Tamaki Y, Akimoto T, Murata O, Kitamoto Y, Maebayashi K, Ishikawa H, Hayakawa K, Niibe H. Interaction between low dose-rate irradiation, mild hyperthermia and low-dose caffeine in a human lung cancer cell line. Int J Radiat Biol 1999; 75:739-45. [PMID: 10405004 DOI: 10.1080/095530099140087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To investigate cell killing by means of low dose-rate irradiation (LDRI) combined with concurrent mild hyperthermia and to determine the effect of low-dose caffeine on this combination treatment. MATERIALS AND METHODS Human lung adenocarcinoma cells, LK87, were treated with LDRI (50 cGy/h) in combination with mild hyperthermia at 41 degrees C and low-dose caffeine (1 mM). Cell survival was estimated by clonogenic assay. Flow-cytometry was performed with PI staining using FACScan. Heat-shock protein (HSP72/73) was measured by the Western blotting method. All treatments were simultaneously performed for up to 48 h (24 Gy). RESULTS LDRI cytotoxicities were enhanced by hyperthermia at 41 degrees C. D0 calculated from the dose-response curve for LDRI combined with 41 degrees C was 3.46 Gy whereas it was 6.55 Gy for LDRI alone. The survival curve for LDRI +41 degrees C demonstrated no chronic thermotolerance up to 48 h. For LDRI + simultaneous low-dose caffeine, cell killing was also enhanced, where D0 was 3.38 Gy at 37 degrees C. Radiosensitization caused by caffeine was enhanced by combination with simultaneous mild hyperthermia at 41 degrees C, where D0=1.78 Gy. Cell cycle analysis demonstrated remarkable G2 and mild G1 arrest for LDRI alone, but only G1 arrest was observed for LDRI combined with 41 degrees C and for LDRI combined with caffeine. Strong and early G1 arrest was observed in the treatment with LDRI + caffeine at 41 degrees C. The amount of HSP72/73 in the combination of LDRI with caffeine at 41 degrees C was less than that at 41 degrees C alone. CONCLUSION LDRI cytotoxicity was enhanced by non-lethal hyperthermia. Low dose caffeine produced further cell killing in the combination of LDRI with mild hyperthermia.
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Affiliation(s)
- H Sakurai
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi, Japan. hsakurai@sb. gunma-u.ac.jp
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Abstract
PURPOSE We reported that two established rat yolk sac tumor cell lines differ in their radiosensitivity by 1.7 fold, and the variation is most likely manifested by the differences seen in their apoptotic response. We investigated the relationship between radiosensitivity and p53 in these cell lines. METHODS AND MATERIALS We assessed the status of p53 in cell lines by polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) and sequence analysis, and also analyzed protein expression of p53, p21, and bax as a function of time after irradiation to determine the signal transduction for p53 by immunoblotting. RESULTS A band shift was observed only in exon 7 for the radioresistant NMT-1R cells and no band shift was detected for the radiosensitive NMT-1 cells. A band shift was confirmed also at the mRNA level. Exon 7 of p53 DNA showed a three base substitution of DNA at codon 267 to 268. Expression of p53, p21, and bax proteins in NMT-1R cells did not change after 10 Gy irradiation; however, in NMT-1 cells, the expression of these proteins was increased from 1-12 h after irradiation. CONCLUSION A loss of p53 function by radiation-induced mutation of p53 decreased the radiosensitivity in these cell lines.
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Affiliation(s)
- K Maebayashi
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi, Japan
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Hayakawa K, Mitsuhashi N, Hasegawa M, Saito Y, Sakurai H, Ohno T, Maebayashi K, Ebara T, Hayakawa KY, Niibe H. The prognostic significance of immunohistochemically detected p53 protein expression in non-small cell lung cancer treated with radiation therapy. Anticancer Res 1998; 18:3685-8. [PMID: 9854477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The prognostic significance of nuclear p53 protein expression in survival and local control was investigated immunohistochemically in 36 patients with inoperable or unresectable non-small cell lung cancer who were treated with radiation therapy (RT). Formalin-fixed, paraffin-embedded sections obtained by bronchoscopy were used to examine the expression of nuclear p53 protein with immunohistochemistry. In 25 cases (69%), p53 protein expression was detected. There was no relation between p53 expression and other pretreatment characteristics. Response to RT was found in all p-53 negative cases versus 72% in p53-positive cases (p < 0.05). The 2-year survival rate for p53-negative cases was 51% with a median survival time of 21 months. The corresponding rate for p53-positive cases was 31% with a median survival time of 9 months. This difference, however, did not reach a statistically significant level because of the small sample size. In conclusion, the results of this study suggest that p53 protein expression may be of predictive value on response to RT in non-small cell lung cancer.
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Affiliation(s)
- K Hayakawa
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Japan.
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49
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Mitsuhashi N, Ishikawa H, Saito Y, Takahashi T, Sakurai H, Nozaki M, Akimoto T, Hasegawa M, Maebayashi K, Niibe H. A quantitative study of radiation-induced apoptosis in two rat yolk sac tumour cell lines with different radiosensitivities in vitro. Anticancer Res 1997; 17:3605-8. [PMID: 9413210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Two rat yolk sac tumour cell lines with different radiosensitivities were used to quantify the extent of apoptosis following irradiation by using a DNA fragmentation assay in vitro. Apoptosis was also confirmed by fluorescence analysis of nuclear morphological changes by using Hoechst 33258. A radiosensitive cell line, NMT-1 cells, showed morphological changes characteristic of apoptosis by fluorescence microscopic observation at 24 hours after irradiation with a single dose of 10 Gy. Development of apoptosis in NMT-1 cells was observed as a function of time within 24 hours after irradiation. There was a significant increase in the amount of apoptosis between 2 and 5 Gy only in NMT-1 cells but increasing the radiation dose from 5 Gy to 10 Gy did not result in increased apoptosis. A radioresistant NMT-1R cells, on the other hand, displayed a small apoptotic response to an irradiation dose of 10 Gy at 24 hours after irradiation.
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Affiliation(s)
- N Mitsuhashi
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Japan.
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50
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Takahashi T, Mitsuhashi N, Sakurai H, Saito Y, Akimoto T, Kitamoto Y, Maebayashi K, Fukusato T, Niibe H. Adult embryonal rhabdomyosarcoma showing marked response to radiotherapy: a case report. Radiat Med 1997; 15:177-80. [PMID: 9278375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
A case of embryonal rhabdomyosarcoma (RMS) arising from adult lower proximal extremity is described. Rhabdomyosarcoma (RMS) is most common among children, but adult embryonal RMS is rare. The patient was a 44-year-old man with a large tumor of the left extremity invading to the pelvis. The histological diagnosis was embryonal RMS. Radiation therapy was delivered a total dose of 50 Gy to the tumor. Although adult RMS, usually pleomorphic type, is considered to be radioresistant, the tumor showed marked response to radiotherapy and local control was achieved easily in this case.
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Affiliation(s)
- T Takahashi
- Department of Radiology and Radiation Oncology, Gunma University School of Medicine, Maebashi, Japan
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