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Murakami M, Ishikawa H, Sekino Y, Nishiyama H, Suzuki H, Sugahara S, Iizumi T, Mizumoto M, Okumura T, Keino N, Iizumi Y, Hashimoto K, Gosho M, Sakurai H. Moderately hypofractionated proton beam therapy for localized prostate cancer: 5-year outcomes of a phase II trial. J Radiat Res 2024:rrae026. [PMID: 38739903 DOI: 10.1093/jrr/rrae026] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Revised: 02/23/2024] [Indexed: 05/16/2024]
Abstract
The usefulness of moderately hypofractionated radiotherapy for localized prostate cancer has been extensively reported, but there are limited studies on proton beam therapy (PBT) using similar hypofractionation schedules. The aim of this prospective phase II study is to confirm the safety of a shortened PBT course using 70 Gy relative biological effectiveness (RBE) in 28 fractions. From May 2013 to June 2015, 102 men with localized prostate cancer were enrolled. Androgen deprivation therapy was administered according to risk classification. Toxicity was assessed using Common Terminology Criteria for Adverse Events version 4.0. Of the 100 patients ultimately evaluated, 15 were classified as low risk, 43 as intermediate risk, and 42 as high risk. The median follow-up time of the surviving patients was 96 months (range: 60-119 months). The 5-year cumulative incidences of grade 2 gastrointestinal/genitourinary adverse events were 1% (95% CI: 0.1-6.9) and 4% (95% CI: 1.5-10.3), respectively; no grade ≥ 3 gastrointestinal/genitourinary adverse events were observed. The current study revealed a low incidence of late adverse events in prostate cancer patients treated with moderately hypofractionated PBT of 70 Gy (RBE) in 28 fractions, indicating the safety of this schedule.
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Affiliation(s)
- Motohiro Murakami
- Department of Radiation Oncology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Hitoshi Ishikawa
- Department of Radiation Oncology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, Chiba, 263-8555, Japan
| | - Yuta Sekino
- Department of Radiation Oncology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
- JCOG Data Center and Operations Office, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuuo-ku, Tokyo, 104-0045, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine and Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Hiroyoshi Suzuki
- Department of Urology, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan
| | - Shinji Sugahara
- Department of Radiology, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuuo, Ami-machi, inashiki-gun, Ibaraki, 300-0395, Japan
| | - Takashi Iizumi
- Department of Radiation Oncology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Masashi Mizumoto
- Department of Radiation Oncology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Toshiyuki Okumura
- Department of Radiation Oncology, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, Kasama, Ibaraki, 309-1793, Japan
| | - Naoto Keino
- Tsukuba Clinical Research and Development Organization (T-CReDO), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Yuichi Iizumi
- Tsukuba Clinical Research and Development Organization (T-CReDO), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Koichi Hashimoto
- Tsukuba Clinical Research and Development Organization (T-CReDO), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Masahiko Gosho
- Department of Biostatistics, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
| | - Hideyuki Sakurai
- Department of Radiation Oncology, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8576, Japan
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Thunnissen E, Borczuk A, Flieder D, Witte B, Beasley MB, Chung JH, Dacic S, Lantuejoul S, Russell P, Den Bakker M, Botling J, Brambilla E, De Cuba E, Geisinger K, Hiroshima K, Marchevsky A, Minami Y, Moreira A, Nicholson A, Yoshida A, Tsao M, Warth A, Duhig E, Chen G, Matsuno Y, Travis W, Butnor K, Cooper W, Mino-Kenudson M, Motoi N, Polari C, Pelosi G, Kerr K, Ishikawa Y, Buettner R, Keino N, Yatabe Y, Noguchi M. PUB015 The Use of Immunohistochemistry Improves the Diagnosis of SCLC. An International Reproducibility Study in a Demanding Set of Cases. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.1985] [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: 11/27/2022]
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Thunnissen E, Borczuk AC, Flieder DB, Witte B, Beasley MB, Chung JH, Dacic S, Lantuejoul S, Russell PA, den Bakker M, Botling J, Brambilla E, de Cuba E, Geisinger KR, Hiroshima K, Marchevsky AM, Minami Y, Moreira A, Nicholson AG, Yoshida A, Tsao MS, Warth A, Duhig E, Chen G, Matsuno Y, Travis WD, Butnor K, Cooper W, Mino-Kenudson M, Motoi N, Poleri C, Pelosi G, Kerr K, Aisner SC, Ishikawa Y, Buettner RH, Keino N, Yatabe Y, Noguchi M. The Use of Immunohistochemistry Improves the Diagnosis of Small Cell Lung Cancer and Its Differential Diagnosis. An International Reproducibility Study in a Demanding Set of Cases. J Thorac Oncol 2016; 12:334-346. [PMID: 27998793 DOI: 10.1016/j.jtho.2016.12.004] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 11/23/2016] [Accepted: 12/01/2016] [Indexed: 01/22/2023]
Abstract
INTRODUCTION The current WHO classification of lung cancer states that a diagnosis of SCLC can be reliably made on routine histological and cytological grounds but immunohistochemistry (IHC) may be required, particularly (1) in cases in which histologic features are equivocal and (2) in cases in which the pathologist wants to increase confidence in diagnosis. However, reproducibility studies based on hematoxylin and eosin-stained slides alone for SCLC versus large cell neuroendocrine carcinoma (LCNEC) have shown pairwise κ scores ranging from 0.35 to 0.81. This study examines whether judicious use of IHC improves diagnostic reproducibility for SCLC. METHODS Nineteen lung pathologists studied interactive digital images of 79 tumors, predominantly neuroendocrine lung tumors. Images of resection and biopsy specimens were used to make diagnoses solely on the basis of morphologic features (level 1), morphologic features along with requested IHC staining results (level 2), and all available IHC staining results (level 3). RESULTS For the 19 pathologists reading all 79 cases, the rate of agreement for level 1 was 64.7%, and it increased to 73.2% and 77.5% in levels 2 and 3, respectively. With IHC, κ scores for four tumor categories (SCLC, LCNEC, carcinoid tumors, and other) increased in resection samples from 0.43 to 0.60 and in biopsy specimens from 0.43 to 0.64. CONCLUSIONS Diagnosis using hematoxylin and eosin staining alone showeds moderate agreement among pathologists in tumors with neuroendocrine morphology, but agreement improved to good in most cases with the judicious use of IHC, especially in the diagnosis of SCLC. An approach for IHC in the differential diagnosis of SCLC is provided.
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MESH Headings
- Adenocarcinoma/classification
- Adenocarcinoma/diagnosis
- Adenocarcinoma/metabolism
- Biomarkers, Tumor/metabolism
- Carcinoma, Neuroendocrine/classification
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/metabolism
- Carcinoma, Non-Small-Cell Lung/classification
- Carcinoma, Non-Small-Cell Lung/diagnosis
- Carcinoma, Non-Small-Cell Lung/metabolism
- Carcinoma, Squamous Cell/classification
- Carcinoma, Squamous Cell/diagnosis
- Carcinoma, Squamous Cell/metabolism
- Diagnosis, Differential
- Humans
- Immunoenzyme Techniques
- International Agencies
- Lung Neoplasms/classification
- Lung Neoplasms/diagnosis
- Lung Neoplasms/metabolism
- Neoplasm Staging
- Prognosis
- Reproducibility of Results
- Small Cell Lung Carcinoma/classification
- Small Cell Lung Carcinoma/diagnosis
- Small Cell Lung Carcinoma/metabolism
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Affiliation(s)
- Erik Thunnissen
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands.
| | - Alain C Borczuk
- Deptartment of Pathology, Weill Cornell Medicine, New York, New York
| | - Douglas B Flieder
- Department of Pathology, Fox Chase Cancer Center, Philadelphia, Pennsylvania
| | - Birgit Witte
- Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, The Netherlands
| | - Mary Beth Beasley
- Department of Pathology, Mount Sinai Medical Center, New York, New York
| | - Jin-Haeng Chung
- Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Sanja Dacic
- Department of Pathology University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sylvie Lantuejoul
- Department of Biopathology, Centre Léon Bérard UNICANCER, Lyon, France
| | - Prudence A Russell
- St. Vincent's Pathology and The University of Melbourne, Melbourne, Australia
| | - Michael den Bakker
- Department of Pathology, Maasstad Ziekenhuis, Rotterdam, the Netherlands
| | - Johan Botling
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - Elisabeth Brambilla
- CHU Albert Michallon-Institut de Biologie, Département d'Anatomie et Cytologie Pathologiques, Grenoble, France
| | - Erienne de Cuba
- Department of Pathology, VU University Medical Center, Amsterdam, The Netherlands
| | - Kim R Geisinger
- Department of Pathology, The University of Mississippi Medical Center, Jackson, Mississippi
| | - Kenzo Hiroshima
- Department of Pathology, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Japan
| | | | - Yuko Minami
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, Japan
| | - Andre Moreira
- Pulmonary Pathology, New York University Center for Biospecimen Research and Development, New York University, New York, New York
| | - Andrew G Nicholson
- Department of Histopathology, Royal Brompton and Harefield Hospitals National Health Service Foundation Trust and National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Akihiko Yoshida
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Ming-Sound Tsao
- Department of Pathology, University Health Network-Princess Margaret Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Arne Warth
- Institute of Pathology, Heidelberg University, Heidelberg, Germany
| | - Edwina Duhig
- Sullivan Nicolaides Pathology, The John Flynn Hospital, Tugun, Queensland, Australia
| | - Gang Chen
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yoshihiro Matsuno
- Department of Surgical Pathology, Hokkaido University Hospital, Sapporo, Japan
| | - William D Travis
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kelly Butnor
- Department of Pathology, University of Vermont, Burlington, Vermont
| | - Wendy Cooper
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Noriko Motoi
- Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Claudia Poleri
- Laboratorio de Patología Torácica, Buenos Aires, Argentina
| | - Giuseppe Pelosi
- Department of Oncology and Hemato-Oncology, Università degli Studi di Milano, Milan, Italy
| | - Keith Kerr
- Department of Pathology, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Seena C Aisner
- Department of Pathology and Laboratory Medicine at Rutgers New Jersey Medical School, Rutgers University, Newark, New Jersey
| | - Yuichi Ishikawa
- Division of Pathology, The Cancer Institute, Japan Foundation Cancer Research, Tokyo, Japan
| | | | - Naoto Keino
- Tsukuba Clinical Research and Development Organization, University of Tsukuba, Tsukuba, Japan
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan
| | - Masayuki Noguchi
- Department of Pathology, Institute of Basic Medical Sciences, University of Tsukuba, Tsukuba, Japan
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Matsui Y, Ogawa O, Ishitsuka R, Miyazaki J, Inoue T, Kageyama S, Sugimoto M, Mitsuzuka K, Shiraishi Y, Kinoshita H, Wakeda H, Nomoto T, Kikuchi E, Fujie K, Keino N, Nishiyama H. Current status of systemic chemotherapy for octogenarians with advanced urothelial cancer in Japan: a Japanese multi-institutional study (CURE study). Int J Clin Oncol 2016; 21:1142-1149. [PMID: 27349431 DOI: 10.1007/s10147-016-1007-8] [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: 03/12/2016] [Accepted: 06/14/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND The standard regimen of systemic chemotherapy for patients with advanced urothelial cancer (UC) changed from methotrexate, vinblastine, adriamycin, and cisplatin (MVAC) to gemcitabine and cisplatin (GC) in 2008 when the use of gemcitabine for UC began to be reimbursed by public health insurance in Japan. We examined its influence on the chemotherapy trend in elderly patients aged ≥80 years. METHODS Among 345 patients included in our previous multicenter retrospective cohort study (chemotherapy for urothelial carcinoma: renal function and efficacy study; CURE study), the outcome of 30 patients aged ≥80 years was reviewed before and after 2008 and compared with 315 young patients. RESULTS There were only 7 (4.6 %) elderly individuals among all registered patients before 2008, whereas the number increased to 23 (12 %) after 2008. Before 2008, only one elderly patient received MVAC, while GC (whose rate was similar to the rate in young patients) was administered to 13 patients (56.5 %) after 2008. The chemotherapeutic effect and overall survival (OS) rate was not significantly different between young and elderly patients. In the elderly treated with the GC regimen, the renal impairment rate after the first cycle was significantly higher, and the presence of distant metastases and renal impairment were independent prognostic factors in a multivariate analysis. CONCLUSION Since GC was approved as the standard regimen for first-line chemotherapy in UC, selected elderly patients have been able to safely receive systemic chemotherapy like young patients. The clinical response rate and OS rate were similar to the young, but we need to monitor changes in renal function more closely in the elderly treated with GC.
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Affiliation(s)
- Yoshiyuki Matsui
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, 606-8501, Japan.
| | - Osamu Ogawa
- Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, 606-8501, Japan
| | - Ryutaro Ishitsuka
- Department of Urology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Jun Miyazaki
- Department of Urology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takamitsu Inoue
- Department of Urology, Akita University Graduate School of Medicine, Akita, 010-8502, Japan
| | - Susumu Kageyama
- Department of Urology, Shiga University of Medical Science, Shiga, 520-2192, Japan
| | - Mikio Sugimoto
- Department of Urology, Kagawa University, Faculty of Medicine, Kagawa, 761-0701, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University, Graduate School of Medicine, Miyagi, 980-8575, Japan
| | - Yusuke Shiraishi
- Department of Urology, Hyogo College of Medicine, Hyogo, 663-8501, Japan
| | - Hidefumi Kinoshita
- Department of Urology and Andrology, Kansai Medical University, Osaka, 573-1191, Japan
| | - Hironobu Wakeda
- Department of Urology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Takeshi Nomoto
- Department of Urology, Tokai University School of Medicine, Kanagawa, 259-1193, Japan
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Keiko Fujie
- Faculty of Medicine, University of Tsukuba, Ibaraki, 305-8575, Japan.,Tsukuba Clinical Research and Development Organization, University of Tsukuba, Ibaraki, 305-8575, Japan
| | - Naoto Keino
- Tsukuba Clinical Research and Development Organization, University of Tsukuba, Ibaraki, 305-8575, Japan
| | - Hiroyuki Nishiyama
- Department of Urology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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