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Onishi H, Shioyama Y, Matsumoto Y, Matsuo Y, Miyakawa A, Yamashita H, Matsushita H, Aoki M, Nihei K, Kimura T, Ishiyama H, Murakami N, Nakata K, Takeda A, Uno T, Nomiya T, Taguchi H, Seo Y, Komiyama T, Marino K, Aoki S, Matsuda M, Akita T, Saito M. Real-World Results of Stereotactic Body Radiotherapy for 399 Medically Operable Patients with Stage I Histology-Proven Non-Small Cell Lung Cancer. Cancers (Basel) 2023; 15:4382. [PMID: 37686657 PMCID: PMC10486748 DOI: 10.3390/cancers15174382] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/10/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
Surgery is the standard treatment for stage I non-small cell lung cancer (NSCLC); however, no clear randomized trial demonstrates its superiority to stereotactic body radiotherapy (SBRT) regarding survival. We aimed to retrospectively evaluate the treatment outcomes of SBRT in operable patients with stage I NSCLC using a large Japanese multi-institutional database to show real-world outcome. Exactly 399 patients (median age 75 years; 262 males and 137 females) with stage I (IA 292, IB 107) histologically proven NSCLC (adenocarcinoma 267, squamous cell carcinoma 96, others 36) treated at 20 institutions were reviewed. SBRT was prescribed at a total dose of 48-70 Gy in 4-10 fractions. The median follow-up period was 38 months. Local progression-free survival rates were 84.2% in all patients and 86.1% in the T1, 78.6% in T2, 89.2% in adenocarcinoma, and 70.5% in squamous cell subgroups. Overall 3-year survival rates were 77.0% in all patients: 90.7% in females, 69.6% in males, and 41.2% in patients with pulmonary interstitial changes. Fatal radiation pneumonitis was observed in two patients, all of whom had pulmonary interstitial changes. This real-world evidence will be useful in shared decision-making for optimal treatment, including SBRT for operable stage I NSCLC, particularly in older patients.
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Affiliation(s)
- Hiroshi Onishi
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Yoshiyuki Shioyama
- Ion Beam Therapy Center, SAGA-HIMAT Foundation, 3049 Harakoga-machi, Tosu 841-0071, Japan
| | - Yasuo Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, 2-15-3 Kawagishi, Chuo-ku, Niigata 951-8566, Japan;
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;
| | - Akifumi Miyakawa
- Department of Radiology, School of Medicine, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan;
| | - Hideomi Yamashita
- Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;
| | - Haruo Matsushita
- Department of Radiation Oncology, School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan;
| | - Masahiko Aoki
- Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki City 036-8562, Aomori, Japan;
| | - Keiji Nihei
- Department of Radiation Oncology, Tokyo Metropolitan Cancer, Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan;
| | - Tomoki Kimura
- Department of Radiation Oncology, Hiroshima University, 1-2-3, Kasumi Minami-ku, Hiroshima 734-8551, Japan;
| | - Hiromichi Ishiyama
- Department of Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara 252-0375, Kanagawa, Japan;
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
| | - Kensei Nakata
- Department of Radiation Oncology, Sapporo Medical University, S1W17, Chuo-ku, Sapporo 060-8556, Hokkaido, Japan;
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura 247-0056, Kanagawa, Japan;
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City 260-8670, Chiba, Japan;
| | - Takuma Nomiya
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata-shi 990-9585, Yamagata, Japan;
| | - Hiroshi Taguchi
- Department of Radiation Oncology, Hokkaido University Hospital, North-14 West-5, Kita-ku, Sapporo 060-8648, Japan;
| | - Yuji Seo
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamada-oka, Suita 565-0871, Osaka, Japan;
| | - Takafumi Komiyama
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Kan Marino
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Shinichi Aoki
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Masaki Matsuda
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Tomoko Akita
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Masahide Saito
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
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Aoki S, Onishi H, Karube M, Yamamoto N, Yamashita H, Shioyama Y, Matsumoto Y, Matsuo Y, Miyakawa A, Matsushita H, Ishikawa H. Comparative Analysis of Photon Stereotactic Radiotherapy and Carbon-Ion Radiotherapy for Elderly Patients with Stage I Non-Small-Cell Lung Cancer: A Multicenter Retrospective Study. Cancers (Basel) 2023; 15:3633. [PMID: 37509294 PMCID: PMC10377658 DOI: 10.3390/cancers15143633] [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: 05/30/2023] [Revised: 07/04/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
The emergence of an aging society and technological advances have made radiotherapy, especially stereotactic body radiotherapy (SBRT), a common alternative to surgery for elderly patients with early stage non-small-cell lung cancer (NSCLC). Carbon-ion radiotherapy (CIRT) is also an attractive treatment option with potentially lower toxicity for elderly patients with comorbidities. We compared the clinical outcomes of the two modalities using Japanese multicenter data. SBRT (n = 420) and single-fraction CIRT (n = 70) data for patients with stage I NSCLC from 20 centers were retrospectively analyzed. Contiguous patients ≥ 80 years of age were enrolled, and overall survival (OS), disease-specific survival (DSS), local control (LC), and adverse event rates were compared. The median age was 83 years in both groups and the median follow-up periods were 28.5 and 42.7 months for SBRT and CIRT, respectively. The 3-year OS, DSS, and LC rates were 76.0% vs. 72.3% (p = 0.21), 87.5% vs. 81.6% (p = 0.46), and 79.2% vs. 78.2% (p = 0.87), respectively, for the SBRT vs. CIRT groups. Regarding toxicity, 2.9% of the SBRT group developed grade ≥ 3 radiation pneumonitis, whereas none of the CIRT group developed grade ≥ 2 radiation pneumonitis. SBRT and CIRT in elderly patients showed similar survival and LC rates, although CIRT was associated with less severe radiation pneumonitis.
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Affiliation(s)
- Shuri Aoki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
- Department of Radiology, University of Tokyo Hospital, Tokyo 113-8655, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi 400-0016, Japan
| | - Masataka Karube
- Department of Radiology, Teikyo University Mizonokuchi Hospital, Kanagawa 213-8507, Japan
| | - Naoyoshi Yamamoto
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Hideomi Yamashita
- Department of Radiology, University of Tokyo Hospital, Tokyo 113-8655, Japan
| | | | - Yasuo Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata 951-8133, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
- Department of Radiation Oncology, Faculty of Medicine, Kindai University, Osaka 577-8502, Japan
| | - Akifumi Miyakawa
- Department of Radiology, Graduate School of Medical Sciences, Nagoya City University, Aichi 467-8501, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8577, Japan
| | - Hitoshi Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
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Yamamoto T, Katagiri Y, Tsukita Y, Matsushita H, Umezawa R, Katsuta Y, Kadoya N, Takahashi N, Suzuki Y, Takeda K, Kishida K, Omata S, Miyauchi E, Saito R, Jingu K. Stereotactic Radiosurgery for Lung Cancer with a Risk-Adapted Strategy Using the Volumetric Modulated Arc Therapy Technique: A Single Arm Phase II Study. Cancers (Basel) 2022; 14:cancers14163993. [PMID: 36010985 PMCID: PMC9406332 DOI: 10.3390/cancers14163993] [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: 07/16/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Stereotactic radiosurgery (SRS) for lung cancer has an attractive schedule. In this study, we focused on the efficacy of SRS, and the primary endpoint of this study was the 3-year local recurrence rate. The results showed that the 3-year local recurrence rate was 5.3% (95% confidence interval: 0.3–22.2%), and this rate was less than the expected rate. Good results were obtained in this study and this regimen of SRS is a candidate for a future phase III trial. Abstract Purpose: A phase II study carried out to assess the efficacy of a risk-adapted strategy of stereotactic radiosurgery (SRS) for lung cancer. The primary endpoint was 3-year local recurrence, and the secondary endpoints were overall survival (OS), disease-free survival (DFS), rate of start of systemic therapy or best supportive care (SST-BSC), and toxicity. Materials and Methods: Eligible patients fulfilled the following criteria: performance status of 2 or less, forced expiratory volume in 1 s of 700 mL or more, and tumor not located in central or attached to the chest wall. Twenty-eight Gy was prescribed for primary lung cancers with diameters of 3 cm or less and 30 Gy was prescribed for primary lung cancers with diameters of 3.1–5.0 cm or solitary metastatic lung cancer diameters of 5 cm or less. Results: Twenty-one patients were analyzed. The patients included 7 patients with adenocarcinoma, 2 patients with squamous cell carcinoma, 1 patient with metastasis, and 11 patients with clinical diagnosis. The median tumor diameter was 1.9 cm. SRS was prescribed at 28 Gy for 18 tumors and 30 Gy for 3 tumors. During the median follow-up period of 38.9 months for survivors, 1 patient had local recurrence, 7 patients had regional or distant metastasis, and 5 patients died. The 3-year local recurrence, SST-BSC, DFS, and OS rates were 5.3% (95% confidence interval [CI]: 0.3–22.2%), 20.1% (95% CI: 6.0–40.2%), 59.2% (95% CI: 34.4–77.3%), and 78.2% (95% CI: 51.4–91.3%), respectively. The 95% CI upper value of local recurrence was lower than the null local recurrence probability. There was no severe toxicity, and grade 2 radiation pneumonitis occurred in 1 patient. Conclusions: Patients who received SRS for lung cancer had a low rate of 3-year local recurrence and tolerable toxicity.
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Affiliation(s)
- Takaya Yamamoto
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
- Correspondence: ; Tel.: +81-22-717-7312; Fax: +81-22-717-7316
| | - Yu Katagiri
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Yoko Tsukita
- Department of Respiratory Medicine, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Yoshiyuki Katsuta
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Yu Suzuki
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Kazuya Takeda
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Keita Kishida
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - So Omata
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Eisaku Miyauchi
- Department of Respiratory Medicine, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Ryota Saito
- Department of Respiratory Medicine, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai 980-8574, Japan
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Yamamoto T, Tsukita Y, Katagiri Y, Matsushita H, Umezawa R, Ishikawa Y, Takahashi N, Suzuki Y, Takeda K, Miyauchi E, Saito R, Katsuta Y, Kadoya N, Jingu K. Durvalumab after chemoradiotherapy for locally advanced non-small cell lung cancer prolonged distant metastasis-free survival, progression-free survival and overall survival in clinical practice. BMC Cancer 2022; 22:364. [PMID: 35379201 PMCID: PMC8981776 DOI: 10.1186/s12885-022-09354-1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background In clinical practice, the effect of durvalumab and radiation pneumonitis (RP) on survival after intensity-modulated radiotherapy (IMRT) is not fully understood. The purpose of this retrospective study was to investigate factors related to distant metastasis-free survival (DMFS), progression-free survival (PFS) and overall survival (OS) after IMRT for locally advanced non-small cell lung cancer (LA-NSCLC). Methods All patients who were treated with conventional fractionated IMRT for LA-NSCLC between April 2016 and March 2021 were eligible. Time-to-event data were assessed by using the Kaplan–Meier estimator, and the Cox proportional hazards model was used for prognostic factor analyses. Factors that emerged after the start of IMRT, such as durvalumab administration or the development of RP, were analysed as time-dependent covariates. Results A total of 68 consecutive patients treated with conventional fractionated IMRT for LA-NSCLC were analysed. Sixty-six patients completed radiotherapy, 50 patients received concurrent chemotherapy, and 36 patients received adjuvant durvalumab. During the median follow-up period of 14.3 months, 23 patients died, and tumour progression occurred in 37 patients, including 28 patients with distant metastases. The 1-year DMFS rate, PFS rate and OS rate were 59.9%, 48.7% and 84.2%, respectively. Grade 2 RP occurred in 16 patients, grade 3 in 6 patients and grade 5 in 1 patient. The 1-year cumulative incidences of grade 2 or higher RP and grade 3 or higher RP were 33.8% and 10.3%, respectively. The results of multivariate analyses showed that durvalumab had a significantly lower hazard ratio (HR) for DMFS, PFS and OS (HR 0.31, p < 0.01; HR 0.33, p < 0.01 and HR 0.32, p = 0.02), respectively. Grade 2 or higher RP showed significance for DMFS and a nonsignificant trend for OS (HR 2.28, p = 0.04 and HR 2.12, p = 0.13), respectively, whereas a higher percentage of lung volume receiving 20 Gy or higher was significant for PFS (HR 2.25, p = 0.01). Conclusions In clinical practice, durvalumab administration following IMRT with concomitant chemotherapy showed a significant survival benefit. Reducing the risk of grade 2 or higher RP would also be beneficial.
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Affiliation(s)
- Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Yoko Tsukita
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Katagiri
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Suzuki
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuya Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Eisaku Miyauchi
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryota Saito
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshiyuki Katsuta
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Takeda K, Matsushita H, Umezawa R, Yamamoto T, Ishikawa Y, Takahashi N, Suzuki Y, Jingu K. Hyperfractionated radiotherapy for re-irradiation of recurrent esophageal cancer. Radiat Oncol J 2022; 39:265-269. [PMID: 34986547 PMCID: PMC8743462 DOI: 10.3857/roj.2021.00325] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Re-irradiation is a treatment option for recurrent esophageal cancer patients with a history of radiotherapy, but there is a risk of severe late adverse effects. This study focused on the efficacy and safety of re-irradiation using hyperfractionated radiotherapy. Materials and Methods Twenty-six patients who underwent re-irradiation by the hyperfraction technique using twice-daily irradiation of 1.2 Gy per fraction for recurrent esophageal cancer were retrospectively included in this study. The overall survival period after the start of secondary radiotherapy and the occurrence of late adverse effects were investigated. Results Of 26 patients, 21 (81%) received re-irradiation with definitive intention and 21 (81%) underwent concurrent chemotherapy. The median re-irradiation dose was 60 Gy in 50 fractions in 25 treatment days, and the median accumulated irradiation dose in equivalent dose in 2 Gy per fraction was 85.4 Gy with an α/β value of 3. The median interval between two courses of radiotherapy was 21.0 months. The median overall survival period was 15.8 months and the 1-year and 3-year overall survival rates were 64.3% and 28.3%, respectively. Higher dose of re-irradiation and concurrent chemotherapy significantly improved survival (p < 0.001 and p = 0.019, respectively). Severe late adverse effects with the Common Terminology Criteria for Adverse Events grade 3 or higher were observed in 5 (19.2%) patients, and 2 (7.7%) of them developed a grade 5 late adverse effect. Conclusion High-dose re-irradiation using a hyperfractionated schedule with concurrent chemotherapy might be related to good prognosis, while the rate of late severe adverse effects is not high compared with the rates in past reports.
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Affiliation(s)
- Kazuya Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Suzuki
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Affiliation(s)
- M Kojima
- Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Kase
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - H Matsushita
- Department of Laboratory Medicine, National Cancer Center Hospital, Tokyo, Japan
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7
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Takeda K, Umezawa R, Ishikawa Y, Yamamoto T, Takahashi N, Takeda K, Kadoya N, Matsushita H, Kawasaki Y, Mitsuzuka K, Ito A, Arai Y, Takai Y, Jingu K. Clinical predictors of severe late urinary toxicity after curative intensity-modulated radiation therapy for localized prostate cancer. J Radiat Res 2021:rrab074. [PMID: 34467400 DOI: 10.1093/jrr/rrab074] [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] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/17/2021] [Indexed: 06/13/2023]
Abstract
Intractable late urinary toxicity is a serious complication after radiotherapy for patients with localized prostate cancer (LPC). We assessed clinical factors correlated with severe late urinary toxicity in LPC treated with curative image-guided intensity-modulated radiation therapy (IMRT). A total of 452 patients with LPC treated with IMRT between 2002 and 2016 were retrospectively analyzed. Among them, 432 patients received androgen deprivation therapy (ADT). The median total irradiated doses were 80 (range, 76-80) Gy. Each daily dose was 2 Gy per fraction. The median follow-up was 83 (range, 4-210) months. Late urinary toxicity was scored according to the National Cancer Institute Common Terminology Criteria for Adverse Events, Version 4.03. Grade 3 late urinary toxicity was observed in 27 patients. No cases with grade ≥ 4 late urinary toxicity were observed. The 5-, 10-, and 12.5-year grade 3 late urinary toxicity-free survival rates were 97%, 91.8% and 88.1%, respectively. Age, risk classification, total irradiated dose, ADT duration, antithrombotic therapy (AT), cardiovascular disease, hypertension (HT), diabetes mellitus (DM), dyslipidemia (DL), prior transurethral resection of the prostate (TURP) and prior high-intensity focused ultrasound (HIFU) were investigated for correlations with grade 3 late urinary toxicity. In univariate analysis, AT and prior HIFU and no other studied factors, were correlated with grade 3 late urinary toxicity. AT and prior HIFU appear to be predictive of grade 3 late urinary toxicity. Patients with LPC with these relevant clinical factors should be carefully followed up by sharing detailed information with the urology department.
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Affiliation(s)
- Ken Takeda
- Course of Radiological Technology, Health Sciences, Tohoku University School of Medicine, 2-1, Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Kazuya Takeda
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yoshihide Kawasaki
- Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Akihiro Ito
- Department of Urology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yoichi Arai
- Department of Urology, Miyagi Cancer Center, 47-1, Medeshimashiotenodayama, Natori, 981-1293, Japan
| | - Yoshihiro Takai
- Southern Tohoku BNCT Research Center, 7-10, Yatsuyamada, Koriyama, 963-8052, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University School of Medicine, 1-1, Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
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Yamamoto T, Kawasaki Y, Umezawa R, Kadoya N, Matsushita H, Takeda K, Ishikawa Y, Takahashi N, Suzuki Y, Takeda K, Kawabata K, Ito A, Jingu K. Stereotactic body radiotherapy for kidney cancer: a 10-year experience from a single institute. J Radiat Res 2021; 62:533-539. [PMID: 33866363 PMCID: PMC8127673 DOI: 10.1093/jrr/rrab031] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/09/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this retrospective study was to investigate survival outcomes and irradiated tumor control (local control [LC]) and locoregional control (LRC) after stereotactic body radiotherapy (SBRT) for T1 or recurrent T1 (rT1) kidney cancer. Twenty-nine nonconsecutive patients with 30 tumors were included. SBRT doses of 70 Gy, 60 Gy or 50 Gy in 10 fractions were prescribed with a linear accelerator using daily image guidance. The Kaplan-Meier method was used to estimate time-to-event outcomes, and the log-rank test was used to compare survival curves between groups divided by each possible factor. The median follow-up periods for all patients and survivors were 57 months and 69.6 months, respectively. The five-year LC rate, LRC rate, progression-free survival (PFS) rate, disease-specific survival (DSS) rate and overall survival (OS) rate were 94%, 88%, 50%, 96% and 68%, respectively. No significant factor was related to OS and PFS. Three of 24 non-hemodialysis (HD) patients had new-onset-HD because of the progression of underlying kidney disease. Grade 3 or higher toxicities from SBRT did not occur. In conclusion, SBRT for kidney cancer provided a high rate of LC, LRC and DSS with minimal toxicities, but patient selection and indication for SBRT should be done carefully considering the relatively low OS rate.
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Affiliation(s)
- Takaya Yamamoto
- Corresponding author. Takaya Yamamoto, M.D., Ph.D., Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. Tel: +81-22-717-7312, Fax: +81-22-717-7316, E-mail:
| | - Yoshihide Kawasaki
- Department of Urology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Kazuya Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Yu Suzuki
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Ken Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Kousei Kawabata
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Akihiro Ito
- Department of Urology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Japan
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Watanabe K, Toi Y, Nakamura A, Chiba R, Akiyama M, Sakakibara-Konishi J, Tanaka H, Yoshimura N, Miyauchi E, Nakagawa T, Igusa R, Minemura H, Mori Y, Fujimoto K, Matsushita H, Takahashi F, Fukuhara T, Inoue A, Sugawara S, Maemondo M. Randomized phase II trial of uracil/tegafur and cisplatin versus pemetrexed and cisplatin with concurrent thoracic radiotherapy for locally advanced unresectable stage III non-squamous non-small cell lung cancer: NJLCG1001. Transl Lung Cancer Res 2021; 10:712-722. [PMID: 33718016 PMCID: PMC7947416 DOI: 10.21037/tlcr-20-721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background The optimal regimen for concurrent chemoradiotherapy (CCRT) of locally advanced non-squamous non-small cell lung cancer (NSCLC) was not definitive. We conducted randomized phase II study, NJLCG0601, and chemoradiotherapy with uracil/tegafur (UFT) and cisplatin achieved promising efficacy without severe toxicities. Here, we evaluated between this regimen and pemetrexed plus cisplatin in chemoradiotherapy for stage III non-squamous NSCLC. Methods Patients with inoperable stage III non-squamous NSCLC were randomly assigned in a 1:1 ratio to UFT 400 mg/m2 on days 1–14 and 29–42, and cisplatin 80 mg/m2 on days 8 and 36 (UP), or cisplatin 75 mg/m2 and pemetrexed 500 mg/m2 on days 1, 22, and 43 (PP). Involved-field radiotherapy (IFRT) underwent from day 1 to a total dose of 66 Gy in 33 fractions. Consolidation chemotherapy after CCRT was prohibited for this study. The primary endpoint was defined as 2-year overall survival (OS). This trial was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000003948). Results From November 2010 to June 2017, 86 patients were entered from 11 institutions. Median follow-up was 54 months. Of the 85 eligible patients, the 2-year OS rate was 78.6% (95% CI, 62.8–88.3%) in UP and 85.5% (95% CI, 70.5–93.2%) in PP. Median PFS and OS was 12.3 and 64.2 months in UP, 26.2 months and not reached in PP, respectively. Grade 3/4 febrile neutropenia was more frequent in the UP group (14.0% vs. 2.0%). Conclusions Both UP and PP with IFRT achieved the expected 2-year OS. PP engendered more favorable OS and PFS compared to UP in terms.
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Affiliation(s)
- Kana Watanabe
- Department of Respiratory Medicine, Miyagi Cancer Center, Natori, Japan
| | - Yukihiro Toi
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Ryosuke Chiba
- Division of Pulmonary Medicine, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | - Masachika Akiyama
- Division of Pulmonary Medicine, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
| | | | - Hisashi Tanaka
- Department of Respiratory Medicine, Hirosaki University, Hirosaki, Japan
| | - Naruo Yoshimura
- Department of Respiratory Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Eisaku Miyauchi
- Department of Respiratory Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Taku Nakagawa
- Department of Thoracic Surgery, Omagari Kosei Medical Center, Daisen, Japan
| | - Ryotaro Igusa
- Department of Respiratory Medicine, Osaki Citizen Hospital, Osaki, Japan
| | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Yoshiaki Mori
- Department of Respiratory Medicine, Iwate Prefectural Central Hospital, Morioka, Japan
| | - Keisuke Fujimoto
- Department of Radiation Oncology, Miyagi Cancer Center, Natori, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University School of Medicine, Sendai, Japan
| | - Fumiaki Takahashi
- Department of Information Science, Iwate Medical University, Morioka, Japan
| | - Tatsuro Fukuhara
- Department of Respiratory Medicine, Miyagi Cancer Center, Natori, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Makoto Maemondo
- Division of Pulmonary Medicine, Department of Internal Medicine, Iwate Medical University School of Medicine, Yahaba, Japan
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10
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Katagiri Y, Jingu K, Yamamoto T, Matsushita H, Umezawa R, Ishikawa Y, Takahashi N, Takeda K, Tasaka S, Kadoya N. Differences in patterns of recurrence of squamous cell carcinoma and adenocarcinoma after radiotherapy for stage III non-small cell lung cancer. Jpn J Radiol 2021; 39:611-617. [PMID: 33484424 DOI: 10.1007/s11604-021-01091-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/04/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the differences in patterns of recurrence and treatment results by histology after definitive radiotherapy for stage III non-small cell lung cancer (NSCLC) in Japan. MATERIALS AND METHODS Patients with stage III NSCLC who underwent definitive radiotherapy between 2000 and 2016 in our institution were included. A total of 217 patients were enrolled. Propensity score matching was used to exclude the following confounding factors: (1) age (≥70 years or <70 years), (2) gender, (3) T factor, (4) N factor, (5) Eastern Cooperative Oncology Group performance status score and (6) smoking status (Brinkman index ≥400 or <400). RESULTS The median observation period for survivors was 55.1 months. After propensity score matching, the Sqcc and adenocarcinoma groups each included 62 paired patients. There was no significant difference in OS or PFS between the adenocarcinoma and Sqcc groups. However, rates of recurrence in the GTV-primary site (p = 0.009) and GTV-lymph node site (p = 0.037) were significantly higher in patients with Sqcc than in patients with adenocarcinoma. New metastatic recurrence was more frequent in patients with adenocarcinoma than in patients with Sqcc (p = 0.025). CONCLUSION There were significant differences in patterns of recurrence after definitive (chemo)radiotherapy between patients with Sqcc and patients with adenocarcinoma.
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Affiliation(s)
- Yu Katagiri
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan.
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Kazuya Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Shun Tasaka
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
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11
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Umezawa R, Kadoya N, Ota H, Nakajima Y, Saito M, Takagi H, Takanami K, Takahashi N, Ishikawa Y, Yamamoto T, Matsushita H, Takeda K, Takase K, Jingu K. Dose-Dependent Radiation-Induced Myocardial Damage in Esophageal Cancer Treated With Chemoradiotherapy: A Prospective Cardiac Magnetic Resonance Imaging Study. Adv Radiat Oncol 2020; 5:1170-1178. [PMID: 33305078 PMCID: PMC7718544 DOI: 10.1016/j.adro.2020.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/09/2020] [Revised: 07/15/2020] [Accepted: 07/20/2020] [Indexed: 12/25/2022] Open
Abstract
Purpose The purpose of this prospective study was to evaluate radiation-induced myocardial damage after mediastinal radiation therapy (RT) using late gadolinium-enhancement (LGE) magnetic resonance imaging (MRI). Methods and Materials We enrolled 19 patients with esophageal cancer who were expected to have long-term survival by definitive treatment. They underwent delayed contrast-enhanced MRI (19 patients before treatment, 19 patients 6 months after treatment, and 12 patients 1.5 years after treatment). Dose distribution of the left ventricle was made using computed tomography, and the dose volume histogram of the left ventricle was calculated. Myocardial signal intensities in individual MRIs were normalized by the mean values in regions receiving low doses (<5 Gy). Changes in the normalized signal intensities after mediastinal radiation therapy were compared among regions where irradiation doses were 0 to 10 Gy, 10 to 20 Gy, 20 to 30 Gy, 30 to 40 Gy, 40 to 50 Gy, and 50 to 60 Gy, and we investigated whether intensity change was detected in a dose-dependent manner. Results The registered patients were treated with concurrent chemoradiotherapy with a median total dose of 60 Gy (50.4-66 Gy). Chemotherapy consisting of cisplatin and 5-fluorouracil was administered. In the population-based dose-response curve, dose-dependent intensity changes progressively increased in regions receiving more than 30 Gy. The averages of relative intensity change at 6 months and 1.5 years after treatment were 1.1% and −1.9% at 20 to 30 Gy and 37.5% and 17.5% at 40 to 50 Gy, respectively. LGE in regions receiving more than 30 Gy was detected in 68% (13/19) of the patients. Conclusions A dose-dependent relationship for myocardial signal intensity change was found by using LGE MRI. It may be necessary to reduce the volume of the myocardium receiving more than 30 Gy.
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Affiliation(s)
- Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yujiro Nakajima
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masahide Saito
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hidenobu Takagi
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kentaro Takanami
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ken Takeda
- Department of Radiological Technology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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12
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Tang L, Ma Z, Ishikawa Y, Matsushita H, Ishida T, Jingu K. Effect of radiotherapy after breast-conserving surgery in elderly patients with early breast cancer according to the AJCC 8th Edition Breast Cancer Staging System in Japan. Breast Cancer 2020; 28:465-470. [PMID: 33141399 DOI: 10.1007/s12282-020-01181-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 07/30/2020] [Accepted: 10/22/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND The number of elderly patients in Japan with breast cancer has been gradually increasing. The aim of this study was to determine the efficacy of radiotherapy (RT) after breast-conserving surgery (BCS) for elderly patients with early breast cancer who were restaged according to the 8th Edition Breast Cancer Staging System. METHODS We reviewed patients age ≥ 65 years who received BCS and adjuvant RT or BCS alone for breast cancer between 2010 and 2015 in our institution and restaged those patients using the AJCC 8th edition pathological prognostic staging system. We compared relapse-free survival (RFS) and overall survival (OS) rates in the RT group and no RT group. RESULTS A total of 170 patients were eligible for analysis: 94 (55.3%) were treated with RT and 76 (44.7%) were treated without RT. Age (p < 0.01) was associated with the use of RT. Adjuvant RT significantly improved RFS (95.75% vs 84.21%, p = 0.02). There was no significant difference between the OS rates in the two groups. Univariate analysis showed that pathologic T stage and N stage were significantly associated with both RFS and OS and that histologic grade, chemotherapy, HER2, and RT were significantly associated with RFS, but not with OS. RT reduced the risk of recurrence (HR = 0.56, 95% CI = 0.19-0.96, p = 0.04). CONCLUSIONS RT was associated with significantly improved RFS, but had no significant impact on OS in elderly patients with breast cancer after BCS. Adjuvant RT should be performed even for elderly patients with early breast cancer.
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Affiliation(s)
- Liuwei Tang
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Zichang Ma
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Takanori Ishida
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan.
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Takeda K, Umezawa R, Ishikawa Y, Yamamoto T, Takahashi N, Takeda K, Katagiri Y, Tasaka S, Kadoya N, Ito K, Katsuta Y, Tanaka S, Sato K, Matsushita H, Kawasaki Y, Mitsuduka K, Ito A, Arai Y, Takai Y, Jingu K. Clinical Predictors Of Severe Late Urinary Toxicity After Curative Intensity-Modulated Radiation Therapy For Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.520] [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: 11/24/2022]
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14
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Takahashi N, Umezawa R, Kishida K, Matsushita H, Yamamoto T, Ishikawa Y, Takeda K, Suzuki Y, Kawabata K, Teramura S, Jingu K. Radiotherapy for Esophageal Cancer in Patients ≥80 years: A Retrospective Study in a Single Institution. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1948] [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: 11/25/2022]
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15
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Matsushita H, Kinoshita W, Kurokawa H, Kousaka T. Particle swarm optimization-based strategy for detecting border-collision bifurcation points in piecewise smooth maps. Appl Soft Comput 2020. [DOI: 10.1016/j.asoc.2020.106319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Matsushita H, Shimizu S, Morita N, Watanabe K, Wakatsuki A. Effects of royal jelly on bone metabolism in postmenopausal women: a randomized, controlled study. Climacteric 2020; 24:164-170. [PMID: 32880201 DOI: 10.1080/13697137.2020.1806815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 10/23/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effects of royal jelly (RJ) supplementation on bone metabolism in postmenopausal women. METHODS This was a randomized, double-blind, placebo-controlled clinical trial. Seventy-two healthy postmenopausal women aged 45-60 years within 5 years after menopause were randomized into two groups: women in the RJ group (n = 36) received capsules containing dried RJ (equivalent to 3000 mg of fresh RJ); and women in the placebo group (n = 36) received placebo daily for 6 months. Bone mineral density (BMD) of the lumbar spine (L2-L4) and left proximal femur, hip structural analysis (HSA) of the left hip, and bone turnover markers were measured. RESULTS Although women in the placebo group experienced a significant loss of BMD and deterioration in HSA parameters of the femur, no significant differences were found in these parameters in women in the RJ group. The levels of total procollagen type 1 N-terminal propeptide (P1NP) and tartrate-resistant acid phosphatase decreased significantly in the placebo group; however, the total P1NP level, a marker of bone formation, was not significantly different in the RJ group at postintervention compared with baseline. CONCLUSION RJ consumption may ameliorate decreases in femoral BMD and strength in postmenopausal women.
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Affiliation(s)
- H Matsushita
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - S Shimizu
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - N Morita
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - K Watanabe
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
| | - A Wakatsuki
- Department of Obstetrics and Gynecology, Aichi Medical University School of Medicine, Nagakute, Japan
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Yamamoto T, Umezawa R, Tokunaga H, Kubozono M, Kozumi M, Takahashi N, Matsushita H, Kadoya N, Ito K, Sato K, Tsuji K, Shimada M, Jingu K. Clinical experience of pelvic radiotherapy or chemoradiotherapy for postoperative uterine cervical cancer using intensity-modulated radiation therapy. J Radiat Res 2020; 61:470-478. [PMID: 32100833 PMCID: PMC7299262 DOI: 10.1093/jrr/rraa004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/13/2020] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
The purpose of this study was to reveal treatment outcomes and toxicity after pelvic intensity-modulated radiotherapy (IMRT) for postoperative uterine cervical cancer of Japanese patients. Consecutive patients who were treated with pelvic IMRT for postoperative cervical cancer in our institute were retrospectively analyzed. Relapse-free survival (RFS) and overall survival (OS) were calculated using the Kaplan-Meier estimator, and log-rank tests were used to compare differences. From the database, 62 patients were identified. The pathology was squamous cell carcinoma in 44 patients and other pathology in 18 patients. Of the 62 patients, 35 had high-risk prognostic factors and 27 patients had intermediate-risk prognostic factors. The prescribed radiation doses were 50 Gy in 25 fractions for 58 patients and 50.4 Gy in 28 fractions for 4 patients. One patient received a vaginal cuff boost. Chemotherapy was administered in 36 patients. During the median follow-up period of 50.9 months, there was no locoregional failure. Six patients in the high-risk group relapsed, but none of the patients in the intermediate-risk group relapsed (P = 0.02). The 3-year OS and RFS rates were 98.2% and 90.9%, respectively. Significant factors related to RFS were squamous cell carcinoma pathology (P = 0.02), pathological T stage (P = 0.04), surgical margin status (P < 0.01) and multiple lymph nodes metastases (P < 0.01). Grade 3 or more toxicity occurred in 6 patients. Four patients had obstruction of the intestine, and 2 patients had stenosis of the urinary tract. In clinical practice, the use of pelvic IMRT for postoperative cervical cancer of Japanese patients showed a low rate of toxicity without decreasing the efficacy.
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Affiliation(s)
- Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hideki Tokunaga
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masaki Kubozono
- Department of Radiation Oncology, Miyagi Cancer Center, Natori, Japan
| | - Maiko Kozumi
- Division of Radiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kengo Ito
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyokazu Sato
- Radiation Technology, Tohoku University Hospital, Sendai, Japan
| | - Keita Tsuji
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Muneaki Shimada
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Onishi H, Shioyama Y, Matsuo Y, Takayama K, Miyakawa A, Yamashita H, Nomiya T, Matsumo Y, Matsushita H, Kimura T, Murakami N, Ishiyama H, Uno T, Takanaka T, Katoh N, Takeda A, Nakata K, Ogawa K, Nihei K, Aoki M, Kuriyama K, Komiyama T, Marino K, Araya M, Aoki S, Saito R, Maehata Y, Tominaga R, Nonaka H, Oguri M, Matsuda M, Yamada T, Akita T, Hiraoka M. Prognosis after Local Recurrence or Metastases in Medically Operable Stage I Non-Small Cell Lung Cancer Patients Treated By Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2424] [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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Sato B, Kanda M, Ito S, Teramoto H, Mochizuki Y, Ishigure K, Murai T, Asada T, Ishiyama A, Matsushita H, Tanaka C, Kobayashi D, Fujiwara M, Kodera Y. Proposal of optimal cut-off of preoperative serum tumor marker levels to predict postoperative recurrences of gastric cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.173] [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: 11/12/2022] Open
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Watanabe K, Toi Y, Nakamura A, Fukuhara T, Chiba R, Akiyama M, Sakakibara-Konishi J, Tanaka H, Yoshimura N, Miyauchi E, Nakagawa T, Igusa R, Minemura H, Mori Y, Fujimoto K, Matsushita H, Takahashi F, Inoue A, Sugawara S, Maemondo M. Randomized phase Ⅱ trial of uracil/tegafur and cisplatin versus pemetrexed and cisplatin with concurrent thoracic radiotherapy for locally advanced unresectable stage Ⅲ non-squamous non-small-cell lung cancer: NJLCG1001. J Clin Oncol 2019. [DOI: 10.1200/jco.2019.37.15_suppl.8527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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
8527 Background: It is unknown which regimen is the best in concurrent chemoradiotherapy (CCRT) of locally advanced non-squamous non-small cell lung cancer (NSCLC). Our previous randomized phase Ⅱ study, NJLCG0601, showed that chemoradiotherapy with uracil/tegafur (UFT) and cisplatin achieved promising efficacy with acceptable toxicities. In this trial, this regimen was compared to a regimen with pemetrexed and cisplatin for stage Ⅲ non-squamous NSCLC. Methods: Patients with inoperable stage Ⅲ non-squamous NSCLC were randomized to UFT 400 mg/m2 on days 1–14 and 29–42, and cisplatin 80 mg/m2 on days 8 and 36 (UP), or pemetrexed 500 mg/m2 and cisplatin 75 mg/m2 on days 1, 22, and 43 (PP). Involved-field radiotherapy (IFRT) was administered from day 1 to a total dose of 66 Gy radiotherapy in 33 fractions. Consolidation chemotherapy after CCRT was not planned for this study. The primary endpoint was 2-year overall survival (OS), with expected rates of 55% and a lower limit of 35% (alfa 0.05, beta 0.2). Secondary endpoints were the objective response rate (ORR), progression-free survival (PFS), OS, and toxicity profile. Results: From November 2010 to June 2017, 86 patients were enrolled from 11 institutions. Of the 85 eligible patients, the rate of 2-year OS was 78.6% (95% CI: 62.8–88.3%) in the UP arm and 85.5% (95% CI: 70.5–93.2%) in the PP arm. The ORR was 76.7% in the UP arm and 81.0% in the PP arm. With a median follow-up of 54 months, median PFS and OS were 12.3 and 64.2 months in the UP arm, and 26.2 months and not reached in the PP arm, respectively. Grade 3/4 febrile neutropenia was more frequent in the UP arm than in the PP arm (14.0%, 2.0%, respectively). Grade 3/4 pneumonitis occurred in 7.0% and 4.8% of patients in UP and PP arms, respectively. Conclusions: Both regimens with IFRT achieved the expected 2-year survival rate. PP had more favorable results than UP in terms of OS and PFS. We selected the PP arm for the next step.
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Affiliation(s)
- Kana Watanabe
- Department of Respiratory Medicine, Miyagi Cancer Center, Natori, Japan
| | - Yukihiro Toi
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Atsushi Nakamura
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
| | - Tatsuro Fukuhara
- Department of Respiratory Medicine, Miyagi Cancer Center, Natori, Japan
| | | | - Masachika Akiyama
- Iwate Medical University Division of Plumonaruy Medicine, Allergy, and Rheumatology, Morioka, Japan
| | | | - Hisashi Tanaka
- Department of Respiratory Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Naruo Yoshimura
- Department of Respiratory Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan
| | | | - Taku Nakagawa
- Department of Thoracic Surgery, Omagari Kosei Medical Center, Daisen, Japan
| | | | - Hiroyuki Minemura
- Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan
| | | | | | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Fumiaki Takahashi
- Department of Information Science, Iwate Medical University, Iwate, Japan
| | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Shunichi Sugawara
- Department of Pulmonary Medicine, Sendai Kousei Hospital, Sendai, Japan
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Jingu K, Umezawa R, Yamamoto T, Takeda K, Ishikawa Y, Takahashi N, Kadoya N, Matsushita H. FDG-PET might not contribute to improving survival in patients with locally advanced inoperable esophageal cancer. Int J Clin Oncol 2019; 24:927-933. [PMID: 30863993 DOI: 10.1007/s10147-019-01428-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/29/2018] [Accepted: 03/07/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND In Japan, positron emission tomography using 18F-fluorodeoxyglucose (FDG-PET) has been covered by the national health insurance for esophageal cancer since 2006. FDG-PET is commonly performed in advanced esophageal cancer. The aim of this study was to determine the effect of FDG-PET on survival in patients with locally advanced inoperable esophageal cancer. METHODS We retrospectively reviewed all patients with cT4 and without M1 esophageal cancer on CT in our institution between 2000 and 2014, and data for 78 patients who meet the eligibility criteria described below were used for analysis in this study. The eligibility criteria included (1) cT4 esophageal cancer without distant metastases or M1 lymph node metastasis (UICC 2002), (2) histologically proven squamous cell carcinoma, (3) 20-79 years of age, (4) having undergone at least 1 cycle of concomitant chemotherapy, (5) having been irradiated with 50 Gy or more, and (6) no other active malignant tumor during treatment. RESULTS Two patients were excluded because abdominal lymph node metastases or neck lymph node metastases were detected by FDG-PET. In 78 eligible patients, FDG-PET was not performed before treatment in 41 of the 78 patients and was performed in the other patients. The median observation period was 68 months. The 3-year and 5-year overall survival rates in 78 patients were 36.9% and 30.8%, respectively. There was no significant difference in overall survival or progression-free survival between patients in whom FDG-PET was performed and those in whom FDG-PET was not performed (12.0 months vs. 11.0 months, p = 0.920 and 6.0 months vs. 6.0 months, p = 0.844, respectively). CONCLUSIONS Compared with only CT, additional information from FDG-PET is not associated with improving survival in patients with locally advanced esophageal cancer. Our results suggest that FDG-PET might not have much meaning for survival in locally advanced esophageal cancer.
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Affiliation(s)
- Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan.
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Kazuya Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, 980-8574, Japan
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Jingu K, Matsushita H, Yamamoto T, Umezawa R, Ishikawa Y, Takahashi N, Katagiri Y, Takeda K, Kadoya N. Stereotactic Radiotherapy for Pulmonary Oligometastases From Colorectal Cancer: A Systematic Review and Meta-Analysis. Technol Cancer Res Treat 2019; 17:1533033818794936. [PMID: 30145943 PMCID: PMC6111389 DOI: 10.1177/1533033818794936] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The purpose of this study was to determine whether pulmonary oligometastases from colorectal cancer have greater radioresistance than that of pulmonary oligometastases from other cancers and whether good local control can be achieved by dose escalation in stereotactic body radiotherapy. MATERIALS AND METHODS This systematic review and meta-analysis were conducted according to the preferred reporting items for systematic reviews and meta-analyses statement and methods. Studies were obtained from a database search of PubMed, Web of Science, and Google Scholar for publications using search terms designed to identify studies on "oligometastases," "lung," "stereotactic radiotherapy," and "colorectal cancer." For meta-analysis 1, studies that showed the number of local failures after stereotactic body radiotherapy for pulmonary metastases from colorectal carcinoma and other cancers were included. For meta-analysis2, studies in which a comparison was made of local control rates of pulmonary metastases from colorectal carcinoma by stereotactic body radiotherapy with a higher dose and that with a lower dose were included. A meta-analysis was performed using Mantel-Haenszel statics with the fixed or random-effect model by Review Manager 5.3. RESULTS Eighteen retrospective studies with 1920 patients with pulmonary oligometastases were used in meta-analysis 1. The local control rate in patients with pulmonary oligometastases from colorectal cancer was significantly lower than that in patients with pulmonary oligometastases from other cancers (odds ratio = 3.10, P < .00001). Next, 8 retrospective studies with 478 patients were included in meta-analysis 2 for dose escalation. Better local control was achieved by a higher prescription dose than by a lower prescription dose (odds ratio = 0.16, P < .00001). CONCLUSION Our meta-analysis indicated that local control of pulmonary oligometastases from colorectal cancer by stereotactic body radiotherapy was significantly worse than that of pulmonary metastases from other cancers; however, our results also indicated that good local control of pulmonary oligometastases from colorectal cancer can be achieved by dose escalation.
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Affiliation(s)
- Keiichi Jingu
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takaya Yamamoto
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rei Umezawa
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Katagiri
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuya Takeda
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Kadoya
- 1 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Onimaru R, Onishi H, Ogawa G, Hiraoka M, Ishikura S, Karasawa K, Matsuo Y, Kokubo M, Shioyama Y, Matsushita H, Ito Y, Shirato H. Final report of survival and late toxicities in the Phase I study of stereotactic body radiation therapy for peripheral T2N0M0 non-small cell lung cancer (JCOG0702). Jpn J Clin Oncol 2019; 48:1076-1082. [PMID: 30277519 PMCID: PMC6255689 DOI: 10.1093/jjco/hyy141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 07/06/2018] [Accepted: 09/10/2018] [Indexed: 12/25/2022] Open
Abstract
Purpose A dose escalation study to determine the recommended dose with stereotactic body radiation therapy (SBRT) for peripheral T2N0M0 non-small cell carcinomas (JCOG0702) was conducted. The purpose of this paper is to report the survival and the late toxicities of JCOG0702. Materials and methods The continual reassessment method was used to determine the dose level that patients should be assigned to and to estimate the maximum tolerated dose. The starting dose was 40 Gy in four fractions at D95 of PTV. Results Twenty-eight patients were enrolled. Ten patients were treated with 40 Gy at D95 of PTV, four patients with 45 Gy, eight patients with 50 Gy, one patient with 55 Gy and five patients with 60 Gy. Ten patients were alive at the last follow-up. Overall survival (OS) for all patients was 67.9% (95% CI 47.3–81.8%) at 3 years and 40.8% (95% CI 22.4–58.5%) at 5 years. No Grade 3 or higher toxicity was observed after 181 days from the beginning of the SBRT. Compared to the toxicities up to 180 days, chest wall related toxicities were more frequent after 181 days. Conclusions The 5-year OS of 40.8% indicates the possibility that SBRT for peripheral T2N0M0 non-small cell lung cancer is superior to conventional radiotherapy. The effect of the SBRT dose escalation on OS is unclear and further studies are warranted.
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Affiliation(s)
- Rikiya Onimaru
- Department of Radiation Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi Graduate School of Medical Science, Chuo, Japan
| | - Gakuto Ogawa
- JCOG Data Center, Center for Research Administration and Support, National Cancer Center, Tokyo, Japan
| | - Masahiro Hiraoka
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Satoshi Ishikura
- Department of Radiation Oncology, Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku Nagoya, Japan
| | - Katsuyuki Karasawa
- Department of Radiation Oncology, Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masaki Kokubo
- Department of Image-based Medicine, Institute of Biomedical Research and Innovation, Kobe, Japan.,Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yoshiyuki Shioyama
- Department of Clinical Radiology, Kyushu University Graduate School of Medicine, Fukuoka, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshinori Ito
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroki Shirato
- Department of Radiation Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
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Takahashi N, Matsushita H, Umezawa R, Yamamoto T, Ishikawa Y, Katagiri Y, Tasaka S, Takeda K, Fukui K, Kadoya N, Ito K, Jingu K. Hypofractionated Radiotherapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution. Eur Thyroid J 2019; 8:24-30. [PMID: 30800638 PMCID: PMC6381908 DOI: 10.1159/000493315] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 08/27/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Anaplastic thyroid carcinoma (ATC) is a rare cancer and has a poor prognosis. Several radiation protocols have been reported, but the results were not satisfactory. OBJECTIVE The aim of this study was to determine the effect of hypofractionated radiotherapy. METHODS Thirty-three patients who received radiotherapy for ATC between January 2000 and December 2014 were retrospectively included. We defined hypofractionated radiotherapy as a single dose ≥5 Gy. RESULTS Nineteen patients were treated with hypofractionated radiotherapy. Twenty-eight patients died, and 27 of those patients died from ATC. Sixteen patients died from distant metastasis and 6 from local recurrence. In the hypofractionated radiotherapy group, local recurrence occurred in 5 patients and 1 of them died from active bleeding from a local tumor. There was local recurrence in 7 patients who received the other protocol, and 5 of them died from asphyxiation, active bleeding, or uncontrollable growth of a local tumor on the neck. The median overall survival (OS) was 5 months. In multivariate analysis, patients who received an equivalent dose in 2-Gy fractions (EQD2) ≥50 Gy had significantly better OS (p = 0.016). In univariate analysis, patients who received hypofractionated radiotherapy did not have significantly better OS (p = 0.872) or local control (p = 0.090). The χ2 test showed that significantly fewer patients died from local recurrence in the hypofractionated radiotherapy group (p = 0.025). CONCLUSIONS Multivariate analysis showed that an EQD2 ≥50 Gy resulted in better OS, and hypofractionated radiotherapy decreased the rate of mortality from local recurrence.
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Affiliation(s)
- Noriyoshi Takahashi
- *Noriyoshi Takahashi, Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574 (Japan), E-Mail
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Shioyama Y, Onishi H, Takayama K, Matsuo Y, Takeda A, Yamashita H, Miyakawa A, Murakami N, Aoki M, Matsushita H, Matsumoto Y, Shibamoto Y. Clinical Outcomes of Stereotactic Body Radiotherapy for Patients With Stage I Small-Cell Lung Cancer: Analysis of a Subset of the Japanese Radiological Society Multi-Institutional SBRT Study Group Database. Technol Cancer Res Treat 2018; 17:1533033818783904. [PMID: 29983096 PMCID: PMC6048619 DOI: 10.1177/1533033818783904] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Stereotactic body radiotherapy (SBRT) is widely used as a curative treatment option for
stage I non-small-cell lung cancer, but for patients with stage I small-cell lung cancer,
the role of stereotactic body radiotherapy is unclear. In this study, we retrospectively
analyzed the outcomes of a subset of patients with stage I small-cell lung cancer treated
with stereotactic body radiotherapy in the database of the Japanese Radiological
Society-Multi-Institutional stereotactic body radiotherapy Study Group. The 43 patients
treated with stereotactic body radiotherapy for stage I small-cell lung cancer between
2004 and 2012 at 11 Japanese institutions were studied: median age = 77 years; 32 (74%)
males and 11 females; and 80% were medically inoperable. The clinical stage was IA in 31
and IB in 12. In all patients, the lung tumors were pathologically proven as small-cell
lung cancer. A total dose of 48 to 60 Gy was administered in 4 to 8 fractions. The median
biologically effective dose (α/β = 10 Gy) was 105.6 Gy. Chemotherapy and prophylactic
cranial irradiation were administered in only 8 patients, respectively. The median
follow-up time was 23.2 months. The 2-year overall survival, progression-free survival,
and distant metastasis-free survival rates were 72.3%, 44.6%, and 47.2%, respectively. The
2-year local control was 80.2%. Regarding the patterns of failure, distant metastasis,
lymph node metastasis, and local recurrence were observed in 47%, 28%, and 16% of
patients, respectively. No ≥grade 3 stereotactic body radiotherapy-related toxicities were
observed. Although stereotactic body radiotherapy was thus revealed to be effective for
the local control of stage I small-cell lung cancer, the incidence of distant metastases
was high. Further investigations of larger cohorts are needed, including analyses of the
effects of combined chemotherapy.
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Affiliation(s)
- Yoshiyuki Shioyama
- 1 Department of Radiation Oncology, Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
| | - Hiroshi Onishi
- 2 Department of Radiology, Graduate School of Medicine, Yamanashi University, Yamanashi, Japan
| | - Kenji Takayama
- 3 Division of Radiation Oncology, Institute of Biomedical Research and Innovation, Kobe, Japan
| | - Yukinori Matsuo
- 4 Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Kyoto, Japan
| | - Atsuya Takeda
- 5 Department of Radiology, Ofuna Chuo Hospital, Kamakura, Japan
| | - Hideomi Yamashita
- 6 Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akifumi Miyakawa
- 7 Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Naoya Murakami
- 8 Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Masahiko Aoki
- 9 Department of Radiology and Radiation Oncology, Graduate School of Medicine, Hirosaki University, Hirosaki, Japan
| | - Haruo Matsushita
- 10 Department of Radiation Oncology, Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yasuo Matsumoto
- 11 Department of Radiation Oncology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Yuta Shibamoto
- 7 Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Kimura Y, Dobashi S, Ishizawa Y, Kadoya N, Ito K, Chiba T, Takayama Y, Sato K, Matsushita H, Jingu K, Takeda K. [Field Shape Optimization Technique Based on Dose Volume Histogram Using Daily Cone-beam Computed Tomography in Three-dimensional Conformal Radiation Therapy for Localized Prostate Cancer: Develop and Evaluation]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2018; 74:1396-1405. [PMID: 30568089 DOI: 10.6009/jjrt.2018_jsrt_74.12.1396] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study aimed to develop and evaluate field shape optimization technique based on dose calculation using daily cone-beam computed tomography (CBCT) to compensate for interfractional anatomic changes in three-dimensional conformal radiation therapy (3D-CRT) for prostate cancer. For each of 10 patients, 9-10 CBCT images were obtained throughout the treatment course. The prostate, seminal vesicles, and rectum were manually contoured in all CBCT images. Subsequently, plan adaptation was performed with a program developed in-house. This program calculates dose distributions on CBCT images and optimizes field shape to minimize rectal dose while keeping the target at the optimal dose coverage (the planning target volume D95% receives 95% of the prescription dose). To evaluate the adaptive planning approach, we re-calculated dose distributions on CBCT images based on the conventional and adaptive plans. For the entire cohort, plan adaptation improved rectal V50 Gy, V60 Gy, V65 Gy, and V70 Gy by -7.71±8.43%, -8.30±8.90%, -7.91±8.51% and -7.03±7.70% on average (±SD), respectively. Our results demonstrate that adaptive planning approach is superior to the conventional planning approach for optimizing dose distribution, and this adaptive approach can optimize field shape in 3 min. The proposed approach can be an effective solution for the problem of interfractional anatomic changes in 3D-CRT for prostate cancer.
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Affiliation(s)
- Yuto Kimura
- Course of Radiological Technology, Health Sciences, Tohoku University School of Medicine (Current address: Division of Medical Physics, Aomori Shintoshi Hospital)
| | - Suguru Dobashi
- Course of Radiological Technology, Health Sciences, Tohoku University School of Medicine
| | - Yoshiki Ishizawa
- Course of Radiological Technology, Health Sciences, Tohoku University School of Medicine
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University School of Medicine
| | - Kengo Ito
- Department of Radiation Oncology, Tohoku University School of Medicine
| | - Takahito Chiba
- Department of Radiation Oncology, Tohoku University School of Medicine
| | - Yoshiki Takayama
- Department of Radiation Oncology, Tohoku University School of Medicine
| | | | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University School of Medicine
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University School of Medicine
| | - Ken Takeda
- Course of Radiological Technology, Health Sciences, Tohoku University School of Medicine
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Tang L, Matsushita H, Jingu K. Controversial issues in radiotherapy after breast-conserving surgery for early breast cancer in older patients: a systematic review. J Radiat Res 2018; 59:789-793. [PMID: 30321392 PMCID: PMC6251423 DOI: 10.1093/jrr/rry071] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 07/25/2018] [Indexed: 06/08/2023]
Abstract
Breast cancer is the most common malignant disease among older women, and the number of new older patients per year is increasing year by year. Radiotherapy has been confirmed as an important treatment after breast conservation for the reduction of local recurrence and mortality for all patients, including node-positive cases. However, there are fewer clinical trials evaluating the toxicity and benefits of radiotherapy for older patients. Whether radiotherapy can provide substantial benefit for older patients after breast-conserving surgery is controversial. This systematic review will focus on the key aspects of this controversial issue.
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Affiliation(s)
- Liuwei Tang
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-chou, Aoba-ku, Sendai, Japan
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Takahashi N, Matsushita H, Umezawa R, Yamamoto T, Ishikawa Y, Katagiri Y, Tasaka S, Takeda K, Fukui K, Kadoya N, Ito K, Jingu K. Hypofractionated Radiation Therapy for Anaplastic Thyroid Carcinoma: 15 Years of Experience in a Single Institution. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1096] [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: 10/28/2022]
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Onishi H, Imai T, Ito Y, Matsumo Y, Onimaru R, Shioyama Y, Yoshitake T, Kokubo M, Takayama K, Yamashita H, Matsuo Y, Matsushita H, Karasawa K, Kuriyama K, Komiyama T, Shirato H. Single Nucleotide Polymorphisms of Inflammation-Related Genes As Predictive Risk Factors of Radiation Pneumonitis after Stereotactic Body Radiation Therapy for Stage I Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1882] [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: 10/28/2022]
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Shimizu S, Matsushita H, Minami A, Kanazawa H, Suzuki T, Watanabe K, Wakatsuki A. Royal jelly does not prevent bone loss but improves bone strength in ovariectomized rats. Climacteric 2018; 21:601-606. [PMID: 30296854 DOI: 10.1080/13697137.2018.1517739] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 12/13/2022]
Abstract
OBJECTIVE Royal jelly (RJ) has been used for medical and nutritional purposes, and previous studies have indicated that it may have estrogenic activity. The present study investigated the effects of RJ on bone metabolism in ovariectomized (OVX) rats. METHODS Rats (12 weeks old) were randomly divided into four groups, namely Baseline, Sham, OVX, and OVX + RJ groups. Rats in the Baseline group were killed immediately, whereas rats in the OVX and OVX + RJ groups underwent bilateral ovariectomy and those in the Sham group underwent sham operation. RJ was administered to rats in the OVX + RJ group daily for 12 weeks. At the end of the 12-week period, bone mass, bone histomorphometry, and bone mechanics were analyzed. RESULTS Femur bone mineral density (BMD) was significantly lower in the OVX group than in the Sham group, and this decrease in BMD was not ameliorated by RJ administration. However, femur stiffness, as evaluated by a three-point bending test, was significantly higher in the OVX + RJ group than in the OVX group. CONCLUSION The findings of the present study suggest that RJ does not prevent bone loss, but does improve bone strength in OVX rats.
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Affiliation(s)
- S Shimizu
- a Department of Obstetrics and Gynecology, School of Medicine , Aichi Medical University , Nagakute , Japan
| | - H Matsushita
- a Department of Obstetrics and Gynecology, School of Medicine , Aichi Medical University , Nagakute , Japan
| | - A Minami
- b Department of Biochemistry, School of Pharmaceutical Sciences , University of Shizuoka , Shizuoka , Japan
| | - H Kanazawa
- c Department of Functional Anatomy, School of Nursing , University of Shizuoka , Shizuoka , Japan
| | - T Suzuki
- b Department of Biochemistry, School of Pharmaceutical Sciences , University of Shizuoka , Shizuoka , Japan
| | - K Watanabe
- a Department of Obstetrics and Gynecology, School of Medicine , Aichi Medical University , Nagakute , Japan
| | - A Wakatsuki
- a Department of Obstetrics and Gynecology, School of Medicine , Aichi Medical University , Nagakute , Japan
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Yamamoto T, Kadoya N, Morishita Y, Sato Y, Matsushita H, Umezawa R, Ishikawa Y, Takahashi N, Katagiri Y, Takeda K, Jingu K. Assessment and agreement of the CT appearance pattern and its severity grading of radiation-induced lung injury after stereotactic body radiotherapy for lung cancer. PLoS One 2018; 13:e0204734. [PMID: 30286105 PMCID: PMC6171841 DOI: 10.1371/journal.pone.0204734] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 09/13/2018] [Indexed: 02/07/2023] Open
Abstract
Purpose Radiographic severity of radiation-induced lung injury (RILI) has not been well-studied. The goal of this study was to assess the CT appearance pattern and severity of RILI without consideration of the clinical presentation. Material and methods A total of 49 patients, 41 with primary lung cancer and 8 with metastatic lung cancer, were treated by 4-fraction stereotactic body radiotherapy (SBRT). RILI after SBRT was separately assessed by two observers. The early and late CT appearance patterns and CT-based severity grading were explored. Results The median follow-up period was 39.0 months. In the early CT findings of observers 1 and 2, there was diffuse consolidation in 15 and 8, diffuse ground glass opacity (GGO) in 0 and 0, patchy consolidation and GGO in 17 and 20, patchy GGO in 3 and 3, and no changes in 10 and 14, respectively (kappa = 0.61). In late CT findings of observer 1 and 2, there were modified conventional pattern in 28 and 24, mass-like pattern in 8 and 11, scar-like pattern in 12 and 12, and no changes in 1 and 2, respectively (kappa = 0.63). In the results of the CT-based grading by observers 1 and 2, there were grade 0 in 1 and 2, grade 1 in 10 and 14, grade 2 in 31 and 29, grade 3 in 7 and 4, and none of grade 4 or more, respectively (kappa = 0.66). According to multivariate analyses (MVA), the significant predicting factors of grade 2 or more CT-based RILI were age (p = 0.01), oxygen dependence (p = 0.03) and interstitial shadow (p = 0.03). Conclusions The agreement of the CT appearance and CT-based grading between two observers was good. These indicators may be able to provide us with more objective information and a better understanding of RILI.
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Affiliation(s)
- Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
- * E-mail:
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yohei Morishita
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshinao Sato
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Katagiri
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ken Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Nejo T, Matsushita H, Karasaki T, Nomura M, Takayanagi S, Tanaka S, Mukasa A, Kakimi K, Saito N. P04.14 Multiomics analysis on primary and recurrent paired tumors reveals a possible immune evasion mechanism through reduced neoantigen expression in some glioma. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Nejo
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
- Department of Immunotherapeutics, The University of Tokyo Hospital, Tokyo, Japan
| | - H Matsushita
- Department of Immunotherapeutics, The University of Tokyo Hospital, Tokyo, Japan
| | - T Karasaki
- Department of Immunotherapeutics, The University of Tokyo Hospital, Tokyo, Japan
| | - M Nomura
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - S Takayanagi
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - S Tanaka
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - A Mukasa
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
| | - K Kakimi
- Department of Immunotherapeutics, The University of Tokyo Hospital, Tokyo, Japan
| | - N Saito
- Department of Neurosurgery, The University of Tokyo, Tokyo, Japan
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Hosoda J, Ishikawa T, Matsumoto K, Iguchi K, Kiyokuni M, Matsushita H, Taguchi Y, Andoh K, Nobuyoshi M, Fujii S, Inoue K, Shizuta S, Kimura T, Isshiki T. P1947Gender differences in cardiac response and outcomes with cardiac resynchronization therapy in heart failure patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p1947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- J Hosoda
- Yokohama City University, Yokohama, Japan
| | - T Ishikawa
- Yokohama City University, Yokohama, Japan
| | | | - K Iguchi
- Yokohama City University, Yokohama, Japan
| | - M Kiyokuni
- Yokohama City University, Yokohama, Japan
| | | | - Y Taguchi
- Yokohama City University, Yokohama, Japan
| | - K Andoh
- Kokura Memorial Hospital, Kitakyushu, Japan
| | | | - S Fujii
- Kurashiki Central Hospital, Kurashiki, Japan
| | - K Inoue
- Sakurabashi-Watanabe Hospital, Osaka, Japan
| | - S Shizuta
- Kyoto University Hospital, Kyoto, Japan
| | - T Kimura
- Kyoto University Hospital, Kyoto, Japan
| | - T Isshiki
- Teikyo University Hospital, Tokyo, Japan
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Takase M, Shirai M, Matsushita H, Umehara H, Wakabayashi S, Doi A, Inoue I. The severity of unilateral spatial neglect was positively correlated with that of Pusher syndrome. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.078] [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: 10/28/2022]
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Takeda K, Umezawa R, Takahashi N, Matsushita H, Kozumi M, Ishikawa Y, Yamamoto T, Takeda K, Jingu K. Impact of change in serum albumin level during and after chemoradiotherapy in patients with locally advanced esophageal cancer. Esophagus 2018; 15:190-197. [PMID: 29951984 DOI: 10.1007/s10388-018-0612-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 03/23/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND In patients with locally advanced esophageal cancer treated by concurrent chemoradiotherapy (CCRT), baseline malnutrition and its progression have been shown to be associated with a poor outcome. We conducted this study to determine the variation in four blood test parameters including serum albumin level (ALB), creatinine (Cre), hemoglobin (Hb) and platelet (Plt) during CCRT for stage III esophageal cancer patients and its effect on patients' outcome. METHODS One hundred eighty-three patients diagnosed with stage III esophageal cancer were retrospectively investigated. In addition to known prognostic factors, baseline level of the four blood test parameters and their variation at day 105 (ΔALB, ΔCre, ΔHb and ΔPlt, respectively) were analyzed. RESULTS The median observation period for patients who survived was 57.2 months, and the 5-year overall survival rate was 35.6% (95% CI 34.2-36.9%). In multivariate analyses, baseline ALB (≥ 3.6 g/dL), higher ΔALB (≥ + 0.3 g/dL) were independent predictors for overall survival (p = 0.001 and < 0.001, respectively), in addition to other clinical factors including T stage and overall treatment time (OTT). For disease-free survival, ΔALB was only a predictor in hematological parameters (p = 0.001) in addition to T stage and OTT. No hematological and clinical parameters had significant correlation with local control in multivariate analysis. Furthermore, ΔALB showed significant correlation with OS and DFS in log-rank test (p = 0.002 and 0.002, respectively). CONCLUSIONS Our results suggest improvement in ALB after treatment might be a favorable prognostic factor in esophageal cancer patients treated by CCRT.
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Affiliation(s)
- Kazuya Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Maiko Kozumi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
| | - Ken Takeda
- Department of Radiological Technology, School of Health Sciences, Faculty of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai, 980-8575, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan
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Kozumi M, Ota H, Yamamoto T, Umezawa R, Matsushita H, Ishikawa Y, Takahashi N, Matsuura T, Takase K, Jingu K. Oesophageal squamous cell carcinoma: histogram-derived ADC parameters are not predictive of tumour response to chemoradiotherapy. Eur Radiol 2018; 28:4296-4305. [PMID: 29725833 PMCID: PMC6132721 DOI: 10.1007/s00330-018-5439-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/09/2018] [Accepted: 03/19/2018] [Indexed: 12/13/2022]
Abstract
Objectives To evaluate correlations between tumour response to definitive chemoradiotherapy (CRT) in oesophageal squamous cell carcinoma (SCC) and histogram-derived apparent diffusion coefficient (ADC) parameters on diffusion-weighted MR images. Methods Forty patients with clinical T3–4 oesophageal SCC underwent concurrent CRT. MR examination at 3 T was performed 1–3 days prior to CRT. Readout-segmented echo-planar diffusion imaging was used to acquire ADC maps. Pre- and post-treatment CT examinations were performed. Histogram parameters (mean, 10th, 25th, 50th, 75th, 90th percentiles, skewness and kurtosis) of the ADC values were compared with post-treatment disease status based on RECIST and the tumour regression ratio. Results None of the ADC parameters showed significant correlation with post-treatment status (range of Spearman’s ρ values − 0.19 to 0.14, range of p values 0.22–0.47) or tumour regression ratio (range of Spearman’s ρ values − 0.045 to 0.18, range of p values 0.26–0.96). Neither progression-free survival (PFS) (p = 0.17) nor overall survival (OS) (p = 0.15) was significantly different between the two groups corresponding to the lower (< median) and upper arms (≥ median) of the mean ADC values. Conclusions Histogram-derived pretreatment ADC parameters were not predictive imaging biomarkers for tumour response to CRT in patients with oesophageal SCC. Key Points • Apparent diffusion coefficient (ADC) values are derived from diffusion-weighted MR imaging. • High-resolution diffusion-weighted images are generated by readout-segmented echo-planar diffusion imaging. • Readout-segmented echo-planar diffusion-weighted imaging enabled evaluation of ADC parameters. • Pretreatment ADC parameters do not predict chemoradiotherapy response in patients with oesophageal carcinoma. Electronic supplementary material The online version of this article (10.1007/s00330-018-5439-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maiko Kozumi
- Department of Radiology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, Japan.
| | - Hideki Ota
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomonori Matsuura
- Department of Radiology, Tohoku Medical and Pharmaceutical University Hospital, 1-12-1 Fukumuro, Miyagino-ku, Sendai, Miyagi, Japan
| | - Kei Takase
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, Japan
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Katsuta Y, Kadoya N, Fujita Y, Shimizu E, Majima K, Matsushita H, Takeda K, Jingu K. Log file-based patient dose calculations of double-arc VMAT for head-and-neck radiotherapy. Phys Med 2018; 48:6-10. [DOI: 10.1016/j.ejmp.2018.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 02/23/2018] [Accepted: 03/11/2018] [Indexed: 11/16/2022] Open
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Matsushita H, Jingu K, Umezawa R, Yamamoto T, Ishikawa Y, Takahashi N, Katagiri Y, Kadoya N. Stereotactic Radiotherapy for Oligometastases in Lymph Nodes-A Review. Technol Cancer Res Treat 2018; 17:1533033818803597. [PMID: 30352542 PMCID: PMC6201169 DOI: 10.1177/1533033818803597] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/22/2018] [Accepted: 08/27/2018] [Indexed: 01/26/2023] Open
Abstract
In recent years, the concept of oligometastases has become accepted and reports on stereotactic body radiotherapy as a treatment method have been published. Lesions in the brain, lung, and liver have been reported as target lesions. However, lymph node oligometastases could be a good candidate for stereotactic body radiotherapy as well. In this study, the usability of stereotactic body radiotherapy for oligometastases to lymph nodes is assessed by researching for each primary site. As a result, we could consider that stereotactic body radiotherapy could be almost well applied for lymph node oligometastases from the breast, gynecological organs, and prostate. However, doubts remain concerning the usefulness of stereotactic body radiotherapy for cervical node metastases from head and neck cancer or for mediastinal node metastases from lung or esophageal cancer since late toxicities have occurred with a large radiation dose at hypofractionation to major vessels or the central respiratory tract, especially in patients with irradiation histories. In addition, high-dose irradiation is required to control lymph node metastases from colorectal cancer due to its radioresistance, and severe late adverse events would therefore occur in adjacent organs such as the gastrointestinal tract. In cases of lymph node oligometastases with a primary tumor in the stomach or esophagus, stereotactic body radiotherapy should be used limitedly at present because this patient population is not so large and these metastases are often located close to organs at risk. Because of the varied status of recurrence and varied conditions of patients, it is difficult to determine the optimal dose for tumor control. It might be reasonable to determine the treatment dose individually based on dose constraints of adjacent organs. The oligometastatic state is becoming more frequently identified with more sensitive methods of detecting such oligometastases. In addition, there seems to be another type of oligometastases, so-called induced oligometastases, following successful systemic treatment. To determine the optimal indication of stereotactic body radiotherapy for lymph node oligometastases, further investigation about the mechanisms of oligometastases and further clinical studies including a phase III study are needed.
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Affiliation(s)
- Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
| | - Yu Katagiri
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of
Medicine, Sendai, Japan
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Katsuta Y, Kadoya N, Fujita Y, Shimizu E, Matsunaga K, Sawada K, Matsushita H, Majima K, Jingu K. Patient-Specific Quality Assurance Using Monte Carlo Dose Calculation and Elekta Log Files for Prostate Volumetric-Modulated Arc Therapy. Technol Cancer Res Treat 2017; 16:1220-1225. [PMID: 29334027 PMCID: PMC5762095 DOI: 10.1177/1533034617745250] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Log file–based methods are attracting increasing interest owing to their ability to validate volumetric-modulated arc therapy outputs with high resolution in the leaf and gantry positions and in delivered dose. Cross-validation of these methods for comparison with measurement-based methods using the ionization chamber/ArcCHECK-3DVH software (version 3.2.0) under the same conditions of treatment anatomy and plan enables an efficient evaluation of this method. In this study, with the purpose of cross-validation, we evaluate the accuracy of a log file–based method using Elekta log files and an X-ray voxel Monte Carlo dose calculation technique in the case of leaf misalignment during prostate volumetric-modulated arc therapy. In this study, 10 prostate volumetric-modulated arc therapy plans were used. Systematic multileaf collimator leaf positional errors (±0.4 and ±0.8 mm for each single bank) were deliberately introduced into the optimized plans. Then, the delivered 3-dimensional doses to a phantom with a certain patient anatomy were estimated by our system. These doses were compared with the ionization chamber dose and the ArcCHECK-3DVH dose. For the given phantom and patient anatomy, the estimated dose strongly coincided with the ionization chamber/ArcCHECK-3DVH dose (P < .01). In addition, good agreement between the estimated dose and the ionization chamber/ArcCHECK-3DVH dose was observed. The dose estimation accuracy of our system, which combines Elekta log files and X-ray voxel Monte Carlo dose calculation, was evaluated.
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Affiliation(s)
- Yoshiyuki Katsuta
- 1 Department of Radiology, Takeda General Hospital, Aizuwakamatsu, Japan.,2 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyuki Kadoya
- 2 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukio Fujita
- 3 Department of Radiation Oncology, Tokai University Graduate School of Medicine, Isehara, Japan
| | - Eiji Shimizu
- 1 Department of Radiology, Takeda General Hospital, Aizuwakamatsu, Japan
| | - Kenichi Matsunaga
- 1 Department of Radiology, Takeda General Hospital, Aizuwakamatsu, Japan
| | - Kinya Sawada
- 1 Department of Radiology, Takeda General Hospital, Aizuwakamatsu, Japan
| | - Haruo Matsushita
- 2 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuhiro Majima
- 1 Department of Radiology, Takeda General Hospital, Aizuwakamatsu, Japan
| | - Keiichi Jingu
- 2 Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Karasaki T, Nagayama K, Fukumoto K, Kitano K, Nitadori J, Sato M, Anraku M, Hosoi A, Matsushita H, Kakimi K, Nakajima J. P1.07-017 Assessment of Cancer Immunity Status in Each Patient Using Immunogram. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.935] [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: 10/18/2022]
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Katsuta Y, Kadoya N, Fujita Y, Shimizu E, Matsunaga K, Matsushita H, Majima K, Jingu K. Clinical impact of dosimetric changes for volumetric modulated arc therapy in log file-based patient dose calculations. Phys Med 2017; 42:1-6. [DOI: 10.1016/j.ejmp.2017.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/19/2017] [Accepted: 08/09/2017] [Indexed: 11/29/2022] Open
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42
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Yamamoto T, Kadoya N, Sato Y, Matsushita H, Umezawa R, Kubozono M, Ishikawa Y, Kozumi M, Takahashi N, Morishita Y, Katagiri Y, Sato K, Ito K, Takeda K, Jingu K. Prognostic Value of Radiation Pneumonitis After Stereotactic Body Radiotherapy: Effect of Pulmonary Emphysema Quantitated Using CT Images. Clin Lung Cancer 2017; 19:e85-e90. [PMID: 28655592 DOI: 10.1016/j.cllc.2017.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 03/28/2017] [Revised: 05/28/2017] [Accepted: 05/30/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND The aim of this study was to determine the prognostic factors of radiation pneumonitis (RP) after stereotactic body radiotherapy (SBRT). PATIENTS AND METHODS A total of 50 patients (36 male and 14 female) were treated with SBRT for 42 primary lung cancers and 8 metastatic lung cancers. SBRT was performed with 48 Gy in 4 fractions to the isocenter or with 40 Gy in 4 fractions covering 95% of the planning target volume. Percentage of low attenuation area (%LAA) was defined as percentage of the lung area with attenuation of -860 Hounsfield units (HU) or lower (%LAA-860) or of -960 HU or lower (%LAA-960). The dosimetric parameter of V20 Gy, which means percentage volume of the lung receiving 20 Gy or more, was recalculated. RP was assessed using Common Terminology Criteria for Adverse Events version 4.0. RESULTS The median follow-up period was 39.0 months (range, 7.2-94.5 months). RP of Grade 0, Grade 1, and Grade 2 to 3 was diagnosed in 11, 29, and 10 patients, respectively. Multivariate analyses (MVA) for Grade 1 showed that higher %LAA-860 and higher %LAA-960 were significantly associated with a lower rate of Grade 1 RP. MVA for Grade 2 to 3 showed that lower Brinkman index and lower lung V20 Gy were significantly associated with a lower rate of Grade 2 to 3 RP, and, in contrast, %LAA-860 and %LAA-960 had no association with Grade 2 to 3 RP. CONCLUSION This result suggests that high %LAA is associated with radiological changes (Grade 1) but that %LAA has no correlation with Grade 2 to 3 RP because symptomatic RP might also be affected by other factors.
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Affiliation(s)
- Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yoshinao Sato
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masaki Kubozono
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yojiro Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Maiko Kozumi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yohei Morishita
- Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yu Katagiri
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kiyokazu Sato
- Radiation Technology, Tohoku University Hospital, Sendai, Japan
| | - Kengo Ito
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ken Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Taguchi Y, Ishikawa T, Ogino Y, Matsushita H, Hosoda J, Matsumoto K, Sumita S, Matsushita K, Tamura K. P1751Validation of pacemaker-detected sleep apnea in Japanese people. Europace 2017. [DOI: 10.1093/ehjci/eux161.061] [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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44
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Hosoda J, Ishikawa T, Matsumoto K, Iguchi K, Matsushita H, Ogino Y, Taguchi Y, Tamura K, Andoh K, Nobuyoshi M, Fujii S, Shizuta S, Kimura T, Isshiki T. P1557Impact of quality of life on cardiac function and outcomes in heart failure patients with cardiac resynchronization therapy. Europace 2017. [DOI: 10.1093/ehjci/eux158.183] [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: 11/12/2022] Open
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45
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Yabuno A, Matsushita H, Fujieda N, Shintani D, Ogasawara A, Fujiwara K, Kakimi K, Hasegawa K. Serum cytokine arrays reveal different cytokine profiles as prognostic factors for overall survival in patients with ovarian high-grade serous and clear cell carcinoma. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.201] [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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46
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Hasegawa K, Matsushita H, Oda K, Yamamoto S, Nishijima A, Imai Y, Asada K, Ikeda Y, Fujiwara K, Aburatani H, Kakimi K. Immunoediting, neoantigen frequency, and clinical outcome in patients with ovarian clear cell carcinoma. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.039] [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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47
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Jingu K, Umezawa R, Yamamoto T, Matsushita H, Ishikawa Y, Kozumi M, Kubozono M, Takahashi N, Kadoya N, Takeda K. Elective nodal irradiation is not necessary in chemoradiotherapy for postoperative loco-regional recurrent esophageal cancer. Jpn J Clin Oncol 2017; 47:200-205. [PMID: 28031356 DOI: 10.1093/jjco/hyw195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [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: 11/07/2016] [Accepted: 12/06/2016] [Indexed: 11/14/2022] Open
Abstract
Purpose The purposes of the present study were to evaluate prognostic factors for patients with postoperative loco-regional recurrent esophageal cancer treated with chemoradiotherapy by multivariate analysis and to determine which irradiation is better, involved field irradiation or elective nodal irradiation, by matched-pair analysis. Methods We reviewed records for 80 patients with postoperative loco-regional recurrent esophageal cancer treated by chemoradiotherapy between 2000 and 2014. The median follow-up period was 62.0 months. Thirty-one cases were treated with elective nodal irradiation and were randomly matched by risk factors to 49 cases treated with involved field irradiation (1:1). Results Fifty-one patients had disease recurrence again, and irradiated-field failure was observed in 26 patients. The 5-year overall survival rate was 30.5% with a median survival period of 26.5 months. Grade 3 or higher late toxicity was observed in only one patient. In multivariate analysis, short disease-free interval and anastomotic recurrence were statistically significant unfavorable prognostic factors for overall survival (hazard ratios: 2.1 and 2.5, respectively). Matched-pair analysis including disease-free interval, pattern of recurrence and number of recurrent regions revealed that overall survival rate and irradiated-field control rate in patients treated with involved field irradiation were significantly better than those in patients treated with elective nodal irradiation (P = 0.016 and P = 0.014, respectively). Conclusions Short disease-free interval and anastomotic recurrence are unfavorable factors and elective nodal irradiation is not necessary in chemoradiotherapy for patients with postoperative loco-regional recurrent esophageal cancer.
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Affiliation(s)
- Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Takaya Yamamoto
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Haruo Matsushita
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Youjirou Ishikawa
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Maiko Kozumi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Masaki Kubozono
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Noriyoshi Takahashi
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
| | - Ken Takeda
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Japan
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48
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Koiwai K, Shinoda A, Ozawa T, Matsushita H, Fukazawa A, Sakai K, Kadoya M. EP-1811: Aligning the chest with a couch improved reproducibility in radiotherapy for head and neck cancers. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)32174-6] [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: 11/17/2022]
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49
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Kumagai T, Nakano T, Matsushita H, Jingu K, Ohuchi N, Kamei T. Successful corticosteroid treatment for pleural effusion due to radiation-induced pleuritis after chemoradiotherapy in a patient with esophageal cancer. Int Cancer Conf J 2017; 6:138-143. [PMID: 31149489 DOI: 10.1007/s13691-017-0293-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 01/27/2017] [Accepted: 03/31/2017] [Indexed: 12/25/2022] Open
Abstract
Concurrent chemoradiotherapy (CRT) is one of the therapies with curative intent used to treat esophageal squamous cell carcinoma (ESCC), and overall survival of patients with esophageal carcinoma treated with CRT has improved. As the number of long-term survivors treated with concurrent CRT has increased, more patients experience late toxicities. A delayed adverse event, such as pleural effusion, is sometimes fatal, but little is known about its treatment. A 72-year-old man diagnosed with ESCC was treated with definitive CRT. He had a complete response to CRT, and 4 years later he complained of dyspnea, caused by pleural effusion. Diuretic agents and drainage of pleural effusion were not sufficiently effective in this case. After oral administration of 30 mg prednisolone, re-accumulation of fluid in the pleural space was controlled and the prednisolone dose was gradually tapered. Corticosteroids could be effective treatment for delayed pleural effusion after radiotherapy, and should be considered an option for treatment-refractory pleural effusion.
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Affiliation(s)
- Takuro Kumagai
- 1Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Toru Nakano
- 1Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Haruo Matsushita
- 2Department of Radiation Oncology, Graduate School of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Keiichi Jingu
- 2Department of Radiation Oncology, Graduate School of Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Noriaki Ohuchi
- 1Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Kamei
- 1Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, Sendai, Japan
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50
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Isobe M, Nagaoka K, Yoshimura Y, Minami T, Akiyama T, Suzuki C, Nishimura S, Nakamura K, Shimizu A, Takahashi C, Toi K, Matsuoka K, Okamura S, Matsushita H, Murakami S. Reheat Mode Discharges in Search of Attainable High Stored Energy and Density Limit of Compact Helical System. Fusion Science and Technology 2017. [DOI: 10.13182/fst06-a1240] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Isobe
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - K. Nagaoka
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - Y. Yoshimura
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - T. Minami
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - T. Akiyama
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - C. Suzuki
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - S. Nishimura
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - K. Nakamura
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - A. Shimizu
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - C. Takahashi
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - K. Toi
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - K. Matsuoka
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - S. Okamura
- National Institute for Fusion Science, Toki 509-5292, Japan
| | - H. Matsushita
- The Graduate University for Advanced Studies, Toki 509-5292, Japan
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