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Uchinami Y, Yasuda K, Minatogawa H, Dekura Y, Nishikawa N, Kinoshita R, Nishioka K, Katoh N, Mori T, Otsuka M, Miyamoto N, Suzuki R, Kobashi K, Shimizu Y, Taguchi J, Tsushima N, Kano S, Homma A, Aoyama H. Impact of adaptive radiotherapy on survival in locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiotherapy. Radiat Oncol J 2024; 42:74-82. [PMID: 38549386 PMCID: PMC10982056 DOI: 10.3857/roj.2023.00374] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 04/04/2024] Open
Abstract
PURPOSE To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival. RESULTS The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541). CONCLUSION Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.
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Affiliation(s)
- Yusuke Uchinami
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Koichi Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Hideki Minatogawa
- Department of Radiation Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Yasuhiro Dekura
- Department of Radiation Oncology, Kin-ikyo Chuo Hospital, Sapporo, Japan
| | - Noboru Nishikawa
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Rumiko Kinoshita
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Kentaro Nishioka
- Global Center for Biomedical Science and Engineering, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Norio Katoh
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takashi Mori
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Manami Otsuka
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- Department of Radiation Oncology, National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan
| | - Naoki Miyamoto
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
- Division of Applied Quantum Science and Engineering, Faculty of Engineering, Hokkaido University, Sapporo, Japan
| | - Ryusuke Suzuki
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Keiji Kobashi
- Global Center for Biomedical Science and Engineering, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasushi Shimizu
- Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Jun Taguchi
- Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nayuta Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Dekura Y, Yasuda K, Minatogawa H, Uchinami Y, Tsushima N, Suzuki T, Kano S, Mori T, Nishioka K, Kobashi K, Katoh N, Homma A, Aoyama H. Daily fraction dose-adjusted radiotherapy policy to avoid prolonging the overall treatment time for early glottic squamous cell carcinoma: a single-institutional retrospective study. J Radiat Res 2024; 65:63-70. [PMID: 37952082 PMCID: PMC10803170 DOI: 10.1093/jrr/rrad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/24/2023] [Indexed: 11/14/2023]
Abstract
The objective of this study was to determine the outcomes of radical radiotherapy for early glottic squamous cell carcinoma (EGSCC) with the policy of increasing the fraction size during radiotherapy when the overall treatment time (OTT) was expected to be prolonged. Patients diagnosed with clinical T1-2N0M0 EGSCC, who were treated with radical radiotherapy between 2008 and 2019 at Hokkaido University Hospital, were included. Patients received 66 Gy in 33 fractions for T1 disease and 70 Gy in 35 fractions for T2 disease as our standard regimen (usual group [UG]). If the OTT was expected to extend for >1 week, the dose fraction size was increased from 2.0 to 2.5 Gy from the beginning or during radiotherapy (adjusted group [AG]). At this time, we performed a statistical analysis between UG and AG. In total, 116 patients were identified, and the treatment schedules of 29 patients were adjusted. The median follow-up was 60.9 months. In the T1 group, the cumulative 5-year local failure rate was 12.0% in the AG and 15.4% in the UG, and in the T2 group, the rate was 40.7% in the AG and 25.3% in the UG. There were no significant differences between the AG and UG. Similarly, no significant differences were observed for overall survival and progression-free survival rates. Our single-institutional retrospective analysis of EGSCC patients suggested that a method of adjusting the radiotherapy schedule to increase fraction size from the beginning or during the course may be effective in maintaining treatment outcomes.
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Affiliation(s)
- Yasuhiro Dekura
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
- Department of Radiation Oncology, Kin-ikyo Chuo Hospital, 1-9-1 Higashinaebo5, Higashi-ku, Sapporo, Hokkaido 007-0805 , Japan
| | - Koichi Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Hideki Minatogawa
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Yusuke Uchinami
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Nayuta Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Takashi Mori
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Kentaro Nishioka
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
- Department of Radiation Medical Science and Engineering, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Keiji Kobashi
- Global Center for Biomedical Science and Engineering, Hokkaido University Faculty of Medicine and Graduate School of Medicine, Kita15, Nishi7, Kita-Ku, Sapporo, Hokkaido 060-8638, Japan
| | - Norio Katoh
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Hokkaido University Hospital, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Kita14, Nishi5, Kita-Ku, Sapporo, Hokkaido 060-8648, Japan
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Higaki H, Nishioka K, Otsuka M, Nishikawa N, Shido M, Minatogawa H, Nishikawa Y, Takashina R, Hashimoto T, Katoh N, Taguchi H, Kinoshita R, Yasuda K, Mori T, Uchinami Y, Koizumi F, Fujita Y, Takahashi S, Hattori T, Nishiyama N, Aoyama H. Brain metastases in Japanese NSCLC patients: prognostic assessment and the use of osimertinib and immune checkpoint inhibitors-retrospective study. Radiat Oncol 2023; 18:25. [PMID: 36750899 PMCID: PMC9903535 DOI: 10.1186/s13014-023-02218-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA) has not been validated for use with Japanese non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) and the factors impacting survival need to be assessed. METHODS We retrospectively analyzed 294 NSCLC patients who were newly diagnosed with BM between 2013 and 2020 and had received radiotherapy for BM initially at the Hokkaido Cancer Center. We evaluated the effect on the prognosis of Lung-molGPA items, the expression of PD-L1 (classified as high, low, and no expression), and the treatment history. The main outcome was the survival measured from the day of the diagnosis of BM, and log-rank tests were performed to evaluate the results. RESULTS The median overall survival (OS) times for adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, 2.5‒3.0, and 3.5‒4.0) were 5.5, 14.8, 28.3, and 39.0 months (p < 0.0001), respectively. The median survival times for non-adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, and 2.5‒3.0) were 3.2, 11.0, and 16.0 months (p = 0.0011), respectively. In adenocarcinoma patients with gene mutations, osimertinib significantly improved the outcome (median OS: 34.2 and 17.6 months with and without osimertinib, respectively (p = 0.0164)). There was no significant difference in the OS between patients who were initially treated with tyrosine-kinase inhibitor for BM and those who initially received radiotherapy (p = 0.5337). In patients tested for PD-L1 expression, the median survival times after the diagnosis of BM were 5.6, 22.5, and 9.3 months for the high-, low- and no-expression groups (p = 0.2198), respectively. Also, in patients with high PD-L1 expressions, those with ICI had survival (median OS, 8.6 months) than those without (median OS, 3.6 months). CONCLUSIONS We confirmed that Lung-molGPA successfully classified Japanese NSCLC patients with BM by the prognosis. Osimertinib prolonged survival of EGFR-positive NSCLC patients with BM, and ICI was effective in patients with high PD-L1 expressions.
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Affiliation(s)
- Hajime Higaki
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Kentaro Nishioka
- grid.39158.360000 0001 2173 7691Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido Japan
| | - Manami Otsuka
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan ,grid.415270.5Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan
| | - Noboru Nishikawa
- grid.412167.70000 0004 0378 6088Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Motoyasu Shido
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Hideki Minatogawa
- grid.415270.5Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan
| | - Yukiko Nishikawa
- grid.415270.5Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan
| | - Rikiya Takashina
- grid.415270.5Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan
| | - Takayuki Hashimoto
- grid.39158.360000 0001 2173 7691Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido Japan
| | - Norio Katoh
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Hiroshi Taguchi
- grid.412167.70000 0004 0378 6088Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Rumiko Kinoshita
- grid.412167.70000 0004 0378 6088Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Koichi Yasuda
- grid.412167.70000 0004 0378 6088Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Takashi Mori
- grid.412167.70000 0004 0378 6088Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Yusuke Uchinami
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Fuki Koizumi
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Yoshihiro Fujita
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Shuhei Takahashi
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Takahiro Hattori
- grid.39158.360000 0001 2173 7691Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido 060-8638 Japan
| | - Noriaki Nishiyama
- grid.415270.5Department of Radiation Therapy, Hokkaido Cancer Center, Sapporo, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Kita 15-Jo Nishi 7-Chome, Kita-Ku, Sapporo, Hokkaido, 060-8638, Japan.
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Otsuka M, Yasuda K, Uchinami Y, Tsushima N, Suzuki T, Kano S, Suzuki R, Miyamoto N, Minatogawa H, Dekura Y, Mori T, Nishioka K, Taguchi J, Shimizu Y, Katoh N, Homma A, Aoyama H. Detailed analysis of failure patterns using deformable image registration in hypopharyngeal cancer patients treated with sequential boost intensity-modulated radiotherapy. J Med Imaging Radiat Oncol 2023; 67:98-110. [PMID: 36373823 DOI: 10.1111/1754-9485.13491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/23/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Sequential boost intensity-modulated radiotherapy (SQB-IMRT) uses two different planning CTs (pCTs) and treatment plans. SQB-IMRT is a form of adaptive radiotherapy that allows for responses to changes in the shape of the tumour and organs at risk (OAR). On the other hand, dose accumulation with the two plans can be difficult to evaluate. The purpose of this study was to analyse patterns of loco-regional failure using deformable image registration (DIR) in hypopharyngeal cancer patients treated with SQB-IMRT. METHODS Between 2013 and 2019, 102 patients with hypopharyngeal cancer were treated with definitive SQB-IMRT at our institution. Dose accumulation with the 1st and 2nd plans was performed, and the dose to the loco-regional recurrent tumour volume was calculated using the DIR workflow. Failure was classified as follows: (i) in-field (≥95% of the recurrent tumour volume received 95% of the prescribed dose); (ii) marginal (20-95%); or (iii) out-of-field (<20%). RESULTS After a median follow-up period of 25 months, loco-regional failure occurred in 34 patients. Dose-volume histogram analysis showed that all loco-regional failures occurred in the field within 95% of the prescribed dose, with no marginal or out-of-field recurrences observed. CONCLUSION The dosimetric analysis using DIR showed that all loco-regional failures were within the high-dose region. More aggressive treatment may be required for gross tumours.
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Affiliation(s)
- Manami Otsuka
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.,Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Koichi Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Yusuke Uchinami
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Nayuta Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Ryusuke Suzuki
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Naoki Miyamoto
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Hideki Minatogawa
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Yasuhiro Dekura
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Takashi Mori
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Kentaro Nishioka
- Department of Radiation Medical Science and Engineering, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Jun Taguchi
- Department of Medical Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Yasushi Shimizu
- Department of Medical Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Norio Katoh
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.,Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
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Fujita Y, Katoh N, Uchinami Y, Taguchi H, Nishioka K, Mori T, Yasuda K, Minatogawa H, Koizumi F, Otsuka M, Takao S, Tamura M, Tanaka S, Sutherland K, Tha K, Ito Y, Shimizu S, Aoyama H. Pre-Treatment Apparent Diffusion Coefficient Histogram Metrics as a Predictor of Local Tumor Control After Proton Beam Therapy in Patients With Hepatocellular Carcinomas. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.360] [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: 10/20/2022]
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Otsuka M, Yasuda K, Minatogawa H, Fujita Y, Uchinami Y, Koizumi F, Suzuki R, Miyamoto N, Suzuki T, Tsushima N, Kano S, Taguchi J, Shimizu Y, Homma A, Shimizu S, Aoyama H. A Dosimetric Analysis of Locoregional Failure Using Deformable Image Registration in Hypopharyngeal Cancer After Sequential-Boost Intensity-Modulated Radiotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1082] [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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Shimomura K, Minatogawa H, Mashiko T, Arioka H, Iihara H, Sugawara M, Hida N, Akiyama K, Nawata S, Tsuboya A, Mishima K, Izawa N, Miyaji T, Honda K, Inada Y, Ohno Y, Katada C, Morita H, Yamaguchi T, Nakajima T. LBA63 Placebo-controlled, double-blinded phase Ⅲ study comparing dexamethasone on day 1 with dexamethasone on days 1 to 4, with combined neurokinin-1 receptor antagonist, palonosetron, and olanzapine in patients receiving cisplatin-containing highly emetogenic chemotherapy: SPARED trial. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2144] [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: 10/20/2022] Open
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Yasuda K, Minatogawa H, Dekura Y, Takao S, Tamura M, Tsushima N, Suzuki T, Kano S, Mizumachi T, Mori T, Nishioka K, Shido M, Katoh N, Taguchi H, Fujima N, Onimaru R, Yokota I, Kobashi K, Shimizu S, Homma A, Shirato H, Aoyama H. Analysis of acute-phase toxicities of intensity-modulated proton therapy using a model-based approach in pharyngeal cancer patients. J Radiat Res 2021; 62:329-337. [PMID: 33372202 PMCID: PMC7948838 DOI: 10.1093/jrr/rraa130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/09/2020] [Indexed: 05/21/2023]
Abstract
Pharyngeal cancer patients treated with intensity-modulated proton therapy (IMPT) using a model-based approach were retrospectively reviewed, and acute toxicities were analyzed. From June 2016 to March 2019, 15 pharyngeal (7 naso-, 5 oro- and 3 hypo-pharyngeal) cancer patients received IMPT with robust optimization. Simulation plans for IMPT and intensity-modulated X-ray therapy (IMXT) were generated before treatment. We also reviewed 127 pharyngeal cancer patients with IMXT in the same treatment period. In the simulation planning comparison, all of the normal-tissue complication probability values for dysphagia, dysgeusia, tube-feeding dependence and xerostomia were lower for IMPT than for IMXT in the 15 patients. After completing IMPT, 13 patients completed the evaluation, and 12 of these patients had a complete response. The proportions of patients who experienced grade 2 or worse acute toxicities in the IMPT and IMXT cohorts were 21.4 and 56.5% for dysphagia (P < 0.05), 46.7 and 76.3% for dysgeusia (P < 0.05), 73.3 and 62.8% for xerostomia (P = 0.43), 73.3 and 90.6% for mucositis (P = 0.08) and 66.7 and 76.4% for dermatitis (P = 0.42), respectively. Multivariate analysis revealed that IMPT was independently associated with a lower rate of grade 2 or worse dysphagia and dysgeusia. After propensity score matching, 12 pairs of IMPT and IMXT patients were selected. Dysphagia was also statistically lower in IMPT than in IMXT (P < 0.05). IMPT using a model-based approach may have clinical benefits for acute dysphagia.
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Affiliation(s)
- Koichi Yasuda
- Corresponding author. Department of Radiation Oncology, Hokkaido University Hospital. North-15 West-7, Sapporo, 060-8638, Japan. Tel: (+81)11-706-5977; Fax: (+81)11-706-7876;
| | - Hideki Minatogawa
- Department of Radiation Oncology, Hokkaido University Hospital, North-15 West-7, Sapporo, Japan
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Yasuhiro Dekura
- Department of Radiation Oncology, Hokkaido University Hospital, North-15 West-7, Sapporo, Japan
- Department of Radiation Medical Science and Engineering, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Seishin Takao
- Department of Medical Physics, Hokkaido University Hospital, North-15 West-7, Sapporo, Japan
| | - Masaya Tamura
- Department of Medical Physics, Hokkaido University Hospital, North-15 West-7, Sapporo, Japan
| | - Nayuta Tsushima
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Takayoshi Suzuki
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Satoshi Kano
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Takatsugu Mizumachi
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Takashi Mori
- Department of Oral Radiology, Graduate School of Dental Medicine, Hokkaido University, Hokkaido University, North-13 West-7, Sapporo, Japan
| | - Kentaro Nishioka
- Department of Radiation Medical Science and Engineering, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Motoyasu Shido
- Department of Radiation Oncology, Hokkaido University Hospital, North-15 West-7, Sapporo, Japan
| | - Norio Katoh
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Hiroshi Taguchi
- Department of Radiation Oncology, Hokkaido University Hospital, North-15 West-7, Sapporo, Japan
| | - Noriyuki Fujima
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Rikiya Onimaru
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Isao Yokota
- Department of Biostatistics, Faculty and Graduate School of Medicine, Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Keiji Kobashi
- Department of Medical Physics, Hokkaido University Hospital, North-15 West-7, Sapporo, Japan
- Department of Radiation Medical Science and Engineering, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Shinichi Shimizu
- Department of Radiation Medical Science and Engineering, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Akihiro Homma
- Department of Otolaryngology-Head and Neck Surgery, Faculty and Graduate School of Medicine,Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Hiroki Shirato
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, North-15 West-7, Sapporo, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Faculty and Graduate School of Medicine, Hokkaido University, North-15 West-7, Sapporo, Japan
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Minatogawa H, Yasuda K, Dekura Y, Takao S, Matsuura T, Yoshimura T, Suzuki R, Yokota I, Fujima N, Onimaru R, Shimizu S, Aoyama H, Shirato H. Potential benefits of adaptive intensity-modulated proton therapy in nasopharyngeal carcinomas. J Appl Clin Med Phys 2020; 22:174-183. [PMID: 33338323 PMCID: PMC7856494 DOI: 10.1002/acm2.13128] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/24/2020] [Accepted: 11/25/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose To investigate potential advantages of adaptive intensity‐modulated proton beam therapy (A‐IMPT) by comparing it to adaptive intensity‐modulated X‐ray therapy (A‐IMXT) for nasopharyngeal carcinomas (NPC). Methods Ten patients with NPC treated with A‐IMXT (step and shoot approach) and concomitant chemotherapy between 2014 and 2016 were selected. In the actual treatment, 46 Gy in 23 fractions (46Gy/23Fx.) was prescribed using the initial plan and 24Gy/12Fx was prescribed using an adapted plan thereafter. New treatment planning of A‐IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A‐IMXT with A‐IMPT. Results The means of the Dmean of the right parotid gland (P < 0.001), right TM joint (P < 0.001), left TM joint (P < 0.001), oral cavity (P < 0.001), supraglottic larynx (P = 0.001), glottic larynx (P < 0.001), , middle PCM (P = 0.0371), interior PCM (P < 0.001), cricopharyngeal muscle (P = 0.03643), and thyroid gland (P = 0.00216), in A‐IMPT are lower than those of A‐IMXT, with statistical significance. The means of, D0.03cc, and Dmean of each sub portion of auditory apparatus and D30% for Eustachian tube and D0.5cc for mastoid volume in A‐IMPT are significantly lower than those of A‐IMXT. The mean doses to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 Gy (RBE = 1.1). Conclusions An adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.
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Affiliation(s)
- Hideki Minatogawa
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Koichi Yasuda
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan.,Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
| | - Yasuhiro Dekura
- Department of Radiation Oncology, Hokkaido University Hospital, Sapporo, Japan
| | - Seishin Takao
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Taeko Matsuura
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Takaaki Yoshimura
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan.,Department of Health Sciences and Technology, Faculty of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Ryusuke Suzuki
- Department of Medical Physics, Hokkaido University Hospital, Sapporo, Japan
| | - Isao Yokota
- Department of Biostatistics, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Noriyuki Fujima
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Rikiya Onimaru
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Shinichi Shimizu
- Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan.,Department of Radiation Medical Science and Engineering, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroki Shirato
- Department of Radiation Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.,Global Station for Quantum Medical Science and Engineering, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo, Japan
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10
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Mizumachi T, Kano S, Homma A, Akazawa M, Hasegawa C, Shiroishi Y, Okamoto C, Kumagai S, Nishimura M, Takasaki H, Takeda H, Yasuda K, Minatogawa H, Dekura Y, Onimaru R, Shirato H, Fukuda S. [A Nutritional Supplement with a High Blend Ratio of ω-3 Fatty Acids(Prosure®) Reduces Severe Oral Mucositis and Body Weight Loss for Head and Neck Cancer Patients Treated with Chemoradiotherapy]. Gan To Kagaku Ryoho 2019; 46:685-689. [PMID: 31164507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Oral mucositis and body weight loss are the most critical conditions known to lead to the discontinuation of chemoradiotherapy for head and neck cancer. We investigated the effect of a nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)on body weight loss, oral mucositis, and the completion rate of chemoradiotherapy in patients with oropharyngeal and hypopharyngeal cancer. PATIENTS AND METHODS The study group comprised patients with oropharyngeal and hypopharyngeal cancer who were treated with concomitant cisplatin and 70 Gy of radiotherapy. These patients received 2 packs of Prosure®per day during chemoradiotherapy. RESULTS A total of 17 patients were included in this study. The reduction in body weight was significantly improved compared with that in the historical control group that did not receive Prosure®(7.3% vs 10.3%, p<0.01), and the rate of Grade 3-4 oral mucositis was significantly reduced for the patient groups that received Prosure®(CTCAE v3.0 GradeB3; 24% vs 58%, p<0.05). The completion rate of chemoradiotherapy was not significantly different between both groups(77% vs 60%, NS). CONCLUSIONS A nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)had effects on oral mucositis and body weight loss in head and neck cancer patients treated with chemoradiotherapy.
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Affiliation(s)
- Takatsugu Mizumachi
- Dept. of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University
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Yasuda K, Takao S, Matsuo Y, Yoshimura T, Tamura M, Minatogawa H, Dekura Y, Matsuura T, Onimaru R, Shiga T, Shimizu S, Umegaki K, Shirato H. Intensity-Modulated Proton Therapy with Dose Painting based on Hypoxia Imaging for Nasopharyngeal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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