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Yoshida K, Hanada T, Fukada J, Kawamura M, Shigematsu N. Incidence of Radiation-induced Nausea and Vomiting: A Prospective Single-institution Pilot Study. Keio J Med 2024:2023-0021-OA. [PMID: 38403636 DOI: 10.2302/kjm.2023-0021-oa] [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] [Indexed: 02/27/2024]
Abstract
Radiation-induced nausea and vomiting (RINV) is a frequent adverse event that occurs in patients undergoing radiotherapy. However, research on RINV is underrepresented. This prospective single-institution exploratory pilot study investigated the incidence of RINV according to the irradiation site and observed the efficacy of symptomatic antiemetic treatment in controlling symptoms of RINV. The primary outcomes were the proportions of emesis-free days and nausea-free days. The secondary endpoints included the time to the first episode of RINV, frequency of vomiting, and severity of nausea, including its impact on eating habits and weight loss. Fifteen patients were enrolled in each group (minimal, low, and moderate emetogenic risk). All patients received greater than 20 Gy in five fractions. Evaluation was based on weekly questionnaires completed by patients during routine clinic visits. Nausea and vomiting occurred in 11 and 0 patients, respectively. Six of 15 patients in the minimal-risk group, 1 in the low-risk group, and 4 in the moderate-risk group experienced nausea. Although all 11 symptomatic patients were offered antiemetics, only 3 used them, who reported satisfactory control of nausea. The percentage of emesis-free days for all patients was 100% and the percentage of nausea-free days for the 11 patients who developed RINV was 38%. An unexpectedly high percentage of patients in the minimal-risk group experienced nausea; all had breast cancer. Future studies should investigate factors beyond the irradiation site, including the characteristics of the patient and the treatment, to better predict an individual's risk of RINV.
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Affiliation(s)
- Kayo Yoshida
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Hanada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Junichi Fukada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Mariko Kawamura
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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Tamari K, Kishigami M, Nagata Y, Mizowaki T, Kodaira T, Onishi H, Ogawa K, Shioyama Y, Shigematsu N, Uno T. The impact of the COVID-19 pandemic on radiotherapy delivery in Japan: An observational study based on the national database. Cancer Med 2023; 12:21032-21040. [PMID: 37902228 PMCID: PMC10709724 DOI: 10.1002/cam4.6661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 09/13/2023] [Accepted: 10/04/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND This study analyzed the impact of the coronavirus disease 2019 (COVID-19) pandemic on radiotherapy delivery in Japan using a high-quality Japanese national database based on universal health coverage. METHODS We performed a retrospective observational study using National Database of Health Insurance Claims and Specific Health Checkups of Japan open data focused on radiotherapy between fiscal year (FY) 2019 and FY2020 and the number of COVID-19 cases from the Ministry of Health, Labour, and Welfare. We statistically analyzed the relationship between the number of COVID-19 cases and the number of radiotherapy deliveries in Japan as a whole and by prefecture. RESULTS The total number of external beam radiotherapy (EBRT) fractions was 4,472,140 in FY2019 and 4,227,673 in FY2020 (-5.8%). EBRT courses were 250,395 in FY2019 and 240,329 in FY2020 (-4.0%), stereotactic radiotherapy courses were 27,619 in FY2019 and 31,786 in FY2020 (+15.1%), and single-fraction palliative radiotherapy courses were 4124 in FY2019 and 5255 in FY2020 (+21.5%). The total number of breast and prostate hypofractionated radiotherapy (HFRT) fractions was 155,773 and 48,188 in FY2019, and 200,256 and 84,230 in FY2020 (+28.6% and +74.8%), respectively. In the Pearson correlation analysis, EBRT fractions were lower, and breast HFRT fractions were higher in prefectures with more COVID-19 cases. CONCLUSIONS Overall, radiotherapy delivery in Japan was relatively stable after the pandemic, with an increase in HFRT. Also, EBRT fractions decreased, and breast HFRT were more likely to be used in prefectures with more COVID-19 cases.
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Affiliation(s)
- Keisuke Tamari
- Department of Radiation OncologyOsaka University Graduate School of MedicineOsakaJapan
| | - Maiko Kishigami
- Department of Radiation OncologyOsaka University Graduate School of MedicineOsakaJapan
| | - Yasushi Nagata
- Department of Radiation OncologyHiroshima University HospitalHiroshimaJapan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image‐Applied Therapy, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Takeshi Kodaira
- Department of Radiation OncologyAichi Cancer Center HospitalAichiJapan
| | - Hiroshi Onishi
- Department of RadiologyUniversity of Yamanashi School of MedicineYamanashiJapan
| | - Kazuhiko Ogawa
- Department of Radiation OncologyOsaka University Graduate School of MedicineOsakaJapan
| | | | | | - Takashi Uno
- Department of RadiologyChiba University Graduate School of MedicineChibaJapan
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Saito T, Shikama N, Takahashi T, Harada H, Ueno S, Notsu A, Shirato H, Yamada K, Uezono H, Koide Y, Kubota H, Yamasaki T, Ito K, Heianna J, Okada Y, Tonari A, Katoh N, Wada H, Ejima Y, Yoshida K, Kosugi T, Takahashi S, Komiyama T, Uchida N, Miwa M, Watanabe M, Nagakura H, Ikeda H, Asakawa I, Shigematsu N. Factors associated with quality of life in patients receiving palliative radiotherapy for bone metastases: a secondary cross-sectional analysis of data from a prospective multicenter observational study. Br J Radiol 2023; 96:20230351. [PMID: 37750858 PMCID: PMC10607414 DOI: 10.1259/bjr.20230351] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 07/14/2023] [Accepted: 08/21/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE To identify factors significantly associated with quality of life (QOL) and determine if these associations are strong enough to predict certain aspects of QOL without measuring them. METHODS We conducted an exploratory secondary analysis of baseline data of 224 patients (enrolled between December 2020 and March 2021) from a previously published prospective observational study on radiotherapy for bone metastases at 26 centres. Using univariable linear regression, we assessed the association between patient/treatment factors and QOL scale scores as measured by the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 15-Palliative (QLQ-C15-PAL) and the EORTC QOL Questionnaire Bone Metastases module (QLQ-BM22). RESULTS Age and sex were not significantly associated with QOL. Worse performance status, higher pain scores, and opioid and single-fraction use were significantly associated with most QOL scales; these four factors were associated with worse global QOL, worse functioning status, and more severe symptoms. The coefficients of determination for most QOL scales were less than 0.2, indicating that most of the variability in QOL scores was not explained by any of the explanatory variables. CONCLUSION Performance status, pain intensity, and opioid and single-fraction use were significantly associated with most QOL scales. However, the associations were not strong enough to estimate QOL. ADVANCES IN KNOWLEDGE To date, the association between treatment factors and QOL in patients with bone metastases has not been fully studied. We identified the factors that were significantly associated with QOL and found that these associations were not strong enough to predict QOL.
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Affiliation(s)
- Tetsuo Saito
- Department of Radiation Oncology, Arao Municipal Hospital, Kumamoto, Japan
| | - Naoto Shikama
- Department of Radiation Oncology, Juntendo University, Tokyo, Japan
| | - Takeo Takahashi
- Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Hideyuki Harada
- Division of Radiation Therapy, Shizuoka Cancer Center, Shizuoka, Japan
| | - Shuichi Ueno
- Department of Radiation Oncology, Saitama Medical Center, Saitama Medical University, Saitama, Japan
| | - Akifumi Notsu
- Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hiroki Shirato
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Kazunari Yamada
- Department of Radiation Oncology, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - Haruka Uezono
- Department of Radiation Oncology, Hyogo Cancer Center, Hyogo, Japan
| | - Yutaro Koide
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hikaru Kubota
- Division of Radiation Oncology, Kobe University Hospital, Hyogo, Japan
| | - Takuya Yamasaki
- Department of Radiology, Nagasaki University Hospital, Nagasaki, Japan
| | - Kei Ito
- Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Joichi Heianna
- Department of Radiology, Nanbu Tokushukai Hospital, Okinawa, Japan
| | - Yukinori Okada
- Department of Radiation Oncology, St. Marianna University School of Medicine, Kanagawa, Japan
| | - Ayako Tonari
- Department of Radiation Oncology, Kyorin University Hospital, Tokyo, Japan
| | - Norio Katoh
- Department of Radiation Oncology, Faculty of Medicine, Hokkaido University, Hokkaido, Japan
| | - Hitoshi Wada
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center, Fukushima, Japan
| | - Yasuo Ejima
- Department of Radiology, Dokkyo Medical University, Tochigi, Japan
| | - Kayo Yoshida
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Takashi Kosugi
- Department of Radiation Oncology, Fujieda Municipal General Hospital, Shizuoka, Japan
| | - Shigeo Takahashi
- Department of Radiation Oncology, Kagawa University Hospital, Kagawa, Japan
| | | | - Nobue Uchida
- Department of Radiation Oncology, Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - Misako Miwa
- Department of Radiation Oncology, Sendai Kousei Hospital, Miyagi, Japan
| | - Miho Watanabe
- Department of Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hisayasu Nagakura
- Department of Radiology, KKR Sapporo Medical Center, Hokkaido, Japan
| | - Hiroko Ikeda
- Department of Radiation Oncology, Osaka City General Hospital, Osaka, Japan
| | - Isao Asakawa
- Department of Radiation Oncology, Nara Medical University, Nara, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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Mizuno R, Sawada M, Tanaka T, Shiraishi Y, Ohashi T, Shigematsu N, Oya M. Comparison of the Efficacy of Low Dose Tadalafil with Tamsulosin against Lower Urinary Tract Symptoms and Sexual Dysfunction after Low Dose Rate Prostate Brachytherapy. Int J Radiat Oncol Biol Phys 2023; 117:e418. [PMID: 37785377 DOI: 10.1016/j.ijrobp.2023.06.1570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients with clinically localized prostate cancer (PCa) can be curatively treated with different modalities, including low dose rate (LDR) prostate brachytherapy (PB). LDR-PB allows the patient a relatively short recovery time compared with other treatment modalities such as prostatectomy. However, PB might exert distinct impact on quality of life, lower urinary tract symptoms (LUTS) and sexual dysfunction (SD) are two major concerns. The aim of present study was to assess prospectively the efficacy of low dose tadalafil treatment on both SD and LUTS compared with tamsulosin treatment in patients treated PB for localized PCa. MATERIALS/METHODS Patients scheduled for PB with I-125 seeds for low or intermediate-risk localized PCa at our institution were eligible for this study. The prescribed dose was set at 160 gray. Participants were randomized into two groups; those started treating with a daily use of 0.2 mg of tamsulosin hydrochloride or 5 mg of tadalafil just after PB. The duration of the study was 12 months and the patients were assessed for urinary and sexual function status at baseline, and 1, 3, 6, and 12 months after PB. The primary study endpoints were both changes from baseline in urinary and sexual function status. RESULTS Between July 2015 and August 2020, 120 participants were enrolled in this study. The median age was 68 years with the median PSA of 6.5 ng/ml. A total 15 patients were excluded within 6 months after randomization. All subjective LUTS findings, including International Prostate Symptom Score (IPSS), and Over Active Bladder Symptom Score (OABSS), were significantly deteriorated at 1, 3, and 6 months after PB compared with baseline in both groups, respectively (p<0.05). Among objective LUTS findings, a significant decrease in maximum urinary flow rate (Qmax) was found at 1, 3, 6, and 12 months after PB compared with baseline in both groups, respectively (p<0.05). A significant increase in post void residual urine (PVR) was found at 1, 3, and 6 months after PB compared to baseline in tadalafil group, whereas no significant increase was seen in tamsulosin group. There were no statistically significant differences between the 2 groups in scores of the total International Index of Erectile Function (IIEF)-15 and Erection Hardness Score (EHS) before and at 1 month post PB. The EHS was significantly higher in tadalafil group compared with tamsulosin group at 3, 6 and 12 months (p = 0.001, p = 0.004, and p = 0.019, respectively). The EHS after PB in tadalafil group was not significantly decreased from baseline. CONCLUSION After LDR-PB, tamsulosin treatment significantly decreased PVR compared with tadalafil. On the other hand, tadalafil contributed to maintain erection hardness compared with tamsulosin.
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Affiliation(s)
- R Mizuno
- Dept of Urology, Keio university, school of medicine, Tokyo, Japan
| | - M Sawada
- Keio University Graduate School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - T Tanaka
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Y Shiraishi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - T Ohashi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - N Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - M Oya
- Dept of Urology, Keio university, school of medicine, Tokyo, Japan
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Abe Y, Itano O, Takemura Y, Minagawa T, Ojima H, Shinoda M, Kitago M, Obara H, Shigematsu N, Kitagawa Y. Phase I study of neoadjuvant S-1 plus cisplatin with concurrent radiation for biliary tract cancer (Tokyo Study Group for Biliary Cancer: TOSBIC02). Ann Gastroenterol Surg 2023; 7:808-818. [PMID: 37663959 PMCID: PMC10472356 DOI: 10.1002/ags3.12682] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/01/2023] [Accepted: 04/11/2023] [Indexed: 09/05/2023] Open
Abstract
Aim Neoadjuvant chemoradiotherapy may improve survival in patients with advanced cholangiocarcinoma. This Phase I study aimed to determine the recommended dose of neoadjuvant chemoradiotherapy and decide whether to move to a Phase II study. Methods Patients diagnosed with resectable stage II-IVa cholangiocarcinoma were administered cisplatin (40 [level 0], 50 [level 1 as starting dose], or 60 [level 2] mg/m2), 80 mg/m2 of S-1, and 50.4 Gy of external beam radiation. The recommended dose was defined as a dose one-step lower than the maximum-tolerated dose, which was defined when dose-limiting toxicity was observed in three or more of the six patients. Results Twelve patients were eligible from November 2012 to May 2016. Ten patients had perihilar cholangiocarcinoma and two patients had distal cholangiocarcinoma. Dose-limiting toxicity was observed in one of the first six patients at level 1 and two of the next six patients at level 2; thus, the maximum-tolerated dose was not determined even at level 2 and the recommended dose was determined as level 2. Four patients had partial response, four patients had stable disease, and two patients had progression of disease because of liver metastases. Finally, nine patients underwent radical surgery and seven cases achieved R0 resection. However, five cases suffered biliary leakage and one suffered intrahospital death due to rupture of the hepatic artery. Conclusion We determined the recommended dose of neoadjuvant chemoradiotherapy for resectable cholangiocarcinoma. However, we terminated the trial due to a high incidence of morbidity and unexpected mortality.
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Affiliation(s)
- Yuta Abe
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Osamu Itano
- Department of SurgeryKeio University School of MedicineTokyoJapan
- Department of Hepato‐Biliary‐Pancreatic and Gastrointestinal SurgeryInternational University of Health and Welfare School of MedicineChibaJapan
| | - Yusuke Takemura
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Takuya Minagawa
- Department of Hepato‐Biliary‐Pancreatic and Gastrointestinal SurgeryInternational University of Health and Welfare School of MedicineChibaJapan
| | - Hidenori Ojima
- Department of PathologyKeio University School of MedicineTokyoJapan
| | - Masahiro Shinoda
- Department of SurgeryKeio University School of MedicineTokyoJapan
- Digestive Disease CenterMita Hospital, International University of Health and WelfareTokyoJapan
| | - Minoru Kitago
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | - Hideaki Obara
- Department of SurgeryKeio University School of MedicineTokyoJapan
| | | | - Yuko Kitagawa
- Department of SurgeryKeio University School of MedicineTokyoJapan
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Sawada M, Shiraishi Y, Toyama H, Tanaka T, Kota R, Shigematsu N. Dosimetric comparison of rectal dose-reductive techniques in intra-cavitary brachytherapy for cervical cancer: A retrospective analysis. J Contemp Brachytherapy 2023; 15:269-274. [PMID: 37799123 PMCID: PMC10548429 DOI: 10.5114/jcb.2023.130842] [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: 05/30/2023] [Accepted: 07/25/2023] [Indexed: 10/07/2023] Open
Abstract
Purpose Rectal complications in radiotherapy for cervical cancer can highly affect quality of life and correlate with rectal dose. Vaginal gauze packing (VP) and rectal retraction (RR) are widely used for rectal dose reduction in high-dose-rate brachytherapy. We aimed to perform a dosimetric comparison of these two methods for three-dimensional image-guided adaptive brachytherapy. Material and methods We retrospectively examined 50 patients with cervical cancer treated with definitive radiotherapy, including intra-cavitary brachytherapy, performed with VP and RR. We extracted two fractions for each patient: one fraction with VP and the next fraction with RR, and then compared dose-volume parameters. In total, 50 fractions each were analyzed in VP and RR groups. Dose to 90% (D90) of high-risk clinical target volume (HR-CTV), and minimum dose to most exposed 2.0 cm3 of other organs at risk (D2cm3) for the rectum and bladder were determined from planning computed tomography. Results There were no significant differences between VP and RR in D90 of HR-CTV (mean: 7.479 Gy and 7.652 Gy, respectively, p = 0.172). The D2cm3 values for the rectum (mean: 4.234 Gy vs. 4.627 Gy, p = 0.008) and bladder (mean: 5.959 Gy vs. 6.690 Gy, p < 0.001) were significantly lower with VP compared with RR. Conclusions VP reduced the dose to the rectum and bladder when compared with RR without impairing the dose to CTV.
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Affiliation(s)
- Masafumi Sawada
- Address for correspondence: Masafumi Sawada, Department of Radiology, Keio University School of Medicine, 35, Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan, phone: +81-3-5363-3835, fax: +81-3-3359-7425, ⌧ e-mail:
| | - Yutaka Shiraishi
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department and institution address where the research was conducted: Department of Radiology, Keio University School of Medicine, 35, Shinano-machi, Shinjuku-ku, Tokyo, Japan
| | - Hirofumi Toyama
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department and institution address where the research was conducted: Department of Radiology, Keio University School of Medicine, 35, Shinano-machi, Shinjuku-ku, Tokyo, Japan
| | - Tomoki Tanaka
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department and institution address where the research was conducted: Department of Radiology, Keio University School of Medicine, 35, Shinano-machi, Shinjuku-ku, Tokyo, Japan
| | - Ryuichi Kota
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department and institution address where the research was conducted: Department of Radiology, Keio University School of Medicine, 35, Shinano-machi, Shinjuku-ku, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Department and institution address where the research was conducted: Department of Radiology, Keio University School of Medicine, 35, Shinano-machi, Shinjuku-ku, Tokyo, Japan
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Kanda D, Hanada T, Yoshida K, Tanaka T, Eriguchi T, Yorozu A, Ohashi T, Shigematsu N. Evaluation of dose perturbations around iodine-125 seed sources in supplemental external beam prostate radiotherapy. J Radiat Res 2023:7152939. [PMID: 37154504 DOI: 10.1093/jrr/rrad023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/07/2023] [Accepted: 03/13/2023] [Indexed: 05/10/2023]
Abstract
We investigated dose perturbations caused by 125I seeds in patients undergoing supplemental external beam radiotherapy (EBRT) for prostate cancer. We examined two types of nonradioactive seed models: model 6711 and model STM1251. All experiments were performed using a water-equivalent phantom. Radiochromic film was used to measure the dose distributions adjacent to the seeds upstream and downstream of the external beam source. Single and clusters of multiple seeds were placed in slots in a solid water (SW) slab to measure dose perturbations with separate versus dense seed placement at beam energies of 6 or 10 MV. Monte Carlo simulations (MCSs) were also performed to include the theoretical basis against film dosimetry. Distinct patterns of dose enhancement (buildup [BU]) were upstream, and dose reduction (builddown [BD]) were downstream of the radiation source. Model 6711 with lower photon beam energies produced larger dose perturbations of BU and BD than the model STM1251. The results showed the same tendency with different seed placements and beam energies. However, these differences were not observed in the rotational irradiation measurement, which replicated a clinical plan. Dose perturbations around seeds result in dose enhancement and dose reduction with varying impact depending on the photon beam energy and seed type. This has the potential to cancel out these perturbations using multiple beam direction fields.
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Affiliation(s)
- Daisuke Kanda
- Department of Radiology, Tokyo Medical Center, National Hospital Organization, Higashigaoka 2-5-1, Meguro-ku, Tokyo 152-8902, Japan
| | - Takashi Hanada
- Department of Radiology, Tokyo Medical Center, National Hospital Organization, Higashigaoka 2-5-1, Meguro-ku, Tokyo 152-8902, Japan
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kayo Yoshida
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tomoki Tanaka
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Takahisa Eriguchi
- Radiation Oncology Center, Ofuna Chuo Hospital, Ofuna 6-2-24, Kamakura, Kanagawa 247-0056, Japan
| | - Atsunori Yorozu
- Department of Radiology, Tokyo Medical Center, National Hospital Organization, Higashigaoka 2-5-1, Meguro-ku, Tokyo 152-8902, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan
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Shirato H, Harada H, Iwasaki Y, Notsu A, Yamada K, Uezono H, Koide Y, Wada H, Kubota H, Shikama N, Yamazaki T, Ito K, Heianna J, Okada Y, Tonari A, Takahashi S, Kosugi T, Ejima Y, Katoh N, Yoshida K, Komiyama T, Uchida N, Miwa M, Watanabe M, Nagakura H, Saito T, Ikeda H, Asakawa I, Seiichiro T, Takahashi T, Shigematsu N. Income and Employment of Patients at the Start and in the Follow-up of Palliative Radiotherapy for Bone Metastasis. Adv Radiat Oncol 2023; 8:101205. [PMID: 37077179 PMCID: PMC10106830 DOI: 10.1016/j.adro.2023.101205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 02/16/2023] [Indexed: 03/06/2023] Open
Abstract
Purpose The aim of this study was to understand the income and employment status of patients at the start of and during follow-up after palliative radiation therapy for bone metastasis. Methods and Materials From December 2020 to March 2021, a prospective multi-institutional observational study was conducted to investigate income and employment of patients at the start of administration of radiation therapy for bone metastasis and at 2 and 6 months after treatment. Of 333 patients referred to radiation therapy for bone metastasis, 101 were not registered, mainly because of their poor general condition, and another 8 were excluded from the follow-up analysis owing to ineligibility. Results In 224 patients analyzed, 108 had retired for reasons unrelated to cancer, 43 had retired for reasons related to cancer, 31 were taking leave, and 2 had lost their jobs at the time of registration. The number of patients who were in the working group was 40 (30 with no change in income and 10 with decreased income) at registration, 35 at 2 months, and 24 at 6 months. Younger patients (P = 0), patients with better performance status (P = 0), patients who were ambulatory (P = .008), and patients with lower scores on a numerical rating scale of pain (P = 0) were significantly more likely to be in the working group at registration. There were 9 patients who experienced improvements in their working status or income at least once in the follow-up after radiation therapy. Conclusions The majority of patients with bone metastasis were not working at the start of or after radiation therapy, but the number of patients who were working was not negligible. Radiation oncologists should be aware of the working status of patients and provide appropriate support for each patient. The benefit of radiation therapy to support patients continuing their work and returning to work should be investigated further in prospective studies.
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Tamari K, Nagata Y, Mizowaki T, Kodaira T, Onishi H, Ogawa K, Shioyama Y, Shigematsu N, Uno T. The impact of the COVID-19 pandemic on radiotherapy in Japan: nationwide surveys from May 2020 through June 2021. J Radiat Res 2023; 64:126-132. [PMID: 36109327 PMCID: PMC9494496 DOI: 10.1093/jrr/rrac055] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/25/2022] [Indexed: 06/15/2023]
Abstract
A longitudinal online questionnaire survey on the impact of coronavirus disease 2019 (COVID-19) on the operation of radiotherapy departments in Japan was conducted. Approximately 26.1-70.9% of the radiotherapy departments participated, and their responses were collected in May, July and November 2020, and February and June 2021. The survey results revealed that while the number of patients receiving radiotherapy decreased in 41.2% and 30.7% of institutions in May 2020 and June 2021, respectively, it increased in 4% and 16.8% of institutions in May 2020 and June 2021, respectively. There were a few institutions limiting or postponing patient treatments in June 2021. The hypofractionated regimen was used more during the pandemic than during the pre-pandemic period, particularly for the treatment of breast and prostate cancers as well as for palliation. Infection control measures for patients and staff were followed. Approximately 20% of the respondent institutions had cases of patients with COVID-19 infection receiving radiotherapy. Most institutions encountered challenges in the continuous provision of radiotherapy for patients with COVID-19. In conclusion, COVID-19 had a multifaceted impact on the operations of radiotherapy departments in Japan. Further follow-up and analysis are warranted to understand the long-term impact of COVID-19 on radiotherapy.
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Affiliation(s)
- Keisuke Tamari
- Corresponding author. Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
| | - Yasushi Nagata
- Department of Radiation Oncology, Hiroshima University Hospital, Hiroshima, 734-8551, Japan
| | - Takashi Mizowaki
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi, 464-0021, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi School of Medicine, Yamanashi, 409-3898, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | | | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, 160-0016, Japan
| | - Takashi Uno
- Department of Radiology, Chiba University Graduate School of Medicine, Chiba, 260-8677, Japan
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10
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Nemoto T, Futakami N, Kunieda E, Yagi M, Takeda A, Akiba T, Mutu E, Shigematsu N. [Effects of sample size and data augmentation on U-Net-based automatic segmentation of various organs]. Igaku Butsuri 2023; 43:19. [PMID: 37045760 DOI: 10.11323/jjmp.43.1_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
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11
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Okamoto H, Igaki H, Chiba T, Shibuya K, Sakasai T, Jingu K, Inaba K, Kuroda K, Aoki S, Tatsumi D, Nakamura M, Kadoya N, Furuyama Y, Kumazaki Y, Tohyama N, Tsuneda M, Nishioka S, Itami J, Onishi H, Shigematsu N, Uno T. Practical guidelines of online MR-guided adaptive radiotherapy. J Radiat Res 2022; 63:730-740. [PMID: 35946325 PMCID: PMC9494538 DOI: 10.1093/jrr/rrac048] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/02/2022] [Indexed: 06/15/2023]
Abstract
The first magnetic resonance (MR)-guided radiotherapy system in Japan was installed in May 2017. Implementation of online MR-guided adaptive radiotherapy (MRgART) began in February 2018. Online MRgART offers greater treatment accuracy owing to the high soft-tissue contrast in MR-images (MRI), compared to that in X-ray imaging. The Japanese Society for Magnetic Resonance in Medicine (JSMRM), Japan Society of Medical Physics (JSMP), Japan Radiological Society (JRS), Japanese Society of Radiological Technology (JSRT), and Japanese Society for Radiation Oncology (JASTRO) jointly established the comprehensive practical guidelines for online MRgART. These guidelines propose the essential requirements for clinical implementation of online MRgART with respect to equipment, personnel, institutional environment, practice guidance, and quality assurance/quality control (QA/QC). The minimum requirements for related equipment and QA/QC tools, recommendations for safe operation of MRI system, and the implementation system are described. The accuracy of monitor chamber and detector in dose measurements should be confirmed because of the presence of magnetic field. The ionization chamber should be MR-compatible. Non-MR-compatible devices should be used in an area that is not affected by the static magnetic field (outside the five Gauss line), and their operation should be checked to ensure that they do not affect the MR image quality. Dose verification should be performed using an independent dose verification system that has been confirmed to be reliable through commissioning. This guideline proposes the checklists to ensure the safety of online MRgART. Successful clinical implementation of online MRgART requires close collaboration between physician, radiological technologist, nurse, and medical physicist.
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Affiliation(s)
- Hiroyuki Okamoto
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, 104-0045, Japan
| | - Hiroshi Igaki
- Corresponding author. Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. Tel: +81(3)3542-2511; E-mail/Fax: , +81(3) 3547-5291
| | - Takahito Chiba
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, 104-0045, Japan
| | - Keiko Shibuya
- Department of Radiation Oncology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, 545-8586, Japan
| | - Tatsuya Sakasai
- Department of Radiological Technology, National Cancer Center Hospital, Tokyo, 104-0045, Japan
| | - Keiichi Jingu
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Miyagi, 980-8574, Japan
| | - Koji Inaba
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, 104-0045, Japan
| | - Kagayaki Kuroda
- Department of Human and Information Science, School of Information Science and Technology, Tokai University, Hiratsuka, 259-1292, Japan
| | - Shigeki Aoki
- Department of Radiology, Juntendo University Graduate School of Medicine, Tokyo, 113-8421, Japan
| | | | - Mitsuhiro Nakamura
- Department of Information Technology and Medical Engineering, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Noriyuki Kadoya
- Department of Radiation Oncology, Tohoku University Graduate School of Medicine, Miyagi, 980-8574, Japan
| | - Yoshinobu Furuyama
- Department of Radiology, Chiba University Hospital, Chiba, 260-8677, Japan
| | - Yu Kumazaki
- Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama, 350-1298, Japan
| | - Naoki Tohyama
- Division of Medical Physics, Tokyo Bay Advanced Imaging & Radiation Oncology Makuhari Clinic, Chiba, 261-0024, Japan
| | - Masato Tsuneda
- Department of Radiation Oncology, MR Linac ART Division, Graduate School of Medicine, Chiba University, Chiba, 260-8677, Japan
| | - Shie Nishioka
- Department of Radiation Oncology, Kyoto Second Red Cross Hospital, Kyoto, 602-8026, Japan
| | - Jun Itami
- Shin-Matsudo Accuracy Radiation Therapy Center, Shin-Matsudo Central General Hospital, Chiba, 270-0034, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, 409-3898, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, Chiba, 260-8677, Japan
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12
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Nemoto T, Takeda A, Matsuo Y, Kishi N, Eriguchi T, Kunieda E, Kimura R, Sanuki N, Tsurugai Y, Yagi M, Aoki Y, Oku Y, Kimura Y, Han C, Shigematsu N. Applying Artificial Neural Networks to Develop a Decision Support Tool for Tis-4N0M0 Non-Small-Cell Lung Cancer Treated With Stereotactic Body Radiotherapy. JCO Clin Cancer Inform 2022; 6:e2100176. [PMID: 35749675 PMCID: PMC9259118 DOI: 10.1200/cci.21.00176] [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] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Clear evidence indicating whether surgery or stereotactic body radiation therapy (SBRT) is best for non-small-cell lung cancer (NSCLC) is lacking. SBRT has many advantages. We used artificial neural networks (NNs) to predict treatment outcomes for patients with NSCLC receiving SBRT, aiming to aid in decision making. PATIENTS AND METHODS Among consecutive patients receiving SBRT between 2005 and 2019 in our institution, we retrospectively identified those with Tis-T4N0M0 NSCLC. We constructed two NNs for prediction of overall survival (OS) and cancer progression in the first 5 years after SBRT, which were tested using an internal and an external test data set. We performed risk group stratification, wherein 5-year OS and cancer progression were stratified into three groups. RESULTS In total, 692 patients in our institution and 100 patients randomly chosen in the external institution were enrolled. The NNs resulted in concordance indexes for OS of 0.76 (95% CI, 0.73 to 0.79), 0.68 (95% CI, 0.60 to 0.75), and 0.69 (95% CI, 0.61 to 0.76) and area under the curve for cancer progression of 0.80 (95% CI, 0.75 to 0.84), 0.72 (95% CI, 0.60 to 0.83), and 0.70 (95% CI, 0.57 to 0.81) in the training, internal test, and external test data sets, respectively. The survival and cumulative incidence curves were significantly stratified. NNs selected low-risk cancer progression groups of 5.6%, 6.9%, and 7.0% in the training, internal test, and external test data sets, respectively, suggesting that 48% of patients with peripheral Tis-4N0M0 NSCLC can be at low-risk for cancer progression. CONCLUSION Predictions of SBRT outcomes using NNs were useful for Tis-4N0M0 NSCLC. Our results are anticipated to open new avenues for NN predictions and provide decision-making guidance for patients and physicians.
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Affiliation(s)
- Takafumi Nemoto
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan.,Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Noriko Kishi
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takahisa Eriguchi
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan
| | - Etsuo Kunieda
- Radiation Oncology Center, Tokyo General Hospital, Tokyo, Japan
| | - Ryusei Kimura
- Biostatistics Unit, Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan
| | - Naoko Sanuki
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan
| | - Yuichiro Tsurugai
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan
| | | | - Yousuke Aoki
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan
| | - Yohei Oku
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan
| | - Yuto Kimura
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Kanagawa, Japan
| | - Changhee Han
- Department of Health Sciences, Saitama Prefectural University, Saitama, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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13
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Sawada M, Shiraishi Y, Nemoto T, Tanaka T, Kota R, Koike N, Shigematsu N. PO-1796 Dosimetric comparison of rectal dose reduction methods in brachytherapy for cervical cancer. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03759-8] [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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14
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Hayakawa N, Mizuno R, Shiraishi Y, Tanaka T, Matsumoto K, Kosaka T, Ohashi T, Kikuchi E, Shigematsu N, Oya M. PO-1818 Prospective study of tadalafil treatment in patients treated with prostate brachytherapy in Japan. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03781-1] [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]
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15
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Fukada J, Fukata K, Koike N, Kota R, Shigematsu N. Mean heart dose-based normal tissue complication probability model for pericardial effusion: a study in oesophageal cancer patients. Sci Rep 2021; 11:18166. [PMID: 34518576 PMCID: PMC8437977 DOI: 10.1038/s41598-021-97605-9] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/24/2021] [Indexed: 12/13/2022] Open
Abstract
We investigated the normal tissue complication probability (NTCP) of the incidence of pericardial effusion (PCE) based on the mean heart dose (MHD) in patients with oesophageal cancer treated with definitive chemoradiotherapy. The incidences of PCE in any grade (A-PCE) and symptomatic PCE (S-PCE) were evaluated separately. To identify predictors for PCE, several clinical and dose-volume parameters were analysed using a receiver operating characteristic (ROC) curve and multivariate regression analysis. To validate its clinical applicability, the generated NTCP model was compared to the Lyman–Kutcher–Burman (LKB) model. Among 229 eligible patients, A-PCE and S-PCE were observed in 100 (43.7%) and 18 (7.9%) patients, respectively. MHD showed a preferable area under the curve (AUC) value for S-PCE (AUC = 0.821) and A-PCE (AUC = 0.734). MHD was the only significant predictor for A-PCE; MHD and hypertension were selected as significant factors for S-PCE. The estimated NTCP, using the MHD-based model, showed excellent correspondence to the LKB model in A-PCE and S-PCE. The NTCP curve of A-PCE was gentler than that of S-PCE and had no threshold. The MHD-based NTCP model was simple but comparable to the LKB model for both A-PCE and S-PCE. Therefore, the estimated NTCP may provide clinically useful parameters for predicting PCE.
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Affiliation(s)
- Junichi Fukada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Kyohei Fukata
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.,Cancer Center, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naoyoshi Koike
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Ryuichi Kota
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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16
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Nemoto T, Futakami N, Kunieda E, Yagi M, Takeda A, Akiba T, Mutu E, Shigematsu N. Effects of sample size and data augmentation on U-Net-based automatic segmentation of various organs. Radiol Phys Technol 2021; 14:318-327. [PMID: 34254251 DOI: 10.1007/s12194-021-00630-6] [Citation(s) in RCA: 8] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/01/2021] [Accepted: 07/05/2021] [Indexed: 10/20/2022]
Abstract
Deep learning has demonstrated high efficacy for automatic segmentation in contour delineation, which is crucial in radiation therapy planning. However, the collection, labeling, and management of medical imaging data can be challenging. This study aims to elucidate the effects of sample size and data augmentation on the automatic segmentation of computed tomography images using U-Net, a deep learning method. For the chest and pelvic regions, 232 and 556 cases are evaluated, respectively. We investigate multiple conditions by changing the sum of the training and validation datasets across a broad range of values: 10-200 and 10-500 cases for the chest and pelvic regions, respectively. A U-Net is constructed, and horizontal-flip data augmentation, which produces left and right inverse images resulting in twice the number of images, is compared with no augmentation for each training session. All lung cases and more than 100 prostate, bladder, and rectum cases indicate that adding horizontal-flip data augmentation is almost as effective as doubling the number of cases. The slope of the Dice similarity coefficient (DSC) in all organs decreases rapidly until approximately 100 cases, stabilizes after 200 cases, and shows minimal changes as the number of cases is increased further. The DSCs stabilize at a smaller sample size with the incorporation of data augmentation in all organs except the heart. This finding is applicable to the automation of radiation therapy for rare cancers, where large datasets may be difficult to obtain.
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Affiliation(s)
- Takafumi Nemoto
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Natsumi Futakami
- Department of Radiation Oncology, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1143, Japan
| | - Etsuo Kunieda
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan.,Department of Radiation Oncology, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1143, Japan
| | - Masamichi Yagi
- Platform Technical Engineer Division, HPC and AI Business Department, System Platform Solution Unit, Fujitsu Limited, World Trade Center Building, 4-1, Hamamatsucho 2-chome, Minato-ku, Tokyo, 105-6125, Japan
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura-shi, Kanagawa, 247-0056, Japan
| | - Takeshi Akiba
- Department of Radiation Oncology, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1143, Japan
| | - Eride Mutu
- Department of Radiation Oncology, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1143, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, 160-8582, Japan
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17
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Hanada T, Yorozu A, Kikumura R, Ohashi T, Shigematsu N. Radiation dose rate variations in different measurement scenarios after prostate 125I brachytherapy. Brachytherapy 2021; 20:1305-1311. [PMID: 34274244 DOI: 10.1016/j.brachy.2021.06.147] [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: 02/02/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to directly compare different measurement scenarios using a supplemental radiation exposure measurement data set. MATERIALS AND METHODS Two sets of measurement scenarios comparing different body postures, such as standing and chair sitting positions, and different measurement directions, such as anterior and posterior directions, were assessed for radiation dose rate variations in this study at the Tokyo Medical Center, Japan. The estimated precaution time for holding children in the spoon position while sitting was also calculated. RESULTS Different radiation dose rate measurement scenarios showed different variation tendencies. Radiation dose rate measurement showed higher mean values of measured radiation dose tendency in the standing position than in the sitting positions. The measurement from the anterior direction showed a slightly lower tendency than that from the posterior direction. Assuming a dose limit of 1 mSv, the precaution time calculated for children being held in the spoon position for a certain duration every day was 51.5 (range, 12.5-152.2) minutes. CONCLUSIONS Our study presented a supplemental radiation exposure measurement data set and directly compared different measurement scenarios. Several trends in radiation exposure variations were found in the measurement scenarios at different body postures and different measurement directions. Our study data set could be a useful source of concrete information regarding radiation safety and contribute to the review and revision of public guidance in the future.
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Affiliation(s)
- Takashi Hanada
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan; Department of Radiology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan.
| | - Atsunori Yorozu
- Department of Radiology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Riki Kikumura
- Department of Radiology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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18
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Mukai K, Peterson BJ, Ezumi N, Shigematsu N, Ohshima S, Miyashita A, Matoike R. Sensitivity improvement of infrared imaging video bolometer for divertor plasma measurement. Rev Sci Instrum 2021; 92:063521. [PMID: 34243579 DOI: 10.1063/5.0043664] [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] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/04/2021] [Indexed: 06/13/2023]
Abstract
The sensitivity of an infrared imaging video bolometer (IRVB) was improved for the measurement of relatively low energy plasma radiation from the viewpoint of the metal foil absorber material. The photon energy of the radiation was considered up to 1 keV for the divertor plasma measurement. The thickness of the foil absorber was evaluated not only for conventional heavy elements, e.g., platinum, but also for light elements by the relation between the photon energy and attenuation length and by mechanical strength. A heat-transfer calculation using ANSYS suggested that light elements with practical foil thickness provide a higher temperature rise of the foil absorber compared with heavier elements with practical foil thickness. The maximum of the temperature rise was evaluated using He-Ne laser irradiation onto absorber samples. The material dependence of the temperature rise has a similar tendency between calculations and experiments. Experimentally, the sensitivity of the IRVB improved from 280 to 110 µW/cm2 using titanium with 1 µm thickness compared with conventional platinum with 2.5 µm thickness. Consequently, the signal-to-noise ratio of the IRVB could be improved from 2.8 to 9.1.
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Affiliation(s)
- K Mukai
- National Institute for Fusion Science, National Institutes of Natural Science, Toki, Gifu 509-5292, Japan
| | - B J Peterson
- National Institute for Fusion Science, National Institutes of Natural Science, Toki, Gifu 509-5292, Japan
| | - N Ezumi
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - N Shigematsu
- Plasma Research Center, University of Tsukuba, Tsukuba, Ibaraki 305-8577, Japan
| | - S Ohshima
- Institute of Advanced Energy, Kyoto University, Uji, Kyoto 611-0011, Japan
| | - A Miyashita
- Graduated School of Energy Science, Kyoto University, Uji, Kyoto 611-0011, Japan
| | - R Matoike
- Graduated School of Energy Science, Kyoto University, Uji, Kyoto 611-0011, Japan
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19
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Mizumoto M, Fuji H, Miyachi M, Soejima T, Yamamoto T, Aibe N, Demizu Y, Iwata H, Hashimoto T, Motegi A, Kawamura A, Terashima K, Fukushima T, Nakao T, Takada A, Sumi M, Oshima J, Moriwaki K, Nozaki M, Ishida Y, Kosaka Y, Ae K, Hosono A, Harada H, Ogo E, Akimoto T, Saito T, Fukushima H, Suzuki R, Takahashi M, Matsuo T, Matsumura A, Masaki H, Hosoi H, Shigematsu N, Sakurai H. Proton beam therapy for children and adolescents and young adults (AYAs): JASTRO and JSPHO Guidelines. Cancer Treat Rev 2021; 98:102209. [PMID: 33984606 DOI: 10.1016/j.ctrv.2021.102209] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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] [Received: 09/23/2020] [Revised: 04/02/2021] [Accepted: 04/11/2021] [Indexed: 11/19/2022]
Abstract
Children and adolescents and young adults (AYAs) with cancer are often treated with a multidisciplinary approach. This includes use of radiotherapy, which is important for local control, but may also cause adverse events in the long term, including second cancer. The risks for limited growth and development, endocrine dysfunction, reduced fertility and second cancer in children and AYAs are reduced by proton beam therapy (PBT), which has a dose distribution that decreases irradiation of normal organs while still targeting the tumor. To define the outcomes and characteristics of PBT in cancer treatment in pediatric and AYA patients, this document was developed by the Japanese Society for Radiation Oncology (JASTRO) and the Japanese Society of Pediatric Hematology/Oncology (JSPHO).
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Affiliation(s)
- Masashi Mizumoto
- Departments of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroshi Fuji
- Department of Radiology and National Center for Child Health and Development, Tokyo, Japan
| | - Mitsuru Miyachi
- Department of Pediatrics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Toshinori Soejima
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan
| | - Norihiro Aibe
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yusuke Demizu
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan
| | - Hiromitsu Iwata
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, Aichi, Japan
| | - Takayuki Hashimoto
- Department of Radiation Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Atsufumi Kawamura
- Department of Neurosurgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Keita Terashima
- Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan
| | - Takashi Fukushima
- Department of Pediatric Hematology and Oncology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Tomohei Nakao
- Department of Pediatrics, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Akinori Takada
- Department of Radiology, Mie University Hospital, Tsu-shi, Mie, Japan
| | - Minako Sumi
- Department of Radiation Oncology and Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Radiation Oncology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan
| | | | - Kensuke Moriwaki
- Department of Medical Statistics, Kobe Pharmaceutical University, Kobe, Hyogo, Japan
| | - Miwako Nozaki
- Department of Radiology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Saitama, Japan
| | - Yuji Ishida
- Department of Pediatrics, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
| | - Yoshiyuki Kosaka
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Hyogo, Japan
| | - Keisuke Ae
- Department of Orthopaedic Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Ako Hosono
- Department of Pediatric Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Hideyuki Harada
- Division of Radiation Therapy, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
| | - Etsuyo Ogo
- Department of Radiology, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Takashi Saito
- Departments of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hiroko Fukushima
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Ryoko Suzuki
- Department of Child Health, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Mitsuru Takahashi
- Department of Orthopaedic Oncology, Shizuoka Cancer Center Hospital, Nagaizumi, Shizuoka, Japan
| | - Takayuki Matsuo
- Department of Neurosurgery, Nagasaki University Graduate School of Medicine, Nagasaki, Japan
| | - Akira Matsumura
- Departments of Neurosurgery, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Hidekazu Masaki
- Proton Therapy Center, Aizawa Hospital, Matsumoto, Nagano, Japan
| | - Hajime Hosoi
- Department of Pediatrics, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Sakurai
- Departments of Radiation Oncology, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Nemoto T, Futakami N, Yagi M, Akiba T, Takeda A, Kunieda E, Shigematsu N. The Effects Of Sample Size And Data Augmentation On The Efficacy Of Semantic Segmentation For Prostate Cancer Using Deep Learning: A Report Of More Than 500 Cases. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.209] [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: 11/24/2022]
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Shiraishi Y, Tanaka T, Toya K, Yorozu A, Shigematsu N. Machine Learning Algorithms for Late Toxicity Prediction after Prostate Permanent Brachytherapy. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Sawada M, Kunieda E, Akiba T, Kabuki S, Nagao R, Fukuzawa T, Matsumoto Y, Shigematsu N. Dosimetric study of whole-brain irradiation with high-energy photon beams for dose reduction to the scalp. Br J Radiol 2020; 93:20200159. [PMID: 32650647 PMCID: PMC7548379 DOI: 10.1259/bjr.20200159] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/25/2020] [Accepted: 07/06/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate the efficiency of high-energy photons for mitigating alopecia due to whole-brain irradiation (WBRT). METHODS Planning CT data from 10 patients who received WBRT were collected. We prepared 4 WBRT plans that used 6 or 15 MV photon beams, with or without use of a field-in-field (FiF) technique, and compared outcomes using a treatment planning system. The primary outcome was dose parameters to the scalp, including the mean dose, maximum dose, and dose received to 50% scalp(D50%). Secondary outcomes were minimum dose to the brain surface. RESULTS Using FiF, the mean doses were 24.4-26.0 and 22.4-24.1 Gy, and the maximum doses were 30.5-32.1 and 28.5-30.8 Gy for 6 and 15 MV photon beams, respectively. Without FiF, the mean doses were 24.6-26.9 and 22.6-24.5 Gy, and the maximum doses were 30.8-34.6 and 28.6-32.4 Gy for 6 and 15 MV photon beams. The 15 MV plan resulted in a lower scalp dose for each dose parameter (p < 0.001). Using FiF, the minimum doses to the brain surface for the 6 and 15 MV plans were 28.9 ± 0.440 and 29.0 ± 0.557 Gy, respectively (p = 0.70). Without FiF, the minimum doses to the brain surface for the 6 and 15 MV plans were 28.9 ± 0.456 and 29.0 ± 0.529, respectively (p = 0.66). CONCLUSION Compared with the 6 MV plan, the 15 MV plan achieved a lower scalp dose without impairing the brain surface dose. ADVANCES IN KNOWLEDGE High-energy photon WBRT may mitigate alopecia of patients who receiving WBRT.
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Affiliation(s)
| | | | - Takeshi Akiba
- Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Shigeto Kabuki
- Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Ryuta Nagao
- Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Tsuyoshi Fukuzawa
- Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Yoshitsugu Matsumoto
- Department of Radiation Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan
| | - Naoyuki Shigematsu
- Department of Radiation Oncology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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Nemoto T, Futakami N, Yagi M, Kunieda E, Akiba T, Takeda A, Shigematsu N. Simple low-cost approaches to semantic segmentation in radiation therapy planning for prostate cancer using deep learning with non-contrast planning CT images. Phys Med 2020; 78:93-100. [DOI: 10.1016/j.ejmp.2020.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/24/2020] [Accepted: 09/01/2020] [Indexed: 10/23/2022] Open
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Kaneda T, Ohashi T, Hanada T, Takenaka K, Nishimura S, Sakayori M, Sutani S, Momma T, Shigematsu N. Comparison of prostate verification with implanted gold markers in tissue surrounding the prostate and pelvic bony anatomy for external beam radiation therapy following low-dose-rate brachytherapy: a prospective clinical trial. J Radiat Res 2020; 61:784-790. [PMID: 32808018 PMCID: PMC7482168 DOI: 10.1093/jrr/rraa063] [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] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/16/2020] [Indexed: 06/11/2023]
Abstract
We aimed to investigate whether gold marker implantation in the tissue surrounding the prostate could accurately monitor setup errors during external beam radiation therapy (EBRT) following low-dose-rate (LDR) brachytherapy. Thirty-eight patients had confirmed intermediate- or high-risk prostate cancer and received EBRT following LDR brachytherapy. In >175 computed tomography imaging sessions, the average values of the weekly setup error during EBRT to the prostate centroid at the time of gold marker matching in the surrounding tissue of the prostate and pelvic bone matching were measured and then compared using the Wilcoxon signed-rank test. Gold marker matching in the surrounding tissue of the prostate estimated setup errors better than those estimated by bone matching (3D displacement = 2.7 ± 2.0 vs 3.8 ± 2.6 mm, P < 0.01). Overall, the standard deviation of systematic (Σ) and random (σ) setup error was lower with gold marker matching than with bone matching (3D displacement = 1.8 and 1.1 mm vs 2.1 and 1.6 mm, respectively). With gold marker matching, the setup error of the position of the prostate centroid was smaller, and the optimal setup margin was lower than that with bone matching (2Σ + 0.7σ and 2.5Σ + 0.7σ of 3D displacement = 4.3 and 5.2 mm vs 5.3 and 6.4 mm, respectively). This high-precision radiotherapy approach placing gold markers in the surrounding tissue of the prostate can allow more accurate setup during EBRT following LDR brachytherapy.
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Affiliation(s)
- Tomoya Kaneda
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Radiology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako, Saitama 351-0102, Japan
| | - Toshio Ohashi
- Corresponding author. Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan. Tel: +81-3-3353-1211; Fax: +81-3-3359-7425;
| | - Takashi Hanada
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Koji Takenaka
- Department of Radiology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako, Saitama 351-0102, Japan
| | - Shuichi Nishimura
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Masanori Sakayori
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
- Department of Radiology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako, Saitama 351-0102, Japan
| | - Shinya Sutani
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Tetsuo Momma
- Department of Urology, National Hospital Organization Saitama Hospital, 2-1 Suwa, Wako, Saitama 351-0102, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
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Shigeta K, Kikuchi E, Matsushima M, Ogihara K, Kosaka T, Mizuno R, Tanaka T, Shigematsu N, Oya M. Relationship between radiation doses and erectile function deterioration in patients with localized prostate cancer treated with permanent prostate brachytherapy. Int J Urol 2020; 27:1087-1093. [PMID: 32893378 DOI: 10.1111/iju.14358] [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] [Received: 05/03/2020] [Accepted: 07/20/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the relationship between radiation doses in prostate brachytherapy and deterioration of erectile function in patients with localized prostate cancer. METHODS A longitudinal survey study was carried out among 261 prostate cancer patients who received prostate brachytherapy. A total of 48 patients were potent at baseline and they did not receive any supplemental therapy preoperatively. Dosimetry parameters of the whole prostate gland, prostate apex, urethra and rectum were collected using the VariSeed 8.0 treatment planning system (Varian Medical Systems, Palo Alto, CA, USA). We carried out a logistic regression analysis to clarify the relationship between radiation doses and erectile function deterioration, which was assessed using the International Index of Erectile Function-15 questionnaire. RESULTS The median patient age was 66 years (range 53-70 years) with a median follow-up time of 44 months (36-71 months). The mean total International Index of Erectile Function-15 score decreased from 49.9 at baseline to 34.7 after 12 months (P < 0.001), but gradually plateaued within 36 months. Erectile function deterioration was noted in 32 (66.7%) patients 36 months after prostate brachytherapy. In an analysis of risk factors for erectile function deterioration after prostate brachytherapy, age ≥70 years (P = 0.029), prostate V100 ≥95% (P = 0.024), apex V100 ≥95% (P = 0.024), apex V150 ≥70% (P = 0.009) and apex D90 ≥150 Gy (P = 0.011) correlated with erectile function deterioration. A multivariate analysis identified an age of ≥70 years (odds ratio 7.91, P = 0.024) and apex V150 ≥70% (odds ratio 7.75, P = 0.007) as independent risk factors for erectile function deterioration after prostate brachytherapy. CONCLUSIONS An excessive radiation dose, particularly to the prostate apex area, and an advanced age might have a negative impact on the preservation of potency after prostate brachytherapy.
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Affiliation(s)
- Keisuke Shigeta
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, Tokyo, Japan.,Department of Urology, St. Marianna University School of Medicine, Kanagawa, Japan
| | | | - Koichiro Ogihara
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Tomoki Tanaka
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
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Raturi VP, Wu C, Mohammad S, Hojo H, Bei Y, Nakamura M, Okumura M, Rachi T, Singh R, Gupta R, Parmar D, Hasan F, Gaur J, Kishan D, Kumar S, Badajena A, Katepogu P, Shigematsu N. Could excision repair cross‐complementing group‐1 mRNA expression from peripheral blood lymphocytes predict locoregional failure with cisplatin chemoradiation for locally advanced laryngeal cancer? Asia Pac J Clin Oncol 2020; 16:e19-e26. [DOI: 10.1111/ajco.13239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 08/07/2019] [Indexed: 12/24/2022]
Affiliation(s)
- Vijay Parshuram Raturi
- Department of Radiation OncologyKing George's Medical University Lucknow India
- Division of Radiation Oncology and Particle TherapyNational Cancer Center Hospital East Kashiwa Japan
| | - Chen‐Ta Wu
- Department of Radiation OncologyGraduate School of Medicine, Keio University Tokyo Japan
| | - Suhel Mohammad
- Department of Radiation OncologyKing George's Medical University Lucknow India
| | - Hidehiro Hojo
- Division of Radiation Oncology and Particle TherapyNational Cancer Center Hospital East Kashiwa Japan
| | - Yanping Bei
- Division of Radiation Oncology and Particle TherapyNational Cancer Center Hospital East Kashiwa Japan
| | - Masaki Nakamura
- Division of Radiation Oncology and Particle TherapyNational Cancer Center Hospital East Kashiwa Japan
| | - Masayuki Okumura
- Division of Radiation Oncology and Particle TherapyNational Cancer Center Hospital East Kashiwa Japan
| | - Toshiya Rachi
- Division of Radiation Oncology and Particle TherapyNational Cancer Center Hospital East Kashiwa Japan
| | - Rahul Singh
- Department of Radiation OncologyKing George's Medical University Lucknow India
| | - Rajeev Gupta
- Department of Radiation OncologyKing George's Medical University Lucknow India
| | | | - Feza Hasan
- Indian Institute of Toxicology and Research Lucknow India
| | - Jalaj Gaur
- Department of Radiation OncologyKing George's Medical University Lucknow India
| | - Dewesh Kishan
- Department of Radiation OncologyKing George's Medical University Lucknow India
| | - Saurabh Kumar
- Department of RadiologyKing George's Medical University Lucknow India
| | - Avinash Badajena
- Department of Radiation OncologyKing George's Medical University Lucknow India
| | - Pranay Katepogu
- Department of Radiation OncologyKing George's Medical University Lucknow India
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Nemoto T, Futakami N, Yagi M, Kumabe A, Takeda A, Kunieda E, Shigematsu N. Efficacy evaluation of 2D, 3D U-Net semantic segmentation and atlas-based segmentation of normal lungs excluding the trachea and main bronchi. J Radiat Res 2020; 61:257-264. [PMID: 32043528 PMCID: PMC7246058 DOI: 10.1093/jrr/rrz086] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 09/23/2019] [Accepted: 12/28/2019] [Indexed: 05/29/2023]
Abstract
This study aimed to examine the efficacy of semantic segmentation implemented by deep learning and to confirm whether this method is more effective than a commercially dominant auto-segmentation tool with regards to delineating normal lung excluding the trachea and main bronchi. A total of 232 non-small-cell lung cancer cases were examined. The computed tomography (CT) images of these cases were converted from Digital Imaging and Communications in Medicine (DICOM) Radiation Therapy (RT) formats to arrays of 32 × 128 × 128 voxels and input into both 2D and 3D U-Net, which are deep learning networks for semantic segmentation. The number of training, validation and test sets were 160, 40 and 32, respectively. Dice similarity coefficients (DSCs) of the test set were evaluated employing Smart SegmentationⓇ Knowledge Based Contouring (Smart segmentation is an atlas-based segmentation tool), as well as the 2D and 3D U-Net. The mean DSCs of the test set were 0.964 [95% confidence interval (CI), 0.960-0.968], 0.990 (95% CI, 0.989-0.992) and 0.990 (95% CI, 0.989-0.991) with Smart segmentation, 2D and 3D U-Net, respectively. Compared with Smart segmentation, both U-Nets presented significantly higher DSCs by the Wilcoxon signed-rank test (P < 0.01). There was no difference in mean DSC between the 2D and 3D U-Net systems. The newly-devised 2D and 3D U-Net approaches were found to be more effective than a commercial auto-segmentation tool. Even the relatively shallow 2D U-Net which does not require high-performance computational resources was effective enough for the lung segmentation. Semantic segmentation using deep learning was useful in radiation treatment planning for lung cancers.
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Affiliation(s)
- Takafumi Nemoto
- Division of Radiation Oncology, Saiseikai Yokohamashi Tobu-Hospital, Shimosueyoshi 3-6-1, Tsurumi-ku, Yokohama-shi, Kanagawa, 230-8765, Japan
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Natsumi Futakami
- Department of Radiation Oncology, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1143, Japan
| | - Masamichi Yagi
- HPC&AI Business Dept., Platform Technical Engineer Div., System Platform Solution Unit, Fujitsu Limited, World Trade Center Building, 4-1, Hamamatsucho 2-chome, Minato-ku, Tokyo, 105-6125, Japan
| | - Atsuhiro Kumabe
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku-ku, Tokyo, 160-8582, Japan
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, 247-0056, Japan
| | - Etsuo Kunieda
- Department of Radiation Oncology, Tokai University School of Medicine, Shimokasuya 143, Isehara-shi, Kanagawa, 259-1143, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Shinanomachi 35, Shinjyuku-ku, Tokyo, 160-8582, Japan
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Yamano T, Tomita N, Sato T, Hayakawa K, Kamikonya N, Matoba S, Uki A, Baba H, Oya N, Hasegawa H, Shigematsu N, Hiraoka M, Shimada M, Noda M, Sakai Y, Sato H, Saegusa M, Takeuchi M, Oguchi M, Oya M, Watanabe M. Influence of chemoradiotherapy on nutritional status in locally advanced rectal cancer: Prospective multicenter study. Nutrition 2020; 77:110807. [PMID: 32402940 DOI: 10.1016/j.nut.2020.110807] [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] [Received: 11/25/2019] [Revised: 02/27/2020] [Accepted: 03/04/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the influence of chemoradiotherapy (CRT) on nutritional status and the association between changes in nutritional status and clinical outcomes (treatment completion, adverse events, perioperative complications, and relapse-free survival [RFS]) in patients with locally advanced rectal cancer (LARC). METHODS In this multicenter, phase II study, 41 patients with LARC underwent CRT for 5 wk, followed by a 6- to 8-wk interval before surgery. Body weight, body mass index (BMI), lean body mass, serum albumin, and prealbumin levels were measured before (pre-), during, and after CRT, and before surgery. Changes in these data and scores on the Malnutrition Universal Screening Tool (MUST) were calculated based on pre-CRT status. RESULTS Twelve patients (29.3%) experienced body weight loss (BWL) ≥5% (defined as malnutrition) after CRT (P < 0.001) and before surgery (P = 0.035). Significant changes were seen in serum albumin levels and BMI during and after CRT (P < 0.001), and in MUST scores after CRT (P = 0.003) and before surgery (P = 0.035). Treatment completion was significantly associated with BWL (P = 0.028), MUST score (P = 0.013), and decreased serum albumin level (P = 0.001) after CRT. Regarding adverse events, MUST score before surgery (P = 0.009) and serum albumin level after CRT (P = 0.002) were significantly associated with diarrhea severity. Serum albumin level during CRT was associated with the onset of neutropenia (P = 0.005). No association was found between BWL and RFS. CONCLUSIONS These findings suggest that malnutrition and changes in nutritional status are not only commonly observed after CRT, but also associated with treatment completion and adverse events.
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Affiliation(s)
- Tomoki Yamano
- Division of Lower GI Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan.
| | - Naohiro Tomita
- Division of Lower GI Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Takeo Sato
- Department of Colorectal Surgery, Kitasato University School of Medicine, Kanagawa, Japan
| | - Kazushige Hayakawa
- Department of Radiology, National Hospital Organization Disaster Medical Center, Tokyo, Japan
| | | | - Shuichiro Matoba
- Department of Gastrointestinal Surgery, Toranomon Hospital, Tokyo, Japan
| | - Akiyoshi Uki
- Department of Radiology, Toranomon Hospital, Tokyo, Japan
| | - Hideo Baba
- Department of Gastroenterological Surgery, Graduate School of Medical Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Natsuo Oya
- Department of Radiation Oncology, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan
| | | | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | | | - Mitsuo Shimada
- Department of Surgery, Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
| | - Masafumi Noda
- Division of Lower GI Surgery, Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Yoshiharu Sakai
- Department of Surgery, Graduate School of Medicine and Faculty of Medicine Kyoto University, Kyoto, Japan
| | - Hirohiko Sato
- Department of Surgery, Yoshinogawa Medical Center, Tokushima, Japan
| | - Makoto Saegusa
- Department of Pathology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Masahiro Takeuchi
- Department of Clinical Medicine (Biostatistics), Kitasato University School of Pharmacy, Tokyo, Japan
| | - Masahiko Oguchi
- Radiation Oncology Department, The Cancer Institute Hospital Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masatoshi Oya
- Department of Surgery, Saitama Medical Center, Dokkyo Medical University, Saitama, Japan
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Takagawa Y, Tamaki W, Suzuki S, Inaba K, Murakami N, Takahashi K, Igaki H, Nakayama Y, Shigematsu N, Itami J. Radiotherapy for localized sebaceous carcinoma of the eyelid: a retrospective analysis of 83 patients. J Radiat Res 2019; 60:622-629. [PMID: 31271440 PMCID: PMC6805970 DOI: 10.1093/jrr/rrz046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 04/12/2019] [Revised: 05/22/2019] [Indexed: 06/09/2023]
Abstract
The current study retrospectively analyzed the results of radiotherapy for clinically localized sebaceous carcinoma of the eyelid.We reviewed records of 83 patients with histologically confirmed sebaceous carcinoma who were treated radiotherapeutically between 1983 and 2015. Sixty-five patients (78%) were initially treated with radiotherapy of curative intent, while the remaining 18 patients underwent postoperative radiotherapy due to tumor recurrence or positive surgical margins. Thirty-seven patients belonged to T1-2, while 46 belonged to T3-4. All 83 patients were treated with radiotherapy with a median radiation dose of 60 Gy. The median follow-up period was 92.1 months (range, 2.8-310.3 months). At the time of analysis, 13 patients (15.1%) died, and 36 patients (43.3%) had local recurrence. The 7-year overall survival, freedom from neck lymph node recurrence, and local control (LC) rates for all patients were 83.5%, 75.5%, and 52.3%, respectively. Patients with a tumor size ≤10 mm had a higher 7-year LC rate than those with a tumor size >10 mm (58.8% vs 46.6%, P = 0.054). Neck lymph node recurrence was observed in 17 patients (20%) and significantly related to the tumor size. Late toxicity of an eyelid dysfunction of grade 3 was observed in 1 patient with T3 tumor. Radiotherapy for sebaceous carcinoma of the eyelid is a reasonable alternative to surgical resection for tumors <10 mm in size with few severe complications, while larger tumors should be treated with surgery if feasible.
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Affiliation(s)
- Yoshiaki Takagawa
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Wakana Tamaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
- Department of Radiation Oncology, Prefectural Chubu Hospital, Okinawa, Japan
| | - Shigenobu Suzuki
- Department of Ophthalmology, National Cancer Center Hospital, Tokyo, Japan
| | - Koji Inaba
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kana Takahashi
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Jun Itami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
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Eriguchi T, Takeda A, Tsurugai Y, Sanuki N, Kibe Y, Hara Y, Kaneko T, Taguri M, Shigematsu N. Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT. Radiother Oncol 2019; 134:191-198. [PMID: 31005215 DOI: 10.1016/j.radonc.2019.02.005] [Citation(s) in RCA: 4] [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: 11/26/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Clinical staging, as used for patients treated with stereotactic body radiotherapy (SBRT) for early-stage lung cancer, inadequately accounts for pleural invasion, which is a pathologic criteria. Considering the current situation, we analyzed effects of relationships between tumors and the pleura on treatment outcomes of SBRT for early-stage lung cancer. MATERIALS AND METHODS Among consecutive patients treated with SBRT between 2006 and 2017, we retrospectively identified non-small cell lung cancer patients with primary tumor diameters ≤4 cm and N0M0. The relationships between tumors and the pleura were investigated. The effects of these findings on treatment outcomes were analyzed. RESULTS We identified 386 patients which met the inclusion criteria. Among these patients, 323 patients were with tumors of 0.1-3.0 cm (T1-size), and 63 patients were with tumors of 3.1-4.0 cm (T2a-size). Among patients with T1-size tumors, 120, 134, and 23 had findings of pleural contact, pleural indentation, and pleural thickening, respectively. When we divided T1-size patients into 2 groups based on pleural contact (contact- or contact+), the 3-year cause-specific mortality and overall survival in patients with T1-size & contact+ were significantly worse than those in patients with T1-size & contact- (17.6% (95% confidence interval (CI), 10.7-25.9%) vs. 6.6% (95% CI, 3.5-11.1%), p < 0.01), and 58.2% (95% CI, 47.6-67.5%) vs. 77.6% (95% CI, 70.5-83.2%), p < 0.01). Local recurrence, regional recurrence, pleural cavity recurrence, and distant metastasis were associated with worse cause-specific mortality and overall survival. On multivariate analysis, pleural contact was associated with cause-specific mortality (hazard ratio (HR), 1.96; 95% CI, 1.09-3.52; p = 0.03) and overall survival (HR, 1.59; 95% CI, 1.08-2.34; p = 0.02). CONCLUSION Pleural contact in clinical T1N0M0 lung cancer patients was associated with significantly worse survivals.
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Affiliation(s)
- Takahisa Eriguchi
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Japan; Department of Radiation Oncology, Saiseikai Yokohamashi Tobu Hospital, Yokohama, Japan; Department of Radiation Oncology, Keio University School of Medicine, Tokyo, Japan
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Japan.
| | | | - Naoko Sanuki
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Japan
| | - Yuichi Kibe
- Radiation Oncology Center, Ofuna Chuo Hospital, Kamakura, Japan
| | - Yu Hara
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Takeshi Kaneko
- Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masataka Taguri
- Department of Data Science, Yokohama City University School of Data Science, Yokohama, Japan
| | - Naoyuki Shigematsu
- Department of Radiation Oncology, Keio University School of Medicine, Tokyo, Japan
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Fukada J, Fukata K, Abe T, Koike N, Kota R, Kitagawa Y, Shigematsu N. Can Mean Pericardial Irradiated Dose (MPD) Predict Pericardial Effusion after Chemoradiotherapy in Esophageal Cancer Patients? Normal Tissue Complication Probability (NTCP) Model-Based Analyses. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.513] [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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Yura M, Takahashi T, Fukuda K, Nakamura R, Wada N, Fukada J, Kawakubo H, Takeuchi H, Shigematsu N, Kitagawa Y. A Highly Advanced Gastric Cancer Maintaining a Clinical Complete Response after Chemoradiotherapy Comprising S-1 and Cisplatin. Case Rep Gastroenterol 2018; 12:578-585. [PMID: 30323733 PMCID: PMC6180270 DOI: 10.1159/000492206] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022] Open
Abstract
We report a patient with highly advanced gastric carcinoma who was treated successfully with chemoradiotherapy (CRT) comprising S-1 and cisplatin. The patient was a 71-year-old male who was diagnosed with advanced gastric carcinoma by esophagogastroduodenoscopy (EGD) by medical examination. EGD demonstrated type 3 advanced gastric carcinoma in the posterior wall of the upper gastric body. An abdominal computed tomography (CT) scan showed that the gastric wall was thickened due to gastric primary tumor, and large lymph nodes (LNs) including the lesser curvature LN, anterosuperior LN along the common hepatic artery and some para-aortic LNs were detected. The patient was diagnosed with stage IV advanced gastric carcinoma according to the Japanese classification of gastric carcinoma (cT4a, cN3, cM1 [para-aortic LN], cStage IV). Preoperative CRT was carried out in an attempt to downstage the disease. Remarkable reduction of the primary tumor and metastatic LNs was observed after initial CRT, and radiological examination determined that a partial response had been achieved. Adverse effects included grade 2 anorexia and grade 3 ALP elevation (919 U/ml). No grade 4 or more severe adverse event was observed. After CRT, although we recommended curative surgery, the patient refused surgical treatment and opted for conservative treatment. Thus, we continued S-1 oral administration for 1 year. Five months after beginning CRT, upper endoscopy showed that the tumor had maintained regression and scar formation, in which no cancer cells were detected by endoscopic biopsy. The patient is doing well and has maintained a clinical complete response for more than 42 months without curative surgery. CRT could be considered as an option for treatment of patients with locally advanced gastric carcinoma diagnosed as unresectable, or for those who refuse surgical treatment.
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Affiliation(s)
- Masahiro Yura
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | | | - Kazumasa Fukuda
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Rieko Nakamura
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Norihito Wada
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Junichi Fukada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Hirofumi Kawakubo
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Hiroya Takeuchi
- Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu-shi, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Yuko Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Ito K, Saito S, Yorozu A, Kojima S, Kikuchi T, Higashide S, Aoki M, Koga H, Satoh T, Ohashi T, Nakamura K, Katayama N, Tanaka N, Nakano M, Shigematsu N, Dokiya T, Fukushima M, Takahashi Y, Tsukiyama I, Nasu Y, Harada M, Fukagai T, Yamashita T, Matsubara A, Igawa M, Egawa S, Kakehi Y, Katsuoka Y, Kanetake H, Kubota Y, Kumon H, Yamasaki I, Suzuki K, Deguchi T, Ueno M, Naito S, Namiki M, Baba S, Hayakawa K, Hirao Y, Fujioka T, Horie S, Miki T, Murai M, Yoshida H, Itami J, Inoue T, Imai Y, Kataoka M, Kubo A, Shibuya H, Nishio M, Tanaka H, Tanaka Y, Teramukai S, Harada C, Yamashiro K, Kiba T, Kitagawa SI, Uno E, Nishimura T, Kinoshita F, Iida S, Maruo S, Miyakoda K, Daimon T, Kawamoto A, Kaneda H, Yoshidomi M, Nishiyama T, Yagi Y, Namitome R, Toya K, Koike N, Yoshida K, Tabata K, Tsumura H, Kimura M, Ishiyama H, Kotani S, Tanaka N, Kondo H, Fujimoto K, Hasegawa M, Tamamoto T, Asakawa I, Nishizawa S, Hashida I, Takezawa Y, Harada K, Tanji S, Sato K, Matsuura T, Ariga H, Ehara S, Nakamura R, Nakano M, Hayashi S, Ohtakara K, Kihara K, Hayashi K, Okamoto K, Sho K, Kono N, Okihara K, Kobayashi K, Betsuku K, Katayama N, Takemoto M, Kanazawa S, Miyakubo M, Kato H, Noda H, Nagashima J, Harabayashi T, Nagamori S, Nishiyama N, Kanemura M, Aruga T, Fukumori T, Furutani S, Kotoh S, Masumoto H, Yamasaki T, Kawashima K, Inoue K, Matsubara A, Teishima J, Kenjo M, Hashine K, Tatsugami K, Kuroiwa K, Inokuchi J, Ohga S, Nakamura K, Sasaki T, Shuin T, Kariya S, Miki K, Sasaki H, Kido M, Yonese J, Kozuka T, Sumura M, Uchida N, Morita M, Ogawa Y, Hamada K, Nakai Y, Yoshioka Y, Sakai H, Hayashi N, Masumori N, Hori M, Hasumi M, Kudo S, Uemura H, Hayashi N, Sano F, Ogino I, Ishikawa A, Shiraishi K, Muraishi O, Nakamura N, Shiroki R, Ito F, Tomioka S, Ohta S, Yokoyama O, Shioura H, Hioka T, Suzuki K, Kageyama Y, Saito Y, Kikugawa T, Nishikawa A, Nagata H, Sugawara A, Kawakita S, Shiga Y, Momma T, Yamashita S. Nationwide Japanese Prostate Cancer Outcome Study of Permanent Iodine-125 Seed Implantation (J-POPS): first analysis on survival. Int J Clin Oncol 2018; 23:1148-1159. [DOI: 10.1007/s10147-018-1309-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/16/2018] [Indexed: 11/24/2022]
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Sato M, Uematsu M, Hama Y, Kondo M, Kutsuki S, Shigematsu N, Ando Y, Kusano S, Kubo A. Low-Dose Induction Radiotherapy for Stomach Conservation in Patients with Massive Gastric Lymphoma. Tumori 2018; 86:286-8. [PMID: 11016705 DOI: 10.1177/030089160008600405] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Low-dose induction radiotherapy was performed in 4 patients with massive gastric lymphoma in order to treat the disease without gastrectomy. Following the radiotherapy, gastric lesions had shrunk considerably without any complications. Standard chemotherapy and/or radiotherapy could then be performed safely, and stomach conservation could be achieved in all 4 patients.
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Affiliation(s)
- M Sato
- Radiation Oncology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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35
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Kumabe A, Fukada J, Kota R, Koike N, Shiraishi Y, Seki S, Yoshida K, Kitagawa Y, Shigematsu N. Long-term results of concurrent chemoradiotherapy with daily-low-dose continuous infusion of 5-fluorouracil and cisplatin (LDFP) for Stage I-II esophageal carcinoma. Dis Esophagus 2018; 31:4714779. [PMID: 29228166 DOI: 10.1093/dote/dox138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 11/01/2017] [Indexed: 12/11/2022]
Abstract
We investigated long-term treatment outcomes and the feasibility of chemoradiotherapy consisting of daily-low-dose 5-fluorouracil and cisplatin (LDFP) chemotherapy plus radiotherapy for Stage I-II squamous cell esophageal cancer. Treatment records from the 2000 through 2008 period were reviewed retrospectively. Fractionated radiotherapy was performed with a total dose of 60 Gy delivered in 2 Gy per fraction. LDFP chemotherapy, as continuous infusion of 200 mg/m2 5-fluorouracil combined with one hour infusion of 4 mg/m2 cisplatin, was administered on the same days as radiotherapy. Survival was calculated by the Kaplan-Meier method. Survival, responses, failure patterns, and toxicities were evaluated. Seventy-six (47 stage I and 29 stage II) patients were analyzed with a median follow-up of 93.6 months. The 8-year overall survival (OS), progression-free survival (PFS) and cause-specific survival (CSS) rates were 63.4%, 49.8%, and 76.7%, respectively. The 8-year OS, PFS, and CSS for stage I and stage II patients were 71.0%/56.1%/82.9% and 45.2%/40.2%/66.6%, respectively. Sixty-eight patients (89.5%) completed the treatment regimen. A complete response (CR) was achieved in 68 patients (89.5%). Twenty-five patients (36.8%) experienced recurrence after CR. The failure patterns were (overlap included): local failure (n = 12), nodal metastasis (n = 12), distant metastasis (n = 3), details unknown (n = 2). Salvage therapy was performed for local failure; endoscopic therapy (n = 7) or surgery (n = 2). Six patients remain alive without relapse after salvage endoscopic therapy. Major Grade 3 or higher acute adverse events were leukopenia (22%), anorexia (17%), and esophagitis (11%). Major late toxicities (Grade 3 or 4) involved pericardial effusion (12%), pleural effusion (4%), and esophageal stenosis (3%). Chemoradiotherapy with LDFP provided favorable long-term survival with acceptable toxicity for Stage I-II squamous cell esophageal cancer. The tumor response was excellent, but close endoscopic follow-up is essential for detecting and treating local recurrence.
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Affiliation(s)
- A Kumabe
- Department of Radiology and Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - J Fukada
- Department of Radiology and Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - R Kota
- Department of Radiology and Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - N Koike
- Department of Radiology and Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Y Shiraishi
- Department of Radiology and Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - S Seki
- Department of Radiation Oncology, Saitama Medical University Hospital, Saitama, Tokyo, Japan
| | - K Yoshida
- Department of Radiology and Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Y Kitagawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - N Shigematsu
- Department of Radiology and Department of Surgery, Keio University School of Medicine, Tokyo, Japan
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Nishimura S, Ohashi T, Momma T, Sakayori M, Eriguchi T, Tanaka T, Yamashita S, Kosaka T, Oya M, Shigematsu N. Prostate-specific antigen nadir within 12 months as an early surrogate marker of biochemical failure and distant metastasis after low-dose-rate brachytherapy or external beam radiotherapy for localized prostate cancer. Cancer Med 2018; 7:1794-1801. [PMID: 29577651 PMCID: PMC5943430 DOI: 10.1002/cam4.1443] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 02/01/2018] [Accepted: 02/19/2018] [Indexed: 11/09/2022] Open
Abstract
Prostate-specific antigen nadir (nPSA) after radiotherapy for localized prostate cancer has been investigated as a predictor. However, nPSA usually requires several years, limiting its clinical utility. We investigated the significance of nPSA within 12 months (nPSA12) after low-dose-rate prostate brachytherapy (LDR-PB) or external beam radiotherapy (EBRT) on treatment outcomes. Between 2006 and 2014, 663 patients with prostate cancer were treated with LDR-PB or EBRT at two institutions. Four hundred and seventy-four men received LDR-PB and 189 men received EBRT, without androgen deprivation therapy. The Kaplan-Meier method was used for biochemical failure (BF)-free survival (BFFS) and distant metastasis (DM)-free survival (DMFS) analyses, and multivariable Cox regression analysis was performed. The median follow-up was 61.3 months. The median nPSA12 in the LDR-PB and EBRT cohorts was 0.7 and 1.0 ng/mL, respectively. The 7-year BFFS and DMFS rates in LDR-PB patients with nPSA12 ≤ 0.7 ng/mL were 99.1% and 99.5%, respectively; when nPSA12 was >0.7 ng/mL, they were 90.2% and 94.8%, respectively. In EBRT patients with nPSA12 ≤ 1.0 ng/mL, BFFS and DMFS rates were 85.4% and 98.5%, respectively; when nPSA12 was >1.0 ng/mL, they were 67.1% and 87.2%, respectively. nPSA12 was an independent predictor of BF and DM in both cohorts (LDR-PB, P = 0.004 and 0.020, respectively; EBRT, P = 0.005 and 0.041, respectively). The nPSA12 after LDR-PB or EBRT is significantly associated with treatment outcomes of prostate cancer. Higher nPSA12 may identify patients at high risk of relapse who might benefit from salvage treatment.
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Affiliation(s)
- Shuichi Nishimura
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuo Momma
- Department of Urology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Masanori Sakayori
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Takahisa Eriguchi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Tomoki Tanaka
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shoji Yamashita
- Department of Radiology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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Kumabe A, Zenda S, Motegi A, Onozawa M, Nakamura N, Kojima T, Daiko H, Shigematsu N, Akimoto T. Long-term Clinical Results of Concurrent Chemoradiotherapy for Patients with Cervical Esophageal Squamous Cell Carcinoma. Anticancer Res 2017; 37:5039-5044. [PMID: 28870931 DOI: 10.21873/anticanres.11919] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 06/10/2017] [Revised: 07/02/2017] [Accepted: 07/04/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM We assessed the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) in patients with squamous cell carcinoma of the cervical esophagus. PATIENTS AND METHODS We retrospectively analyzed 37 patients treated with definitive CCRT. The patients received radiotherapy at a fraction dose of 2 Gy (total; 60 or 70 Gy) and concurrent chemotherapy. Adjuvant chemotherapy consisted of 1 to 2 cycles of 5-fluorouracil plus cisplatin or nedaplatin. RESULTS The median follow-up was 119.0 months, the 10-year overall survival, progression-free survival and laryngectomy-free survival rates were 35.6, 19.9 and 30.2% respectively. In the univariate analysis, T stage (T4 vs. T1-3) was the only prognostic factor for PFS. The most common acute toxicity was leukocytopenia (Grade 3; 27%). As for late toxicities, 4 patients (11%) developed Grade 2 or 3 esophageal strictures. CONCLUSION The results of this study demonstrated that CCRT yielded satisfactory clinical outcomes with acceptable toxicities.
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Affiliation(s)
- Atsuhiro Kumabe
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Sadatomo Zenda
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Masakatsu Onozawa
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Naoki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takashi Kojima
- Department of Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroyuki Daiko
- Department of Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Sakayori M, Ohashi T, Momma T, Kaneda T, Nishimura S, Sutani S, Yamashita S, Shigematsu N. Quantitative analysis of genitourinary toxicity after iodine-125 brachytherapy for localized prostate cancer: Followup of the International Prostate Symptom Score and Overactive Bladder Symptom Score. Brachytherapy 2017; 16:806-814. [PMID: 28552494 DOI: 10.1016/j.brachy.2017.04.241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/18/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To analyze genitourinary toxicity by followup of the International Prostate Symptom Score (IPSS) and Overactive Bladder Symptom Score (OABSS) after prostate brachytherapy. METHODS AND MATERIALS Six hundred eighty patients were treated with iodine-125 brachytherapy for localized prostate cancer. IPSS, OABSS, and two categories of IPSS questions (storage symptom score [IPSS-S] and voiding symptom score [IPSS-V]) were evaluated. RESULTS The median followup was 54 months (range, 24-108). All scales showed rapid increases followed by gradual decreases. The median times to IPSS peak and resolution were 1 and 6 months, respectively. The resolution rates of IPSS, IPSS-S, IPSS-V, and OABSS at the last followup were 84.2%, 86.3%, 89.5%, and 83.0%, respectively. The difference between IPSS baseline and peak was greater for larger preimplant prostate volumes (≥25 mL, p = 0.004). The time to resolution was longer for higher biologic effective dose (BED) (≥210 Gy, p = 0.019 [IPSS]), in those with larger prostate volumes (≥25 mL, p = 0.025 [OABSS]), in younger patients (younger than 70 years, p = 0.043 [IPSS-S]), and in those with androgen deprivation therapy (ADT) use (p = 0.049 [IPSS-V]). Urge incontinence, included in the OABSS, was observed more commonly in older patients (75 years and older, p = 0.018), with ADT use (p < 0.001), and for higher BED (≥210 Gy, p = 0.006). CONCLUSIONS The IPSS and OABSS showed similar patterns of change. Urinary symptoms improved more rapidly in those with high baseline IPSS levels. The OABSS was useful for following urinary symptoms after prostate brachytherapy. Age, ADT use, preimplant prostate volume, and BED were significantly associated with urinary outcomes.
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Affiliation(s)
- Masanori Sakayori
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan; Department of Radiology, National Hospital Organization Saitama Hospital, Saitama, Japan.
| | - Tetsuo Momma
- Department of Urology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Tomoya Kaneda
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shuichi Nishimura
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shinya Sutani
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shoji Yamashita
- Department of Radiology, National Hospital Organization Saitama Hospital, Saitama, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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Eriguchi T, Takeda A, Sanuki N, Tsurugai Y, Aoki Y, Oku Y, Hara Y, Akiba T, Shigematsu N. Stereotactic body radiotherapy for operable early-stage non-small cell lung cancer. Lung Cancer 2017; 109:62-67. [PMID: 28577952 DOI: 10.1016/j.lungcan.2017.04.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 02/14/2017] [Revised: 04/28/2017] [Accepted: 04/29/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE To analyze outcomes of stereotactic body radiotherapy (SBRT) for operable patients with early-stage non-small cell lung cancer (NSCLC) and to evaluate factors associated with outcomes. METHODS We retrospectively analyzed operable patients with NSCLC, staged as cT1-2N0M0, treated with SBRT between 2006 and 2015. Both biopsy-proven and clinically diagnosed NSCLC were included. Local control and survival rates were calculated and compared between subsets of patients. We investigated factors associated with outcomes. RESULTS We identified 88 operable patients among 661 patients with cT1-2N0M0 NSCLC. The median age was 79 years (range: 55-88). The median follow-up time after SBRT was 40 months (range: 4-121). Fifty-nine patients had been pathologically diagnosed and the other 29 had been clinically diagnosed as having NSCLC. Local control, cause-specific survival (CSS) and overall survival (OS) at 3 years were 91%, 97% and 90% for T1, and 100%, 82% and 74% for T2, respectively. The CSS and OS at 3 years were 100% and 100% for GGO and 83% and 59% for solid tumors, respectively (p=0.005). On univariate analysis, age and T stage were significantly associated with CSS, and age, the Charlson Comorbidity Index (CCI), and opacity were significantly associated with OS. On multivariate analysis, age and CCI were significantly associated with OS. As for toxicities, Grades 0, 1, 2 and 3 radiation pneumonitis occurred in 37.5%, 47.7%, 13.6% and 1.1% of patients, respectively. No Grade 4 or 5 radiation pneumonitis occurred, and no other toxicities of Grade 2 or above were observed. CONCLUSION Outcomes of SBRT for operable early stage NSCLC were as good as previous SBRT and surgery studies. Further investigation for selecting good SBRT candidates is warranted in high-risk operable patients.
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Affiliation(s)
- Takahisa Eriguchi
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 247-0056, Japan; Department of Radiation Oncology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-0016, Japan.
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 247-0056, Japan.
| | - Naoko Sanuki
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 247-0056, Japan.
| | - Yuichiro Tsurugai
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 247-0056, Japan.
| | - Yousuke Aoki
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 247-0056, Japan.
| | - Yohei Oku
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 247-0056, Japan.
| | - Yu Hara
- Department of Respiratory Medicine, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura, Kanagawa 247-0056, Japan; Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
| | - Takeshi Akiba
- Department of Radiation Oncology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
| | - Naoyuki Shigematsu
- Department of Radiation Oncology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-0016, Japan.
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Sakamoto Y, Koike N, Takei H, Ohno M, Miwa T, Yoshida K, Shigematsu N, Kishi K. Influence of backscatter radiation on cranial reconstruction implants. Br J Radiol 2016; 90:20150537. [PMID: 27925774 DOI: 10.1259/bjr.20150537] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE We aimed to evaluate backscatter dose variations in different cranial bone implant materials in an experimental model designed to simulate post-operative radiotherapy. METHODS We assessed the radiation backscatter doses associated with sheet- and mesh-type titanium plates and hydroxyapatite (HAP) samples (porosity: 35%, 50% and 85%). The samples were irradiated with 6- and 10-MV photon beams from a linear accelerator. Measurements were obtained using an ionization chamber and radiochromic films cut from the same batch. RESULTS At 6 MV, the titanium sheet showed the highest peak for backscattered radiation, followed by (in decreasing order) HAP30%, HAP50%, titanium mesh and HAP85%. At 10 MV, HAP30% showed the highest peak, followed by HAP50%, titanium sheet, titanium mesh and HAP85%. The peaks were at different depths in the titanium and HAP samples. The thickness of the human scalp is approximately 7 mm; therefore, measurements were obtained 0-7 mm above the implants to assess the likely dose on the scalp. A comparison of the maximum dose on the scalp showed the titanium sheet had the highest dose at both 6 and 10 MV. CONCLUSION The backscatter dose differed with the density of the material and the backscatter depth was different for each material. Advances in knowledge: Ulcer formation due to radiotherapy after brain tumour depends on not only radiation but also the implant material. Therefore, the density and type of implant material should be considered when planning radiotherapy and selecting bone reconstruction materials.
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Affiliation(s)
- Yoshiaki Sakamoto
- 1 Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Naoyoshi Koike
- 2 Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Hideyuki Takei
- 2 Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Mari Ohno
- 2 Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Tomoru Miwa
- 3 Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazunari Yoshida
- 3 Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Naoyuki Shigematsu
- 2 Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Kishi
- 1 Department of Plastic and Reconstructive Surgery, Keio University School of Medicine, Tokyo, Japan
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Eriguchi T, Takeda A, Sanuki N, Nishimura S, Takagawa Y, Enomoto T, Saeki N, Yashiro K, Mizuno T, Aoki Y, Oku Y, Yokosuka T, Shigematsu N. Stereotactic body radiotherapy for T3 and T4N0M0 non-small cell lung cancer. J Radiat Res 2016; 57:265-272. [PMID: 26983978 PMCID: PMC4915546 DOI: 10.1093/jrr/rrw023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Revised: 01/20/2016] [Accepted: 01/23/2016] [Indexed: 06/05/2023]
Abstract
To evaluate the outcomes and feasibility of stereotactic body radiotherapy (SBRT) for cT3 and cT4N0M0 non-small cell lung cancer (NSCLC), 25 patients with localized primary NSCLC diagnosed as cT3 or cT4N0M0, given SBRT between May 2005 and July 2013, were analyzed. All patients had inoperable tumors. The major reasons for tumors being unresectable were insufficient respiratory function for curative resection, advanced age (>80 years old) or technically inoperable due to invasion into critical organs. The median patient age was 79 years (range; 60-86). The median follow-up duration was 25 months (range: 5-100 months). The 2-year overall survival rates for T3 and T4 were 57% and 69%, respectively. The 2-year local control rates for T3 and T4 were 91% and 68%, respectively. As for toxicities, Grade 0-1, Grade 2 and Grade 3 radiation pneumonitis occurred in 23, 1 and 1 patient, respectively. No other acute or symptomatic late toxicities were reported. Thirteen patients who had no local, mediastinal or intrapulmonary progression at one year after SBRT underwent pulmonary function testing. The median variation in pre-SBRT and post-SBRT forced expiratory volume in 1 s (FEV1) values was -0.1 (-0.8-0.8). This variation was not statistically significant (P = 0.56). Forced vital capacity (FVC), vital capacity (VC), %VC and %FEV1 also showed no significant differences. SBRT for cT3 and cT4N0M0 NSCLC was both effective and feasible. Considering the favorable survival and low morbidity rate, SBRT is a potential treatment option for cT3 and cT4N0M0 NSCLC.
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Affiliation(s)
- Takahisa Eriguchi
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan Department of Radiology, Keio University School of Medicine
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Naoko Sanuki
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Shuichi Nishimura
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Yoshiaki Takagawa
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Tatsuji Enomoto
- Department of Respiratory Medicine, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Noriyuki Saeki
- Department of Thoracic Surgery, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Kae Yashiro
- Department of Radiology, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Tomikazu Mizuno
- Department of Radiology, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Yousuke Aoki
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Yohei Oku
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura-shi, Kanagawa 247-0056, Japan
| | - Tetsuya Yokosuka
- Department of Thoracic Surgery, Tokyo Metropolitan Hiroo Hospital
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Hanada T, Yorozu A, Shinya Y, Kuroiwa N, Ohashi T, Saito S, Shigematsu N. Prospective study of direct radiation exposure measurements for family members living with patients with prostate (125)I seed implantation: Evidence of radiation safety. Brachytherapy 2016; 15:412-419. [PMID: 27180131 DOI: 10.1016/j.brachy.2016.04.007] [Citation(s) in RCA: 4] [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] [Received: 02/18/2016] [Revised: 04/12/2016] [Accepted: 04/12/2016] [Indexed: 10/21/2022]
Abstract
PURPOSE To broaden the current understanding of radiation exposure and risk and to provide concrete evidence of radiation safety related to (125)I seed implantation. METHODS AND MATERIALS Direct radiation exposure measurements were obtained from dosimeters provided to 25 patients who underwent (125)I seed implantation, along with their family members. The estimated lifetime exposure dose and the precaution time for holding children near the patient's chest were calculated in two study periods. RESULTS During the first and second study period, the mean estimated lifetime exposure doses were, respectively, 7.61 (range: 0.45, 20.21) mSv and 6.84 (range: 0.41, 19.20) mSv for patients, and 0.19 (range: 0.02, 0.54) mSv and 0.25 (range: 0.04, 1.00) mSv for family members. The mean ratios of first and second period measurements were 1.05 (range: 0.44, 3.18) for patients and 1.82 (range: 0.21, 7.04) for family members. The corresponding absolute differences between first and second period measurements were -0.77 (range: -11.40, 7.63) mSv and 0.06 (range: -0.26, 0.79) mSv, respectively. Assuming a dose limit of 1 mSv, the precaution times for holding a child every day of the first and second periods were 250.9 (range: 71.3, 849.4) min and 275.2 (range: 75.0, 883.4) min, respectively. Assuming a dose limit of 0.5 mSv, the corresponding precaution times were 179.0 (range: 35.6, 811.5) min and 178.9 (range: 37.5, 1131.8) min, respectively. CONCLUSIONS Our study demonstrated low radiation exposures to family members of patients undergoing (125)I prostate implantation. It was clear that (125)I seed implantation did not pose a threat to the safety of family members.
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Affiliation(s)
- Takashi Hanada
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan; Department of Radiology, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan.
| | - Atsunori Yorozu
- Department of Radiology, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan
| | - Yukiko Shinya
- Department of Radiology, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan
| | - Nobuko Kuroiwa
- Department of Radiology, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shiro Saito
- Department of Urology, Tokyo Medical Center, National Hospital Organization, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
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Eriguchi T, Yorozu A, Kuroiwa N, Yagi Y, Nishiyama T, Saito S, Toya K, Hanada T, Shiraishi Y, Ohashi T, Shigematsu N. Predictive factors for urinary toxicity after iodine-125 prostate brachytherapy with or without supplemental external beam radiotherapy. Brachytherapy 2016; 15:288-295. [PMID: 26924022 DOI: 10.1016/j.brachy.2015.12.011] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/20/2015] [Accepted: 12/21/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE We examined the factors associated with urinary toxicities because of brachytherapy with iodine-125 with or without supplemental external beam radiotherapy (EBRT) for prostate cancer. METHODS AND MATERIALS We investigated 1313 patients with localized prostate cancer treated with iodine-125 brachytherapy with or without supplemental EBRT between 2003 and 2009. The International Prostate Symptom Score (IPSS) and Common Terminology Criteria for Adverse Events data were prospectively determined. Patients, treatment, and implant factors were investigated for their association with urinary toxicity or symptoms. RESULTS IPSS resolution was not associated with biologically effective dose (BED). Baseline IPSS, total needles, and the minimal dose received by 30% of the urethra had the greatest effect according to multivariate analysis (MVA). Urinary symptom flare was associated with baseline IPSS, age, BED, and EBRT on MVA. Urinary symptom flare and urinary Grade 2 or higher (G2+) toxicity occurred in 51%, 58%, and 67% (p = 0.025) and 16%, 22%, and 20% (p = 0.497) of the <180, 180-220, and >220 Gy BED groups, respectively. Urinary G2+ toxicity was associated with baseline IPSS, neoadjuvant androgen deprivation therapy (NADT), and seed density on MVA. When we divided patients into four groups according to prostate volume (<30 cc or ≥30 cc) and NADT use, urinary G2+ toxicity was most commonly observed in those patients with larger prostates who received NADT, and least in the patients with smaller prostates and no NADT. CONCLUSIONS NADT was associated with urinary G2+ toxicity. Higher dose and supplemental EBRT did not appear to increase moderate to severe urinary toxicities or time to IPSS resolution; however, it influenced urinary symptom flare.
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Affiliation(s)
- Takahisa Eriguchi
- Department of Radiology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan; Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.
| | - Atsunori Yorozu
- Department of Radiology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Nobuko Kuroiwa
- Department of Radiology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Yasuto Yagi
- Department of Urology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Toru Nishiyama
- Department of Urology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Shiro Saito
- Department of Urology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Kazuhito Toya
- Department of Urology, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan; Department of Radiology, International University of Health and Welfare Mita Hospital, Minato-ku, Tokyo, Japan
| | - Takashi Hanada
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Yutaka Shiraishi
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
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Matsushima M, Kikuchi E, Matsumoto K, Kosaka T, Mizuno R, Ohashi T, Mikami S, Miyajima A, Shigematsu N, Oya M. Erectile function status is highly associated with prostate-specific antigen bounce in localized prostate cancer patients treated with permanent prostate brachytherapy. Int J Urol 2015; 23:247-52. [PMID: 26663514 DOI: 10.1111/iju.13029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 11/09/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To examine the relationship between erectile function status and prostate-specific antigen bounce after prostate brachytherapy for localized prostate cancer. METHODS We identified 154 patients who were followed up for at least 24 months after brachytherapy. Erectile function status was assessed prospectively before brachytherapy (baseline), and 3, 6, 12, 18, 24 and 36 months postoperatively using the International Index of Erectile Function-15 questionnaire. Prostate-specific antigen bounce was defined as an increase of at least 0.4 ng/mL from a previous prostate-specific antigen level with a subsequent decline equal to, or less than, the initial nadir without treatment. A logistic regression analysis was used to identify a significant set of independent predictors of prostate-specific antigen bounce after brachytherapy. RESULTS Prostate-specific antigen bounce was observed in 38 (24.7%) men. The prostate-specific antigen bounce group had a higher erectile function domain score, higher orgasmic function domain score, and higher total International Index of Erectile Function-15 score before (at baseline) and after brachytherapy (3, 6, 12, 18, 24 and 36 months after brachytherapy) than their counterparts (P < 0.05). Of the 77 patients who completed the International Index of Erectile Function-15 questionnaire 18 months after brachytherapy (the median time of prostate-specific antigen bounce), sexual desire and intercourse satisfaction domain scores, and total International Index of Erectile Function scores 18 months after brachytherapy correlated with the occurrence of prostate-specific antigen bounce. A multivariate analysis identified the intercourse satisfaction domain score 18 months after brachytherapy as an independent indicator for the occurrence of prostate-specific antigen bounce (P = 0.008). CONCLUSIONS International Index of Erectile Function-15 score seems to be correlated with the prostate-specific antigen bounce in prostate cancer patients undergoing brachytherapy, and an occurrence of prostate-specific antigen bounce seems to be more likely in those who are more sexually active.
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Affiliation(s)
| | - Eiji Kikuchi
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | | | - Takeo Kosaka
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Shuji Mikami
- Department of Pathology, Keio University School of Medicine, Tokyo, Japan
| | - Akira Miyajima
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Tokyo, Japan
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Kumabe A, Fukuhara N, Utsunomiya T, Kawase T, Iwata K, Okada Y, Sutani S, Ohashi T, Oya M, Shigematsu N. Three-dimensional conformal arc radiotherapy using a C-arm linear accelerator with a computed tomography on-rail system for prostate cancer: clinical outcomes. Radiat Oncol 2015; 10:208. [PMID: 26458948 PMCID: PMC4603912 DOI: 10.1186/s13014-015-0515-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 10/02/2015] [Indexed: 11/26/2022] Open
Abstract
Background We report the feasibility and treatment outcomes of image-guided three-dimensional conformal arc radiotherapy (3D-CART) using a C-arm linear accelerator with a computed tomography (CT) on-rail system for localized prostate cancer. Methods and materials Between 2006 and 2011, 282 consecutive patients with localized prostate cancer were treated with in-room CT-guided 3D-CART. Biochemical failure was defined as a rise of at least 2.0 ng/ml beyond the nadir prostate-specific antigen level. Toxicity was scored according to the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Results A total of 261 patients were analyzed retrospectively (median follow-up: 61.6 months). The median prescribed 3D-CART dose was 82 Gy (2 Gy/fraction, dose range: 78–86 Gy), and 193 of the patients additionally received hormonal therapy. The 5-year overall survival rate was 93.9 %. Among low-, intermediate-, and high-risk patients, 5-year rates of freedom from biochemical failure were 100, 91.5 and 90.3 %, respectively. Rates of grade 2–3 late gastrointestinal and genitourinary toxicities were 2.3 and 11.4 %, respectively. No patient experienced late grade 4 or higher toxicity. Conclusions In-room CT-guided 3D-CART was feasible and effective for localized prostate cancer. Treatment outcomes were comparable to those previously reported for intensity-modulated radiotherapy.
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Fukada J, Kitago M, Sutani S, Itano O, Hanada T, Kitagawa Y, Shigematsu N. Quantification of Interfraction and Intrafraction Pancreas Motion Using Pancreatic Stent. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1005] [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: 10/22/2022]
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Shiraishi Y, Hanada T, Ohashi T, Yorozu A, Shigematsu N. Normal Tissue Complication Probability (NTCP) Modeling of Late Rectal Bleeding Following Iodine-125 Prostate Brachytherapy Combined With External Beam Radiation Therapy. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1080] [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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Sutani S, Ohashi T, Sakayori M, Kaneda T, Yamashita S, Momma T, Hanada T, Shiraishi Y, Fukada J, Oya M, Shigematsu N. Comparison of genitourinary and gastrointestinal toxicity among four radiotherapy modalities for prostate cancer: Conventional radiotherapy, intensity-modulated radiotherapy, and permanent iodine-125 implantation with or without external beam radiotherapy. Radiother Oncol 2015; 117:270-6. [PMID: 26318662 DOI: 10.1016/j.radonc.2015.08.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [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: 05/28/2015] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare late genitourinary (GU) and gastrointestinal (GI) toxicity following different prostate cancer treatment modalities. MATERIALS AND METHODS This study included 1084 consecutive prostate cancer patients treated with conventional radiotherapy, intensity-modulated radiotherapy (IMRT), permanent iodine-125 implantation (PI) alone, and PI combined with external beam radiotherapy (PI+EBRT). The effects of treatment- and patient-related factors on late grade ⩾ 2 (G2+) GU/GI toxicity risk were assessed. RESULTS The median follow-up was 43 months (range, 12-97 months). Compared to the PI+EBRT, there was significantly less G2+ GU toxicity in the conventional radiotherapy (hazard ratio [HR] = 0.39; 95% CI, 0.20-0.77) and the IMRT (HR=0.45, 95% CI, 0.27-0.73). Compared to the PI+EBRT, there was significantly more G2+ GI toxicity in the IMRT (HR = 2.38; 95% CI, 1.16-4.87). In PI-related groups, prostate equivalent dose in 2 Gy fractions was a significant predictor of G2+ GU toxicity (p = 0.001), and the rectal volume receiving more than 100% of the prescribed dose was a significant predictor of G2+ GI toxicity (p = 0.001). CONCLUSION The differences in the late G2+ GU/GI risk cannot be explained by the differences in treatment modalities themselves, but by the total radiation dose to the GU/GI tract, which had a causal role in the development of late G2+ GU/GI toxicity across all treatment modality groups.
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Affiliation(s)
- Shinya Sutani
- Department of Radiology, Keio University School of Medicine, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of Medicine, Japan; Department of Radiology, National Hospital Organization Saitama Hospital, Japan.
| | | | - Tomoya Kaneda
- Department of Radiology, Keio University School of Medicine, Japan
| | - Shoji Yamashita
- Department of Radiology, National Hospital Organization Saitama Hospital, Japan
| | - Tetsuo Momma
- Department of Urology, National Hospital Organization Saitama Hospital, Japan
| | - Takashi Hanada
- Department of Radiology, Keio University School of Medicine, Japan
| | - Yutaka Shiraishi
- Department of Radiology, Keio University School of Medicine, Japan
| | - Junichi Fukada
- Department of Radiology, Keio University School of Medicine, Japan
| | - Mototsugu Oya
- Department of Urology, Keio University School of Medicine, Japan
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49
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Kobayashi K, Murakami N, Wakita A, Nakamura S, Okamoto H, Umezawa R, Takahashi K, Inaba K, Igaki H, Ito Y, Shigematsu N, Itami J. Dosimetric variations due to interfraction organ deformation in cervical cancer brachytherapy. Radiother Oncol 2015; 117:555-8. [PMID: 26316394 DOI: 10.1016/j.radonc.2015.08.017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 12/21/2014] [Revised: 08/16/2015] [Accepted: 08/17/2015] [Indexed: 11/28/2022]
Abstract
We quantitatively estimated dosimetric variations due to interfraction organ deformation in multi-fractionated high-dose-rate brachytherapy (HDRBT) for cervical cancer using a novel surface-based non-rigid deformable registration. As the number of consecutive HDRBT fractions increased, simple addition of dose-volume histogram parameters significantly overestimated the dose, compared with distribution-based dose addition.
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Affiliation(s)
- Kazuma Kobayashi
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan.
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Akihisa Wakita
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Satoshi Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Hiroyuki Okamoto
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Rei Umezawa
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Kana Takahashi
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Koji Inaba
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Yoshinori Ito
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
| | - Naoyuki Shigematsu
- Department of Radiology, Keio University School of Medicine, Shinjuku-ku, Japan
| | - Jun Itami
- Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Japan
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Muro Y, Kosaka T, Mizuno R, Ohashi T, Shigematsu N, Oya M. Combination of 5α-reductase inhibitor with combined androgen blockade (CAB) as a novel cytoreductive regimen before prostate brachytherapy: Ultra-CAB. Am J Clin Exp Urol 2015; 3:48-50. [PMID: 26069888 PMCID: PMC4446383] [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] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 03/30/2015] [Indexed: 06/04/2023]
Abstract
We report a first case of using a 5α-reductase inhibitor (5ARI) and combined androgen blockade (CAB) as a cytoreductive regimen before prostate brachytherapy. Prostate volume reduction with CAB is limited to approximately 40% in most cases, making it difficult to meet anatomical constraints to perform these procedures in cases with large prostate volume. With the added administration of 5ARI, further volume reduction can be expected. Here, we describe this cytoreductive regimen used in a 63 year-old prostate cancer patient who became eligible to receive brachytherapy after dutasteride (0.5 mg daily) was added to CAB and prostate volume reduction of 57% was achieved.
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Affiliation(s)
- Yusuke Muro
- Department of Urology, Keio University School of MedicineTokyo, Japan
| | - Takeo Kosaka
- Department of Urology, Keio University School of MedicineTokyo, Japan
| | - Ryuichi Mizuno
- Department of Urology, Keio University School of MedicineTokyo, Japan
| | - Toshio Ohashi
- Department of Radiology, Keio University School of MedicineTokyo, Japan
| | | | - Mototsugu Oya
- Department of Urology, Keio University School of MedicineTokyo, Japan
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