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Varnava M, Musha A, Tashiro M, Kubo N, Okano N, Kawamura H, Ohno T. Dose-volume constraints for head-and-neck cancer in carbon ion radiotherapy: A literature review. Cancer Med 2023; 12:8267-8277. [PMID: 36799088 PMCID: PMC10134371 DOI: 10.1002/cam4.5641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/27/2022] [Accepted: 01/02/2023] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Carbon ion radiotherapy (CIRT) has been applied in cancer treatment for over 25 years. However, guidelines for dose-volume constraints have not been established yet. The aim of this review is to summarize the dose-volume constraints in CIRT for head-and-neck (HN) cancer that were determined through previous clinical studies based on the Japanese models for relative biological effectiveness (RBE). METHODS A literature review was conducted to identify all constraints determined for HN cancer CIRT that are based on the Japanese RBE models. RESULTS Dose-volume constraints are reported for 17 organs at risk (OARs), including the brainstem, ocular structures, masticatory muscles, and skin. Various treatment planning strategies are also presented for reducing the dose delivered to OARs. CONCLUSIONS The reported constraints will provide assistance during treatment planning to ensure that radiation to OARs is minimized, and thus adverse effects are reduced. Although the constraints are given based on the Japanese RBE models, applying the necessary conversion factors will potentially enable their application by institutions worldwide that use the local effect model for RBE.
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Affiliation(s)
- Maria Varnava
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan
| | - Atsushi Musha
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan.,Department of Oral and Maxillofacial Surgery and Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Mutsumi Tashiro
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan
| | - Nobuteru Kubo
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan.,Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Naoko Okano
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan.,Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Hidemasa Kawamura
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan.,Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma, Japan.,Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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Nguyen CN, Urquieta E. Contemporary review of dermatologic conditions in space flight and future implications for long-duration exploration missions. LIFE SCIENCES IN SPACE RESEARCH 2023; 36:147-156. [PMID: 36682824 DOI: 10.1016/j.lssr.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/23/2022] [Accepted: 10/11/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Future planned exploration missions to outer space will almost surely require the longest periods of continuous space exposure by the human body yet. As the most external organ, the skin seems the most vulnerable to injury. Therefore, discussion of the dermatological implications of such extended-duration missions is critical. OBJECTIVES In order to help future missions understand the risks of spaceflight on the human skin, this review aims to consolidate data from the current literature pertaining to the space environment and its physiologic effects on skin, describe all reported dermatologic manifestations in spaceflight, and extrapolate this information to longer-duration mission. METHODS AND MATERIALS The authors searched PubMed and Google Scholar using keywords and Mesh terms. The publications that were found to be relevant to the objectives were included and described. RESULTS The space environment causes changes in the skin at the cellular level by thinning the epidermis, altering wound healing, and dysregulating the immune system. Clinically, dermatological conditions represented the most common medical issues occurring in spaceflight. We predict that as exploration missions increase in duration, astronauts will experience further physiological changes and an increased rate and severity of adverse events. CONCLUSION Maximizing astronaut safety requires a continued knowledge of the human body's response to space, as well as consideration and prediction of future events. Dermatologic effects of space missions comprise the majority of health-related issues arising on missions to outer space, and these issues are likely to become more prominent with increasing time spent in space. Improvements in hygiene may mitigate some of these conditions.
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Affiliation(s)
| | - Emmanuel Urquieta
- Department of Emergency Medicine and Center for Space Medicine, Baylor College of Medicine. Houston TX, United States; Translational Research Institute for Space Health, Houston, TX, United States
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Li Y, Sakai M, Tsunoda A, Kubo N, Kitada Y, Kubota Y, Matsumura A, Zhou Y, Ohno T. Normal Tissue Complication Probability Model for Acute Radiation Dermatitis in Patients with Head and Neck Cancer Treated with Carbon Ion Radiotherapy. Int J Radiat Oncol Biol Phys 2022; 113:675-684. [PMID: 35278673 DOI: 10.1016/j.ijrobp.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/21/2022] [Accepted: 03/02/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to explore the prognostic factors associated with acute radiation dermatitis (ARD). A normal tissue complication probability (NTCP) model for ARD in patients with head and neck cancer (HNC) treated with carbon ion radiotherapy (CIRT) was developed. MATERIALS AND METHODS A total of 187 patients were included in the analysis, and the endpoint was ≥grade 2 ARD. The biological and physical dose-surface parameters associated with ARD were used in the logistic regression model. The mean areas under the receiver operating characteristic curve (AUC) in the internal cross-validation and Akaike's corrected Information Criterion (AICc) were examined for model evaluation and selection. The multivariate logistic regression NTCP models were established based on factors with weak correlation. RESULTS Tumour volume, planning target volume to the skin, radiation technique and all dose-surface parameters were significantly associated with ARD (P < 0.05). Models with high performance for grade 2-3 ARD were constructed. The most significant prognostic predictors were S40 Gy (relative biological effectiveness, RBE) and S20 Gy [absolute surface area receiving RBE-weighted dose of 40 Gy (RBE) or physical dose of 20 Gy]. The internal cross-validation-based AUCs for models with S40 Gy (RBE) and S20 Gy were 0.78 and 0.77, respectively. The biological and physical dose-surface parameters had similar performance at various dose levels. However, the performance of the multivariate NTCP models based on two factors was not better than that of the univariate models. CONCLUSIONS NTCP models for ARD may provide a basis for the development of individualised treatment strategies and reduce the incidence of severe ARD in patients with HNC receiving CIRT. Furthermore, biological and physical dose-surface parameter-based models are comparable. However, further validation with more evaluation parameters is warranted.
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Affiliation(s)
- Yang Li
- Gunma University Heavy Ion Medical Center, Maebashi, Japan; Department of Radiation Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Makoto Sakai
- Gunma University Heavy Ion Medical Center, Maebashi, Japan.
| | - Anna Tsunoda
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Nobuteru Kubo
- Gunma University Heavy Ion Medical Center, Maebashi, Japan; Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Yoko Kitada
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Yoshiki Kubota
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Yuan Zhou
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan; Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
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Takakusagi Y, Yoshida D, Kusano Y, Kano K, Anno W, Tsuchida K, Mizoguchi N, Serizawa I, Katoh H, Imura K, Takayama Y, Minohara S, Kamada T. Dosimetric Comparison Between Carbon-ion Radiotherapy and Photon Radiotherapy for Stage I Esophageal Cancer. In Vivo 2021; 35:447-452. [PMID: 33402495 DOI: 10.21873/invivo.12277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIM The present study aimed to compare the radiation dose distribution of carbon-ion radiotherapy (CIRT) for stage I esophageal cancer with three-dimensional conformal radiotherapy (3DCRT) and volumetric modulated arc therapy (VMAT). PATIENTS AND METHODS Fifteen patients with cT1bN0M0 esophageal cancer who received 3DCRT at Kanagawa Cancer Center between January 2014 and April 2019 were enrolled. The dose-volume histogram parameters of the target volume and normal organs planned with CIRT, 3DCRT, and VMAT were evaluated. RESULTS The homogeneity index for the target volume of CIRT was significantly lower than that of 3DCRT and VMAT. In addition, the radiation dose of CIRT to the heart, lungs, spinal cord, and skin was significantly lower than that of 3DCRT and VMAT. CONCLUSION Favorable dose distributions with CIRT were demonstrated compared with 3DCRT and VMAT for esophageal cancer.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan;
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yohsuke Kusano
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Koh Imura
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshiki Takayama
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinichi Minohara
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
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Kubo N, Kubota Y, Oike T, Kawamura H, Sakai M, Imamura A, Komatsu S, Miyasaka Y, Sato H, Musha A, Okano N, Shirai K, Saitoh JI, Chikamatsu K, Ohno T. Skin Dose Reduction by Layer-Stacking Irradiation in Carbon Ion Radiotherapy for Parotid Tumors. Front Oncol 2020; 10:1396. [PMID: 32923391 PMCID: PMC7456805 DOI: 10.3389/fonc.2020.01396] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 07/02/2020] [Indexed: 01/18/2023] Open
Abstract
Background: Layer-stacking irradiation (LSI) results in the accumulation of multiple small spread-out Bragg peaks along the beam direction. Although the superiority of LSI to conventional passive irradiation (CPI) regarding normal tissue sparing is theoretically evident, the clinical benefit of LSI has not been demonstrated. Here, we compared LSI with CPI using the same treatment planning-computed tomography images used for carbon ion radiotherapy (CIRT). Methods: Twenty-one parotid tumors were analyzed. The clinical target volume (CTV) 1 and CTV2 encompassed the parotid grand and the tumor, respectively. CTV1 and CTV2 received 36 Gy (RBE: relative biological effectiveness) in nine fractions and 64 Gy (RBE) in 16 fractions, respectively, using either LSI or CPI. CTV coverage was assessed by DX%, which is the dose covering at least X% of the target volume. Skin dose was assessed by SX, which is the skin surface area receiving at least X Gy (RBE). Results: For CTV1 and CTV2, there were no significant differences in D2% between LSI and CPI. D50% and D98% were slightly higher for CPI; however, the absolute difference between the two methods was <3%. S10–S60 (in increments of 10) were significantly lower for LSI than for CPI (P < 0.001 for all parameters). LSI was associated with a significant trend toward dose reduction at the skin area irradiated with a higher dose by CPI (P < 0.001). Conclusions: LSI achieved better skin sparing than CPI without sacrificing target volume coverage in parotid tumor patients.
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Affiliation(s)
- Nobuteru Kubo
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Yoshiki Kubota
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Takahiro Oike
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Makoto Sakai
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Ayaka Imamura
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | | | - Yuhei Miyasaka
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Hiro Sato
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Atsushi Musha
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Naoko Okano
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Katsuyuki Shirai
- Gunma University Heavy Ion Medical Center, Maebashi, Japan.,Department of Radiology, Saitama Medical Center, Jichi Medical University, Omiya-Ku, Japan
| | - Jun-Ichi Saitoh
- Gunma University Heavy Ion Medical Center, Maebashi, Japan.,Department of Radiation Oncology, Faculty of Medicine, University of Toyama, Toyama, Japan
| | - Kazuaki Chikamatsu
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
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