1
|
Saito M, Ueda K, Nemoto H, Onishi Y, Suzuki H, Suzuki T, Sano N, Komiyama T, Marino K, Onishi H. Development of a phantom for assessing the precision of setup in skin mark-less surface-guided radiotherapy. J Appl Clin Med Phys 2024:e14381. [PMID: 38696715 DOI: 10.1002/acm2.14381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 03/19/2024] [Accepted: 04/10/2024] [Indexed: 05/04/2024] Open
Abstract
BACKGROUND Surface-guided radiotherapy (SGRT) is adopted by several institutions; however, reports on the phantoms used to assess the precision of the SGRT setup are limited. PURPOSE The purpose of this study was to develop a phantom to verify the accuracy of the irradiation position during skin mark-less SGRT. METHODS An acrylonitrile butadiene styrene (ABS) plastic cube phantom with a diameter of 150 mm on each side containing a dummy target of 15 mm and two types of body surface-shaped phantoms (breast/face shape) that could be attached to the cube phantom were fabricated. Films can be inserted on four sides of the cubic phantom (left, right, anterior and posterior), and the center of radiation can be calculated by irradiating the dummy target with orthogonal MV beams. Three types of SGRT using a VOXELAN-HEV600M (Electronics Research&Development Corporation, Okayama, Japan) were evaluated using this phantom: (i) SGRTCT-a SGRT set-up based solely on a computed tomography (CT)-reference image. (ii) SGRTCT + CBCT-a method where cone beam computed tomography (CBCT) matching was performed after SGRTCT. (iii) SGRTScan-a resetup technique using a scan reference image obtained after completing the (ii) step. RESULTS Both the breast and face phantoms were recognized in the SGRT system without problems. SGRTScan ensure precision within 1 mm/1° for breast and face verification, respectively. All SGRT methods showed comparable rotational accuracies with no significant disparities. CONCLUSIONS The developed phantom was useful for verifying the accuracy of skin mark-less SGRT position matching. The SGRTScan demonstrated the feasibility of achieving skin-mark less SGRT with high accuracy, with deviations of less than 1 mm. Additional research is necessary to evaluate the suitability of the developed phantoms for use in various facilities and systems. This phantom could be used for postal surveys in the future.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hikaru Nemoto
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Yoshiko Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
2
|
Nemoto H, Saito M, Satoh Y, Komiyama T, Marino K, Aoki S, Suzuki H, Sano N, Nonaka H, Watanabe H, Funayama S, Onishi H. Evaluation of the performance of both machine learning models using PET and CT radiomics for predicting recurrence following lung stereotactic body radiation therapy: A single-institutional study. J Appl Clin Med Phys 2024:e14322. [PMID: 38436611 DOI: 10.1002/acm2.14322] [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: 11/15/2023] [Revised: 01/14/2024] [Accepted: 02/07/2024] [Indexed: 03/05/2024] Open
Abstract
PURPOSE Predicting recurrence following stereotactic body radiotherapy (SBRT) for non-small cell lung cancer provides important information for the feasibility of the individualized radiotherapy and allows to select the appropriate treatment strategy based on the risk of recurrence. In this study, we evaluated the performance of both machine learning models using positron emission tomography (PET) and computed tomography (CT) radiomic features for predicting recurrence after SBRT. METHODS Planning CT and PET images of 82 non-small cell lung cancer patients who performed SBRT at our hospital were used. First, tumors were delineated on each CT and PET of each patient, and 111 unique radiomic features were extracted, respectively. Next, the 10 features were selected using three different feature selection algorithms, respectively. Recurrence prediction models based on the selected features and four different machine learning algorithms were developed, respectively. Finally, we compared the predictive performance of each model for each recurrence pattern using the mean area under the curve (AUC) calculated following the 0.632+ bootstrap method. RESULTS The highest performance for local recurrence, regional lymph node metastasis, and distant metastasis were observed in models using Support vector machine with PET features (mean AUC = 0.646), Naive Bayes with PET features (mean AUC = 0.611), and Support vector machine with CT features (mean AUC = 0.645), respectively. CONCLUSIONS We comprehensively evaluated the performance of prediction model developed for recurrence following SBRT. The model in this study would provide information to predict the recurrence pattern and assist in making treatment strategies.
Collapse
Affiliation(s)
- Hikaru Nemoto
- Department of Advanced Biomedical Imaging, University of Yamanashi, Chuo, Yamanashi, Japan
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Masahide Saito
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Yoko Satoh
- Imaging Center, Fujita Medical Innovation Center Tokyo, Tokyo, Japan
| | - Takafumi Komiyama
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Kan Marino
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hotaka Nonaka
- Department of Radiology, Fuji City General Hospital, Fuji, Shizuoka, Japan
| | - Hiroaki Watanabe
- Department of Radiology, Yamanashi Central Hospital, Kofu, Yamanashi, Japan
| | - Satoshi Funayama
- Department of Radiology, Hamamatsu University school of medicine, Hamamatsu, Shizuoka, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Chuo, Yamanashi, Japan
| |
Collapse
|
3
|
Saito M, Komiyama T, Marino K, Aoki S, Akita T, Matsuda M, Sano N, Suzuki H, Koji U, Nemoto H, Onishi H. Dosimetric comparison of five different radiotherapy treatment planning approaches for locally advanced non-small cell lung cancer with sequential plan changes. Thorac Cancer 2023; 14:3445-3452. [PMID: 37846145 PMCID: PMC10719662 DOI: 10.1111/1759-7714.15137] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/24/2023] [Revised: 10/02/2023] [Accepted: 10/03/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND The purpose of this study was to compare the dosimetric characteristics of five different treatment planning techniques for locally advanced non-small cell lung cancer (LA-NSCLC) with sequential plan changes. METHODS A total of 13 stage III NSCLC patients were enrolled in this study. These patients had both computed tomography (CT) images for initial and boost treatment plans. The latter CT images were taken if tumor shrinkage was observed after 2 weeks of treatment. The prescription dose was 60 Gy/30 Fr (initial: 40 Gy/20 Fr, and boost: 20 Gy/10 Fr). Five techniques (forward-planed 3-dimensional conformal radiotherapy [F-3DCRT] on both CT images, inverse-planned 3DCRT [I-3DCRT] on both CT images, volumetric modulated arc therapy [VMAT] on both CT images, F-3DCRT on initial CT plus VMAT on boost CT [bVMAT], and hybrid of fixed intensity-modulated radiotherapy [IMRT] beams and VMAT beams on both CT images [hybrid]) were recalculated for all patients. The accumulated doses between initial and boost plans were compared among all treatment techniques. RESULTS The conformity indexes (CI) of the planning target volume (PTV) of the five planning techniques were 0.34 ± 0.10, 0.57 ± 0.10, 0.86 ± 0.08, 0.61 ± 0.12, and 0.83 ± 0.11 for F-3DCRT, I-3DCRT, VMAT, bVMAT, and hybrid, respectively. In the same manner, lung volumes receiving >20 Gy (V20Gy ) were 21.05 ± 10.56%, 20.86 ± 6.45, 19.50 ± 7.38%, 19.98 ± 10.04%, and 17.74 ± 7.86%. There was significant improvement about CI and V20Gy for hybrid compared with F-3DCRT (p < 0.05). CONCLUSION The IMRT/VMAT hybrid technique for LA-NSCLC patients improved target CI and reduced lung doses. Furthermore, if IMRT was not available initially, starting with 3DCRT might be beneficial as demonstrated in the bVMAT procedure of this study.
Collapse
Affiliation(s)
- Masahide Saito
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | | | - Kan Marino
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Shinichi Aoki
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Tomoko Akita
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Masaki Matsuda
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Naoki Sano
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Hidekazu Suzuki
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Ueda Koji
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Hikaru Nemoto
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Hiroshi Onishi
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| |
Collapse
|
4
|
Nemoto H, Saito M, Suzuki T, Suzuki H, Sano N, Mochizuki Z, Mochizuki K, Ueda K, Komiyama T, Marino K, Aoki S, Oguri M, Takahashi H, Onishi H. Evaluation of computed tomography metal artifact and CyberKnife fiducial recognition for novel size fiducial markers. J Appl Clin Med Phys 2023; 24:e14142. [PMID: 37672211 PMCID: PMC10691645 DOI: 10.1002/acm2.14142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 06/28/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023] Open
Abstract
PURPOSE This study aimed to compare fiducial markers used in CyberKnife treatment in terms of metal artifact intensity observed in CT images and fiducial recognition in the CyberKnife system affected by patient body thickness and type of marker. METHODS Five markers, ACCULOC 0.9 mm × 3 mm, Ball type Gold Anchor (GA) 0.28 mm × 10 mm, 0.28 mm × 20 mm, and novel size GA 0.4 mm × 10 mm, 0.4 mm × 20 mm were evaluated. To evaluate metal artifacts of CT images, two types of CT images of water-equivalent gels with each marker were acquired using Aquilion LB CT scanner, one applied SEMAR (SEMAR-on) and the other did not apply this technique (SEMAR-off). The evaluation metric of artifact intensity (MSD ) which represents a variation of CT values were compared for each marker. Next, 5, 15, and 20 cm thickness of Tough Water (TW) was placed on the gel under the condition of overlapping the vertebral phantom in the Target Locating System, and the live image of each marker was acquired to compare fiducial recognition. RESULTS The mean MSD of SEMAR-off was 78.80, 74.50, 97.25, 83.29, and 149.64 HU for ACCULOC, GA0.28 mm × 10 mm, 20 mm, and 0.40 mm × 10 mm, 20 mm, respectively. In the same manner, that of SEMAR-on was 23.52, 20.26, 26.76, 24.89, and 33.96 HU, respectively. Fiducial recognition decreased in the order of 5, 15, and 20 cm thickness, and GA 0.4 × 20 mm showed the best recognition at thickness of 20 cm TW. CONCLUSIONS We demonstrated the potential to reduce metal artifacts in the CT image to the same level for all the markers we evaluated by applying SEMAR. Additionally, the fiducial recognition of each marker may vary depending on the thickness of the patient's body. Particularly, we showed that GA 0.40 × 20 mm may have more optimal recognition for CyberKnife treatment in cases of high bodily thickness in comparison to the other markers.
Collapse
Affiliation(s)
- Hikaru Nemoto
- Department of Advanced Biomedical ImagingUniversity of YamanashiYamanashiJapan
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Masahide Saito
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | | | - Hidekazu Suzuki
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Naoki Sano
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | | | - Koji Mochizuki
- Kasugai CyberKnife Rehabilitation HospitalYamanashiJapan
| | - Koji Ueda
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | | | - Kan Marino
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Shinichi Aoki
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Mitsuhiko Oguri
- Department of RadiologyShizuoka General HospitalShizuokaJapan
| | | | - Hiroshi Onishi
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| |
Collapse
|
5
|
Onishi H, Shioyama Y, Matsumoto Y, Matsuo Y, Miyakawa A, Yamashita H, Matsushita H, Aoki M, Nihei K, Kimura T, Ishiyama H, Murakami N, Nakata K, Takeda A, Uno T, Nomiya T, Taguchi H, Seo Y, Komiyama T, Marino K, Aoki S, Matsuda M, Akita T, Saito M. Real-World Results of Stereotactic Body Radiotherapy for 399 Medically Operable Patients with Stage I Histology-Proven Non-Small Cell Lung Cancer. Cancers (Basel) 2023; 15:4382. [PMID: 37686657 PMCID: PMC10486748 DOI: 10.3390/cancers15174382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 08/10/2023] [Accepted: 08/19/2023] [Indexed: 09/10/2023] Open
Abstract
Surgery is the standard treatment for stage I non-small cell lung cancer (NSCLC); however, no clear randomized trial demonstrates its superiority to stereotactic body radiotherapy (SBRT) regarding survival. We aimed to retrospectively evaluate the treatment outcomes of SBRT in operable patients with stage I NSCLC using a large Japanese multi-institutional database to show real-world outcome. Exactly 399 patients (median age 75 years; 262 males and 137 females) with stage I (IA 292, IB 107) histologically proven NSCLC (adenocarcinoma 267, squamous cell carcinoma 96, others 36) treated at 20 institutions were reviewed. SBRT was prescribed at a total dose of 48-70 Gy in 4-10 fractions. The median follow-up period was 38 months. Local progression-free survival rates were 84.2% in all patients and 86.1% in the T1, 78.6% in T2, 89.2% in adenocarcinoma, and 70.5% in squamous cell subgroups. Overall 3-year survival rates were 77.0% in all patients: 90.7% in females, 69.6% in males, and 41.2% in patients with pulmonary interstitial changes. Fatal radiation pneumonitis was observed in two patients, all of whom had pulmonary interstitial changes. This real-world evidence will be useful in shared decision-making for optimal treatment, including SBRT for operable stage I NSCLC, particularly in older patients.
Collapse
Affiliation(s)
- Hiroshi Onishi
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Yoshiyuki Shioyama
- Ion Beam Therapy Center, SAGA-HIMAT Foundation, 3049 Harakoga-machi, Tosu 841-0071, Japan
| | - Yasuo Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, 2-15-3 Kawagishi, Chuo-ku, Niigata 951-8566, Japan;
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-Applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;
| | - Akifumi Miyakawa
- Department of Radiology, School of Medicine, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan;
| | - Hideomi Yamashita
- Department of Radiology, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan;
| | - Haruo Matsushita
- Department of Radiation Oncology, School of Medicine, Tohoku University, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Miyagi, Japan;
| | - Masahiko Aoki
- Department of Radiation Oncology, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki City 036-8562, Aomori, Japan;
| | - Keiji Nihei
- Department of Radiation Oncology, Tokyo Metropolitan Cancer, Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan;
| | - Tomoki Kimura
- Department of Radiation Oncology, Hiroshima University, 1-2-3, Kasumi Minami-ku, Hiroshima 734-8551, Japan;
| | - Hiromichi Ishiyama
- Department of Radiation Oncology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami, Sagamihara 252-0375, Kanagawa, Japan;
| | - Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan;
| | - Kensei Nakata
- Department of Radiation Oncology, Sapporo Medical University, S1W17, Chuo-ku, Sapporo 060-8556, Hokkaido, Japan;
| | - Atsuya Takeda
- Radiation Oncology Center, Ofuna Chuo Hospital, 6-2-24 Ofuna, Kamakura 247-0056, Kanagawa, Japan;
| | - Takashi Uno
- Diagnostic Radiology and Radiation Oncology, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba City 260-8670, Chiba, Japan;
| | - Takuma Nomiya
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2 Iida-Nishi, Yamagata-shi 990-9585, Yamagata, Japan;
| | - Hiroshi Taguchi
- Department of Radiation Oncology, Hokkaido University Hospital, North-14 West-5, Kita-ku, Sapporo 060-8648, Japan;
| | - Yuji Seo
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 (D10) Yamada-oka, Suita 565-0871, Osaka, Japan;
| | - Takafumi Komiyama
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Kan Marino
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Shinichi Aoki
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Masaki Matsuda
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Tomoko Akita
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| | - Masahide Saito
- Department of Radiology, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi 409-3898, Japan; (T.K.); (K.M.); (S.A.); (M.M.); (T.A.); (M.S.)
| |
Collapse
|
6
|
Saito M, Sano N, Suzuki H, Komiyama T, Marino K, Ueda K, Nemoto H, Onishi H. Long-term experience in quality assurance of on-rail computed tomography systems for image-guided radiotherapy using in-house multifunctional phantoms. Radiol Phys Technol 2023; 16:292-298. [PMID: 37079253 DOI: 10.1007/s12194-023-00718-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/09/2023] [Accepted: 04/10/2023] [Indexed: 04/21/2023]
Abstract
To report the long-term quality assurance (QA) experience of an on-rail computed tomography (CT) system for image-guided radiotherapy using an in-house phantom. An on-rail CT system combining the Elekta Synergy and Canon Aquilion LB was used. The treatment couch was shared by the linear accelerators and CT, and the couch was rotated by 180° when using the on-rail-CT system to ensure that the CT direction was toward the head. All QA analyses were performed by radiation technologists on CBCT or on-rail CT images of the in-house phantom. The CBCT center accuracy from the linac laser, couch rotational accuracy (CBCT center vs. on-rail CT center), horizontal accuracy by CT gantry shift, and remote couch shift accuracy were evaluated. This study reported the QA status of the system during the period 2014-2021. The absolute mean accuracy of couch rotation was 0.4 ± 0.28 mm, 0.44 ± 0.36 mm, and 0.37 ± 0.27 mm in the SI, RL, and AP directions, respectively. Horizontal and remote movement accuracies of the treatment couch were also within 0.5 mm of the absolute mean value. A decrease in the accuracy of couch rotation was also observed due to aging deterioration of related parts caused by the frequent use of couch rotation. The three-dimensional accuracy of on-rail CT systems derived mainly from treatment couches can be maintained within 0.5 mm with appropriate accuracy assurance for at least > 8 years.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan.
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan
| | - Takafumi Komiyama
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan
| | - Kan Marino
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan
| | - Hikaru Nemoto
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-City, Yamanashi, 409-3898, Japan
| |
Collapse
|
7
|
Marino K, Cotoco J, Barone C, Franklin P, Muesse J, Steliga M, Johnson L. OA01.02 Smoking Recidivism in a Low Dose Lung Cancer Screening Program Despite Point of Care Counseling. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.120] [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: 01/29/2023]
|
8
|
Chen Z, Nonaka H, Onishi H, Nakatani E, Oguri M, Saito M, Aoki S, Marino K, Komiyama T, Kuriyama K, Araya M, Tominaga L, Saito R, Maehata Y, Shinohara R. Impact of Systemic Autoimmune Diseases on Treatment Outcomes and Radiation Toxicities in Patients with Stage I Non-Small Cell Lung Cancer Receiving Stereotactic Body Radiation Therapy: A Matched Case-Control Analysis. Cancers (Basel) 2022; 14:cancers14235915. [PMID: 36497397 PMCID: PMC9740448 DOI: 10.3390/cancers14235915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
We aimed to evaluate the impact of systemic autoimmune diseases (SADs) on treatment outcomes and radiation toxicities following stereotactic body radiation therapy (SBRT) for stage I non-small cell lung cancer (NSCLC). We queried an institution-based database on patients with SADs treated with SBRT for lung cancer between 2001 and 2016 (SAD group). Each patient was matched to three controls without SADs. The primary outcomes of interest were the overall survival (OS) and local control rate (LCR). The secondary outcomes were radiation toxicities of grades ≥2 (≥G2). Twelve patients with SADs were matched to 36 controls. The median follow-up duration was 3.6 years. There was a significant intergroup difference in the OS (hazard ratio [HR]: 4.11, 95% confidence incidence [CI]: 1.82−9.27, p < 0.001) and LCR (HR: 15.97, 95% CI: 2.89−88.29, p < 0.001). However, there were no significant intergroup differences in the odds of acute (odds ratio [OR]: 0.38, 95% CI: 0.02−8.91, p = 0.550) and late (OR: 2.20, 95% CI: 0.32−15.10, p = 0.422) ≥G2 radiation pneumonitis. No other ≥G2 toxicities were identified. In conclusion, although radiation toxicities are not enhanced by SADs, SADs are risk factors of poor prognosis following SBRT for stage I NSCLC.
Collapse
Affiliation(s)
- Zhe Chen
- Department of Radiology, Shizuoka General Hospital, Shizuoka 420-8527, Japan
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo 409-3898, Japan
- Correspondence: ; Tel.: +81-54-247-6111
| | - Hotaka Nonaka
- Department of Radiology, Fuji City General Hospital, Fuji 417-8567, Japan
| | - Hiroshi Onishi
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo 409-3898, Japan
| | - Eiji Nakatani
- Graduate School of Public Health (Medical Statistics), Shizuoka Graduate University of Public Health, Shizuoka 420-0881, Japan
| | - Mitsuhiko Oguri
- Department of Radiology, Shizuoka General Hospital, Shizuoka 420-8527, Japan
| | - Masahide Saito
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo 409-3898, Japan
| | - Shinichi Aoki
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo 409-3898, Japan
| | - Kan Marino
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo 409-3898, Japan
| | - Takafumi Komiyama
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo 409-3898, Japan
| | - Kengo Kuriyama
- Department of Radiology, Shizuoka General Hospital, Shizuoka 420-8527, Japan
| | - Masayuki Araya
- Proton Therapy Center, Aizawa Hospital, Matsumoto 390-8510, Japan
| | - Licht Tominaga
- Department of Radiology, Toranomon Hospital, Tokyo 105-8470, Japan
| | - Ryo Saito
- Department of Radiology, Shimada Municipal Hospital, Shimada 427-8502, Japan
| | - Yoshiyasu Maehata
- Department of Radiology, Yamanashi Prefectural Hospital, Kofu 400-8506, Japan
| | - Ryoji Shinohara
- Department of Health Sciences, Basic Science for Clinical Medicine, University of Yamanashi, Chuo 409-3898, Japan
| |
Collapse
|
9
|
Chen Z, Kuriyama K, Nakatani E, Sato Y, Saito R, Marino K, Komiyama T, Onishi H. Anatomy-based prediction method for determining ipsilateral lung doses in postoperative breast radiation therapy assisted by diagnostic computed tomography images. Rep Pract Oncol Radiother 2022; 27:699-706. [PMID: 36196413 PMCID: PMC9521692 DOI: 10.5603/rpor.a2022.0087] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/03/2022] [Indexed: 11/20/2022] Open
Abstract
Background This study aimed to investigate whether ipsilateral lung doses (ILDs) could be predicted by anatomical indexes measured using diagnostic computed tomography (CT) prior to the planning stage of breast radiation therapy (RT). Materials and methods The thoracic diameters and the length of lines drawn manually were measured on diagnostic CT images. The parameters of interest were the skin maximum lung distance (sMLD), central lung distance (CLD), Haller index (HI), and body mass index (BMI). Lung dose-volume histograms were created with conformal planning, and the lung volumes receiving 5-40 Gy (V5-V40) were calculated. Linear regression models were used to investigate the correlations between the anatomical indexes and dose differences and to estimate the slope and 95% confidence intervals (CIs). Results A total of 160 patients who had undergone three-dimensional conformal RT after breast-conserving surgery were included. Univariable analysis revealed that the sMLD (p < 0.001), CLD (p < 0.001), HI (p = 0.002), and BMI (p < 0.001) were significantly correlated with the V20. However, multivariable analysis revealed that only the sMLD (slope: 0.147, p = 0.001, 95% CI: 0.162-0.306) and CLD (0.157, p = 0.005, 0.048-0.266) were strongly correlated with the V20. The p-value for the sMLD was the lowest among the p-values for all indexes, thereby indicating that the sMLD had the best predictive power for ILD. Conclusions sMLD and CLD are anatomical markers that can be used to predict ILD in whole breast RT. An sMLD > 20.5 mm or a CLD > 24.3 mm positively correlated with a high ILD.
Collapse
Affiliation(s)
- Zhe Chen
- Department of Radiology, Shizuoka General Hospital, Shizuoka, Japan
| | - Kengo Kuriyama
- Department of Radiology, Shizuoka General Hospital, Shizuoka, Japan
| | - Eiji Nakatani
- Graduate School of Public Health (Medical Statistics), Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Yoko Sato
- Graduate School of Public Health (Medical Statistics), Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Ryo Saito
- Department of Radiology, Shimada General Medical Center, Shimada, Shizuoka, Japan
| | - Kan Marino
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Takafumi Komiyama
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan
| |
Collapse
|
10
|
Saito M, Ueda K, Suzuki H, Komiyama T, Marino K, Aoki S, Sano N, Onishi H. Evaluation of the detection accuracy of set-up for various treatment sites using surface-guided radiotherapy system, VOXELAN: a phantom study. J Radiat Res 2022; 63:435-442. [PMID: 35467750 PMCID: PMC9124621 DOI: 10.1093/jrr/rrac015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/31/2022] [Indexed: 06/01/2023]
Abstract
The purpose of this study is to evaluate the detection accuracy of a 3-dimensional (3D) body scanner, VOXELAN, in surface-guided radiotherapy (SGRT) of each part of the human body using a whole-body human phantom. We used A Resusci Anne was used as the whole-body phantom. The detection accuracy of VOXELAN in a radiotherapy treatment room with a linear accelerator (LINAC) was evaluated for two reference images: reconstruction of the planning computed tomography (CT) image (CT reference) and scanning by VOXELAN before the treatment (scan reference). The accuracy of the translational and rotational directions was verified for four treatment sites (open face shell, breast, abdomen, and arm), using the magnitude of the 6D robotic couch movement as the true value. Our results showed that the detection accuracy improved as the displacement from the reference position decreased for all the sites. Using the scan reference, the average accuracy of the translational and rotational axes was within 1.44 mm and 0.41°, respectively, for all sites except the arms. Similarly, using the CT reference, the average accuracy was within 2.45 mm and 1.35°, respectively. Additionally, it was difficult for both reference images to recognize misalignment of the arms. In conclusion we discovered that VOXELAN achieved a high detection accuracy for the head with an open face shell, chest, and abdomen, indicating that the system is useful in a clinical setting. However, it is necessary to pay attention to location matching for areas with few features, such as surface irregularities and potential errors, when the reference image is created from CT.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Takafumi Komiyama
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| |
Collapse
|
11
|
Saito M, Suzuki T, Suzuki H, Komiyama T, Marino K, Aoki S, Oguri M, Yamada T, Takahashi H, Onishi H. The minimum required interval between hydrogel spacer injection and treatment planning for stereotactic body radiotherapy for prostate cancer. Pract Radiat Oncol 2022; 12:e556-e559. [DOI: 10.1016/j.prro.2022.01.004] [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] [Received: 01/12/2022] [Revised: 01/20/2022] [Accepted: 01/27/2022] [Indexed: 11/30/2022]
|
12
|
Saito M, Kajihara D, Suzuki H, Komiyama T, Marino K, Aoki S, Ueda K, Sano N, Onishi H. Reproducibility of deep inspiration breath-hold technique for left-side breast cancer with respiratory monitoring device, Abches. J Appl Clin Med Phys 2022; 23:e13529. [PMID: 35018712 PMCID: PMC8992950 DOI: 10.1002/acm2.13529] [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: 07/26/2021] [Revised: 11/28/2021] [Accepted: 12/25/2021] [Indexed: 11/08/2022] Open
Abstract
PURPOSE This study aimed to evaluate the reproducibility of deep inspiration breath-hold (DIBH) using a respiratory control device, Abches, in patients with left-sided breast cancer. MATERIAL AND METHODS Abches comprises a main body, an indicator panel, and two fulcrums, one each on the chest and abdomen. Forty left side breast cancer patients treated with DIBH using abches were enrolled in this study. For all patients, CT images were taken three times to confirm the target position inside the body and to check the breath-hold reproducibility. Three anatomical points on the nipple, sternum, and heart were selected as measurement points on CT images. After measuring the coordinates, breath-hold reproducibility was defined as the mean of the absolute difference in the coordinates between the three CT images. The maximum differences were also investigated. In addition, the dice similarity coefficient (DSC) was calculated to examine the displacement of the heart volume in detail. Moreover, digitally reconstructed radiographs (DRRs) and linac graphs (LGs) were used to measure the positional accuracy of the chest and heart. RESULTS The reproducibility in all patients was within 0.75 mm for the nipple, 0.78 mm for the sternum, and 2.18 mm for the heart in each direction. Similarly, the maximum displacements for all patients were within 1.90 mm, 1.69 mm, and 4.75 mm, respectively, in each direction. For heart volume, the average DSC for all cases was 0.93 ± 0.01. The differences between the DRR and LG images were 1.70 ± 1.10 mm and 2.10 ± 1.60 mm, for the chest and heart, respectively. CONCLUSION Our study showed that DIBH using Abches can be performed with good target reproducibility of less than 3 mm with proper breath-hold practice, whereas the heartbeat-derived reproducibility of the cardiac position is poor and needs to be monitored carefully during treatment simulation.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Daichi Kajihara
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Takafumi Komiyama
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Kan Marino
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi, Japan
| |
Collapse
|
13
|
Saito M, Komiyama T, Marino K, Aoki S, Oguri M, Yamada T, Sano N, Suzuki H, Ueda K, Onishi H. Dosimetric Effects of Differences in Multi-Leaf Collimator Speed on SBRT-VMAT for Central Lung Cancer Patients. Technol Cancer Res Treat 2022; 21:15330338221119752. [PMID: 35950289 PMCID: PMC9379802 DOI: 10.1177/15330338221119752] [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] [Indexed: 11/21/2022] Open
Abstract
Purpose: We aimed to investigate the effects of different multi-leaf
collimator (MLC) speed constraints in volumetric modulated radiotherapy (VMAT)
on the robustness of treatment plans for central lung cancer patients.
Method and Materials: Twenty patients with central lung tumor
who underwent stereotactic body radiotherapy (SBRT) with the VMAT technique at
our hospital were included in this retrospective study. The reference plans were
created with 3 different MLC speed constraints (Plan A: 0.1 cm/deg., Plan B:
0.3 cm/deg., and Plan C: 0.5 cm/deg.) with a 50-Gy/8Fr, planning target volume
(PTV) D95% prescription. In each of these plans, setup errors from 1
to 5 mm were intentionally added in the direction of the central organ at 1-mm
intervals (300 plans [20 cases × 3 MLC speeds × 5 error plans] were created in
total). Each plan was then calculated by the same beam conditions as each
reference plan. The actual average MLC speed and dose difference between the
reference plan and the error-added plan were then calculated and compared among
the 3 MLC speeds. Results: In the reference plans, the actual
average MLC speeds were 0.25 ± 0.04, 0.34 ± 0.07, and 0.39 ± 0.12 cm/deg. for
Plan A, Plan B, and Plan C, respectively (P < .05). For PTV
and OARs, many dose indices tended to improve as the MLC speed increased, while
no significant differences were observed among the 3 MLC speed constraints.
However, in assessments of robustness, no significant differences in dose
difference were observed among the 3 MLC speed constraints for most of the
indices. Conclusions: When necessary, increasing the MLC speed
constraint with a priority on improving the quality of the dose distribution is
an acceptable approach for central lung cancer patients.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Takafumi Komiyama
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Kan Marino
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Mitsuhiko Oguri
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Takashi Yamada
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, 38146University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
14
|
Reed H, Marino K, Muesse J, Mcrae C, Franklin P, Steliga M. P09.07 Integration of Smoking Cessation Services in Mobile Mammography and Mobile COVID Screening to Reach Rural Populations. J Thorac Oncol 2021. [PMCID: PMC8523187 DOI: 10.1016/j.jtho.2021.08.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
15
|
Yoshizawa K, Aoki S, Marino K, Matsuda M, Moroi A, Ueki K. Spacers with boluses applied to various sites of oral squamous cell carcinoma: Technical note and retrospective case series. Mol Clin Oncol 2021; 15:187. [PMID: 34349987 PMCID: PMC8327078 DOI: 10.3892/mco.2021.2349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 07/02/2021] [Indexed: 11/18/2022] Open
Abstract
The present report describes a case series in which spacers with boluses were used at various sites in the oral cavity to enhance the therapeutic effect of radiation therapy in oral squamous cell carcinoma. In radiotherapy, the surface dose is reduced due to the build-up region of X-rays. In the present study, a bolus was used to complement the build-up region and increase the surface dose effect. A total of 7 patients with oral cancer from a primary care hospital underwent radiation therapy using spacers and added boluses to improve the surface dose effect. The spacer was made from a plastic splint and the bolus was connected to the splint with a quick self-curing resin. There were no complaints of pain or adverse events from the patients while wearing the intraoral splint. A total of 2 of the 7 patients were subsequently confirmed as having progressed disease, and the remaining 5 are currently being managed following a complete response to treatment. The spacers used at various sites of oral squamous cell carcinoma were safe and effective and did not cause any severe adverse effects.
Collapse
Affiliation(s)
- Kunio Yoshizawa
- Department of Oral Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Shinichi Aoki
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Kan Marino
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Masaki Matsuda
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Akinori Moroi
- Department of Oral Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Koichiro Ueki
- Department of Oral Maxillofacial Surgery, Division of Medicine, Interdisciplinary Graduate School, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| |
Collapse
|
16
|
Saito M, Shibata Y, Ueda K, Suzuki H, Komiyama T, Marino K, Aoki S, Maehata Y, Sano N, Onishi H. Quantification of image quality of intra-fractional cone-beam computed tomography for arc irradiation with various imaging condition. ACTA ACUST UNITED AC 2021; 26:495-501. [PMID: 34277107 PMCID: PMC8281903 DOI: 10.5603/rpor.a2021.0066] [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: 08/04/2020] [Accepted: 02/25/2021] [Indexed: 11/25/2022]
Abstract
Background 3-dimensional intra-cone beam computed tomography (intra-CBCT ) could be a potentially powerful tool for use with arc irradiation such as volumetric modulated arc therapy. The aim of the study was to evaluate the image quality of intra-cone beam computed tomography (intra-CBCT ) for arc irradiation with various imaging condition. Materials and methods Two types of intra-CBCT imaging techniques were evaluated — intra-fractional CBCT with flattening filtered (FF) beam (intra-FF CBCT ) and that with flattening filter free (FFF) beam (intra-FFF CBCT ). For the intra-MV beams, four different field sizes (2 cm × 2 cm, 5 cm × 5 cm, 10 cm × 10 cm, and 20 cm × 20 cm) were used with dose rates of 500 MU/min and 1600 MU/min, for 6 MV FF and 6 MV FFF, respectively. For all image acquisitions, two rotation angles (full-arc and half-arc) were investigated. Thereafter, the linearity, contrast-to-noise ratio (CNR), and uniformity index (UI) of intra-CBCT image were compared with those of conventional CBCT image. Results All acquisition conditions had good linearity of the CT value (R2 > 0.99). For CNR, the change rates from conventional CBCT ranged from 0.6–33.7% for a 2 cm × 2 cm beam, whereas that for a 20 cm × 20 cm beam ranged from 62.7–82.3%. Similarly, the UI increased from 1.5% to 7.0% as the field size increased. Conclusion Quality of intra-CBCT image was affected by the field size and acquisition angle. Image quality of intra-CBCT was worse than that of conventional CBCT, but it was better under a smaller field and wider correction angle and would be acceptable for clinical use.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Yuki Shibata
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
17
|
Chen Z, Nonaka H, Onishi H, Nakatani E, Sato Y, Funayama S, Watanabe H, Komiyama T, Kuriyama K, Marino K, Aoki S, Araya M, Tominaga L, Saito R, Maehata Y, Oguri M, Saito M. Modified Glasgow Prognostic Score is predictive of prognosis for non-small cell lung cancer patients treated with stereotactic body radiation therapy: a retrospective study. J Radiat Res 2021; 62:457-464. [PMID: 33866376 PMCID: PMC8127692 DOI: 10.1093/jrr/rrab021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/21/2021] [Indexed: 05/09/2023]
Abstract
We aimed to assess the predictive value of the modified Glasgow prognostic score (mGPS) in patients with non-small cell lung cancer (NSCLC) who underwent stereotactic body radiation therapy (SBRT). We retrospectively reviewed the records of 207 patients, with a median age of 79 years. The pretreatment mGPS was calculated and categorized as high (mGPS = 1-2) or low (mGPS = 0). The median follow-up duration was 40.7 months. The five-year overall survival (OS), progression-free survival (PFS) and time to progression (TTP) rates were 44.3%, 36% and 54.4%, respectively. Multivariate analysis revealed that mGPS was independently predictive of OS (hazard ratio [HR] 1.67; 95% confidence interval 1.14-2.44: P = 0.009), PFS (HR 1.58; 1.10-2.28: P = 0.014) and TTP (HR 1.66; 1.03-2.68: P = 0.039). Patients who had high mGPS showed significantly worse OS (33.3 vs 64.5 months, P = 0.003) and worse PFS (23.8 vs 39 months, P = 0.008) than those who had low mGPS. The data showed a trend that patients with high mGPS suffered earlier progression compared to those with low mGPS (54.3 vs 88.1 months, P = 0.149). We confirmed that mGPS is independently predictive of prognosis in NSCLC patients treated with SBRT.
Collapse
Affiliation(s)
- Zhe Chen
- Corresponding author: Dr. Zhe Chen, Department of radiology, University of Yamanashi, Present affiliation: Department of radiology, Shizuoka General Hospital, 4-27-1 Kita-Ando, Shizuoka City, Shizuoka, 420-8527, JAPAN. Tel.: +81-54-247-6111, Fax: +81-54-247-6140,
| | - Hotaka Nonaka
- Department of Radiology, Fuji City General Hospital, Fuji, Shizuoka, 417-8567, Japan
| | - Hiroshi Onishi
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Eiji Nakatani
- Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Shizuoka, Shizuoka, 420-8527, Japan
| | - Yoko Sato
- Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Shizuoka, Shizuoka, 420-8527, Japan
| | - Satoshi Funayama
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Hiroaki Watanabe
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Takafumi Komiyama
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Kengo Kuriyama
- Department of Radiology, Shizuoka General Hospital, Shizuoka, Shizuoka, 420-8527, Japan
| | - Kan Marino
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Shinichi Aoki
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Masayuki Araya
- Proton Therapy Center, Aizawa Hospital, Matsumoto, Nagano, 390-8510, Japan
| | - Licht Tominaga
- Department of Radiology, Toranomon Hospital, Minato, Tokyo, 105-8470, Japan
| | - Ryo Saito
- Department of Radiology, Shimada Municipal Hospital, Shimada, Shizuoka, 427-8502, Japan
| | - Yoshiyasu Maehata
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| | - Mitsuhiko Oguri
- Department of Radiology, Yamanashi Prefectural Hospital, Yamanashi, Yamanashi, 400-8506, Japan
| | - Masahide Saito
- Department of Radiology, School of Medicine, University of Yamanashi, Chuo, Yamanashi, 409-3898, Japan
| |
Collapse
|
18
|
Komiyama T, Saito M, Kuriyama K, Marino K, Aoki S, Saito R, Muramatsu J, Maehata Y, Ze C, Akita T, Yamada T, Sano N, Yoshizawa K, Kazunari A, Hidekazu S, Ueda K, Vu N, Onishi H. Dose Prescription Methods in Stereotactic Body Radiotherapy for Small Peripheral Lung Tumors: Approaches Based on the Gross Tumor Volume Are Superior to Prescribing a Dose That Covers 95% of the Planning Target Volume. Technol Cancer Res Treat 2020; 19:1533033820974030. [PMID: 33272112 PMCID: PMC7720311 DOI: 10.1177/1533033820974030] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose: We aimed to validate the usefulness of prescriptions based on gross tumor volume for stereotactic body radiotherapy for small peripheral lung tumors. Materials and Methods: Radiotherapy treatment planning data of 50 patients with small peripheral lung tumors (adenocarcinoma: 24, squamous cell carcinoma: 10, other: 1, unknown: 15) receiving breath-hold computed tomography-guided stereotactic body radiotherapy at our institution during 2013–2016 were analyzed. For each case, 3 dose prescription methods were applied: one based on 95% (PTVD95%) of the planning target volume, one based on 50% of the gross tumor volume (GTVD50%), and one based on 98% (GTVD98%) of the gross tumor volume. The maximum (GTVDmax), minimum (GTVDmin), and mean gross tumor volume dose (GTVDmean) and the dose covering 98% of the gross tumor volume were calculated to evaluate variations in the gross tumor volume dose. Results: Upon switching to GTVD50%, the variations in GTVDmax and GTVDmean decreased significantly, compared with variations observed for PTVD95% (p < 0.01), but the variation in GTVDmin increased significantly (p < 0.01). Upon switching to the GTVD98%, the variation in GTVDmean decreased significantly compared with that observed for PTVD95% (p < 0.01). Conclusion: Switching from prescriptions based on 95% of the planning target volume to those based on 98% of the gross tumor volume decreased variations among cases in the overall gross tumor volume dose. Overall, prescriptions based on 98% of the gross tumor volume appear to be more suitable than those based on 95% of the planning target volume in cases of small peripheral lung tumors treated with stereotactic body radiotherapy.
Collapse
Affiliation(s)
- Takafumi Komiyama
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Masahide Saito
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Kengo Kuriyama
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Kan Marino
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Ryo Saito
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Juria Muramatsu
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Yoshiyasu Maehata
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Chen Ze
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Tomoko Akita
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Takashi Yamada
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Kazuya Yoshizawa
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Ashizawa Kazunari
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Suzuki Hidekazu
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Nam Vu
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi Faculty of Medicine, Yamanashi, Japan
| |
Collapse
|
19
|
Saito M, Sano N, Kuriyama K, Komiyama T, Marino K, Aoki S, Maehata Y, Suzuki H, Ueda K, Onishi H. New method for measurement of chest surface motion in lung cancer patients: Quantification using a technique of deformable image registration. Med Dosim 2020; 46:111-116. [PMID: 32972812 DOI: 10.1016/j.meddos.2020.09.001] [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: 04/14/2020] [Revised: 08/27/2020] [Accepted: 09/11/2020] [Indexed: 11/29/2022]
Abstract
The purpose of this study was to measure the motion of the chest surface during breath-holding treatment for lung cancer using deformable image registration (DIR). Forty non-small-cell lung cancer patients treated with breath-holding stereotactic body radiation therapy were retrospectively examined. First, intensity-based DIR between 2 breath-holding computed tomography (CT) images was performed. Subsequently, deformation vector field (DVF) for all dimensions (left-right, anterior-posterior, and superior-inferior) was calculated from the result. For the analysis of chest surface, the DVF value of the only chest surface area was extracted after the chest surface was divided into 12 regions of interest (ROI) based on anatomy. Additionally, for the analysis of the correlation with the internal tumor motion, the median value of DVF for each surface ROI and the motion of the center of gravity of the tumor volume were used. It was possible to calculate the motion of chest surface without any outliers for all patients. For the average of 12 surface ROIs, the motion of 3D chest surface was within 2 mm (30 cases), 3 mm (8 cases), and 4 mm (2 cases). There was no correlation between the motion of the chest surface and that of the tumor for all 12 surface ROIs. We proposed a technique to evaluate the surface motion using DIR between multiple CT images. It could be a useful tool to calculate the motion of chest surface.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan.
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Kengo Kuriyama
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
20
|
Vu N, Onishi H, Saito M, Kuriyama K, Komiyama T, Marino K, Araya M, Aoki S, Saito R, Nonaka H, Funayama S, Watanabe H, Sano N. Tumor volume shrinkage during stereotactic body radiotherapy is related to better prognoses in patients with stage I non-small-cell lung cancer. J Radiat Res 2020; 61:740-746. [PMID: 32657333 PMCID: PMC7482165 DOI: 10.1093/jrr/rraa040] [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] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/24/2020] [Indexed: 06/11/2023]
Abstract
The purpose of the study was to investigate the association between tumor volume changes during stereotactic body radiation therapy (SBRT) and prognoses in stage I non-small-cell lung cancer (NSCLC). This retrospective review included stage I NSCLC patients in whom SBRT was performed at a total dose of 48.0-50.5 Gy in four or five fractions. The tumor volumes observed on computed tomography (CT) simulation and on the CT performed at the last treatment session using a CT-on-rails system were measured and compared. Then, the tumor volume changes during the SBRT period were measured and assessed for their association with prognoses (overall survival, local control, lymph node metastases and distant metastases). A total of 98 patients with a mean age of 78.6 years were enrolled in the study. The T-stage was T1a in 42%, T1b in 32% and T2a in 26% of the cases. The gross tumor volume (GTV) shrank and increased ≥10% in 23 (23.5%) and 36 (36.7%) of the cases, respectively. The 5-year local control and overall survival rates in the groups with a tumor shrinkage of ≥10% vs the group with a shrinkage of <10% were 94.7 vs 70.8% and 85.4 vs 47.6%, respectively; these differences were significant, with a P-value < 0.05. During a short SBRT period, the tumor shrank or enlarged in a small number of cases. A decrease of ≥10% in the GTV during SBRT was significantly related to better overall survival and local control.
Collapse
Affiliation(s)
- Nam Vu
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
- Department of Radiology, Hospital 175, Ho Chi Minh, Vietnam
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Kengo Kuriyama
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Ryo Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hotaka Nonaka
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Satoshi Funayama
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroaki Watanabe
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
21
|
Suzuki T, Saito M, Onishi H, Mochizuki Z, Mochizuki K, Satani K, Sano N, Aoki S, Marino K, Komiyama T, Takahashi H. Effect of a hydrogel spacer on the intrafractional prostate motion during CyberKnife treatment for prostate cancer. J Appl Clin Med Phys 2020; 21:63-68. [PMID: 33058517 PMCID: PMC7592967 DOI: 10.1002/acm2.13005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to evaluate the effect of a hydrogel spacer on intrafractional prostate motion during CyberKnife treatment. The retrospective study enrolled 24 patients (with the hydrogel spacer = 12, without the hydrogel spacer = 12) with two fiducial markers. Regarding intrafractional prostate motion, the offset values (mm) of three axes (X-axis; superior [+] to inferior [-], Y-axis; right [+] to left [-], Z-axis; posterior [+] to anterior [-]) obtained from fiducial markers position between a digitally reconstructed radiographs images and live images in the Target Locating System were used, and extracted from generated log files. The mean values of the offset and each standard deviation were calculated for each patient, and both the groups were compared. For all the patients, a total of 2204 offset values and timestamps (without the hydrogel spacer group: 1065, with the hydrogel spacer group: 1139) were recorded for the X-, Y-, and Z-axes, respectively. The offset values (mean ± standard deviation) for the X-, Y-, and Z-axes were -0.04 ± 0.92 mm, -0.03 ± 0.97 mm (P = 0.66), 0.02 ± 0.51, -0.02 ± 0.49 mm (P = 0.50), and 0.56 ± 0.97 mm, 0.34 ± 1.07 mm (P = 0.14), in patients inserted without or with the hydrogel spacer, respectively. There was no effect of a hydrogel spacer on the intrafractional prostate motion in the three axes during CyberKnife treatment for prostate cancer.
Collapse
Affiliation(s)
| | - Masahide Saito
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Hiroshi Onishi
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | | | - Koji Mochizuki
- Kasugai CyberKnife Rehabilitation HospitalYamanashiJapan
| | | | - Naoki Sano
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Shinichi Aoki
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | - Kan Marino
- Department of RadiologyUniversity of YamanashiYamanashiJapan
| | | | | |
Collapse
|
22
|
Saito M, Suzuki T, Sugama Y, Marino K, Sano N, Komiyama T, Aoki S, Maehata Y, Yoshizawa K, Ashizawa K, Suzuki H, Ueda K, Miyasaka Y, Araya M, Takahashi H, Onishi H. Comparison of rectal dose reduction by a hydrogel spacer among 3D conformal radiotherapy, volumetric-modulated arc therapy, helical tomotherapy, CyberKnife and proton therapy. J Radiat Res 2020; 61:487-493. [PMID: 32211861 PMCID: PMC7299260 DOI: 10.1093/jrr/rraa013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 12/09/2019] [Revised: 01/27/2020] [Accepted: 02/28/2020] [Indexed: 06/10/2023]
Abstract
This study aimed to evaluate the rectal dose reduction with hydrogel spacer in 3D conformal radiotherapy (3DCRT), volumetric modulated arc therapy (VMAT), helical tomotherapy (HT), CyberKnife (CK) and proton therapy. Twenty patients who had hydrogel spacer for prostate radiotherapy were retrospectively enrolled. Computed tomography (CT) images with or without hydrogel spacer were used to evaluate rectal dose reduction. In total, 200 plans (20 patients × 2 CT images × 5 techniques) were created using the following criteria: 3DCRT, VMAT and HT [76 Gy/38 fractions (Fr), planning target volume (PTV) D50%], CK (36.25 Gy/5 Fr, PTV D95%) and proton therapy (63 GyE/21 Fr, PTV D50%). Rectal dose reduction was evaluated using low-/middle-dose (D20%, D50% and D80%) and high-dose (D2%) ranges. Rectal dose reduction of each dose index was compared for each technique. Significant rectal dose reduction (P < 0.001) between the treatment plans on pre- and post-CT images were achieved for all modalities for D50%, D20% and D2%. In particular, the dose reduction of high-dose (D2%) ranges were -40.61 ± 11.19, -32.44 ± 5.51, -25.90 ± 9.89, -13.63 ± 8.27 and -8.06 ± 4.19%, for proton therapy, CK, HT, VMAT and 3DCRT, respectively. The area under the rectum dose-volume histogram curves were 34.15 ± 3.67 and 34.36 ± 5.24% (P = 0.7841) for 3DCRT with hydrogel spacer and VMAT without hydrogel spacer, respectively. Our results indicated that 3DCRT with hydrogel spacer would reduce the medical cost by replacing the conventional VMAT without spacer for prostate cancer treatment, from the point of view of the rectal dose. For the high-dose gradient region, proton therapy and SBRT with CK showed larger rectal dose reduction than other techniques.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Yuya Sugama
- Aizawa Hospital Proton Therapy Center, Matsumoto, Japan
| | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kazuya Yoshizawa
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Yosuke Miyasaka
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | | | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
23
|
Onishi H, Shioyama Y, Matsumoto Y, Shibamoto Y, Miyakawa A, Suzuki G, Nishimura Y, Sasaki R, Miyawaki D, Kuriyama K, Komiyama T, Marino K, Aoki S, Saito R, Araya M, Maehata Y, Nonaka H, Tominaga L, Saito M, Sano N, Yamada S. Stereotactic body radiotherapy in patients with lung tumors composed of mainly ground-glass opacity. J Radiat Res 2020; 61:426-430. [PMID: 32219316 PMCID: PMC7299254 DOI: 10.1093/jrr/rraa015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 10/31/2019] [Revised: 02/07/2020] [Indexed: 06/10/2023]
Abstract
We retrospectively reviewed the effect of stereotactic body radiation therapy (SBRT) in patients with stage I lung cancer whose lung tumor showed a nodular appearance of ground glass opacity, so-called ground glass nodule (GGN). A total of 84 patients (42 men, 42 women; mean age, 75 years) with stage I lung cancer with GGN accompanying a solid component <50% in diameter of the tumor and no metastases were studied. Concerning histology, 32 tumors were adenocarcinoma, 1 was squamous cell carcinoma, 2 were unclassified carcinoma and 49 cases were histology-unproven but increased in size or had a positive finding in 18F-FDG positron emission tomography (PET) examination. The median tumor size was 20 mm (range, 10-41 mm). All of the patients were treated with SBRT, and the total prescribed dose at the isocenter ranged between 48 Gy in four fractions and 84 Gy in ten fractions. Median follow-up duration was 33 months. No patient had local failure nor regional lymph node failure. The 3-year rate of distant failure was 2.6%. Two patients who experienced distant metastases had a past surgical history of initial lung cancer before SBRT. The rates of cause-specific and overall survival at 3 years were 98.2 and 94.6%, respectively. Treatment-related adverse events of ≥grade 4 were not reported. Although more cases and longer follow-ups are mandatory, SBRT may be one of the radical treatment options for patients with GGN.
Collapse
Affiliation(s)
- Hiroshi Onishi
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | | | - Yasuo Matsumoto
- Department of Radiation Oncology, Niigata Cancer Center Hospital, Japan
| | - Yuta Shibamoto
- Department of Radiology, School of Medicine, Nagoya City University, Japan
| | - Akifumi Miyakawa
- Department of Radiology, School of Medicine, Nagoya City University, Japan
| | - Gen Suzuki
- Department of Radiation Oncology, School of Medicine, Kurume University, Japan
| | - Yasumasa Nishimura
- Department of Radiation Oncology, Kindai University Faculty of Medicine, Japan
| | - Ryohei Sasaki
- Department of Radiation Oncology, School of Medicine, Kobe University, Japan
| | - Daisuke Miyawaki
- Department of Radiation Oncology, School of Medicine, Kobe University, Japan
| | - Kengo Kuriyama
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Takafumi Komiyama
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Kan Marino
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Ryo Saito
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Masayuki Araya
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Yoshiyasu Maehata
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Hotaka Nonaka
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Licht Tominaga
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Masahide Saito
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, School of Medicine, University of Yamanashi, Japan
| | - Shogo Yamada
- Department of Radiation Oncology, School of Medicine, Tohoku University, Japan
| |
Collapse
|
24
|
Saito M, Suzuki H, Sano N, Ashizawa K, Yoshizawa K, Shibata Y, Ueda K, Komiyama T, Marino K, Aoki S, Saito R, Maehata Y, Onishi H. Evaluation of the target dose coverage of stereotactic body radiotherapy for lung cancer using helical tomotherapy: A dynamic phantom study. Rep Pract Oncol Radiother 2020; 25:200-205. [PMID: 32021577 DOI: 10.1016/j.rpor.2020.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/19/2019] [Accepted: 01/10/2020] [Indexed: 12/25/2022] Open
Abstract
Aim To evaluate the target dose coverage for lung stereotactic body radiotherapy (SBRT) using helical tomotherapy (HT) with the internal tumor volume (ITV) margin settings adjusted according to the degree of tumor motion. Background Lung SBRT with HT may cause a dosimetric error when the target motion is large. Materials and methods Two lung SBRT plans were created using a tomotherapy planning station. Using these original plans, five plans with different ITV margins (4.0-20.0 mm for superior-inferior [SI] dimension) were generated. To evaluate the effects of respiratory motion on HT, an original dynamic motion phantom was developed. The respiratory wave of a healthy volunteer was used for dynamic motion as the typical tumor respiratory motion. Five patterns of motion amplitude that corresponded to five ITV margin sizes and three breathing cycles of 7, 14, and 28 breaths per minute were used. We evaluated the target dose change between a static delivery and a dynamic delivery with each motion pattern. Results The target dose difference increased as the tumor size decreased and as the tumor motion increased. Although a target dose difference of <5 % was observed at ≤10 mm of tumor motion for each condition, a maximum difference of -9.94 % ± 7.10 % was observed in cases of small tumors with 20 mm of tumor motion under slow respiration. Conclusions Minimizing respiratory movement is recommended as much as possible for lung SBRT with HT, especially for cases involving small tumors.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kazuya Yoshizawa
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Yuki Shibata
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Ryo Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
25
|
Greenhawt M, Dunn Galvin A, Chalil J, Chang R, Prinz G, Marino K, McCrone J, Green T. D302 PERCEPTIONS AMONG PEANUT-ALLERGIC CHILDREN: A SURVEY. Ann Allergy Asthma Immunol 2019. [DOI: 10.1016/j.anai.2019.08.075] [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: 10/25/2022]
|
26
|
Nonaka H, Onishi H, Chen Z, Funayama S, Watanabe H, Komiyama T, Marino K, Aoki S, Saito R, Maehata Y. Prognostic Value of Pretreatment Neutrophil-to-Lymphocyte Ratio in Patients with Stage I Non-Small Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy: An Analysis Focusing on Metastases. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2421] [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: 11/26/2022]
|
27
|
Onishi H, Shioyama Y, Matsuo Y, Takayama K, Miyakawa A, Yamashita H, Nomiya T, Matsumo Y, Matsushita H, Kimura T, Murakami N, Ishiyama H, Uno T, Takanaka T, Katoh N, Takeda A, Nakata K, Ogawa K, Nihei K, Aoki M, Kuriyama K, Komiyama T, Marino K, Araya M, Aoki S, Saito R, Maehata Y, Tominaga R, Nonaka H, Oguri M, Matsuda M, Yamada T, Akita T, Hiraoka M. Prognosis after Local Recurrence or Metastases in Medically Operable Stage I Non-Small Cell Lung Cancer Patients Treated By Stereotactic Body Radiotherapy. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
28
|
Saito M, Sano N, Kuriyama K, Komiyama T, Marino K, Aoki S, Maehata Y, Saito R, Suzuki H, Shibata Y, Ueda K, Onishi H. Evaluation of the robustness of 3-dimensional conformal technique with MLC position control into the planning target volume in stereotactic body radiotherapy for lung cancer. Med Dosim 2019; 45:e1-e5. [PMID: 31138512 DOI: 10.1016/j.meddos.2019.04.007] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 04/24/2019] [Indexed: 12/25/2022]
Abstract
The purpose of this study was to evaluate the robustness of 3-dimensional conformal technique with MLC position control into the planning target volume (PTV) in stereotactic body radiotherapy for lung cancer. Two techniques using fixed beams were compared; one technique involved setting the MLC position outside the PTV and was referred to as Plan "O." Another technique involved setting the MLC position inside the PTV and was referred to as Plan "I." Two tumor motions were simulated: (1) tumor motion on the internal target volume (ITV) boundary and (2) tumor motion on the PTV boundary. Ten-phase CT images that captured the tumor in respiratory motion were generated for 2 simulations. Then, 4-dimensional (4D) treatment planning was performed by using deformable image registration. The gross tumor volume (GTV) dose changes between the 4D accumulated dose and treatment planning dose were evaluated for Plan "O" and Plan "I," respectively. For the simulation of tumor motion on the ITV boundary, the changes in GTV D50% were -0.10 ± 0.31% and -0.22 ± 0.26% (p < 0.05) for Plan "O" and Plan "I," respectively. In the same manner, for the simulation of tumor motion on the PTV boundary, the changes in GTV D50% were -3.37 ± 2.16% and -3.68 ± 1.71% (p < 0.05). Our result suggested that the dose change would be negligible in a clinical situation where the tumor moves within the ITV margin for both techniques, while Plan "O" showed better robustness.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan.
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Kengo Kuriyama
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Takafumi Komiyama
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Yoshiyasu Maehata
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Ryo Saito
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hidekazu Suzuki
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Yuki Shibata
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi 409-3898, Japan
| |
Collapse
|
29
|
Funayama S, Onishi H, Kuriyama K, Komiyama T, Marino K, Araya M, Saito R, Aoki S, Maehata Y, Nonaka H, Tominaga L, Muramatsu J, Nakagomi H, Kamiyama M, Takeda M. Renal Cancer is Not Radioresistant: Slowly but Continuing Shrinkage of the Tumor After Stereotactic Body Radiation Therapy. Technol Cancer Res Treat 2019; 18:1533033818822329. [PMID: 30803362 PMCID: PMC6373992 DOI: 10.1177/1533033818822329] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Purpose: To evaluate the safety and efficacy of stereotactic body radiation therapy for primary lesion of renal cell carcinoma with long-term and regular follow-up of tumor size and renal function. Methods: This prospective study included 13 patients treated with stereotactic body radiation therapy for primary lesion of stage I renal cell carcinoma between August 2007 and June 2016 in our institution. Diagnosis of renal cell carcinoma was made by 2 radiologists using computed tomography or magnetic resonance imaging. A dosage of 60 Gy in 10 fractions or 70 Gy in 10 fractions was prescribed. The higher dose was selected if dose constraints were satisfied. Tumor response on imaging examination, local progression-free rate, overall survival, and toxicity were assessed. Results: The mean follow-up period was 48.3 months (range: 11-108 months). The tumors showed very slow but continuous response during long-term follow-up. Three cases (23.1%) showed transient progression during the short follow-up. The mean duration until the day on which partial response was confirmed among the partial or complete response cases was 22.6 months (95% confidence interval, 15.3-30.0 months). Local progression-free rate was 92.3% for 3 years and overall survival rate 91.7% for 2 years and 71.3% for 3 years. Twelve cases (92.3%) had impaired renal function at baseline. Renal function decreased slowly and mildly in most of the cases, but 2 cases of solitary kidney showed grade 4 or 5 renal dysfunction. Conclusion: All renal tumors decreased in size slowly but continuously for years after stereotactic body radiation therapy. Renal cancer can be treated radically with stereotactic body radiation therapy as a radiosensitive tumor, but careful attention should be given in cases with solitary kidney.
Collapse
Affiliation(s)
- Satoshi Funayama
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kengo Kuriyama
- 2 Department of Radiology, Shizuoka General Hospital, Shizuoka, Japan
| | - Takafumi Komiyama
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kan Marino
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Masayuki Araya
- 3 Department of Radiology, Center of Proton Therapy, Aizawa Hospital, Nagano, Japan
| | - Ryo Saito
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Shinichi Aoki
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Yoshiyasu Maehata
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hotaka Nonaka
- 4 Department of Radiology, Fujiyoshida Municipal Medical Center, Yamanashi, Japan
| | - Licht Tominaga
- 5 Department of Radiology, Toranomon Hospital, Tokyo, Japan
| | - Juria Muramatsu
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Nakagomi
- 6 Department of Urology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Manabu Kamiyama
- 6 Department of Urology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Masayuki Takeda
- 6 Department of Urology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
30
|
Onishi H, Marino K, Yamashita H, Terahara A, Onimaru R, Kokubo M, Shioyama Y, Kozuka T, Matsuo Y, Aruga T, Hiraoka M. Case Series of 23 Patients Who Developed Fatal Radiation Pneumonitis After Stereotactic Body Radiotherapy for Lung Cancer. Technol Cancer Res Treat 2019; 17:1533033818801323. [PMID: 30286697 PMCID: PMC6174642 DOI: 10.1177/1533033818801323] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to examine the characteristics and treatment plans of patients who experienced fatal radiation pneumonitis after stereotactic body radiation therapy for primary or oligometastatic lung cancer. Records of 1789 patients treated with stereotactic body radiation therapy for primary or oligometastatic lung cancer were retrospectively reviewed to identify those who developed fatal radiation pneumonitis. Twenty-three (1.3%; 18 men and 5 women) patients developed fatal radiation pneumonitis after stereotactic body radiation therapy for lung cancer; their median age was 74 years. The mean Krebs von den Lungen-6 level and percent vital capacity were 1320 U/mL and 82%, respectively. Prestereotactic body radiation therapy computed tomography revealed pulmonary interstitial change in 14 (73.7%) of 19 patients in whom computed tomography data could be reviewed. Seven (30.4%) of 23 patients had regularly used steroids. The median time duration between stereotactic body radiation therapy commencement and pneumonia symptom appearance was 75 (range: 14-204) days. Median survival time following pneumonia symptom appearance was 53 (range: 4-802) days. The 6- and 12-month overall survival rates were 34.8% and 13.0%, respectively. The 6-month overall survival rates in patients with and without heart disease were 50.0%, 16.7%, and 46.7% for heart disease existence, respectively. There were 4 patients in whom fatal radiation pneumonitis occurred within 2 months after stereotactic body radiation therapy and who died within 1 month. Three of them had no pulmonary interstitial change before stereotactic body radiation therapy, but had heart disease. In summary, the survival time in this case series was generally short but varied widely. More than half of the patients had pulmonary interstitial change before stereotactic body radiation therapy, although immediately progressive fatal radiation pneumonitis was also observed in patients without pulmonary interstitial change. True risk factors for fatal radiation pneumonitis should be examined in a prospective study with a larger cohort.
Collapse
Affiliation(s)
- Hiroshi Onishi
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Kan Marino
- 1 Department of Radiology, School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hideomi Yamashita
- 2 Department of Radiology, School of Medicine, University of Tokyo, Tokyo, Japan
| | - Atsuro Terahara
- 3 Department of Radiology, Toho University Omori Medical Center, Tokyo, Japan
| | - Rikiya Onimaru
- 4 Department of Radiation Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaki Kokubo
- 5 Department of Radiation Oncology, Kobe City Medical Center General Hospital, Kobe, Japan
| | | | - Takuyo Kozuka
- 7 Department of Radiation Oncology, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yukinori Matsuo
- 8 Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takashi Aruga
- 9 Department of Radiation Oncology, Funabashi Municipal Medical Center, Funabashi, Japan
| | - Masahiro Hiraoka
- 8 Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
31
|
Chen Z, Nonaka H, Akita T, Marino K, Aoki S, Komiyama T, Kuriyama K, Onishi H. A Novel Risk Assessment Method Using Pretreatment Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Rates for Early-Stage Non-Small-Cell Lung Cancer Treated with Stereotactic Body Radiation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
32
|
Saito M, Sano N, Shibata Y, Kuriyama K, Komiyama T, Marino K, Aoki S, Ashizawa K, Yoshizawa K, Onishi H. Comparison of MLC error sensitivity of various commercial devices for VMAT pre-treatment quality assurance. J Appl Clin Med Phys 2018; 19:87-93. [PMID: 29500857 PMCID: PMC5978943 DOI: 10.1002/acm2.12288] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 12/04/2017] [Accepted: 01/21/2018] [Indexed: 11/10/2022] Open
Abstract
The purpose of this study was to compare the MLC error sensitivity of various measurement devices for VMAT pre-treatment quality assurance (QA). This study used four QA devices (Scandidos Delta4, PTW 2D-array, iRT systems IQM, and PTW Farmer chamber). Nine retrospective VMAT plans were used and nine MLC error plans were generated for all nine original VMAT plans. The IQM and Farmer chamber were evaluated using the cumulative signal difference between the baseline and error-induced measurements. In addition, to investigate the sensitivity of the Delta4 device and the 2D-array, global gamma analysis (1%/1, 2%/2, and 3%/3 mm), dose difference (1%, 2%, and 3%) were used between the baseline and error-induced measurements. Some deviations of the MLC error sensitivity for the evaluation metrics and MLC error ranges were observed. For the two ionization devices, the sensitivity of the IQM was significantly better than that of the Farmer chamber (P < 0.01) while both devices had good linearly correlation between the cumulative signal difference and the magnitude of MLC errors. The pass rates decreased as the magnitude of the MLC error increased for both Delta4 and 2D-array. However, the small MLC error for small aperture sizes, such as for lung SBRT, could not be detected using the loosest gamma criteria (3%/3 mm). Our results indicate that DD could be more useful than gamma analysis for daily MLC QA, and that a large-area ionization chamber has a greater advantage for detecting systematic MLC error because of the large sensitive volume, while the other devices could not detect this error for some cases with a small range of MLC error.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Yuki Shibata
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Kengo Kuriyama
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kazuya Yoshizawa
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
33
|
Saito M, Sano N, Ueda K, Shibata Y, Kuriyama K, Komiyama T, Marino K, Aoki S, Onishi H. Technical Note: Evaluation of the latency and the beam characteristics of a respiratory gating system using an Elekta linear accelerator and a respiratory indicator device, Abches. Med Phys 2017; 45:74-80. [PMID: 29131346 DOI: 10.1002/mp.12664] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 10/02/2017] [Accepted: 10/30/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To evaluate the basic performance of a respiratory gating system using an Elekta linac and an Abches respiratory-monitoring device. METHODS The gating system was comprised of an Elekta Synergy linac equipped with a ResponseTM gating interface module and an Abches respiratory-monitoring device. The latencies from a reference respiratory signal to the resulting Abches gating output signal and the resulting monitor-ion-chamber output signal were measured. Then, the flatness and symmetry of the gated beams were measured using a two-dimensional ionization chamber array for fixed and arc beams, respectively. Furthermore, the beam quality, TPR20,10 , and the output of the fixed gated beams were also measured using a Farmer chamber. Each of the beam characteristics was compared with each of those for nongated irradiation. RESULTS The full latencies at beam-on and beam-off for 6-MV gated beams were 336.4 ± 23.4 ms and 87.6 ± 7.1 ms, respectively. The differences in flatness between the gated and nongated beams were within 0.91% and 0.87% for the gun-target and left-right directions, respectively. In the same manner, the beam symmetries were within 0.68% and 0.82%, respectively. The percentage differences in beam quality and beam output were below 1% for a beam-on time range of 1.1-7 s. CONCLUSION The latency of the Elekta gating system combined with Abches was found to be acceptable using our measurement method. Furthermore, we demonstrated that the beam characteristics of the gating system using our respiratory indicator were comparable with the nongated beams for a single-arc gated beam delivery.
Collapse
Affiliation(s)
- Masahide Saito
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Naoki Sano
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Koji Ueda
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Yuki Shibata
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Kengo Kuriyama
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | | | - Kan Marino
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Shinichi Aoki
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Onishi
- Department of Radiology, University of Yamanashi, Yamanashi, Japan
| |
Collapse
|
34
|
Komiyama T, Kuriyama K, Marino K, Aoki S, Araya M, Onishi H. P1.05-031 Primary Results of Dose Escalated Stereotactic Body Radiotherapy for Stage IA Non-Small Cell Lung Cancer. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2016.11.815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
35
|
Onishi H, Matsumoto Y, Miyakawa A, Yamashita H, Nomiya T, Niibe Y, Nakata K, Kuriyama K, Komiyama T, Marino K, Aoki S, Maehata Y, Araya M, Saito R, Tomoinaga L, Oguri M, Watanabe I, Nonaka H, Sano N. Japanese Multi-institutional Study of Stereotactic Body Radiation Therapy for Totally 380 Patients With Lung Metastases. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.08.235] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
36
|
Onishi H, Kawasaki T, Zakoji H, Yoshida T, Komiyama T, Kuriyama K, Araya M, Saito R, Aoki S, Maehata Y, Tominaga L, Marino K, Watanabe I, Oguri M, Araki T, Enomoto N, Takeda M, Katoh R. Renal cell carcinoma treated with stereotactic radiotherapy with histological change confirmed on autopsy: a case report. BMC Res Notes 2014; 7:270. [PMID: 24767701 PMCID: PMC4008414 DOI: 10.1186/1756-0500-7-270] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 04/21/2014] [Indexed: 11/23/2022] Open
Abstract
Background Treatment of primary renal cell carcinoma using radiotherapy with curative intent is rare, because renal cell carcinoma is generally regarded as a radiation-resistant tumor. Recently, stereotactic body radiation therapy has been radically applied for cancers in various organs including renal cell carcinoma. However, there were few reports describing pathological changes of renal cell carcinoma post stereotactic body radiation therapy. This is the first report we are aware of documenting late histological effects of stereotactic body radiation therapy on renal cell carcinoma and surrounding normal tissue. Case presentation A right renal tumor was identified in a Japanese 70-year-old man on follow-up computed tomography for his chronic hepatitis. T1N0M0 renal cell carcinoma was clinically diagnosed as the tumor was 3 cm in diameter and well-enhanced with intravenously infused contrast material in the arterial phase on computed tomography. No metastases in regional lymph nodes or distant sites were evident. Stereotactic body radiation therapy was selected as an alternative therapy to surgery because of his poor liver function. A total dose of 60 Gy in 10 fractions over 12 days was delivered using a 10-megavolt X-ray. The renal tumor gradually decreased in size and partial response had been achieved at 2 years after completing stereotactic body radiation therapy. Hepatocellular carcinoma was identified during follow-up in the patient and he died of progression of hepatocellular carcinoma with hepatic failure 2.5 years after completing stereotactic body radiation therapy. Autopsy was done and it showed almost complete necrosis of tumor tissues with a small amount of viable renal carcinoma cells. These pathological findings suggested marked effects of stereotactic body radiation therapy on clear cell renal cell carcinoma. Conclusion Our case demonstrates a good pathological response with small foci of remnant viable cancer cells after stereotactic body radiation therapy of 60Gy in 10 fractions for small renal cell carcinoma. Although further experiences and longer follow-up are mandatory to conclude the optimal treatment schedule and efficacy of stereotactic body radiation therapy for renal cell carcinoma, stereotactic body radiation therapy may represent a novel less-invasive option for the treatment of primary renal cell carcinoma.
Collapse
Affiliation(s)
- Hiroshi Onishi
- Department of Radiation Oncology, University of Yamanashi, 1110 Shimokato, 409-3898 Chuo-city, Yamanashi, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
37
|
Watanabe M, Onishi H, Kuriyama K, Komiyama T, Marino K, Araya M, Saito R, Aoki S, Maehata Y, Tominaga R, Oguri J, Sano N, Araki T. Intrafractional setup errors in patients undergoing non-invasive fixation using an immobilization system during hypofractionated stereotactic radiotherapy for lung tumors. J Radiat Res 2013; 54:762-768. [PMID: 23412467 PMCID: PMC3709672 DOI: 10.1093/jrr/rrt001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [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: 09/11/2012] [Revised: 12/29/2012] [Accepted: 12/31/2012] [Indexed: 06/01/2023]
Abstract
Intrafractional setup errors during hypofractionated stereotactic radiotherapy (SRT) were investigated on the patient under voluntary breath-holding conditions with non-invasive immobilization on the CT-linac treatment table. A total of 30 patients with primary and metastatic lung tumors were treated with the hypofractionated SRT with a total dose of 48-60 Gy with four treatment fractions. The patient was placed supine and stabilized on the table with non-invasive patient fixation. Intrafractional setup errors in Right/Left (R.L.), Posterior/Anterior (P.A.), and Inferior/Superior (I.S.) dimensions were analyzed with pre- and post-irradiation CT images. The means and one standard deviation of the intrafractional errors were 0.9 ± 0.7mm (R.L.), 0.9 ± 0.7mm (P.A.) and 0.5 ± 1.0 mm (I.S.). Setup errors in each session of the treatment demonstrated no statistically significant difference in the mean value between any two sessions. The frequency within 3mm displacement was 98% in R.L., 98% in P.A. and 97% in I.S. directions. SRT under the non-invasive patient fixation immobilization system with a comparatively loose vacuum pillow demonstrated satisfactory reproducibility of minimal setup errors with voluntary breath-holding conditions that required a small internal margin.
Collapse
Affiliation(s)
- Meguru Watanabe
- Department of Radiation Oncology, University of Yamanashi, 1110, Chuo-city, Yamanashi 409-3898, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Nambu A, Onishi H, Aoki S, Tominaga L, Kuriyama K, Araya M, Saito R, Maehata Y, Komiyama T, Marino K, Koshiishi T, Sawada E, Araki T. Rib fracture after stereotactic radiotherapy for primary lung cancer: prevalence, degree of clinical symptoms, and risk factors. BMC Cancer 2013; 13:68. [PMID: 23391264 PMCID: PMC3573931 DOI: 10.1186/1471-2407-13-68] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 02/04/2013] [Indexed: 12/25/2022] Open
Abstract
Background As stereotactic body radiotherapy (SBRT) is a highly dose-dense radiotherapy, adverse events of neighboring normal tissues are a major concern. This study thus aimed to clarify the frequency and degree of clinical symptoms in patients with rib fractures after SBRT for primary lung cancer and to reveal risk factors for rib fracture. Appropriate α/β ratios for discriminating between fracture and non-fracture groups were also investigated. Methods Between November 2001 and April 2009, 177 patients who had undergone SBRT were evaluated for clinical symptoms and underwent follow-up thin-section computed tomography (CT). The time of rib fracture appearance was also assessed. Cox proportional hazard modeling was performed to identify risk factors for rib fracture, using independent variables of age, sex, maximum tumor diameter, radiotherapeutic method and tumor-chest wall distance. Dosimetric details were analyzed for 26 patients with and 22 randomly-sampled patients without rib fracture. Biologically effective dose (BED) was calculated with a range of α/β ratios (1–10 Gy). Receiver operating characteristics analysis was used to define the most appropriate α/β ratio. Results Rib fracture was found on follow-up thin-section CT in 41 patients. The frequency of chest wall pain in patients with rib fracture was 34.1% (14/41), and was classified as Grade 1 or 2. Significant risk factors for rib fracture were smaller tumor-chest wall distance and female sex. Area under the curve was maximal for BED at an α/β ratio of 8 Gy. Conclusions Rib fracture is frequently seen on CT after SBRT for lung cancer. Small tumor-chest wall distance and female sex are risk factors for rib fracture. However, clinical symptoms are infrequent and generally mild. When using BED analysis, an α/β ratio of 8 Gy appears most effective for discriminating between fracture and non-fracture patients.
Collapse
Affiliation(s)
- Atsushi Nambu
- Department of Radiology, University of Yamanashi, Chuo City, Yamanashi Prefecture, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Giovannini M, Marino K, Fabiani C, Longo R, Cappiello G, Spanò A, Spina V. O654 PREVALENCE OF CHLAMYDIA AND MYCOPLASM GENITAL INFECTIONS IN WOMEN AGED <20 YEARS VERSUS ≥20 YEARS. Int J Gynaecol Obstet 2012. [DOI: 10.1016/s0020-7292(12)61084-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
40
|
Onishi H, Kuriyama K, Komiyama T, Marino K, Araya M, Saito R, Aoki S, Maehata Y, Tominaga L, Sano N, Oguri M, Onohara K, Watanabe I, Koshiishi T, Ogawa K, Araki T. Large prostate motion produced by anal contraction. Radiother Oncol 2012; 104:390-4. [DOI: 10.1016/j.radonc.2012.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Revised: 12/04/2011] [Accepted: 04/29/2012] [Indexed: 11/26/2022]
|
41
|
Onishi H, Ozaki M, Kuriyama K, Komiyama T, Marino K, Araya M, Saito R, Aoki S, Maehata Y, Tomiaga L, Oguri M, Watanabe I, Onohara K, Sano N, Araki T. Serious gastric ulcer event after stereotactic body radiotherapy (SBRT) delivered with concomitant vinorelbine in a patient with left adrenal metastasis of lung cancer. Acta Oncol 2012; 51:624-8. [PMID: 22582719 DOI: 10.3109/0284186x.2012.671957] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
42
|
Satoh Y, Nambu A, Onishi H, Sawada E, Tominaga L, Kuriyama K, Komiyama T, Marino K, Aoki S, Araya M, Saito R, Maehata Y, Oguri M, Araki T. Value of dual time point F-18 FDG-PET/CT imaging for the evaluation of prognosis and risk factors for recurrence in patients with stage I non-small cell lung cancer treated with stereotactic body radiation therapy. Eur J Radiol 2011; 81:3530-4. [PMID: 22178287 DOI: 10.1016/j.ejrad.2011.11.047] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Revised: 11/22/2011] [Accepted: 11/24/2011] [Indexed: 12/25/2022]
Abstract
PURPOSE To investigate prognostic and risk factors for recurrence after stereotactic body radiation therapy (SBRT) in patients with stage I non-small cell lung carcinoma (NSCLC), focusing on dual time point [18]F-fluorodeoxyglucose positron emission tomography (FDG PET). MATERIALS AND METHODS We prospectively evaluated 57 patients with stage I NSCLC (45 T1N0M0 and 12 T2N0M0) who had undergone pretreatment FDG-PET/CT and were subsequently treated with SBRT. All patients received a whole-body PET/CT scan at 60 min and a whole-lung at 120 min after the injection. The maximum standardized uptake value (SUV) and retention index (RI) of the lesions were calculated. Local recurrence, regional lymph node metastasis, distant metastasis, and the recurrence pattern were evaluated. Cox proportional hazard regression analyses were performed to evaluate prognostic factors or risk factors of recurrence. RESULTS During the median follow-up period of 27 months, local recurrence, regional lymph node metastasis, and distant metastasis were seen in 17 (30%), 12 (21%), and 17 (30%) of the 57 patients, respectively. The 3-year overall survival rate was 63.4%. SUVmax did not affect any recurrence, DFS, OS, or CSS. RI significantly predicted higher distant metastasis (HR 47.546, p=0.026). In contrast, RI tended to predict lower local recurrence (HR 0.175, p=0.246) and regional lymph node metastasis (HR 0.109, p=0.115). CONCLUSIONS SUVmax at staging FDG-PET does not predict any recurrence, DFS, OS or CSS. In contrast, higher RI predicts higher distant metastasis and tended to predict lower local or regional lymph node metastasis.
Collapse
Affiliation(s)
- Yoko Satoh
- PET Center, Kofu Neurosurgical Hospital, ZIP Code 400-0805, Sakaori 1-16-18, Kofu city, Yamanashi Prefecture, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Nambu A, Onishi H, Aoki S, Koshiishi T, Kuriyama K, Komiyama T, Marino K, Araya M, Saito R, Tominaga L, Maehata Y, Sawada E, Araki T. Rib fracture after stereotactic radiotherapy on follow-up thin-section computed tomography in 177 primary lung cancer patients. Radiat Oncol 2011; 6:137. [PMID: 21995807 PMCID: PMC3213137 DOI: 10.1186/1748-717x-6-137] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2011] [Accepted: 10/13/2011] [Indexed: 12/25/2022] Open
Abstract
Background Chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer has recently been reported. However, its detailed imaging findings are not clarified. So this study aimed to fully characterize the findings on computed tomography (CT), appearance time and frequency of chest wall injury after stereotactic radiotherapy (SRT) for primary lung cancer Materials and methods A total of 177 patients who had undergone SRT were prospectively evaluated for periodical follow-up thin-section CT with special attention to chest wall injury. The time at which CT findings of chest wall injury appeared was assessed. Related clinical symptoms were also evaluated. Results Rib fracture was identified on follow-up CT in 41 patients (23.2%). Rib fractures appeared at a mean of 21.2 months after the completion of SRT (range, 4 -58 months). Chest wall edema, thinning of the cortex and osteosclerosis were findings frequently associated with, and tending to precede rib fractures. No patients with rib fracture showed tumors > 16 mm from the adjacent chest wall. Chest wall pain was seen in 18 of 177 patients (10.2%), of whom 14 patients developed rib fracture. No patients complained of Grade 3 or more symptoms. Conclusion Rib fracture is frequently seen after SRT for lung cancer on CT, and is often associated with chest wall edema, thinning of the cortex and osteosclerosis. However, related chest wall pain is less frequent and is generally mild if present.
Collapse
Affiliation(s)
- Atsushi Nambu
- Department of Radiology, University of Yamanashi, Chuo City, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
44
|
Honda T, Tsuzaki Y, Mitaka K, Fukasawa K, Miyashita Y, Marino K, Saito A, Oyama T, Inase N. Tracheoesophageal fistula closed by chemoradiotherapy in lung cancer. Case Rep Oncol 2011; 4:350-7. [PMID: 21769294 PMCID: PMC3134035 DOI: 10.1159/000330368] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A 45-year-old man complaining of cough, dyspnea, and difficulty in swallowing was referred to our hospital. Chest CT scan showed a mediastinal mass compressing the trachea. He was diagnosed with poorly differentiated lung carcinoma by percutaneous needle biopsy. Bronchoscopy and upper gastrointestinal endoscopy revealed a tracheoesophageal fistula (TEF). Long-lasting febrile neutropenia made it impossible to continue chemotherapy, but a course of radiotherapy (total 61 Gy) was completed. The next endoscopy revealed closure of the TEF. Chemoradiotherapy (CRT) has been reported to close TEF in esophageal cancer, but the risk of a CRT-induced worsening of the fistula has dissuaded physicians from using CRT to treat TEF in lung cancer patients. CRT may serve as a palliative treatment for TEF in lung cancer as well as esophageal cancer.
Collapse
Affiliation(s)
- Takayuki Honda
- Department of Respiratory Medicine, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihito Tsuzaki
- Department of Respiratory Medicine, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Mitaka
- Department of Respiratory Medicine, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kazuhiro Fukasawa
- Department of Respiratory Medicine, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoshihiro Miyashita
- Department of Respiratory Medicine, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kan Marino
- Radiology, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akitoshi Saito
- Radiology, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshio Oyama
- Pathology, Yamanashi Prefectural Central Hospital, Kofu, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naohiko Inase
- Department of Integrated Pulmonology, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
45
|
Marino K, Lane JA, Abrahams JL, Struwe WB, Harvey DJ, Marotta M, Hickey RM, Rudd PM. Method for milk oligosaccharide profiling by 2-aminobenzamide labeling and hydrophilic interaction chromatography. Glycobiology 2011; 21:1317-30. [DOI: 10.1093/glycob/cwr067] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
|
46
|
Onishi H, Kawakami H, Marino K, Komiyama T, Kuriyama K, Araya M, Saito R, Aoki S, Araki T. A simple respiratory indicator for irradiation during voluntary breath holding: a one-touch device without electronic materials. Radiology 2010; 255:917-23. [PMID: 20501729 DOI: 10.1148/radiol.10090890] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE To evaluate the use, structural principles, operation, and acquired reproducibility of a respiratory monitoring device to be used for voluntary patient breath holding. MATERIALS AND METHODS Evaluation was performed of a respiratory monitoring device that enables determination of the respiratory level in a patient by measuring the movement of two contacts on the abdomen and chest wall. Neither metallic nor electronic materials are used in the mechanics for this device. The initial study group comprised 21 consecutive patients (15 men, six women; mean age, 75 years; range, 56-92 years) with lung or abdominal tumors who underwent examination with the device and computed tomography (CT) for three-dimensional reproducibility of lung base position during voluntary breath holding with or without use of the device. RESULTS One patient with mild dementia was excluded; in most of the remaining 20 patients, high reproducibility of the breath-holding position was achieved in a short time with the device. In these 20 patients who were able to adapt to use of the device, three-dimensional mean maximum differences in lung base position during three random voluntary breath holds were 2.0 mm along the cranial-caudal axis, 1.5 mm along the anterior-posterior axis, and 1.2 mm along the right-left axis. The differences in all axes were significantly smaller with use of the respiratory monitoring device than without the device. CONCLUSION The device demonstrates satisfactory reproducibility of voluntary patient breath holding easily and inexpensively and may offer a convenient device for easy use during irradiation with voluntary breath-holding conditions that require a small internal margin.
Collapse
Affiliation(s)
- Hiroshi Onishi
- Department of Radiation Oncology, Yamanashi University, 1110 Shimokato, Chuo-city, Yamanashi, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Oshiro Y, Aruga T, Tsuboi K, Marino K, Hara R, Sanayama Y, Itami J. Stereotactic Body Radiotherapy for Lung Tumors at the Pulmonary Hilum. Strahlenther Onkol 2010; 186:274-9. [DOI: 10.1007/s00066-010-2072-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 03/05/2010] [Indexed: 12/25/2022]
|
48
|
Oshiro Y, Aruga T, Tsuboi K, Marino K, Hara R, Sanayama Y, Itami J. Stereotactic Body Radiotherapy for Lung Tumors at the Pulmonary Hilum. Int J Radiat Oncol Biol Phys 2009. [DOI: 10.1016/j.ijrobp.2009.07.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
49
|
Onishi H, Kuriyama K, Komiyama T, Marino K, Araya M, Saito R, Aoki S, Morisaka H, Araki T. Stereotactic Body Radiotherapy with the use of Patient Voluntary Breath-hold Method and a CT-linac Unit for 105 Patients with Stage I Non-small Cell Lung Cancer: Is a Schedule of 48 Gy in Four Fractions Adequate? Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.1360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
50
|
Onishi H, Kuriyama K, Komiyama T, Yamaguchi M, Tanaka S, Marino K, Sano N, Araki T, Miyata K. T1N0 laryngeal sarcomatoid carcinoma that showed rapid systemic metastases after radical radiotherapy: a case report and review of literature. Am J Otolaryngol 2005; 26:400-2. [PMID: 16275410 DOI: 10.1016/j.amjoto.2005.02.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/11/2004] [Indexed: 11/19/2022]
Abstract
Sarcomatoid carcinomas of the larynx account for less than 1% of all malignant laryngeal tumors and there is currently no consensus regarding the clinical course or appropriate management of this disease. A case of sarcomatoid carcinoma of the larynx displaying rapid systemic progression after radiotherapy and a brief review of the literature are presented.
Collapse
Affiliation(s)
- Hiroshi Onishi
- Department of Radiation Oncology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|