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Machida T, Sakuma K, Fuwa N, Tanaka A. Local Low-dose Anti-PD-L1 Antibodies Improve Antitumor Effects in Oral Squamous Cell Carcinoma. Anticancer Res 2024; 44:993-1002. [PMID: 38423636 DOI: 10.21873/anticanres.16894] [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: 10/30/2023] [Revised: 11/21/2023] [Accepted: 11/22/2023] [Indexed: 03/02/2024]
Abstract
BACKGROUND/AIM Immune checkpoint inhibitors are highly effective for treating recurrent and metastatic head and neck cancers. However, they require systemic administration and are associated with immune-related adverse events (irAEs). Reducing therapeutic antibody doses to prevent irAEs is challenging. MATERIALS AND METHODS Mouse buccal mucosa squamous cell carcinoma cells (Sq-1979) were transplanted into the backs of mice to induce tumors. The antitumor efficacy and tumor immunohistological environment in tumor-bearing mice were compared after administering a standard dose of programmed death-ligand 1 (PD-L1) antibodies systemically (200 mg/body) or 1/10th of the standard dose (20 mg/body) directly to tumors. Mice received four doses of antibody administered in 3-day intervals. Tumor reduction rates and antitumor efficacies were evaluated 21 days after initiating treatment. CD8+T cell counts and PD-L1, PD-1, perforin, and granzyme B levels; CD25 and Foxp3 expression levels; and tumor Tregs were assessed in the resected subcutaneous tumors. RESULTS The antitumor efficacies in the local low-dose and systemic standard-dose groups were compared with that of the control group. The efficacies of the two treatment groups were similar, and both treatment groups revealed significant antitumor effects compared to the control group. Perforin and granzyme B levels were higher in the local low-dose group (p<0.05). CONCLUSION Local low-dose administration of anti-PD-L1 antibodies exhibits antitumor efficacy similar to systemic standard-dose administration suggesting that local low-dose administration is useful for treating oral squamous cell carcinoma.
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Affiliation(s)
- Toko Machida
- Department of Oral & Maxillofacial Surgery, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan;
| | - Kaname Sakuma
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Nobukazu Fuwa
- Oral and Maxillofacial Surgery, The Nippon Dental University Niigata Hospital, Niigata, Japan
- Department of Radiation Oncology, Central Japan International Medical Center, Minokamo, Japan
| | - Akira Tanaka
- Department of Oral & Maxillofacial Surgery, The Nippon Dental University Graduate School of Life Dentistry at Niigata, Niigata, Japan
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
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Sakuma K, Kii T, Machida T, Fuwa N, Tanaka A. The ECAS system can superselectively administer anticancer drugs to numerous feeding arteries from the superficial temporal artery: A case report and literature review. Mol Clin Oncol 2023; 19:76. [PMID: 37719043 PMCID: PMC10502795 DOI: 10.3892/mco.2023.2672] [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: 06/25/2023] [Accepted: 07/31/2023] [Indexed: 09/19/2023] Open
Abstract
Superselective intra-arterial chemoradiotherapy (SSIACRT) is one of the curative treatments for advanced oral cancer. SSIACRT can reportedly treat cervical lymph node metastases in the level I-IIA area by super selectively catheterizing the facial artery (FA) and infusing drugs. However, since advanced oral cancer lesions involve a number of feeding vessels, retrograde treatment requires the placement of catheters from the superficial temporal artery (STA) and occipital artery (OA). Furthermore, in the case of level IIB lymph node metastasis, the catheter must be changed because it is necessary to administer anticancer drugs to more than three routes, including the OA, when the feeding arteries of the primary tumor are combined. The external carotid artery sheath (ECAS) system used in the present study involves the insertion of a microcatheter or steering catheter from one route of the STA, allowing selection of numerous feeding vessels, including the OA. The ECAS system can facilitate the administration of chemotherapy via the STA simultaneously to the maxillary artery, lingual artery, FA and OA. The present study describes cases of maxillary gingival cancer and tongue cancer with cervical lymph node metastasis, which were treated with the ECAS system via the STA; the treatment successfully controlled both the primary tumor and cervical lymph node metastasis. In the two cases described in the present study, metastatic lymph nodes were found in the level ⅠB and ⅡB region, but were successfully treated by administering cisplatin via the OA, in addition to the primary lesion. To date, to the best of our knowledge, there is no case report clearly referring to the treatment of lymph node metastasis using the ECAS system. In conclusion, SSIACRT using ECAS may be considered a useful treatment for oral cancer with cervical lymph node metastasis.
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Affiliation(s)
- Kaname Sakuma
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan
| | - Tomoyuki Kii
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan
| | - Toko Machida
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Central Japan International Medical Center, Minokamo, Gifu 505-8510, Japan
| | - Akira Tanaka
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata 951-8580, Japan
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Sugimoto S, Fuke T, Kobayashi D, Kaneko M, Temma T, Nomura T, Tsuda N, Kawabata M, Matsushima R, Hisada H, Hayashi S, Murabayashi T, Oyamada J, Kamei A, Fuwa N, Yabana T, Yamada H, Nakagawa H. Endoscopic Laryngopharyngeal Surgery Combined with Endoscopic Submucosal Dissection as a Treatment Option for Superficial Hypopharyngeal Cancer with Suspected Synchronous Lymph Node Metastasis. Case Rep Gastroenterol 2023; 17:1-13. [PMID: 36654910 PMCID: PMC9841794 DOI: 10.1159/000528424] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/17/2022] [Indexed: 01/04/2023] Open
Abstract
We report 4 cases of hypopharyngeal cancer preoperatively suspected with synchronous lymph node metastases. Pathologic lymph node metastasis was confirmed in three of the four cases. All 4 cases underwent endoscopic laryngopharyngeal surgery (ELPS) combined with endoscopic submucosal dissection (ESD) and subsequent lymph node dissection as an optional treatment rather than the standard treatment. Peroral resection for primary site was selected because of the expected decline in quality of life (QoL) after radical surgery. Among 4 patients, one developed local recurrence; however, the other three remained recurrence-free and survived without any additional treatment. Furthermore, the patient who developed local recurrence had a recurrence-free survival for more than 5 years, with additional chemoradiation therapy. No disorders in speech, swallowing, or breathing was observed during the follow-up period. ELPS combined with ESD is generally indicated for laryngopharyngeal cancer without synchronous lymph node metastasis. However, this can be a treatment option for patients may wish to preserve a greater QoL after treatment. In the future, when more data on the results and long-term prognosis of this treatment are accumulated, it may be possible to discuss its validity further.
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Affiliation(s)
- Shinya Sugimoto
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan,Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
| | - Tomohito Fuke
- Department of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Ise, Japan
| | - Daisuke Kobayashi
- Department of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Ise, Japan
| | - Mamika Kaneko
- Department of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Ise, Japan
| | - Taishi Temma
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan
| | - Tatsuma Nomura
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan
| | - Nobuyuki Tsuda
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan,Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
| | - Mayu Kawabata
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan,Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
| | - Ryutaro Matsushima
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan,Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
| | - Hirohisa Hisada
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan,Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
| | - Satoshi Hayashi
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan
| | - Toji Murabayashi
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan,Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
| | - Jun Oyamada
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan,Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
| | - Akira Kamei
- Department of Gastroenterology, Ise Red Cross Hospital, Ise, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise, Japan
| | - Tadashi Yabana
- Department of Pathology, Ise Red Cross Hospital, Ise, Japan
| | - Hiroyuki Yamada
- Department of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Ise, Japan
| | - Hayato Nakagawa
- Department of Gastroenterology and Hepatology, Mie University Hospital, Tsu, Japan
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Nomura M, Fuwa N, Ito S, Toyomasu Y, Takada A, Kobayashi D, Fuke T, Taniguchi M, Ii N, Uraki J, Yamada H. Initial Experience of Intra-Arterial Chemotherapy Using a Novel External Carotid Arterial Sheath System Combined with Radiotherapy and Systemic Chemotherapy for Locally Advanced Tongue Cancer. Cancers (Basel) 2022; 14:cancers14225529. [PMID: 36428625 PMCID: PMC9688766 DOI: 10.3390/cancers14225529] [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: 08/29/2022] [Revised: 11/06/2022] [Accepted: 11/08/2022] [Indexed: 11/12/2022] Open
Abstract
We retrospectively evaluated the safety and effectiveness of an external carotid arterial sheath (ECAS) for intra-arterial chemotherapy (IACT) for locally advanced tongue cancer. Thirty-one patients with the Union for International Cancer Control's 8th TNM stage III-IV tongue cancer underwent IACT using the ECAS combined with RT and systemic chemotherapy with either cisplatin and fluorouracil (FP) or docetaxel, cisplatin, and fluorouracil (TPF) between October 2015 and February 2021. The ECAS was inserted retrogradely via the superficial temporal artery, and the tip was placed in the external carotid artery between the maxillary and facial arteries. A microcatheter was inserted into each tumor-feeding artery through the ECAS under fluoroscopy, wherein cisplatin 50 mg/m2 was administered. IACT was performed weekly with neutralization using sodium thiosulfate. Complete response of the primary lesion was achieved in 28/31 (90%) patients. The median follow-up for all patients was 39 months. The 3-year overall survival, progression-free survival, and local control rates were 81.6%, 74.2%, and 83.4%, respectively. Grade 3 and greater toxicities included oral mucositis (45%), neutropenia (39%), nausea (13%), anemia (10%), thrombocytopenia (10%), dry mouth (10%), and fever (3%). There were no severe complications associated with IACT. In conclusion, the ECAS is feasible and effective for locally advanced tongue cancer.
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Affiliation(s)
- Miwako Nomura
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
- Correspondence: ; Tel.: +81-596-28-2171; Fax: +81-596-28-2965
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Central Japan International Medical Center, 1-1 Kenkounomachi, Minokamo 505-8510, Japan
| | - Shintaro Ito
- Department of Medical Technology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
| | - Yutaka Toyomasu
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Akinori Takada
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Daisuke Kobayashi
- Department of Head and Neck Otorhinolaryngology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
| | - Tomohito Fuke
- Department of Head and Neck Otorhinolaryngology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
| | - Masanori Taniguchi
- Department of Medical Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
| | - Noriko Ii
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
| | - Junji Uraki
- Department of Radiology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
| | - Hiroyuki Yamada
- Department of Head and Neck Otorhinolaryngology, Ise Red Cross Hospital, 1-471-2 Funae, Ise 516-8512, Japan
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5
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Ito S, Fuwa N, Nomura M, Daimon T, Ota S, Morishima T, Ii N, Miyati T. Intratumor hemodynamics using contrast-enhanced MRI in intra-arterial chemotherapy for head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133:706-715. [PMID: 35033464 DOI: 10.1016/j.oooo.2021.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 10/14/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objectives of the study were to estimate the perfusion of tumors by drugs used in intra-arterial chemotherapy for head and neck cancer with magnetic resonance imaging and to establish the factors involved in determining the optimal dose. STUDY DESIGN Contrast agent was administered intra-arterially into either the lingual or maxillary artery in 43 patients. Triple-phase continuous fast spin echo magnetic resonance imaging was performed. Changes in blood water longitudinal relaxation rate (⊿R1) were measured in relation to imaging phase, type of artery, measurement site, and tumor size. RESULTS ⊿R1 was significantly higher at the tumor margin than at the center for both arteries, except in the first phase for the lingual artery. ⊿R1 was greatest in the third phase for the lingual artery and in the second phase for the maxillary artery. For both arteries, as the tumor size increased, there was a significant decrease in ⊿R1 at the center of the tumor compared with the margin. CONCLUSIONS The factors associated with ⊿R1 were imaging phase, type of artery, measurement site, and tumor size. When determining a drug's optimal dose, the type of artery and tumor size must be taken into consideration.
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Affiliation(s)
- Shintaro Ito
- Department of Medical Technology, Ise Red Cross Hospital, Mie, Japan; Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan; Department of Radiation Oncology, Central Japan International Medical Center, Gifu, Japan
| | - Miwako Nomura
- Department of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, Hyogo, Japan
| | - Suguru Ota
- Department of Medical Technology, Ise Red Cross Hospital, Mie, Japan
| | | | - Noriko Ii
- Department of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan
| | - Tosiaki Miyati
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan
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Ota Y, Noguchi T, Ariji E, Fushimi C, Fuwa N, Harada H, Hayashi T, Hayashi R, Honma Y, Miura M, Mori T, Nagatsuka H, Okura M, Ueda M, Uzawa N, Yagihara K, Yagishita H, Yamashiro M, Yanamoto S, Kirita T. General rules for clinical and pathological studies on oral cancer (2nd edition): a synopsis. Int J Clin Oncol 2021; 26:623-635. [PMID: 33721113 PMCID: PMC7979619 DOI: 10.1007/s10147-020-01812-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 10/06/2020] [Indexed: 11/24/2022]
Abstract
For doctors and other medical staff treating oral cancer, it is necessary to standardize the basic concepts and rules for oral cancer to achieve progress in its treatment, research, and diagnosis. Oral cancer is an integral part of head and neck cancer and is treated in accordance with the general rules for head and neck cancer. However, detailed rules based on the specific characteristics of oral cancer are essential. The objective of this article was to contribute to the development of the diagnosis, treatment, and research of oral cancer, based on the correct and useful medical information of clinical, surgical, pathological, and imaging findings accumulated from individual patients at various institutions. Our general rules were revised as the UICC was revised for the 8th edition and were published as the Japanese second edition in 2019. In this paper, the English edition of the "Rules" section is primarily presented.
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Affiliation(s)
- Yoshihide Ota
- Division of Surgery, Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Tadahide Noguchi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.
| | - Eiichiro Ariji
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, 2-11 Suemori-dori, Chikusa-ku, Nagoya, 464-8651, Japan
| | - Chihiro Fushimi
- Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo, 108-8329, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie, 516-8512, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Takafumi Hayashi
- Division of Oral and Maxillofacial Radiology, Niigata University Graduate School of Medical and Dental Sciences, 2-5274 Gakkocho-dori, Chuo-ku, Niigata, 951-8514, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
| | - Yoshitaka Honma
- Head and Neck Medical Oncology Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Masahiko Miura
- Department of Oral Radiation Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Taisuke Mori
- Diagnostic Pathology Division, National Cancer Center Hospital, Tsukiji 5-5-1, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hitoshi Nagatsuka
- Department of Oral Pathology and Medicine, Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8525, Japan
| | - Masaya Okura
- Department of Dentistry and Oral Surgery, Saiseikai Matsuzaka General Hospital, 1-15-6 Asahi-cho, Matsuzaka, Mie, 515-8557, Japan
| | - Michihiro Ueda
- Department of Clinical Oral Oncology, Hokkaido Cancer Center, 2-3-54 Kikusui 4, Shiroishi-ku, Sapporo, Hokkaido, 003-0804, Japan
| | - Narikazu Uzawa
- Department of Oral and Maxillofacial Surgery II, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Kazuhiro Yagihara
- Department of Oral Surgery, Saitama Cancer Center, 780 Komuro, Ina-machi, Kitaadachi-gun, Saitama, 362-0806, Japan
| | - Hisao Yagishita
- Division of Oral Diagnosis, Dental and Maxillofacial Radiology and Oral Pathology Diagnostic Services, The Nippon Dental University Hospital, 1-9-20 Fujimi, Chiyoda-ku, Tokyo, 102-8159, Japan
| | - Masashi Yamashiro
- Department of Dentistry and Oral Surgery, NTT Medical Center Tokyo, 5-9-22 Higash-Gotanda, Shinagawa-ku, Tokyo, 141-8625, Japan
| | - Souichi Yanamoto
- Department of Clinical Oral Oncology, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan
| | - Tadaaki Kirita
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8521, Japan
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Iwaki K, Kamaya A, Fuwa N, Tanisada K, Matsueda K, Shibahara T, Fujita Y, Kunieda E, Todaka H, Nomura M, Ii N. Verification of the junctional dose for irradiation of the chest wall and supraclavicular regions under the circumstances of advanced technologies. Med Dosim 2021; 46:e1-e9. [PMID: 33461825 DOI: 10.1016/j.meddos.2020.12.001] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 11/29/2020] [Accepted: 12/03/2020] [Indexed: 11/17/2022]
Abstract
A single-isocenter half-beam technique is commonly used when irradiating the chest wall and supraclavicular regions in patients with high-risk breast cancer. However, several studies have reported that underdosage can occur at the junction of the chest wall and supraclavicular regions due to a "tongue-and-groove" effect. This study verified the efficacy of an open leaf technique (OL-tech) that involves placing a multileaf collimator 5 mm outside from the beam central axis to remove the effect of the multileaf collimator in a single-isocenter half-beam technique. We compared the junction doses of the OL-tech with those of a conventional technique (C-tech) in square and clinical plans, using 4 and 10 MV x-rays in the Clinac iX and 6 and 10 MV x-rays in the Trilogy accelerators (Varian Medical Systems, Palo Alto, CA). EBT3 radiochromic films were used for measurements. Measurements were performed at a depth of 3 cm when verifying field matching. The EBT3 films in the square plan indicated junction doses for the C-tech of 78.3% with the Clinac iX accelerator and 73.6% with the Trilogy accelerator. By contrast, the corresponding doses for the OL-tech were 107.2% and 99.8%, respectively. In the clinical plan, the junction doses for the C-tech were 76.5% with the Clinac iX accelerator and 72.6% with the Trilogy accelerator; the corresponding doses for the OL-tech were 108.3% and 101.7%, respectively. As with the square plan, variations in the junction dose were much smaller using the OL-tech than using the C-tech. Our results suggest that the OL-tech can be useful for improving dose homogeneity at the junction of the chest wall and supraclavicular regions.
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Affiliation(s)
- Kengo Iwaki
- Department of Medical Technology, Ise Red Cross Hospital, Ise- shi, Mie, Japan.
| | - Akira Kamaya
- Department of Medical Technology, Ise Red Cross Hospital, Ise- shi, Mie, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise- shi, Mie, Japan
| | - Kazuaki Tanisada
- Department of Medical Technology, Ise Red Cross Hospital, Ise- shi, Mie, Japan
| | - Kouji Matsueda
- Department of Medical Technology, Ise Red Cross Hospital, Ise- shi, Mie, Japan
| | - Takahiko Shibahara
- Department of Medical Technology, Ise Red Cross Hospital, Ise- shi, Mie, Japan
| | - Yukio Fujita
- Faculty of Health Sciences, Komazawa University, Tokyo, Japan
| | - Etsuo Kunieda
- Department of Radiation Oncology, Tokai University Hachioji Hospital, Tokyo, Japan
| | - Hideharu Todaka
- Department of Radiology, Tokai University Hospital, Isehara-shi, Kanagawa, Japan
| | - Miwako Nomura
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise- shi, Mie, Japan
| | - Noriko Ii
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise- shi, Mie, Japan
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Kato T, Fuwa N, Murakami M. Dose-Volume Comparison of IMRT and PSPT Treatment Plans for Early-Stage Glottic Cancer. Int J Part Ther 2020; 7:42-50. [PMID: 33274256 PMCID: PMC7707328 DOI: 10.14338/ijpt-20-00008.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 07/28/2020] [Indexed: 01/03/2023] Open
Abstract
Purpose To clarify the dose distribution characteristics for early-stage glottic cancer by comparing the dose distribution between intensity-modulated radiation therapy (IMRT) and passive scattering proton therapy (PSPT) and to examine the usefulness of PSPT for early-stage glottic cancer. Materials and Methods Computed tomography datasets of 8 patients with T1-2 glottic cancer who had been treated by PSPT were used to create an IMRT plan in Eclipse with 7 fields and a PSPT plan in XiO-M with 2 fields. Organs at risk (OARs) included the carotid arteries, arytenoids, inferior constrictor muscles, strap muscles, thyroid cartilage, cricoid cartilage, and spinal cord. The prescription dose was 66 GyRBE in 33 fractions to the planning target volume (PTV). All plans were optimized such that 95% of the PTV received 90% of the prescription dose considering that the skin was slightly spared. Results The superiority of the PSPT was confirmed in all OARs. In the PSPT, the dose to the contralateral carotid artery and the spinal cord, which is slightly distant from the PTV, was dramatically reduced while maintaining the dose distribution uniformity of the PTV by comparison with IMRT. Conclusion PSPT for early-stage glottic cancer resulted in good target dose homogeneity and significantly spared the OARs as compared with the IMRT. PSPT is expected to be effective in reducing late effects and particularly useful for young people.
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Affiliation(s)
- Takahiro Kato
- Department of Radiation Physics and Technology, Southern Tohoku Proton Therapy Center, Fukushima, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan
| | - Masao Murakami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Fukushima, Japan
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Takagi M, Demizu Y, Fujii O, Terashima K, Niwa Y, Daimon T, Tokumaru S, Fuwa N, Hareyama M, Okimoto T. Proton Therapy for Localized Prostate Cancer: Long-Term Results From a Single-Center Experience. Int J Radiat Oncol Biol Phys 2020; 109:964-974. [PMID: 33186616 DOI: 10.1016/j.ijrobp.2020.11.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/22/2020] [Accepted: 11/02/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Although proton therapy is controversial, it has been used to treat localized prostate cancer over the past 2 decades. The purpose of this study is to examine the long-term efficacy and toxicity of proton therapy for localized prostate cancer. METHODS AND MATERIALS This was a retrospective observational study of 2021 patients from 2003 to 2014 at a single institution. Patients were classified using the risk groups defined by the National Comprehensive Cancer Network guidelines, version 4.2019. Ninety-eight percent of the patients received 74 Gy (relative biological effectiveness) in 37 fractions. Fifty-one and 6% of the patients received neoadjuvant and adjuvant androgen deprivation therapy, respectively. The outcomes were the time of freedom from biochemical relapse and the time to late toxicity by the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. The outcomes were estimated using the Kaplan-Meier method and were analyzed using multivariable Cox proportional hazards models. RESULTS The median follow-up period was 84 months (interquartile range, 60-110). The 5- and 10-year freedom from biochemical relapse rates were 100% and 100%, 99% and 88%, 93% and 86%, 90% and 79%, 88% and 68%, and 76% and 63% for the very low, low, favorable intermediate, unfavorable intermediate, high, and very high-risk groups, respectively. Patients with higher risk experienced biochemical relapse after shorter periods. The 5-year rates of grade 2 or higher late genitourinary and gastrointestinal toxicity were 2.2% and 4.0%, respectively. The results of multivariable analyses indicate that younger patients more often experienced biochemical relapse. CONCLUSIONS This study demonstrates the favorable biochemical controls of proton therapy even in advanced localized prostate cancer patients with a low incidence of late toxicities, supporting the feasibility of conducting prospective clinical trials. The risk groups defined by the National Comprehensive Cancer Network guidelines, version 4.2019, are useful to classify patients with localized prostate cancer. Our findings might suggest the necessity to develop a treatment strategy that accounts for the patient's age.
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Affiliation(s)
- Masaru Takagi
- Proton Therapy Center, Sapporo Teishinkai Hospital, Sapporo, Hokkaido, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan.
| | - Yusuke Demizu
- Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Osamu Fujii
- Department of Radiation Oncology, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
| | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Yasue Niwa
- Department of Radiation Oncology, Tsuyama Chuo Hospital, Tsuyama, Okayama, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Sunao Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Masato Hareyama
- Proton Therapy Center, Sapporo Teishinkai Hospital, Sapporo, Hokkaido, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
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10
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Ito S, Fuwa N, Nomura M, Ota S, Morishima T, Daimon T, Maeda Y, Ueda J, Tohnai I, Ii N, Miyati T. Drug concentration estimation using contrast-enhanced MRI in intra-arterial chemotherapy for head and neck cancers. Auris Nasus Larynx 2020; 48:496-501. [PMID: 33131964 DOI: 10.1016/j.anl.2020.10.012] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/15/2020] [Accepted: 10/20/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE In cases of head and neck cancer treated with intra-arterial chemotherapy, no objective indices are available for determining the distribution of anticancer drugs administered to multiple arteries. To establish such indices, noninvasive measurements of drug concentrations are required in the arterial perfusion area of each artery. In MRI, changes in 1/T1 (Δ1/T1) are correlated with the contrast agent concentration. We focused on these properties and investigated whether it is possible to estimate anticancer drug concentrations within tissue based on Δ1/T1. METHODS We employed the fast spin echo (FSE) sequence to determine optimum imaging parameters using a phantom. Subsequently, contrast agent was administered via the lingual and external carotid arteries for seven cases of tongue cancer. Δ1/T1 were then measured in tumor and nontumor tissues. The results of this study were compared with those of a previous study in which intratumor concentrations of anticancer agent were measured in excised specimens. RESULTS The optimum imaging parameters for the FSE was two repetition times (TR, 500 and 1000 ms). When compared with the external carotid artery administration, the lingual artery administration of contrast agent resulted in significantly higher Δ1/T1 in both tumor and nontumor tissues (2.13 and 2.62 times, respectively). The multiplying factor for the nontumor tissue and high homogeneity of the contrast agent concentration were reasonably consistent with the results of the previous study. CONCLUSION This method can be applied to estimating intratissue concentrations of intra-arterially administered anticancer drugs, thus possibly providing useful information in determining the distribution of anticancer drugs.
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Affiliation(s)
- Shintaro Ito
- Department of Medical Technology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan; Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan.
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Miwako Nomura
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Suguru Ota
- Department of Medical Technology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Takayuki Morishima
- Department of Medical Technology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8131, Japan
| | - Yoshikazu Maeda
- Proton Therapy Center, Fukui Prefectural Hospital, 2-8-1 Yotsui, Fukui, Fukui 910-8526, Japan
| | - Jun Ueda
- Department of Oral Maxillofacial Surgery, The Nippon Dental University Niigata Hospital, 1-8 Hamaura-cho, Niigata, Niigata 951-8151, Japan
| | - Iwai Tohnai
- Department of Oral Health, Faculty of Health and Medical Sciences, Meikai University, 1 Meikai, Urayasu, Chiba 279-8550, Japan
| | - Noriko Ii
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie 516-8512, Japan
| | - Tosiaki Miyati
- Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80, Kodatsuno, Kanazawa, Ishikawa 920-0942, Japan
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11
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Sugimoto S, Fuke T, Kobayashi D, Ueda K, Sawa M, Kaneko M, Fukukita K, Temma T, Nomura T, Fuwa N, Yamada H. Efficacy of polyglycolic acid sheets and fibrin glue for the prevention of post-ELPS bleeding. Auris Nasus Larynx 2020; 48:471-476. [PMID: 33067053 DOI: 10.1016/j.anl.2020.09.021] [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: 06/19/2020] [Revised: 09/03/2020] [Accepted: 09/29/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To assess the efficacy and safety of a covering method using polyglycolic acid (PGA) sheets and fibrin glue in preventing laryngopharyngeal bleeding after endoscopic laryngopharyngeal surgery (ELPS) combined with endoscopic submucosal dissection (ESD). METHODS Twenty-one patients who underwent ELPS combined with ESD (28 resected pharyngeal carcinomas) were retrospectively evaluated. After completing ELPS combined with ESD, fibrinogen was sprayed onto the ulcer. A PGA sheet cut into 5 × 5 mm pieces that fit the size of the ELPS-induced ulcer was then placed over the ulcer and fixed in place with a fibrin glue comprising thrombin. RESULTS The resection procedure was performed for all lesions. The median long diameter of the resected specimen was 36 mm. The rate of a resected specimen diameter >30 mm, use of anticoagulant/platelet, and macroscopic classification 0-Ⅱa were 68% (19/28), 19% (5/28), and 36% (10/28), respectively. The median time required to cover ELPS-induced ulcers using PGA sheets and fibrin glue was 10 min (range: 3-22 min). No post-ELPS bleeding, subcutaneous emphysema, or aspiration pneumonia (0/28) was observed. CONCLUSION The covering method using PGA sheets and fibrin glue for ELPS-induced ulcers is considered to be sufficiently safe and effective in preventing post-ELPS laryngopharyngeal bleeding. This method could be useful in preventing post-ELPS bleeding in patients with head and neck cancer.
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Affiliation(s)
- Shinya Sugimoto
- Divisions of Gastroenterology, Ise Red Cross Hospital, 471-2, 1, Funae, Ise, Mie 516-8512, Japan
| | - Tomohito Fuke
- Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan
| | - Daisuke Kobayashi
- Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan
| | - Kohki Ueda
- Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan
| | - Masahiro Sawa
- Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan
| | - Mamika Kaneko
- Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan
| | - Kohei Fukukita
- Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan
| | - Taishi Temma
- Divisions of Gastroenterology, Ise Red Cross Hospital, 471-2, 1, Funae, Ise, Mie 516-8512, Japan
| | - Tatsuma Nomura
- Divisions of Gastroenterology, Ise Red Cross Hospital, 471-2, 1, Funae, Ise, Mie 516-8512, Japan
| | - Nobukazu Fuwa
- Divisions of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan
| | - Hiroyuki Yamada
- Divisions of Otolaryngology-Head and Neck Surgery, Ise Red Cross Hospital, Mie, Japan.
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12
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Maeda Y, Sato Y, Yamamoto K, Tamamura H, Sasaki M, Fuwa N, Takamatsu S, Kume K. Stability of daily rectal movement and effectiveness of replanning protocols for sparing rectal doses based on the daily CT images during proton treatment for prostate cancer. J Appl Clin Med Phys 2020; 21:109-121. [PMID: 32888359 PMCID: PMC7592984 DOI: 10.1002/acm2.13015] [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: 03/17/2020] [Revised: 05/04/2020] [Accepted: 07/29/2020] [Indexed: 12/25/2022] Open
Abstract
PURPOSE To evaluate the optimal period of replanning to spare the rectal dose by investigating daily rectal movements during computed tomography (CT) image-guided proton therapy for prostate cancer. MATERIALS AND METHODS To evaluate the optimum reference period for replanning, we analyzed 1483 sets of daily CT (dCT) images acquired from 40 prostate cancer patients and measured the daily rectal movement along the anterior-posterior direction based on the simulator CT (sCT) images and dCT images. We calculated daily dose distributions based on initial plans on the sCT images and replans on the dCT images for 13 representative patients, and evaluated daily dose volume histograms (DVHs) for the prostate, seminal vesicles, and rectum. RESULTS The rectal anterior side on the dCT images around the seminal vesicles largely deviated toward the anterior side relative to the position on the reference sCT images, but the deviation decreased by referring to the dCT images and became nearly zero when we referred to the dCT images after 10-day treatment. The daily DVH values for the prostate showed good dose coverage. For six patients showing rectal movement toward the anterior side, the daily rectal DVH (V77% ) showed a 3.0 ± 1.7 cc excess from the initial plan and this excess was correlated with 9.9 ± 6.8 mm rectal movement. To identify the patients (37.5% in total) for whom the replanning on the 10th-day and 20th-day CT images reduced the V77% excess to 0.4 ± 1.5 cc and -0.2 ± 1.3 cc, respectively, we evaluated the accumulated mean doses with a 1.2 cc criterion. CONCLUSION Our data demonstrate that the daily movement of the rectal anterior side tends to move toward the anterior side, which results in a rectal overdose, and the mean of the movement gradually decreases with the passage of days. In such cases, replanning with the reference CT after 10 days is effective to spare the rectal dose.
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Affiliation(s)
- Yoshikazu Maeda
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan
| | - Yoshitaka Sato
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan
| | - Kazutaka Yamamoto
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan
| | - Hiroyasu Tamamura
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan
| | - Makoto Sasaki
- Proton Therapy Center, Fukui Prefectural Hospital, Fukui, Fukui, Japan
| | - Nobukazu Fuwa
- Department of Radiotherapy, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Shigeyuki Takamatsu
- Department of Radiation Therapy, Kanazawa University Hospital, Kanazawa, Ishikawa, Japan
| | - Kyo Kume
- Research & Development Department, The Wakasa Wan Energy Research Center, Tsuruga, Fukui, Japan
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13
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Takayama K, Nakamura T, Takada A, Kato T, Sakuma H, Mitsudo K, Fuwa N, Murakami M. Proton beam therapy combined with retrograde intra-arterial infusion chemotherapy for an extremely rapid growing recurrent ameloblastic carcinoma: A case report. Mol Clin Oncol 2020; 13:34. [PMID: 32802330 PMCID: PMC7412713 DOI: 10.3892/mco.2020.2104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/01/2020] [Indexed: 11/17/2022] Open
Abstract
Ameloblastic carcinoma (AC) is a very rare malignant odontogenic tumor. Although surgical resection is generally performed, treatment approaches have not been established for recurrent cases. Chemotherapy and radiotherapy are positioned as adjunctive therapies, and few studies investigated definitive non-operative therapy. We present the case of a 71-year-old male with recurrent secondary-type AC arising from the right maxilla, who was treated with proton beam therapy (PBT; 71.4 Gy relative biological effectiveness in 32 fractions) combined with continuous intra-arterial infusion of cisplatin (40 mg/m2) and docetaxel (8 mg/m2). The patient experienced acute grade 3 mucositis, dermatitis and neutropenia, which were resolved within 3 months of treatment. Late adverse events were grade 1 skin atrophy, and grade 2 right optic nerve disorder and retinopathy. After ~8 years of treatment, the patient died from another cause but did not experience any relapse or metastasis during the follow-up period of 94 months. To the best of our knowledge, this is the first report of recurrent AC treated with PBT and intra-arterial infusion chemotherapy without any severe late adverse events. This combination therapy approach may be considered as an effective therapeutic option for inoperable AC.
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Affiliation(s)
- Kanako Takayama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Fukushima 963-8052, Japan.,Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Tatsuya Nakamura
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Fukushima 963-8052, Japan
| | - Akinori Takada
- Department of Radiology, Mie University Hospital, Tsu, Mie 514-8507, Japan
| | - Takahiro Kato
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Fukushima 963-8052, Japan
| | - Hideo Sakuma
- Department of Pathology, Southern Tohoku General Hospital, Koriyama, Fukushima 963-8563, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise, Mie 516-0008, Japan
| | - Masao Murakami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Fukushima 963-8052, Japan
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14
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Takayama K, Kato T, Nakamura T, Azami Y, Ono T, Suzuki M, Takada A, Yamaguchi H, Seto I, Nakasato T, Wada H, Kikuchi Y, Mitsudo K, Fuwa N, Murakami M. Proton Beam Therapy Combined with Intra-Arterial Infusion Chemotherapy for Stage IV Adenoid Cystic Carcinoma of the Base of the Tongue. Cancers (Basel) 2019; 11:cancers11101413. [PMID: 31546728 PMCID: PMC6826952 DOI: 10.3390/cancers11101413] [Citation(s) in RCA: 5] [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] [Received: 08/17/2019] [Revised: 09/12/2019] [Accepted: 09/20/2019] [Indexed: 01/06/2023] Open
Abstract
Adenoid cystic carcinoma (ACC) is a very rare epithelial tumor of the salivary glands. Surgical resection is considered to be a standard therapy. However, the optimal treatment strategy for managing advanced cases has not yet been established. This study evaluated the efficacy and toxicity of proton beam therapy (PBT) combined with selective intra-arterial infusion chemotherapy (IAIC) using weekly cisplatin for locally advanced ACC of the base of the tongue. Between March 2009 and February 2018, 15 patients were treated. The median follow-up duration was 56 (range: 15–116) months. The 5-year local control and overall survival rates were 89% and 76%, respectively. With regard to late toxicities, grade 2 osteoradionecrosis was found in one patient and grade 5 pharyngeal necrosis was observed in one patient. Considering most cases were significantly advanced and inoperable, this therapy was effective in controlling the primary tumor, preserving function and maintaining the quality of life. Although improvements are needed to reduce adverse events, PBT in combination with IAIC can be a treatment option for locally advanced ACC of the base of the tongue.
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Affiliation(s)
- Kanako Takayama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Takahiro Kato
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Tatsuya Nakamura
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Yusuke Azami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Takashi Ono
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Motohisa Suzuki
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Akinori Takada
- Department of Radiation Oncology, Mie University Hospital, 2-174, Edobashi Tsu, Mie 514-8507, Japan.
| | - Hisashi Yamaguchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Ichiro Seto
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Tatsuhiko Nakasato
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Hitoshi Wada
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Kanagawa 236-0004, Japan.
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise red cross hospital, 1-471-2, Funae, Ise, Mie 516-8512, Japan.
| | - Masao Murakami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama, Fukushima 963-8052, Japan.
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15
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Takagi M, Demizu Y, Nagano F, Terashima K, Fujii O, Jin D, Mima M, Niwa Y, Katsui K, Suga M, Yamashita T, Akagi T, Sakata KI, Fuwa N, Okimoto T. Treatment outcomes of proton or carbon ion therapy for skull base chordoma: a retrospective study. Radiat Oncol 2018; 13:232. [PMID: 30477528 PMCID: PMC6260885 DOI: 10.1186/s13014-018-1173-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 11/06/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The usefulness of particle therapy for skull base chordoma has not been established. The aim of this retrospective study was to analyse the treatment outcomes of proton therapy (PT) and carbon ion therapy (CIT) in patients with skull base chordoma at a single institution. METHODS All patients who underwent PT or CIT with curative intent between 2003 and 2014 at Hyogo Ion Beam Medical Center were included in this study. Twenty-four patients were enrolled. Eleven (46%) received PT and 13 (54%) received CIT. Overall survival (OS), progression-free survival (PFS) and local control (LC) were calculated using the Kaplan-Meier method. Late toxicities were evaluated according to the Common Terminology Criteria for Adverse Events version 4.0. RESULTS The median follow-up was 71.5 months (range, 14-175 months). The five-year LC, PFS and OS rates were 85, 81, and 86%, respectively. The LC (P = 0.048), PFS (P = 0.028) and OS (P = 0.012) were significantly improved in patients who had undergone surgery before particle therapy. No significant differences were observed in the LC rate and the incidence of grade 2 or higher late toxicities between patients who received PT and CIT. CONCLUSIONS Both PT and CIT appear to be effective and safe treatments and show potential to become the standard treatments for skull base chordoma. To increase the local control, surgery before particle therapy is preferable.
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Affiliation(s)
- Masaru Takagi
- Proton Therapy Center, Sapporo Teishinkai Hospital, 3-1, East-1, North-33, Higashi-ku, Sapporo, Hokkaido, 065-0033, Japan. .,Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan.
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan.,Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan
| | - Fumiko Nagano
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Osamu Fujii
- Department of Radiation Oncology, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
| | - Dongcun Jin
- Proton Therapy Center, Tsuyama Chuo Hospital, Tsuyama, Okayama, Japan
| | - Masayuki Mima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan.,Department of Radiation Oncology, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan
| | - Yasue Niwa
- Proton Therapy Center, Tsuyama Chuo Hospital, Tsuyama, Okayama, Japan
| | - Kuniaki Katsui
- Department of Radiology, Okayama University, Okayama, Okayama, Japan
| | - Masaki Suga
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Tomohiro Yamashita
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan.,Department of Radiation Physics, Hyogo Ion Beam Medical Center Kobe Proton Center, Kobe, Hyogo, Japan
| | - Takashi Akagi
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Koh-Ichi Sakata
- Department of Radiology, Sapporo Medical University, Sapporo, Hokkaido, Japan
| | - Nobukazu Fuwa
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
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16
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Toyomasu Y, Demizu Y, Matsuo Y, Sulaiman NS, Mima M, Nagano F, Terashima K, Tokumaru S, Hayakawa T, Daimon T, Fuwa N, Sakuma H, Nomoto Y, Okimoto T. Outcomes of Patients With Sinonasal Squamous Cell Carcinoma Treated With Particle Therapy Using Protons or Carbon Ions. Int J Radiat Oncol Biol Phys 2018; 101:1096-1103. [PMID: 29859787 DOI: 10.1016/j.ijrobp.2018.04.041] [Citation(s) in RCA: 17] [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: 11/11/2017] [Revised: 03/29/2018] [Accepted: 04/16/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE This retrospective study aimed to determine the clinical outcomes following particle monotherapy (ie, proton therapy [PT] or carbon ion therapy [CIT]) in patients with sinonasal squamous cell carcinoma at a single institution. METHODS AND MATERIALS Between August 2001 and March 2012, 59 patients were treated with definitive PT or CIT; none underwent chemotherapy or surgery. Of the patients, 22 (37%) had unresectable disease. PT was used in 38 patients (64%); CIT, 21 patients (36%). Almost half of the patients (n = 29, 47%) received 65.0 Gy (relative biological effectiveness) in 26 fractions. RESULTS The median follow-up period was 30 months (range, 8-127 months) for all patients and 65 months (range, 9-127 months) for the survivors. The 3- and 5-year overall survival rates were 56.2% and 41.6%, respectively; progression-free survival rates, 42.9% and 34.7%, respectively; and local control rates, 54.0% and 50.4%, respectively. Late toxicities of grade ≥3 occurred in 13 patients (22%). CONCLUSIONS To our knowledge, this is the largest retrospective study of sinonasal squamous cell carcinoma treated with particle therapy alone. The efficacy of PT and CIT indicated that particle therapy can serve an important role in treating this disease.
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Affiliation(s)
- Yutaka Toyomasu
- Department of Radiation Oncology, Mie University Hospital, Tsu, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan.
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Yoshiro Matsuo
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | | | - Masayuki Mima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Fumiko Nagano
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Sunao Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Tomokatsu Hayakawa
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, Nishinomiya, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yoshihito Nomoto
- Department of Radiation Oncology, Mie University Hospital, Tsu, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
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17
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Maeda Y, Sato Y, Shibata S, Bou S, Yamamoto K, Tamamura H, Fuwa N, Takamatsu S, Sasaki M, Tameshige Y, Kume K, Minami H, Saga Y, Saito M. Effects of organ motion on proton prostate treatments, as determined from analysis of daily
CT
imaging for patient positioning. Med Phys 2018; 45:1844-1856. [DOI: 10.1002/mp.12869] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 03/06/2018] [Accepted: 03/06/2018] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yoshikazu Maeda
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Yoshitaka Sato
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Satoshi Shibata
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Sayuri Bou
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Kazutaka Yamamoto
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Hiroyasu Tamamura
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Nobukazu Fuwa
- Department of Radiotherapy Ise Red Cross Hospital Mie 5168521 Japan
| | - Shigeyuki Takamatsu
- Department of Radiotherapy Kanazawa University Hospital Ishikawa 9208641 Japan
| | - Makoto Sasaki
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Yuji Tameshige
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Kyo Kume
- Research & Development Department The Wakasa Wan Energy Research Center Fukui 9140192 Japan
| | - Hiroki Minami
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Yusuke Saga
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
| | - Makoto Saito
- Proton Therapy Center Fukui Prefectural Hospital Fukui 9108526 Japan
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18
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Takagi M, Demizu Y, Fuwa N, Terashima K, Fujii O, Jin D, Niwa Y, Hareyama M, Okimoto T. EP-1568: Results of proton therapy for castration resistant prostate cancer. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31877-2] [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: 11/28/2022]
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19
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Takagi M, Demizu Y, Fuwa N, Sulaiman N, Terashima K, Fujii O, Jin D, Nagano F, Waki T, Mima M, Niwa Y, Katsui K, Murakami M, Okimoto T. EP-1571: Is Neoadjuvant ADT Necessary for Intermediate-Risk Prostate Cancer Treated with Proton Therapy? Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31880-2] [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: 10/14/2022]
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20
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Takamatsu S, Kozaka K, Kobayashi S, Yoneda N, Yoshida K, Inoue D, Kitao A, Ogi T, Minami T, Kouda W, Kumano T, Fuwa N, Matsui O, Gabata T. Pathology and images of radiation-induced hepatitis: a review article. Jpn J Radiol 2018; 36:241-256. [DOI: 10.1007/s11604-018-0728-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 02/21/2018] [Indexed: 12/12/2022]
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21
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Aibe N, Demizu Y, Sulaiman NS, Matsuo Y, Mima M, Nagano F, Terashima K, Tokumaru S, Hayakawa T, Suga M, Daimon T, Suzuki G, Hideya Y, Yamada K, Sasaki R, Fuwa N, Okimoto T. Outcomes of Patients With Primary Sacral Chordoma Treated With Definitive Proton Beam Therapy. Int J Radiat Oncol Biol Phys 2017; 100:972-979. [PMID: 29485077 DOI: 10.1016/j.ijrobp.2017.12.263] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/07/2017] [Accepted: 12/11/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the efficacy and safety of definitive proton beam therapy (PBT) for primary sacral chordoma. METHODS AND MATERIALS We conducted a retrospective analysis of the clinical outcomes of eligible patients with primary sacral chordoma who had undergone definitive PBT with 70.4 Gy (relative biological effectiveness) in 32 fractions at our institution from September 2009 to October 2015. Local progression-free survival, distant metastasis-free survival, disease-free survival, cause-specific survival, and overall survival were evaluated. To explore the factors that influenced local progression, the following parameters were analyzed: sex, the presence of a spacer (Gore-Tex sheets), gross tumor volume, and extent of cranial tumor extension. Adverse events were evaluated using the Common Terminology Criteria for Adverse Events, version 4.0. To assess the impact of PBT on pain relief, the change in pain grades was investigated between the initiation of PBT and the last follow-up visit. RESULTS Thirty-three eligible patients were analyzed. The median follow-up period was 37 months. The 3-year estimated local progression-free survival, distant metastasis-free survival, disease-free survival, cause-specific survival, and overall survival rates were 89.6%, 88.2%, 81.9%, 95.7%, and 92.7%, respectively. No significant association was between the patients' clinicopathologic characteristics and local progression-free survival. Four patients developed grade 3 adverse events, including acute dermatitis (n = 1), ileus (n = 1), and pain due to sacral insufficiency fractures (n = 2). The pain grades had improved, were unchanged, or had deteriorated in 15, 7, and 11 patients, respectively. CONCLUSIONS Definitive PBT with 70.4 Gy (relative biological effectiveness) in 32 fractions is an effective treatment with acceptable toxicity for primary sacral chordoma and has the potential to reduce pain.
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Affiliation(s)
- Norihiro Aibe
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan.
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | | | - Yoshirou Matsuo
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | - Masayuki Mima
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | - Fumiko Nagano
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | - Sunao Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | - Tomokatsu Hayakawa
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | - Masaki Suga
- Department of Radiation Physics, Hyogo Ion Beam Medical Center, Hyogo, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, Hyogo, Japan
| | - Gen Suzuki
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yamazaki Hideya
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryohei Sasaki
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Mie, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
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22
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Takada A, Toyomasu Y, Ii N, Tanaka H, Kawamura T, Nanpei Y, Mase T, Fuwa N, Sakuma H, Nomoto Y. Preliminary Treatment Results of Radiation Therapy With Intra-Arterial Infusion Chemotherapy for Oral Cancer. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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23
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Takagi M, Demizu Y, Terashima K, Fujii O, Jin D, Niwa Y, Daimon T, Murakami M, Fuwa N, Okimoto T. Long-term outcomes in patients treated with proton therapy for localized prostate cancer. Cancer Med 2017; 6:2234-2243. [PMID: 28879658 PMCID: PMC5633560 DOI: 10.1002/cam4.1159] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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] [Received: 01/25/2017] [Revised: 05/19/2017] [Accepted: 07/16/2017] [Indexed: 12/24/2022] Open
Abstract
The aim of this retrospective study was to report long-term clinical outcomes in patients treated with proton therapy (PT) for localized prostate cancer. Between 2001 and 2014, 1375 consecutive patients were treated with PT. Patients were classified into prognostic risk groups based on the National Comprehensive Cancer Network criteria. Freedom from biochemical relapse (FFBR), cancer-specific survival (CSS) and incidence of late gastrointestinal (GI)/genitourinary (GU) toxicities were calculated. Multivariate analysis was performed to identify clinical prognostic factors for FFBR and late toxicities. The median follow-up period was 70 months (range, 4-145 months). In total, 99% of patients received 74 Gy (relative biologic effectiveness [RBE]); 56% of patients received neoadjuvant androgen deprivation therapy. For the low-, intermediate-, high-, and very high-risk groups, 5-year FFBR was 99% (95% confidence intervals [CI], 96-100%), 91% (95% CI, 88-93%), 86% (95% CI, 82-89%), and 66% (95% CI, 53-76%), respectively, and 5-year CSS was 100% (95% CI, 100-100%), 100% (95% CI, 100-100%) , 99% (95% CI, 97-100%), and 95% (95% CI, 94-98%), respectively. Patient age, T classification, Gleason score, prostate-specific antigen, and percentage of positive cores were significant prognostic factors for FFBR. Grade 2 or higher GI and GU toxicities were 3.9% and 2.0%. Patient age was a prognostic factor for both late GI and GU toxicities. This study represents the largest cohort of patients treated with PT for localized prostate cancer, with the longest follow-up to date. Our results demonstrate that the biochemical control of PT is favorable particularly for high- and very high-risk patients with lower late genitourinary toxicity and indicates the necessity of considering patient age in the treatment protocols.
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Affiliation(s)
- Masaru Takagi
- Proton Therapy Center, Sapporo Teishinkai Hospital, Sapporo, Hokkaido, Japan.,Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Osamu Fujii
- Department of Radiation Oncology, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
| | - Dongcun Jin
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Yasue Niwa
- Department of Radiology, Uji-Tokushukai Medical Center, Uji, Kyoto, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Masao Murakami
- Center for Radiation Oncology, Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
| | - Nobukazu Fuwa
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
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24
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Demizu Y, Jin D, Sulaiman NS, Nagano F, Terashima K, Tokumaru S, Akagi T, Fujii O, Daimon T, Sasaki R, Fuwa N, Okimoto T. Particle Therapy Using Protons or Carbon Ions for Unresectable or Incompletely Resected Bone and Soft Tissue Sarcomas of the Pelvis. Int J Radiat Oncol Biol Phys 2017; 98:367-374. [DOI: 10.1016/j.ijrobp.2017.02.030] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 12/31/2016] [Accepted: 02/14/2017] [Indexed: 10/20/2022]
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25
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Nagata T, Demizu Y, Okumura T, Sekine S, Hashimoto N, Fuwa N, Okimoto T, Shimada Y. Erratum to: Carbon ion radiotherapy for desmoid tumor of the abdominal wall: a case report. World J Surg Oncol 2017; 15:95. [PMID: 28468632 PMCID: PMC5414378 DOI: 10.1186/s12957-017-1154-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 04/18/2017] [Indexed: 01/03/2023] Open
Affiliation(s)
- Takuya Nagata
- Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama 930-0194, Japan.
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Koto, Shingu-cho, Tatsuno-shi, Hyogo, Japan
| | - Tomoyuki Okumura
- Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama 930-0194, Japan
| | - Shinichi Sekine
- Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani, Toyama-shi, Toyama 930-0194, Japan
| | - Naoki Hashimoto
- Department of Radiation Oncology, Kobe Minimally Invasive Cancer Center, Kobe University Hospital 7-5-2 Kusunoki-cho, Chuo-ku, Kobe City, Hyogo Prefecture, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, 471-2 Funae 1 choume, Ise-shi, Mie, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1 Koto, Shingu-cho, Tatsuno-shi, Hyogo, Japan
| | - Yutaka Shimada
- Department of Nanobio Drug Discovery, Graduate School of Pharmaceutical Sciences, Kyoto University, Yoshida-honmachi, Sakyo-ku, Kyoto 606-8501, Japan
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26
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Takagi M, Demizu Y, Fuwa N, Sulaiman N, Jin D, Terashima K, Fujii O, Nagano F, Waki T, Mima M, Niwa Y, Katsui K, Murakami M, Okimoto T. Is Neoadjuvant Androgen Deprivation Therapy Necessary for Patients With Intermediate-Risk Prostate Cancer Treated With Proton Therapy? Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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27
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Nagata T, Demizu Y, Okumura T, Sekine S, Hashimoto N, Fuwa N, Okimoto T, Shimada Y. Carbon ion radiotherapy for desmoid tumor of the abdominal wall: a case report. World J Surg Oncol 2016; 14:245. [PMID: 27624694 PMCID: PMC5022152 DOI: 10.1186/s12957-016-1000-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 09/08/2016] [Indexed: 01/31/2023] Open
Abstract
Background Desmoid tumors, which are associated with familial adenomatous polyposis (FAP), tend to occur frequently in the abdominal wall and mesentery. Currently, there are no recognized treatments other than surgery, and frequent surgeries result in gastrointestinal obstructions and functional gastrointestinal disorders. Case presentation After surgery that was performed on a 39-year-old patient with FAP, we performed a second tumor excision which was the procedure used for frequently occurring mesenteric desmoid tumors. It was determined that the enlarged tumor would be difficult to operate on through an abdominal incision. Subsequently, the carbon ion radiotherapy of 50 Gy was then performed on the patient. Three years later, the tumor still remains reduced in size. In addition, we have not observed any negative effect on the digestive tract. Conclusions This is the first instance that the carbon ion radiotherapy has been effective for the unresected desmoid tumor, and it is believed that this will become the one effective option for the treatment of desmoid tumors.
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Affiliation(s)
- Takuya Nagata
- Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of To1yama, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1, Koto, Singu, Tatsuno, Hyogo, 679-5165, Japan
| | - Tomoyuki Okumura
- Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of To1yama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Shinichi Sekine
- Department of Surgery and Science, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of To1yama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Naoki Hashimoto
- Department of Radiation Oncology, Kobe Minimally Invasive Cancer Center, 8-5-1Minatojima, Tyuoku, Kobe, Hyogo, 650-0046, Japan
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, 1-471-2 Funae, Ise, Mie, 516-8512, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, 1-2-1, Koto, Singu, Tatsuno, Hyogo, 679-5165, Japan
| | - Yutaka Shimada
- Department of Nanobio Drug Discovery, Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Shimoadachi, Yoshida, Sakyoku, Kyoto, 606-8501, Japan
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28
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Miyatake SI, Kawabata S, Fuwa N. [Difference between BNCT and other particle radiation]. Nihon Rinsho 2016; 74 Suppl 7:615-621. [PMID: 30634822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
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29
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Abstract
Purpose: To clarify the Doppler sonographic features of the lingual artery in normal subjects and to evaluate those of patients with cancer of the tongue. Material and Methods: Sixty-seven volunteers and 12 patients with cancer and/or leukoplakia of the tongue were examined with an intraoral sonographic probe. The visibility of the deep lingual artery was determined on transverse and anteroposterior images. On the transverse images, the vascular index, which was defined as the number of colored pixels, was measured on bilateral lingual arteries. Thereafter, the degree of symmetry was evaluated for normal subjects and patients. Results: In normal subjects, between younger and older volunteers, there were no significant differences in visibility of the trunk but differences were found between the two groups for the dorsal branches. The vascular indices of the right and left sides were not different. The characteristic Doppler sonographic feature was vasculature in and around the tumors in the patients with cancer of the tongue. The symmetry indices of the cancer patients were significantly different from those of normal subjects. Conclusion: Doppler sonography should be an important procedure for evaluation of tongue neoplasms.
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Affiliation(s)
- Y Kimura
- Department of Oral and Maxillofacial Radiology, Aichi-Gakuin University School of Dentistry, Department of Radiation Oncology, Aichi Cancer Center, Japan
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30
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Hayashi Y, Nakamura T, Mitsudo K, Kimura K, Yamaguchi H, Ono T, Azami Y, Takayama K, Hirose K, Yabuuchi T, Suzuki M, Hatayama Y, Kikuchi Y, Wada H, Fuwa N, Hareyama M, Tohnai I. Re-irradiation using proton beam therapy combined with weekly intra-arterial chemotherapy for recurrent oral cancer. Asia Pac J Clin Oncol 2016; 13:e394-e401. [DOI: 10.1111/ajco.12502] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 03/18/2016] [Accepted: 04/05/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Yuichiro Hayashi
- Department of Oral and Maxillofacial Surgery; Yokohama City University Graduate School of Medicine; Yokohama Japan
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Tatsuya Nakamura
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Kanako Kimura
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Hisashi Yamaguchi
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Takashi Ono
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Yusuke Azami
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Kanako Takayama
- Department of Oral and Maxillofacial Surgery; Yokohama City University Graduate School of Medicine; Yokohama Japan
| | - Katsumi Hirose
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Tomonori Yabuuchi
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Motohisa Suzuki
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Yoshiomi Hatayama
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Hitoshi Wada
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Nobukazu Fuwa
- Department of Radiology; Ise Red Cross Hospital; Ise Japan
| | - Masato Hareyama
- Department of Radiation Oncology; Southern Tohoku Proton Therapy Center; Koriyama Japan
| | - Iwai Tohnai
- Department of Oral and Maxillofacial Surgery; Yokohama City University Graduate School of Medicine; Yokohama Japan
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31
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Hayashi Y, Nakamura T, Mitsudo K, Yamaguchi H, Ono T, Azami Y, Takayama K, Suzuki M, Hatayama Y, Tsukiyama I, Hareyama M, Kikuchi Y, Fuwa N, Tohnai I. Retrograde intra-arterial chemotherapy and daily concurrent proton beam therapy for recurrent oral cavity squamous cell carcinoma: Analysis of therapeutic results in 46 cases. Head Neck 2016; 38:1145-51. [PMID: 27018982 DOI: 10.1002/hed.24421] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 10/07/2015] [Accepted: 12/30/2015] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The purpose of this study was to evaluate the efficacy and toxicities of proton beam therapy combined with intra-arterial infusion chemotherapy via superficial temporal and occipital arteries for recurrent oral cavity squamous cell carcinoma (SCC). METHODS Between October 2009 and June 2013, 46 patients with recurrent oral cavity SCC were treated by proton beam therapy combined with intra-arterial infusion chemotherapy of cisplatin (CDDP) and docetaxel. Treatment consisted of proton beam therapy (28.6-74.8 GyE in 13-34 fractions) and intra-arterial infusion chemotherapy (CDDP, 30-50 mg/body/week; docetaxel, 5-25 mg/body/week). RESULTS One-year and 2-year overall survival (OS) rates were 65% and 46%, respectively. One-year and 2-year local control rates were 81% and 70%, respectively. CONCLUSION These findings suggest that proton beam therapy combined with intra-arterial infusion chemotherapy could be applied effectively and safely for patients with recurrent oral cavity SCC. © 2016 Wiley Periodicals, Inc. Head Neck 38:1145-1151, 2016.
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Affiliation(s)
- Yuichiro Hayashi
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Tatsuya Nakamura
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Kenji Mitsudo
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hisashi Yamaguchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Takashi Ono
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Yusuke Azami
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Kanako Takayama
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Motohisa Suzuki
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Yoshiomi Hatayama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Iwao Tsukiyama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Masato Hareyama
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Yasuhiro Kikuchi
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, Koriyama, Japan
| | - Nobukazu Fuwa
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Iwai Tohnai
- Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Takada A, Nakamura T, Takayama K, Makita C, Suzuki M, Azami Y, Kato T, Tsukiyama I, Hareyama M, Kikuchi Y, Daimon T, Toyomasu Y, Ii N, Nomoto Y, Sakuma H, Fuwa N. Preliminary treatment results of proton beam therapy with chemoradiotherapy for stage I-III esophageal cancer. Cancer Med 2016; 5:506-15. [PMID: 26806272 PMCID: PMC4799947 DOI: 10.1002/cam4.607] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 04/16/2015] [Revised: 10/22/2015] [Accepted: 11/17/2015] [Indexed: 12/20/2022] Open
Abstract
The effect of proton beam therapy (PBT) on various cancers is controversial. We aimed to evaluate the efficacy and safety of PBT with alternating chemoradiotherapy (ACRT) for patients with stage I–III esophageal cancer. Two cycles of systemic chemotherapy with a continuous infusion of 5‐fluorouracil (5‐FU) on days 1–5 and a 5h infusion of nedaplatin (NDP) on day 6 were accompanied by thoracic irradiation using X‐ray therapy and PBT. During the first half of the treatment, X‐rays were delivered to the prophylactic area. During the second half of the treatment, proton beams were used to irradiate the involved field. To reduce the dose of cardiac irradiation, proton beams were delivered with posterior and posterior oblique angles. Between January 2009 and December 2012, 47 patients were enrolled in this study. The median follow‐up duration was 29 months for all patients and 40 months for survivors. The 3 year overall survival rate, progression‐free survival rate, and local control rate were 59.2%, 56.3%, and 69.8%, respectively. With respect to grade 3–4 late toxicities, there were no pleural or pericardial effusions, but two patients (4.3%) had esophageal stenosis, one patient (2.1%) had fistula, and two patients (4.3%) developed radiation pneumonitis. PBT with ACRT might have the potential to reduce the risk of cardiac damage and might become one of the primary methods of esophageal cancer treatment.
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Affiliation(s)
- Akinori Takada
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Tatsuya Nakamura
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Kanako Takayama
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan.,Department of Dentistry/oral surgery, Graduate School of Medicine, Yokohama City University, Fukuura, Kanazawa-ku, Yokohama, Japan
| | - Chiyoko Makita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusaku, Nagoya, Japan
| | - Motohisa Suzuki
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Yusuke Azami
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Takahiro Kato
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Iwao Tsukiyama
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Masato Hareyama
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Yasuhiro Kikuchi
- Southern Tohoku Proton Therapy Center, Koriyama, Fukushima, Japan
| | - Takashi Daimon
- Division of Biostatistics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Yutaka Toyomasu
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Noriko Ii
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Yoshihito Nomoto
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Hajime Sakuma
- Department of Radiation Oncology, Mie University Hospital, Tsu, Mie, Japan
| | - Nobukazu Fuwa
- Hyogo Ion Beam Medical Center, Shingu, Tatsuno, Hyogo, Japan
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Nakamura T, Azami Y, Ono T, Yamaguchi H, Hayashi Y, Suzuki M, Hatayama Y, Tsukiyama I, Hareyama M, Kikuchi Y, Takayama K, Fuwa N. Preliminary results of proton beam therapy combined with weekly cisplatin intra-arterial infusion via a superficial temporal artery for treatment of maxillary sinus carcinoma. Jpn J Clin Oncol 2015; 46:46-50. [DOI: 10.1093/jjco/hyv160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 09/30/2015] [Indexed: 11/14/2022] Open
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Takagi M, Mima M, Terashima K, Fujii O, Demizu Y, Nagano F, Jin D, Okimoto T, Waki T, Murakami M, Fuwa N. Long-term Outcomes in Patients Treated With Proton Therapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Demizu Y, Fujii O, Nagano F, Terashima K, Jin D, Mima M, Oda N, Takeuchi K, Takeda M, Ito K, Fuwa N, Okimoto T. Unexpected radiation laryngeal necrosis after carbon ion therapy using conventional dose fractionation for laryngeal cancer. Jpn J Clin Oncol 2015; 45:1076-81. [PMID: 26355161 DOI: 10.1093/jjco/hyv121] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Accepted: 07/14/2015] [Indexed: 02/03/2023] Open
Abstract
Carbon ion therapy is a type of radiotherapy that can deliver high-dose radiation to a tumor while minimizing the dose delivered to organs at risk. Moreover, carbon ions are classified as high linear energy transfer radiation and are expected to be effective for even photon-resistant tumors. A 73-year-old man with glottic squamous cell carcinoma, T3N0M0, refused laryngectomy and received carbon ion therapy of 70 Gy (relative biological effectiveness) in 35 fractions. Three months after the therapy, the patient had an upper airway inflammation, and then laryngeal edema and pain occurred. Five months after the therapy, the airway stenosis was severe and computed tomography showed lack of the left arytenoid cartilage and exacerbation of laryngeal necrosis. Despite the treatment, 5 and a half months after the therapy, the laryngeal edema and necrosis had become even worse and the surrounding mucosa was edematous and pale. Six months after the therapy, pharyngolaryngoesophagectomy and reconstruction with free jejunal autograft were performed. The surgical specimen pathologically showed massive necrosis and no residual tumor. Three years after the carbon ion therapy, he is alive without recurrence. The first reported laryngeal squamous cell carcinoma case treated with carbon ion therapy resulted in an unexpected radiation laryngeal necrosis. Tissue damage caused by carbon ion therapy may be difficult to repair even for radioresistant cartilage; therefore, hollow organs reinforced by cartilage, such as the larynx, may be vulnerable to carbon ion therapy. Caution should be exercised when treating tumors in or adjacent to such organs with carbon ion therapy.
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Affiliation(s)
- Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo
| | - Osamu Fujii
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo
| | - Fumiko Nagano
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo
| | - Kazuki Terashima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo
| | - Dongcun Jin
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo
| | - Masayuki Mima
- Department of Radiology, Nishikobe Medical Center, Kobe, Hyogo
| | - Naoharu Oda
- Department of Otorhinolaryngology-Head and Neck Surgery, Matsue Red Cross Hospital, Matsue, Shimane
| | - Kaoru Takeuchi
- Department of Otorhinolaryngology-Head and Neck Surgery, Matsue Red Cross Hospital, Matsue, Shimane
| | - Makiko Takeda
- Department of Otorhinolaryngology-Head and Neck Surgery, Matsue Red Cross Hospital, Matsue, Shimane
| | - Kazuyuki Ito
- Department of Otorhinolaryngology-Head and Neck Surgery, Matsue Red Cross Hospital, Matsue, Shimane
| | - Nobukazu Fuwa
- Department of Radiation Oncology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo
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Fuwa N, Kodaira T, Daimon T, Yoshizaki T. The long-term outcomes of alternating chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: a multiinstitutional phase II study. Cancer Med 2015; 4:1186-95. [PMID: 25991077 PMCID: PMC4559030 DOI: 10.1002/cam4.469] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Revised: 03/01/2015] [Accepted: 03/30/2015] [Indexed: 11/25/2022] Open
Abstract
To examine the long-term outcomes of alternating chemoradiotherapy (ALCRT) for patients with locoregionally advanced nasopharyngeal carcinoma (NPC) and to assess the efficacy of ALCRT for NPC. Patients with stage IIB to IVB, ECOG PS 0-2, 18-70 years-old, and sufficient organ function were eligible for this study. First, chemotherapy, consisting of 5-fluorouracil (800 mg/m(2) per 24 h on days 1-5) and cisplatin (100 mg/m(2) per 24 h on day 6), was administered, then a wide field of radiotherapy (36 Gy/20 fraction), chemotherapy, a shrinking field of radiotherapy (34 Gy/17 fraction), and chemotherapy were performed alternately. Between December 2003 and March 2006, 90 patients in 25 facilities were enrolled in this study, 87 patients were finally evaluated. A total of 67 patients (76.1%) completed the course of treatment. The overall survival and the progression-free survival rates at 5 years were 78.04% (95% CI: 69.1~87.0%), and 68.74% (95% CI: 58.8~78.7%), respectively. The long-term outcomes of ALCRT for NPC were thought to be promising. ALCRT will be considered to be a controlled trial to compare therapeutic results with those of concurrent chemoradiotherapy for NPC.
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Affiliation(s)
- Nobukazu Fuwa
- Department of Radiology, Hyogo Ion Beam Medical CenterHyogo, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer CenterAichi, Japan
| | - Takashi Daimon
- Department of Biostatistics, Hyogo College of MedicineHyogo, Japan
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Kawamura T, Tomii K, Takahashi Y, Okada A, Demizu Y, Fuwa N, Imai Y. Recurrence of a mediastinal liposarcoma 20 years after surgery: A case of carbon ion radiotherapy resulting in fatal tracheoesophageal fistula. Respir Investig 2015; 53:170-2. [PMID: 26100177 DOI: 10.1016/j.resinv.2015.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 01/27/2015] [Accepted: 02/03/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Takahisa Kawamura
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan.
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe 650-0047, Japan
| | - Yutaka Takahashi
- Department of Thoracic Surgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Akihiko Okada
- Department of Gastrointestinal Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Nobukazu Fuwa
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | - Yukihiro Imai
- Department of Clinical Pathology, Kobe City Medical Center General Hospital, Kobe, Japan
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Fujii O, Demizu Y, Hashimoto N, Takagi M, Terashima K, Mima M, Jin D, Nagano F, Katsui K, Okimoto T, Iwata H, Niwa Y, Yamashita T, Akagi T, Daimon T, Sasaki R, Hishikawa Y, Abe M, Murakami M, Fuwa N. Particle therapy for clinically diagnosed stage I lung cancer: comparison with pathologically proven non-small cell lung cancer. Acta Oncol 2015; 54:315-21. [PMID: 25383445 DOI: 10.3109/0284186x.2014.974828] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The purpose of the present study was to present the treatment outcomes of particle therapy for indeterminate pulmonary nodules (IPNs) diagnosed as stage I non-small cell lung cancer, including a comparative analysis involving pathologically proven lung cancer (PPLC). MATERIAL AND METHODS A total of 54 patients (57 lesions) who underwent particle therapy for IPNs were enrolled in this study. Median patient age was 76 (range 52-87) years. T-classification was: T1a, 30; T1b, 16; and T2a, 11. Particle therapy using protons or carbon ions was delivered at total doses of 52.8-80 Gy equivalent in 4-26 fractions. The PPLC cohort included 111 patients. RESULTS The median follow-up time was 41 (range 7-90) months. For all IPN patients, the three-year overall survival, progression-free survival, local control and distant progression-free survival rates were 90%, 72%, 94% and 79%, respectively. Grade 2 toxicities were radiation pneumonitis (19%), dermatitis (9%), rib fracture (2%), chest wall pain (2%) and neuropathy (2%). No ≥grade 3 toxicities were observed. In univariate analysis, the IPN group showed significantly better survival relative to the PPLC group. However, after adjustment for baseline imbalances between these two groups in multivariate analysis, pathological confirmation did not correlate with survival. CONCLUSIONS Particle therapy for IPNs provided favorable outcomes with minimal toxicities, which may be comparable to those for PPLC patients. Further studies are needed to clarify the optimal management of IPN patients.
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Affiliation(s)
- Osamu Fujii
- Department of Radiology and Radiation Physics, Hyogo Ion Beam Medical Center , Tatsuno , Japan
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Makita C, Nakamura T, Takada A, Takayama K, Suzuki M, Azami Y, Kato T, Tsukiyama I, Hareyama M, Kikuchi Y, Daimon T, Hata M, Inoue T, Fuwa N. High-dose proton beam therapy for stage I non-small cell lung cancer: Clinical outcomes and prognostic factors. Acta Oncol 2015; 54:307-14. [PMID: 25291076 DOI: 10.3109/0284186x.2014.948060] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Evidence has suggested that radiation therapy with a lower dose per fraction may be a reasonable option for the treatment of centrally located non-small cell lung cancer (NSCLC). The aim of this study was to evaluate the safety and efficacy of two proton beam therapy (PBT) protocols for stage I NSCLC and to determine prognostic factors. MATERIAL AND METHODS This study included patients clinically diagnosed with stage I NSCLC. Based on the location of the tumor, one of the two PBT protocols was administered. Patients with peripherally located tumors were given 66 Gy relative biological dose effectiveness (RBE) over 10 fractions (Protocol A) while patients with centrally located tumors were given 80 Gy (RBE) over 25 fractions (Protocol B). RESULTS Between January 2009 and May 2012, 56 eligible patients were enrolled (protocol A: 32 patients; protocol B: 24 patients). The three-year overall survival (OS), progression-free survival (PFS), and local control (LC) rates were 81.3% [95% confidence interval (CI) 75.9-86.7%], 73.4% (95% CI 67.2-79.6%), and 96.0% (95% CI 93.2-98.8%), respectively. There were no significant differences in outcomes between the two protocols. Late grade 2 and 3 pulmonary toxicities were observed in nine patients (13.4%) and one patient (1.5%), respectively; no grade 4 or 5 toxicities were observed. Sex, age, performance status, T-stage, operability, and tumor pathology were not associated with OS and PFS. Only maximum standardized uptake value (SUVmax; <5 vs. ≥5) was identified as a significant prognostic factor for OS and PFS. CONCLUSION Both high-dose PBT protocols achieved high LC rates with tolerable toxicities in stage I NSCLC patients, and SUVmax was a significant prognostic factor.
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Affiliation(s)
- Chiyoko Makita
- Department of Radiation Oncology, Aichi Cancer Center Hospital , Chikusaku, Nagoya , Japan
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Toyomasu Y, Demizu Y, Hashimoto N, Takagi M, Mima M, Terashima K, Fujii O, Jin D, Suga M, Takada A, Ii N, Niwa Y, Sasaki R, Murakami M, Hishikawa Y, Abe M, Nomoto Y, Sakuma H, Fuwa N. Treatment Outcomes of Particle Therapy Using Protons or Carbon Ions for Locally Advanced Head and Neck Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1695] [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]
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Sulaiman NS, Fujii O, Demizu Y, Terashima K, Niwa Y, Akagi T, Daimon T, Murakami M, Sasaki R, Fuwa N. Particle beam radiation therapy using carbon ions and protons for oligometastatic lung tumors. Radiat Oncol 2014; 9:183. [PMID: 25127719 PMCID: PMC4152565 DOI: 10.1186/1748-717x-9-183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 02/24/2014] [Accepted: 08/05/2014] [Indexed: 12/25/2022] Open
Abstract
Background A study was undertaken to analyze the efficacy and feasibility of particle beam radiation therapy (PBRT) using carbon ions and protons for the treatment of patients with oligometastatic lung tumors. Methods A total of 47 patients with 59 lesions who underwent PBRT for oligometastatic lung tumors between 2003 and 2011 were included in this study. Patient median age was 66 (range, 39–84) years. The primary tumor site was the colorectum in 11 patients (23.4%), lung in 10 patients (21.3%) and a variety of other sites in 26 patients (55.3%). Thirty-one patients (66%) received chemotherapy prior to PBRT. Thirty-three lesions were treated with 320-MeV carbon ions and 26 were treated with 150- or 210-Mev protons in 1–4 portals. A median total dose of 60 (range, 52.8–70.2) GyE was delivered at the isocenter in 8 (range, 4–26) fractions. Results The median follow-up time was 17 months. The local control, overall survival and progression-free survival rates at 2 years were 79%, 54 and 27% respectively. PBRT-related toxicities were observed; six patients (13%) had grade 2 toxicity (including grade 2 radiation pneumonitis in 2) and six patients (13%) had grade 3 toxicity. Univariate analysis indicated that patients treated with a biologically equivalent dose of 10 (BED10) <110 GyE10, had a significantly higher local recurrence rate. Local control rates were relatively lower in the subsets of patients with the colorectum as the primary tumor site. No local progression was observed in metastases from colorectal cancer irradiated with a BED10 ≥ 110 GyE10. There was no difference in treatment results between proton and carbon ion therapy. Conclusions PRBT is well tolerated and effective in the treatment of oligometastatic lung tumors. To further improve local control, high-dose PBRT with a BED10 ≥ 110 GyE10 may be promising. Further investigation of PBRT for lung oligometastases is warranted.
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Affiliation(s)
- Nor Shazrina Sulaiman
- Division of Radiation Oncology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan.
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Komatsu S, Iwasaki T, Demizu Y, Terashima K, Fujii O, Takebe A, Toyokawa A, Teramura K, Fukumoto T, Ku Y, Fuwa N. Two-stage treatment with hepatectomy and carbon-ion radiotherapy for multiple hepatic epithelioid hemangioendotheliomas. World J Gastroenterol 2014; 20:8729-8735. [PMID: 25024633 PMCID: PMC4093728 DOI: 10.3748/wjg.v20.i26.8729] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Revised: 02/10/2014] [Accepted: 03/10/2014] [Indexed: 02/06/2023] Open
Abstract
Hepatic epithelioid hemangioendothelioma (HEH) is a rare neoplasm of vascular origin with variable malignant potential. Because most patients with this condition have multiple bilobar lesions, liver transplantation is the standard treatment, and hepatectomy is much less frequently indicated. We describe a case of a 35-year-old woman with unresectable multiple bilobar HEH successfully treated by combination treatment with hepatectomy and carbon-ion radiotherapy. This case is very meaningful since it demonstrated the effectiveness of carbon-ion radiotherapy for HEH and the possibility of expanding the curative treatment options for multiple bilobar hepatic tumors.
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Hirata K, Kodaira T, Tomita N, Ohshima Y, Ito J, Tachibana H, Nakanishi T, Fuwa N. Clinical efficacy of alternating chemoradiotherapy by conformal radiotherapy combined with intracavitary brachytherapy for high-risk cervical cancer. Jpn J Clin Oncol 2014; 44:556-63. [PMID: 24755546 DOI: 10.1093/jjco/hyu048] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The purpose of this study was to assess the outcome of alternating chemoradiotherapy in patients with high-risk cervical cancer. METHODS We performed definitive alternating chemoradiotherapy in cervical cancer patients with at least one high-risk factor such as International Federation of Gynecology and Obstetrics III or IVA disease, primary tumor diameter ≥50 mm, positive pelvic node, and positive para-aortic node. Our chemoradiotherapy protocol was as follows: (i) alternating chemoradiotherapy with 5-fluorouracil and nedaplatin; (ii) whole pelvic radiotherapy with the dynamic conformal technique combined with intracavitary brachytherapy; (iii) prophylactic irradiation to the para-aortic region for International Federation of Gynecology and Obstetrics III/IVA or positive pelvic node and full-dose radiotherapy for positive para-aortic node. Between 1998 and 2010, 121 patients were treated with this protocol. RESULTS The median follow-up period was 53.7 months (7.6-162.2). International Federation of Gynecology and Obstetrics stages were IB; (9.1%), IIA; 6 (5.0%), IIB; 53 (43.8%), IIIA; 7 (5.8%), IIIB; 37 (30.6%) and IVA; 7 (5.8%), respectively. Nodal involvement was reported in 77 patients (63.6%) at the pelvis and 25 (20.7%) at the para-aortic region. The 5-year overall survival and progression-free survival rates were 80.0 and 63.4%, respectively. Regarding Grade ≥3 late toxicities, three patients developed urinary and three developed intestinal toxicities. We encountered no treatment-related death. CONCLUSIONS The clinical results of our alternating chemoradiotherapy protocol for high-risk cervical cancer are promising.
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Affiliation(s)
- Kimiko Hirata
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University, Kyoto
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi
| | - Natsuo Tomita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi
| | - Yukihiko Ohshima
- Department of Radiology, Aichi Medical University Hospital, Aichi
| | - Junji Ito
- Department of Radiology, Nagoya University Hospital, Aichi
| | | | - Toru Nakanishi
- Department of Gynecology, Aichi Cancer Center Hospital, Aichi
| | - Nobukazu Fuwa
- Department of Radiology, Hyogo Ion Beam Medical Center, Hyogo, Japan
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Morimoto K, Demizu Y, Hashimoto N, Mima M, Terashima K, Fujii O, Otsuki N, Murakami M, Fuwa N, Nibu KI. Particle radiotherapy using protons or carbon ions for unresectable locally advanced head and neck cancers with skull base invasion. Jpn J Clin Oncol 2014; 44:428-34. [PMID: 24620027 DOI: 10.1093/jjco/hyu010] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To study the oncological outcome of the patients with unresectable locally advanced primary head and neck cancers invading the skull base, treated with particle radiotherapy. METHODS Fifty-seven patients with unresectable primary head and neck cancers invading the skull base received proton or carbon ion radiotherapy as definitive treatment at Hyogo Ion Beam Medical Center between 2003 and 2009. Forty-seven patients were treated with proton radiotherapy and 10 patients were treated with carbon ion radiotherapy. A retrospective review was performed with clinical charts and recorded imagings. RESULTS With a median follow-up of 32 months, the 3-year actual survival and local progression-free rates of all the patients were 61 and 56%, respectively. The 3-year actual survival rates of adenoid cystic carcinoma, squamous cell carcinoma, olfactory neuroblastoma, adenocarcinoma and malignant melanoma were 83, 44, 75, 0 and 38%, respectively. The 3-year actual local control rates of adenoid cystic carcinoma, squamous cell carcinoma, olfactory neuroblastoma, adenocarcinoma and malignant melanoma were 63, 31, 83, 50 and 0%, respectively. Distant metastasis was observed in 13 of 25 patients in adenoid cystic carcinoma, two of 14 patients in squamous cell carcinoma, one of six patients with olfactory neuroblastoma, two of four patients with adenocarcinoma, three of four patients with malignant melanoma and two of three patients with undifferentiated carcinoma. Mucositis and dermatitis were seen as acute toxicities. The most common late toxicity was visual disorder. Grades 2, 3 and 4 visual disorders were observed in seven, five and two patients, respectively. CONCLUSIONS Proton and carbon ion radiotherapy resulted in satisfactory local control in patients with locally advanced unresectable primary head and neck cancers invading the skull base.
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Affiliation(s)
- Koichi Morimoto
- *Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe 650-0017, Japan.
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Makita C, Nakamura T, Takada A, Takayama K, Suzuki M, Ishikawa Y, Azami Y, Kato T, Tsukiyama I, Kikuchi Y, Hareyama M, Murakami M, Fuwa N, Hata M, Inoue T. Clinical outcomes and toxicity of proton beam therapy for advanced cholangiocarcinoma. Radiat Oncol 2014; 9:26. [PMID: 24422711 PMCID: PMC3904195 DOI: 10.1186/1748-717x-9-26] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [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: 03/18/2013] [Accepted: 01/09/2014] [Indexed: 12/25/2022] Open
Abstract
Background We examined the efficacy and toxicity of proton beam therapy (PBT) for treating advanced cholangiocarcinoma. Methods The clinical data and outcomes of 28 cholangiocarcinoma patients treated with PBT between January 2009 and August 2011 were retrospectively examined. The Kaplan–Meier method was used to estimate overall survival (OS), progression-free survival (PFS), and local control (LC) rates, and the log-rank test to analyze the effects of different clinical and treatment variables on survival. Acute and late toxicities were assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Results The median age of the 17 male and 11 female patients was 71 years (range, 41 to 84 years; intrahepatic/peripheral cholangiocarcinoma, n = 6; hilar cholangiocarcinoma/Klatskin tumor, n = 6; distal extrahepatic cholangiocarcinoma, n = 3; gallbladder cancer, n = 3; local or lymph node recurrence, n = 10; size, 20–175 mm; median 52 mm). The median radiation dose was 68.2 Gy (relative biological effectiveness [RBE]) (range, 50.6 to 80 Gy (RBE)), with delivery of fractions of 2.0 to 3.2 Gy (RBE) daily. The median follow-up duration was 12 months (range, 3 to 29 months). Fifteen patients underwent chemotherapy and 8 patients, palliative biliary stent placement prior to PBT. OS, PFS, and LC rates at 1 year were 49.0%, 29.5%, and 67.7%, respectively. LC was achieved in 6 patients, and was better in patients administered a biologically equivalent dose of 10 (BED10) > 70 Gy compared to those administered < 70 Gy (83.1% vs. 22.2%, respectively, at 1 year). The variables of tumor size and performance status were associated with survival. Late gastrointestinal toxicities grade 2 or greater were observed in 7 patients <12 months after PBT. Cholangitis was observed in 11 patients and 3 patients required stent replacement. Conclusions Relatively high LC rates after PBT for advanced cholangiocarcinoma can be achieved by delivery of a BED10 > 70 Gy. Gastrointestinal toxicities, especially those of the duodenum, are dose-limiting toxicities associated with PBT, and early metastatic progression remains a treatment obstacle.
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Affiliation(s)
- Chiyoko Makita
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, 963-8052 Koriyama, Fukushima, Japan.
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Fujii O, Demizu Y, Hashimoto N, Takagi M, Terashima K, Mima M, Jin D, Fuwa N, Niwa Y, Murakami M. EP-1159: Outcomes of involved-field particle radiotherapy for stage II-III nonsmall cell lung cancer. Radiother Oncol 2014. [DOI: 10.1016/s0167-8140(15)31277-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Mima M, Demizu Y, Jin D, Hashimoto N, Takagi M, Terashima K, Fujii O, Niwa Y, Akagi T, Daimon T, Hishikawa Y, Abe M, Murakami M, Sasaki R, Fuwa N. Particle therapy using carbon ions or protons as a definitive therapy for patients with primary sacral chordoma. Br J Radiol 2013; 87:20130512. [PMID: 24288399 DOI: 10.1259/bjr.20130512] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study retrospectively evaluated the efficacy and toxicity of particle therapy using carbon ions or protons for primary sacral chordomas. METHODS We evaluated 23 patients with primary sacral chordoma treated with carbon ion therapy (CIT) or proton therapy (PT) between July 2005 and June 2011 at the Hyogo Ion Beam Medical Center, Hyogo, Japan. The median patient age was 72 years. 14 patients were treated with 70.4 Gy equivalents (GyE) in 16 fractions and 9 were treated with 70.4 GyE in 32 fractions. CIT was used for 16 patients, and PT was used for 7 patients. RESULTS The median follow-up period was 38 months. At 3 years, local control (LC), overall survival (OS) and progression-free survival (PFS) for all patients were 94%, 83% and 68%, respectively. The log-rank test revealed that male sex was significantly related to better PFS (p=0.029). No other factors, including dose fractionation and ion type, were significant for LC, OS or PFS. In nine patients, ≥ Grade 3 acute dermatitis was observed, and ≥ Grade 3 late toxicities were observed in nine patients. The 32-fraction protocol reduced severe toxicities in both the acute and late phases compared with the 16-fraction protocol. CONCLUSION Particle therapy for patients with sacral chordoma showed favourable LC and OS. Severe toxicities were successfully reduced by modifying the dose fractionation and treatment planning in the later treatment era. Thus, this therapeutic modality should be considered useful and safe. ADVANCES IN KNOWLEDGE This is the first study including both CIT and PT for sacral chordomas.
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Affiliation(s)
- M Mima
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
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Doi T, Kurokawa E, Kobori Y, Hoshi M, Osawa H, Nagase H, Makari Y, Miyake Y, Oshima S, Ikeda K, Iijima S, Kikkawa N, Mima M, Demizu Y, Fuwa N. [A case of superior sulcus tumor treated with carbon ion radiotherapy]. Gan To Kagaku Ryoho 2013; 40:2333-2335. [PMID: 24394103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Superior sulcus tumor( SST) is a rare type of lung cancer. Treatment usually consists of surgical resection after chemoradiotherapy. We report a case of a woman in her fifties who underwent carbon ion radiotherapy for SST. The patient complained of left shoulder pain, and imaging studies revealed a 5.2×3.5-cm local solid tumor at the apex of the left lung, invasion to the ribs, and no lymph node swelling. The level of tumor marker, carcinoembryonic antigen (CEA), was 5.7 ng/mL. Needle biopsy specimen revealed adenocarcinoma. The diagnosis was SST, T3N0M0, stage IIB. We did not detect Horner syndrome. Carbon ion radiotherapy at 66 Gy equivalent dose per 10 fractions was administered to the SST site. Subsequently, the tumor size decreased to 4.5×1.9-cm. The adverse effect was Grade 1 skin and pulmonary toxicity. Six months later, Grade 2 left shoulder connective tissue toxicity was observed; it was difficult to differentiate this from tumor recurrence. After 2.5 years from radiotherapy, the patient is free from recurrence. Carbon ion radiotherapy is effective and safe and can be considered as an important treatment option for SST.
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Tanaka M, Fukumoto T, Kido M, Takebe A, Kuramitsu K, Kinoshita H, Komatsu S, Fukushima K, Urade T, So S, Shinzeki M, Matsumoto I, Ajiki T, Terashima K, Fujii O, Demizu Y, Fuwa N, Ku Y. [Analysis of the safety and efficacy of percutaneous isolated hepatic perfusion after particle therapy for advanced hepatocellular carcinoma]. Gan To Kagaku Ryoho 2013; 40:1681-1683. [PMID: 24393887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Here, we report the efficacy of dual treatment with hepatic resection and percutaneous isolated hepatic perfusion (PIHP) for advanced hepatocellular carcinoma( HCC). Recently, we introduced treatment with combined particle therapy and PIHP for unresectable HCC in cases of insufficient liver function. The purpose of this study was to evaluate the safety and efficacy of PIHP for local control in the liver after particle therapy. From 2006 to 2013, 6 patients underwent particle therapy for the main lesion and subsequent PIHP for remnant liver lesions. Their mean age was 64 years, and the mean size of the main lesion was 6.2 cm (range, 2.0-10.8 cm). All patients had liver cirrhosis. After particle therapy, PIHP was performed by hepatic arterial infusion of 100 mg/m2 of doxorubicin and 30 mg/m2 of mitomycin C. With regard to side effects, neutropenia occurred in all patients but no serious hepatobiliary injury was observed. The response rate for PIHP was 50% (partial response: 3 and stable disease: 3). The mean overall survival time was 26.9 months after particle therapy. In conclusion, even after particle therapy, PIHP is a safe treatment and is associated with a good local control rate for remnant HCCs. Further accumulation of data is needed to evaluate the efficacy of this treatment strategy in terms of prognosis.
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Affiliation(s)
- Motofumi Tanaka
- Dept. of Surgery, Division of Hepato-Biliary-Pancreatic Surgery, Kobe University Graduate School of Medicine
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Fujii O, Demizu Y, Hashimoto N, Araya M, Takagi M, Terashima K, Mima M, Iwata H, Niwa Y, Jin D, Daimon T, Sasaki R, Hishikawa Y, Abe M, Murakami M, Fuwa N. A retrospective comparison of proton therapy and carbon ion therapy for stage I non-small cell lung cancer. Radiother Oncol 2013; 109:32-7. [DOI: 10.1016/j.radonc.2013.08.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 08/21/2013] [Accepted: 08/25/2013] [Indexed: 12/25/2022]
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