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Murayama S, Yamada S, Hiroshima Y, Takiyama H, Taguchi H, Kimoto T, Anzai M, Hagiwara Y, Yasui K, Mori K, Ishihara S, Ueno H, Shimizu S, Aoyama H, Tsuji H, Sakurai H. Particle beam therapy for pelvic recurrence of colorectal cancer: a registry data analysis in Japan and a systematic review. J Radiat Res 2023:rrad024. [PMID: 37117038 DOI: 10.1093/jrr/rrad024] [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] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/25/2023] [Indexed: 06/19/2023]
Abstract
The aim of this study was to investigate the efficacy and safety of particle beam therapy (PBT) with proton or carbon ion beam for pelvic recurrence of colorectal cancer (PRCC) by comparing the clinical outcomes of a dataset of prospectively enrolled patients for PBT with those from the literature, which were collected by a systematic review of external X-ray radiotherapy (XRT) and PBT. Patients with PRCC treated at 14 domestic facilities between May 2016 and June 2019 and entered the database for prospective observational follow-up were analyzed. The registry data analyzed included 159 PRCC patients treated with PBT of whom 126 (79%) were treated with carbon ion radiation therapy (CIRT). The 3-year overall survival and local control rate were 81.8 and 76.4%, respectively. Among these PRCC patients, 5.7% had Grade 3 or higher toxicity. Systematic search of PubMed and Cochrane databases published from January 2000 to September 2020 resulted in 409 abstracts for the primary selection. Twelve studies fulfilled the inclusion criteria. With one additional publication, 13 studies were selected for qualitative analysis, including 9 on XRT and 4 on PBT. There were nine XRT studies, which included six on 3D conformal radiotherapy and three on stereotactic body radiation therapy, and four PBT studies included three on CIRT and one on proton therapy. A pilot meta-analysis using literatures with median survival time extractable over a 20-month observation period suggested that PBT, especially CIRT, may be a promising treatment option for PRCC not amenable to curative resection.
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Affiliation(s)
- Shigeyuki Murayama
- Division of Proton Therapy, Radiation and Proton Therapy Center, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka 411-8777, Japan
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
| | - Shigeru Yamada
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan
| | - Yuichi Hiroshima
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
- Department of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Hirotoshi Takiyama
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan
| | - Hiroshi Taguchi
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Takuya Kimoto
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kamigyo-ku, Kyoto 602-0841, Japan
| | - Makoto Anzai
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
- Department of Radiology, Osaka Heavy Ion Therapy Center, 3-1-10 Otemae, Chuo-ku, Osaka-city, Osaka 540-0008, Japan
| | - Yasuhito Hagiwara
- The Japanese Society for Radiation Oncology, Particle Therapy Division, Colorectal Cancer Working Group
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iidanishi, Yamagata city, Yamagata 990-9585, Japan
| | - Kazuaki Yasui
- Division of Radiation Oncology, Radiation and Proton Therapy Center, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka 411-8777, Japan
| | - Keita Mori
- Clinical Research Support Center, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Suntou-gun, Shizuoka 411-8777, Japan
| | - Soichiro Ishihara
- Department of Surgical Oncology, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Hideki Ueno
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan
| | - Shinichi Shimizu
- Department of Carbon Ion Radiotherapy, Graduate School of Medicine, Osaka University, 3-1-10, Otemae, Chuo-ku, Osaka City, Osaka 540-0008, Japan
| | - Hidefumi Aoyama
- Department of Radiation Oncology, Hokkaido University Faculty of Medicine, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Hiroshi Tsuji
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-8555, Japan
| | - Hideyuki Sakurai
- Department of Radiation Oncology & Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan
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Yano N, Ono T, Suzuki T, Sugai Y, Yamada M, Kawashiro S, Harada M, Akamatsu H, Hagiwara Y, Ichikawa M, Sato H, Takagi M, Kanoto M, Nemoto K. MRI Grading Scale Predicts Ambulatory Function After Radiotherapy for Metastatic Spinal Cord Compression: A Prospective Single-Institution Observational Study. Oncol Ther 2022; 10:493-501. [PMID: 35852785 PMCID: PMC9681941 DOI: 10.1007/s40487-022-00204-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/01/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Although magnetic resonance imaging (MRI) is an important modality for the diagnosis of metastatic spinal cord compression (MSCC), there are only a few reports on MSCC findings and symptoms after radiotherapy. We aimed to reveal the factors related to ambulatory function after treatment, including the MRI findings, in a prospective observational study. Methods Patients with suspected MSCC who were treated with radiotherapy were included in this study. Orthopedic surgeons evaluated the neurological function according to the Frankel grade. All patients underwent spinal MRI, and the degree of spinal cord compression was assessed by a radiologist and a radiation oncologist using an MRI grading scale. One month after treatment, orthopedic surgeons reassessed the Frankel grade. Twenty-three patients who were evaluated 1 month after radiotherapy were included in the analysis. Results Before radiotherapy, 17 patients were ambulatory and six were unable to walk. Furthermore, 13 patients were diagnosed with grade 3 compression on MRI (spinal cord compression with no cerebrospinal fluid seen on axial T2-weighted imaging). Patients with grade 3 MSCC were significantly more likely to be non-ambulatory at 1 month. Conclusions The MRI grading scale for MSCC may be a prognostic factor for ambulatory function after radiotherapy. MRI findings could aid in determining the indication for radiotherapy.
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Affiliation(s)
- Natsuko Yano
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan.
| | - Takashi Ono
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Tomoto Suzuki
- Department of Orthopaedics, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Yasuhiro Sugai
- Department of Radiology, Division of Diagnostic Radiology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Masayoshi Yamada
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Shohei Kawashiro
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Mayumi Harada
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Hiroko Akamatsu
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Yasuhito Hagiwara
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Mayumi Ichikawa
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Hiraku Sato
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Michiaki Takagi
- Department of Orthopaedics, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Masafumi Kanoto
- Department of Radiology, Division of Diagnostic Radiology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
| | - Kenji Nemoto
- Department of Radiology, Division of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, 990-9585, Japan
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Bhattacharyya T, Koto M, Windisch P, Ikawa H, Hagiwara Y, Tsuji H, Adeberg S. Emerging Role of Carbon Ion Radiotherapy in Reirradiation of Recurrent Head and Neck Cancers: What Have We Achieved So Far? Front Oncol 2022; 12:888446. [PMID: 35677171 PMCID: PMC9167994 DOI: 10.3389/fonc.2022.888446] [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: 03/02/2022] [Accepted: 04/13/2022] [Indexed: 11/13/2022] Open
Abstract
Administering reirradiation for the treatment of recurrent head and neck cancers is extremely challenging. These tumors are hypoxic and radioresistant and require escalated radiation doses for adequate control. The obstacle to delivering this escalated dose of radiation to the target is its proximity to critical organs at risk (OARs) and possible development of consequent severe late toxicities. With the emergence of highly sophisticated technologies, intensity-modulated radiotherapy (IMRT) and stereotactic body radiotherapy have shown promising outcomes. Proton beam radiotherapy has been used for locally recurrent head and neck cancers because of its excellent physical dose distribution, exploring sharp Bragg peak properties with negligible entrance and exit doses. To further improve these results, carbon ion radiotherapy (CIRT) has been explored in several countries across Europe and Asia because of its favorable physical properties with minimal entrance and exit doses, sharper lateral penumbra, and much higher and variable relative biological efficacy, which cannot be currently achieved with any other form of radiation. Few studies have described the role of CIRT in recurrent head and neck cancers. In this article, we have discussed the different aspects of carbon ions in reirradiation of recurrent head and neck cancers, including European and Asian experiences, different dose schedules, dose constraints of OARs, outcomes, and toxicities, and a brief comparison with proton beam radiotherapy and IMRT.
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Affiliation(s)
- Tapesh Bhattacharyya
- Department of Radiation Oncology, Tata Medical Centre, Kolkata, India
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Masashi Koto
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Paul Windisch
- Department of Radiation Oncology, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Hiroaki Ikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hiroshi Tsuji
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - Sebastian Adeberg
- National Center for Tumor Diseases (NCT), University Hospital Heidelberg (UKHD) and German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Heidelberg (UKHD), Heidelberg, Germany
- Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), UKHD and DKFZ, Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany
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Sugawara Y, Yabe Y, Hagiwara Y, Tsuji I. Association between cognitive social capital and all-cause mortality in Great East Japan Earthquake survivors: a prospective cohort study. Public Health 2022; 207:108-112. [PMID: 35617772 DOI: 10.1016/j.puhe.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Cognitive social capital (SC), such as attitude, trust, or norms, may help improve resilience among survivors, thus improving their health. However, the association between cognitive SC and the risk of all-cause mortality among survivors after the natural disaster has never been investigated. The purpose of the present study is to investigate the association between cognitive SC and the risk of all-cause mortality among survivors of the Great East Japan Earthquake (GEJE). STUDY DESIGN Prospective cohort study. METHODS We conducted a health survey on 1654 residents aged ≥18 years who lived in two areas affected by the GEJE. One year after the GEJE, between June and August 2012, cognitive SC (helping each other, trust, greeting, and solving problems together) was assessed using a self-administrated questionnaire. We divided the subjects into two groups based on response to questionnaire: "high" or "low." We obtained information on death and emigration from the Residential Registration Record and followed up on the participants from June 2012 to November 2020. The Cox proportional hazards regression analysis was used for estimating the multivariate-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of all-cause mortality according to each cognitive SC indicator. RESULTS During the 8.5 years of follow-up, 213 subjects died (12.9%). For greeting, compared with subjects who were "high," subjects who were "low" were significantly associated with the risk of all-cause mortality (HR: 2.92, 95% CI: 1.19-7.17). No statistically significant association was observed for helping each other, trust, and solving problems together. CONCLUSION Our findings suggest that perception of greeting may be associated with the risk of all-cause mortality in survivors after natural disasters.
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Affiliation(s)
- Y Sugawara
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan.
| | - Y Yabe
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - Y Hagiwara
- Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan
| | - I Tsuji
- Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University School of Public Health, Graduate School of Medicine, Sendai, Japan
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Ichikawa M, Uematsu K, Yano N, Yamada M, Ono T, Kawashiro S, Akamatsu H, Hagiwara Y, Sato H, Nemoto K. Implementation rate and effects of multidisciplinary team meetings on decision making about radiotherapy: an observational study at a single Japanese institution. BMC Med Inform Decis Mak 2022; 22:111. [PMID: 35477440 PMCID: PMC9044833 DOI: 10.1186/s12911-022-01849-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cancer treatment requires a multidisciplinary approach. Therefore, multidisciplinary team meetings (MDTMs) have been widely used to determine the direction of treatment. However, no standard provisions exist for conducting MDTMs, and recommendations discussed in MDTMs are sometimes not implemented. This study analyzed the indications for radiotherapy discussed and recommended at MDTMs, identified the rate of radiotherapy recommendations for patients that were not implemented, and clarified the reasons at a single academic center in Japan. METHODS This was a cross-sectional study that analyzed the minutes and electronic medical records of cases discussed at MDTMs held between April 2012-March 2017 at Yamagata University Hospital. We categorized how radiotherapy was initially presented at MDTMs, determined the rate of radiotherapy recommendations made through MDTMs, analyzed whether treatment recommendations were subsequently implemented, and examined the causes of non-implementation. We performed a statistical analysis to assess some clinical factors (sex, age, number of multidisciplinary team meetings, and classification of planned treatment) associated with the non-implementation of radiotherapy recommendations from MDTMs. RESULTS A total of 1813 cases were discussed at MDTMs, of which 71% (1293 cases) were presented with treatment plans, including radiotherapy. Further, 66% (1205 cases) were recommended for radiotherapy through the MDTMs. Recommendations from MDTMs were not implemented in 7% (142 cases). The most typical reason for non-implementation was the clinician's opinion (30%), followed by patient preferences (27%) and disease progression (20%). Change in cancer stage and improvement in symptoms were 12% and 4%, respectively. These ratios were similar each year. We could not find the factors associated with the non-implementation of radiotherapy recommendations from MDTMs. CONCLUSIONS MDTMs had a significant effect on the recommendation of radiotherapy for each patient with a tumor. The primary reason for the non-implementation of decisions made at MDTMs was the opinion of clinicians and the patient's preference. These results were similar to previous studies. We need to establish a monitoring system where patients themselves can decide the treatments based on their choices while using the recommendations from MDTMs.
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Affiliation(s)
- Mayumi Ichikawa
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan.
| | - Ken Uematsu
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Natsuko Yano
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Masayoshi Yamada
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Takashi Ono
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Shohei Kawashiro
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Hiroko Akamatsu
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Hiraku Sato
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Yamagata University School of Medicine, 2-2-2, Iida-nishi, Yamagata, 990-9585, Japan
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Yamada M, Miyasaka Y, Kanai T, Souda H, Uematsu K, Matsueda R, Yano N, Kawashiro S, Akamatsu H, Harada M, Hagiwara Y, Ichikawa M, Sato H, Nemoto K. Prediction of the minimum spacer thickness required for definitive radiotherapy with carbon ions and photons for pelvic tumors: an in silico planning study using virtual spacers. J Radiat Res 2021; 62:699-706. [PMID: 34059894 PMCID: PMC8273800 DOI: 10.1093/jrr/rrab047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/25/2021] [Indexed: 06/12/2023]
Abstract
We aimed to predict the minimum distance between a tumor and the gastrointestinal (GI) tract that can satisfy the dose constraint by creating simulation plans with carbon-ion (C-ion) radiotherapy (RT) and photon RT for each case assuming insertion of virtual spacers of various thicknesses. We enrolled 55 patients with a pelvic tumor adjacent to the GI tract. Virtual spacers were defined as the overlap volume between the GI tract and the volume expanded 7-17 mm from the gross tumor volume (GTV). Simulation plans (70 Gy in 35 fractions for at least 95% of the planning target volume [PTV]) were created with the lowest possible dose to the GI tract under conditions that meet the dose constraints of the PTV. We defined the minimum thickness of virtual spacers meeting D2 cc of the GI tract <50 Gy as 'MTS'. Multiple regression was used with explanatory variables to develop a model to predict MTS. We discovered that MTSs were at most 9 mm and 13 mm for C-ion RT and photon RT plans, respectively. The volume of overlap between the GI tract and a virtual spacer of 14 mm in thickness (OV14)-PTV was found to be the most important explanatory variable in the MTS prediction equation for both C-ion and photon RT plans. Multiple R2 values for the regression model were 0.571 and 0.347 for C-ion RT and photon RT plans, respectively. In conclusion, regression equations were developed to predict MTS in C-ion RT and photon RT.
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Affiliation(s)
- Masayoshi Yamada
- Corresponding author. Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan. ; Tel: +81-23-628-5386
| | - Yuya Miyasaka
- Department of Heavy Particle Medical Science, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Takayuki Kanai
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Hikaru Souda
- Department of Heavy Particle Medical Science, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Ken Uematsu
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Rei Matsueda
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Natsuko Yano
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Shohei Kawashiro
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Hiroko Akamatsu
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Mayumi Harada
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Mayumi Ichikawa
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Hiraku Sato
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
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Yamada M, Miyasaka Y, Kanai T, Souda H, Uematsu K, Matsueda R, Yano N, Kawashiro S, Akamatsu H, Harada M, Hagiwara Y, Ichikawa M, Sato H, Nemoto K. Corrigendum to: Prediction of the minimum spacer thickness required for definitive radiotherapy with carbon ions and photons for pelvic tumors: an in silico planning study using virtual spacers. J Radiat Res 2021; 62:743. [PMID: 34159381 PMCID: PMC8273804 DOI: 10.1093/jrr/rrab062] [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] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/25/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Masayoshi Yamada
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Yuya Miyasaka
- Department of Heavy Particle Medical Science, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Takayuki Kanai
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Hikaru Souda
- Department of Heavy Particle Medical Science, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Ken Uematsu
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Rei Matsueda
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Natsuko Yano
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Shohei Kawashiro
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Hiroko Akamatsu
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Mayumi Harada
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Mayumi Ichikawa
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Hiraku Sato
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, 2-2-2, Iida-Nishi, Yamagata 990-9585, Japan
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IMAIZUMI T, Toda T, Sakurai D, Hagiwara Y, Ando M, Yoshida Y, Maruyama S. POS-325 AN “IMPROVED” eGFR SLOPE IS ASSOCIATED WITH HOSPITALIZATION EVENTS. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hagiwara Y, Yamada S, Isozaki Y, Takiyama H, Shinoto M, Kawashiro S, Bhattacharyya T, Nemoto K, Tsuji H. Efficacy and feasibility of re-irradiation using carbon ions for pancreatic cancer that recurs after carbon-ion radiotherapy. Clin Transl Radiat Oncol 2020; 26:24-29. [PMID: 33294643 PMCID: PMC7691119 DOI: 10.1016/j.ctro.2020.10.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 10/29/2020] [Accepted: 10/31/2020] [Indexed: 12/19/2022] Open
Abstract
Carbon-ion re-irradiation for pancreatic cancer; feasibility and efficacy. Adjuvant chemotherapy improve local control of re-irradiation using carbon ions. Carbon-ion radiotherapy for recurrent pancreatic cancer; reasonable option.
Background and purpose Patients who receive carbon-ion radiotherapy (C-ion RT) for primary pancreatic cancer may experience locoregional recurrence; however, the treatment options for such patients are limited. We aimed to investigate the feasibility and efficacy of carbon-ion re-irradiation for patients with pancreatic cancer who experienced recurrence after initial C-ion RT. Materials and methods Twenty-one patients with recurrent pancreatic cancer who underwent repeat C-ion RT between December 2010 and November 2016 at our institute were retrospectively evaluated. The sites of post-initial C-ion RT failure were in-field central in 16 patients (76.2%) and marginal in 5 (23.8%). The median doses of initial and repeat C-ion RT were both 52.8 Gy (relative biological effectiveness [RBE]). Thirteen patients (61.9%) received concurrent chemotherapy with re-irradiation, while 11 (52.4%) received adjuvant chemotherapy. Results The median follow-up period after re-irradiation was 11 months. The 1-year local control, progression-free survival, and overall survival rates were 53.5%, 24.5%, and 48.7%, respectively. Toxicity data was obtained from the patients’ charts. Only 1 patient (4.8%) developed grade 3 acute toxicities and none developed grade ≥3 late toxicities. Univariate analysis indicated that patients who received adjuvant chemotherapy had significantly improved local control rates compared with those who did not; the 1-year local control rates were 80.0% and 0.0%, respectively (P = 0.0469). Conclusion Repeating C-ion RT may be a reasonable option with tolerable toxicity for patients with recurrent pancreatic cancers. Adjuvant chemotherapy appears to improve the local control rate. This is the first study to examine re-irradiation using C-ion for recurrent pancreatic cancer after initial C-ion RT.
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Key Words
- 18F-FDG-PET, 18F-fluorodeoxyglucose positron emission tomography
- C-ion RT, carbon-ion radiotherapy
- CT, computed tomography
- CTV, clinical target volume
- Carbon-ion radiotherapy
- D2cc, dose covering 2 cc
- EBRT, external beam radiation therapy
- GS, gemcitabine plus S1
- GTV, gross tumour volume
- IMRT, intensity-modulated radiotherapy
- LAPC, locally advanced pancreatic cancer
- LC, local control
- LET, linear energy transfer
- MRI, magnetic resonance imaging
- OS, overall survival
- PFS, progression-free survival
- PTV, planning target volume
- Pancreatic cancer
- RBE, relative biological effectiveness
- Re-irradiation
- S-1, tegafur, gimeracil, and oteracil
- SBRT, stereotactic body radiation therapy
- Survival
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Affiliation(s)
- Yasuhito Hagiwara
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan.,Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Shigeru Yamada
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan.,Department of Charged Particle Therapy Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Yuka Isozaki
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hirotoshi Takiyama
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Makoto Shinoto
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Shohei Kawashiro
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Tapesh Bhattacharyya
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Hiroshi Tsuji
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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Hagiwara Y, Nakayama Y, Kudo S, Hayakawa T, Nakamura N, Kitamoto Y, Takahashi S, Tsujino K, Kubo N, Tamaki Y, Nagata Y. Corrigendum to: Nationwide survey of radiation therapy in Japan for lung cancer complicated with interstitial lung disease. J Radiat Res 2020; 61:817. [PMID: 32789509 PMCID: PMC7482151 DOI: 10.1093/jrr/rraa070] [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] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/11/2020] [Accepted: 12/12/2019] [Indexed: 06/11/2023]
Affiliation(s)
- Yasuhito Hagiwara
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, Iida-nishi 2-2-2, Yamagata-shi, 990-9585 Yamagata, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, 104-045 Tokyo, Japan
| | - Shigehiro Kudo
- Department of Radiation Oncology, Saitama Cancer Center, Komuro 780, Ina-machi, Kitaadachi-gun, 362-0806 Saitama, Japan
| | - Toyokazu Hayakawa
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Kitazato 1-15-1, Minami-ku, Sagamihara-shi, 252-0373 Kanagawa, Japan
| | - Naoki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa-shi, 277-8577 Chiba, Japan
| | - Yoshizumi Kitamoto
- Department of Radiation Oncology, National Hospital Organization Takasaki General Medical Center, Takamatsu-cho 36, Takasaki-shi 370-0829 Gunma, Japan
| | - Shigeo Takahashi
- Department of Radiation Oncology, Kagawa University Faculty of Medicine, Ikenobe 1750-1, Kimi-cho, Kita-gun, 761-0793 Kagawa, Japan
| | - Kayoko Tsujino
- Department of Radiation Oncology, Hyogo Cancer Center, Kitaoji-cho 13-70, Akashi-shi, 673-8558 Hyogo, Japan
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Aramaki-machi 4-2, Maebashi-shi, 371-8510 Gunma, Japan
| | - Yukihisa Tamaki
- Department of Radiation Oncology, Shimane University Faculty of Medicine, Enya-cho 89-1, Izumo-shi, 693-8501 Shimane, Japan
| | - Yasushi Nagata
- Department of Radiation Oncology, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima-shi, 734-8551 Hiroshima, Japan
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Hagiwara Y, Nakayama Y, Kudo S, Hayakawa T, Nakamura N, Kitamoto Y, Takahashi S, Tsujino K, Kubo N, Tamaki Y, Nagata Y. Nationwide survey of radiation therapy in Japan for lung cancer complicated with interstitial lung disease. J Radiat Res 2020; 61:563-574. [PMID: 32363376 PMCID: PMC7336568 DOI: 10.1093/jrr/rraa018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/11/2020] [Accepted: 12/12/2019] [Indexed: 05/02/2023]
Abstract
The purpose of this study was to clarify the opinions of radiation oncologists in Japan regarding treatment for lung cancer complicated with interstitial lung disease (ILD) by a questionnaire survey, and the risk of acute exacerbation (AE) after radiotherapy. Questionnaires were sent to all of the facilities in which radiation therapy is performed for lung cancer in Japan by using the mailing list of the Japanese Society for Radiation Oncology (JASTRO). The questionnaire survey was conducted to clarify who judges the existence of ILD, the indications for radiation therapy in cases of ILD-combined lung cancer, and the ratio of ILD-combined lung cancer in lung cancer patients treated with radiation therapy. Patients with ILD-combined lung cancer who received radiotherapy during the period from April 2014 to March 2015 were retrospectively analysed. Any cases of AE without any other obvious cause were included. ILD confirmation was performed by central radiologists using computed tomography images. A total of 47 facilities responded to the questionnaire. Radiation therapy was an option in cases of ILD-combined lung cancer in 39 (83%) of the facilities. The indication for radiation therapy was based on image findings in 35 (90%) of the 39 facilities in which radiation therapy was acceptable or was a choice in some cases of ILD. The final indication was based on the opinion of the pulmonologist in 29 (74%) of those 39 facilities. In fiscal year 2014, a total of 2128 patients in 38 facilities received chest irradiation. Seventy-eight (3.7%) of those 2128 patients had ILD-combined lung cancer. Sixty-seven patients were included in patient analysis. AE occurred in 5 patients (7.5%), and one of those 5 patients (20.0%) died from radiation-induced AE. The median period from radiotherapy to AE was 4 months (range, 2-7 months). The following four independent risk factors for AE were identified in univariate analysis: non-advanced age (<75 years), increased C-reactive protein level (≥0.3 mg/dl), adjuvant chemotherapy and ≥ Grade 2 radiation pneumonitis. Radiotherapy was an option for lung cancer even in cases with ILD in 83% (39/47) of the facilities in Japan. Seventy-eight (3.7%) of 2128 patients who received radiation therapy for lung cancer had ILD. Radiotherapy for ILD-combined lung cancer may induce AE at a substantial rate and AE can be life-threatening. Minimizing the risk of radiation pneumonitis might enable the risk of AE to be reduced.
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Affiliation(s)
- Yasuhito Hagiwara
- Department of Radiation Oncology, Yamagata University Faculty of Medicine, Iida-nishi 2-2-2, Yamagata-shi, 990-9585 Yamagata, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, 104-045 Tokyo, Japan
- Corresponding author. Department of Radiation Oncology, National Cancer Center Hospital, Tsukiji 5-1-1, Chuo-ku, 104-045 Tokyo, Japan. Tel: +81-3-3542-2511;
| | - Shigehiro Kudo
- Department of Radiation Oncology, Saitama Cancer Center, Komuro 780, Ina-machi, Kitaadachi-gun, 362-0806 Saitama, Japan
| | - Toyokazu Hayakawa
- Department of Radiology and Radiation Oncology, Kitasato University School of Medicine, Kitazato 1-15-1, Minami-ku, Sagamihara-shi, 252-0373 Kanagawa, Japan
| | - Naoki Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwanoha 6-5-1, Kashiwa-shi, 277-8577 Chiba, Japan
| | - Yoshizumi Kitamoto
- Department of Radiation Oncology, National Hospital Organization Takasaki General Medical Center, Takamatsu-cho 36, Takasaki-shi 370-0829 Gunma, Japan
| | - Shigeo Takahashi
- Department of Radiation Oncology, Kagawa University Faculty of Medicine, Ikenobe 1750-1, Kimi-cho, Kita-gun, 761-0793 Kagawa, Japan
| | - Kayoko Tsujino
- Department of Radiation Oncology, Hyogo Cancer Center, Kitaoji-cho 13-70, Akashi-shi, 673-8558 Hyogo, Japan
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Aramaki-machi 4-2, Maebashi-shi, 371-8510 Gunma, Japan
| | - Yukihisa Tamaki
- Department of Radiation Oncology, Shimane University Faculty of Medicine, Enya-cho 89-1, Izumo-shi, 693-8501 Shimane, Japan
| | - Yasushi Nagata
- Department of Radiation Oncology, Hiroshima University, Kasumi 1-2-3, Minami-ku, Hiroshima-shi, 734-8551 Hiroshima, Japan
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Koto M, Ikawa H, Kaneko T, Hagiwara Y, Hayashi K, Tsuji H. Long-term outcomes of skull base chordoma treated with high-dose carbon-ion radiotherapy. Head Neck 2020; 42:2607-2613. [PMID: 32472716 PMCID: PMC7496814 DOI: 10.1002/hed.26307] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 04/24/2020] [Accepted: 05/15/2020] [Indexed: 12/18/2022] Open
Abstract
Background We evaluated the long‐term efficacy and safety of carbon‐ion radiotherapy (C‐ion RT) for skull base chordoma, a rare neoplasm. Methods Thirty‐four patients with skull base chordoma who were treated with C‐ion RT were prospectively enrolled and analyzed retrospectively. C‐ion RT was delivered with 60.8 Gy (relative biological effectiveness [RBE]) in 16 fractions at four fractions per week. Results The median follow‐up period was 108 months. The 5‐ and 9‐year local control rates were 76.9% and 69.2%, respectively. The 5‐ and 9‐year overall survival rates were 93.5% and 77.4%, respectively. Regarding grade 3 or more severe late reactions, one patient developed a grade 3 mucosal ulcer, two developed grade 4 ipsilateral optic nerve injuries, and one developed a grade 5 mucosal ulcer at 9 years and 3 months after C‐ion RT. Conclusion C‐ion RT with 60.8 Gy (RBE)/16 fractions is a promising treatment option for inoperable skull base chordoma.
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Affiliation(s)
- Masashi Koto
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and TechnologyChibaJapan
| | - Hiroaki Ikawa
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and TechnologyChibaJapan
| | - Takashi Kaneko
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and TechnologyChibaJapan
| | - Yasuhito Hagiwara
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and TechnologyChibaJapan
| | - Kazuhiko Hayashi
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and TechnologyChibaJapan
| | - Hiroshi Tsuji
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and TechnologyChibaJapan
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13
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Hagiwara Y, Koto M, Bhattacharyya T, Hayashi K, Ikawa H, Nemoto K, Tsuji H. Long-term outcomes and toxicities of carbon-ion radiotherapy in malignant tumors of the sphenoid sinus. Head Neck 2020; 42:50-58. [PMID: 31584731 PMCID: PMC6973156 DOI: 10.1002/hed.25965] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/31/2019] [Accepted: 09/06/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Most of the primary sphenoid sinus tumors present with locally advanced stages with involvement of adjacent critical structures and are not amenable to radical resection. We sought to evaluate the safety and efficacy of carbon-ion radiotherapy (C-ion RT) for sphenoid sinus malignancies. METHODS This is a retrospective analysis of 22 patients of primary sphenoid carcinomas treated with definitive C-ion RT. RESULTS Adenoid cystic carcinoma was the most common histology (15 patients, 68.2%). The median follow-up of this cohort was 48.5 months. The actuarial local control and overall survival at 5 years were 51.0% and 62.7%, respectively. Grade 4 visual impairment and grade 4 brain necrosis were seen in six and one patient, respectively. CONCLUSION C-ion RT can provide a reasonably good clinical outcome in locally advanced sphenoid sinus malignancies with a marginally higher late toxicity profile because of extremely close proximity of the target volume to critical structures.
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Affiliation(s)
- Yasuhito Hagiwara
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Tapesh Bhattacharyya
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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14
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Hagiwara Y, Bhattacharyya T, Matsufuji N, Isozaki Y, Takiyama H, Nemoto K, Tsuji H, Yamada S. Influence of dose-averaged linear energy transfer on tumour control after carbon-ion radiation therapy for pancreatic cancer. Clin Transl Radiat Oncol 2019; 21:19-24. [PMID: 31886424 PMCID: PMC6920502 DOI: 10.1016/j.ctro.2019.11.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [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: 11/20/2019] [Accepted: 11/24/2019] [Indexed: 01/11/2023] Open
Abstract
High LET and high RBE of carbon ion made it a promising tool for treating pancreatic cancers. Dose averaged LET minimum within the GTV is significantly associated with local control. Outcome of CIRT in pancreatic cancers can be improved by modulating dose averaged LET within the GTV.
Background and purpose High linear energy transfer (LET) radiation carbon-ion radiotherapy (C-ion RT) is one of the most promising modalities for treating unresectable primary pancreatic cancers. However, how LET contributes to a therapeutic effect is not clear. To assess whether there is an enhanced effect of high LET radiation on tumour control, we aimed to determine the impact of dose-averaged LET on local control (LC) of primary pancreatic tumours. Materials and methods A retrospective analysis of 18 patients with primary pancreatic carcinomas treated with definitive C-ion RT with concurrent chemotherapy in 2013 was conducted. The dose of irradiation was 55.2 Gy (RBE). The relationship between dose-averaged LET and LC of primary tumours was evaluated. Results All patients had histologically confirmed adenocarcinoma. The median follow-up duration was 22 months. The actuarial LC and overall survival (OS) at 18 months were 62.5% and 70.1%, respectively. There were no cases of grade ≥3 late toxicities observed. Local recurrences developed in four patients (22%), all of which were infield central recurrences. Although there were no significant differences in gross tumour volume (GTV) dose coverage, patients with higher minimum dose-averaged LET (LETmin) values within the GTV had better LC (dose-averaged LETmin ≥44 keV/microm; 18-months LC 100.0% vs 34.3%; p = 0.0366). Conclusion Dose-averaged LETmin within the GTV was significantly associated with LC of primary pancreatic cancers. Our data suggest that outcomes for patients with unresectable primary pancreatic cancers receiving C-ion RT can be improved by modulating the dose-averaged LET within the GTV.
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Affiliation(s)
- Yasuhito Hagiwara
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan.,Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Iida-nishi 2-2-2, Yamagata-shi, 990-9585 Yamagata, Japan
| | - Tapesh Bhattacharyya
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan
| | - Naruhiro Matsufuji
- Department of Accelerator and Medical Physics, Research Center for Particle Therapy, National Institute of Radiological Sciences, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan
| | - Yuka Isozaki
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan
| | - Hirotoshi Takiyama
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Iida-nishi 2-2-2, Yamagata-shi, 990-9585 Yamagata, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan
| | - Shigeru Yamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan.,Department of Charged Particle Therapy Research, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Anagawa 4-9-1, Inage-ku, 263-8555 Chiba, Japan
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15
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El Hafi L, Isobe S, Tabuchi Y, Katsumata Y, Nakamura H, Fukui T, Matsuo T, Garcia Ricardez GA, Yamamoto M, Taniguchi A, Hagiwara Y, Taniguchi T. System for augmented human–robot interaction through mixed reality and robot training by non-experts in customer service environments. Adv Robot 2019. [DOI: 10.1080/01691864.2019.1694068] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- L. El Hafi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - S. Isobe
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Y. Tabuchi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Y. Katsumata
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - H. Nakamura
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - T. Fukui
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - T. Matsuo
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - G. A. Garcia Ricardez
- Division of Information Science, Nara Institute of Science and Technology, Ikoma, Japan
| | - M. Yamamoto
- Business Innovation Division, Panasonic Corporation, Osaka, Japan
| | - A. Taniguchi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - Y. Hagiwara
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - T. Taniguchi
- College of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
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Takahashi J, Goto T, Ishimaru T, Okamoto H, Hagiwara Y, Watase H, Hasegawa K. 73 Association of Advanced Age With a Higher Risk of Endobronchial Intubation in the Emergency Department. Ann Emerg Med 2019. [DOI: 10.1016/j.annemergmed.2019.08.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Bhattacharyya T, Koto M, Ikawa H, Hayashi K, Hagiwara Y, Makishima H, Kasuya G, Yamamoto N, Kamada T, Tsuji H. First prospective feasibility study of carbon-ion radiotherapy using compact superconducting rotating gantry. Br J Radiol 2019; 92:20190370. [PMID: 31317764 PMCID: PMC6849685 DOI: 10.1259/bjr.20190370] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Objective: We had developed compact rotating gantry for carbon ion using superconducting magnets in 2015 which became clinically operational in 2017. The objective of this study was to assess the clinical feasibility and safety of using compact rotating gantry with three-dimensional active scanning in delivery of carbon-ion radiotherapy (C-ion RT) for relatively stationary tumours. Methods: A prospective feasibility study was conducted with 10 patients who had been treated with C-ion RT using compact rotating gantry between April 2017 and April 2018 at Hospital of the National Institute of Radiological Sciences (NIRS) for head and neck and prostate cancers. The primary end point was evaluation of acute toxicities within 3 months of starting C-ion RT. Results: Out of 10 cases 8 were of head and neck cancers and 2 were of prostate cancers. All of those eight head and neck cases were of locally advanced stages. Both of the prostate cancer patients belong to intermediate risk categories. None of the patients developed even Grade 2 or more severe skin reactions. Six out of eight cases with head and neck cancers experienced Grade 2 mucosal reactions; however, nobody developed Grade 3 or more severe mucosal reactions. There was no gastrointestinal reaction observed in prostate cancer patients. One patient developed Grade 2 genitourinary reaction. Conclusion: C-ion RT using compact rotating gantry and three-dimensional active scanning is a safe and feasible treatment for relatively less mobile tumours. Advances in knowledge: This study will be the first step to establish the use of superconducting rotating gantry in C-ionRT in clinical setting paving the way for treating large number of patients and make it a standard of practice in the future.
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Affiliation(s)
- Tapesh Bhattacharyya
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Yasuhito Hagiwara
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hirokazu Makishima
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Goro Kasuya
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Naoyoshi Yamamoto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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Taniguchi T, Mochihashi D, Nagai T, Uchida S, Inoue N, Kobayashi I, Nakamura T, Hagiwara Y, Iwahashi N, Inamura T. Survey on frontiers of language and robotics. Adv Robot 2019. [DOI: 10.1080/01691864.2019.1632223] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- T. Taniguchi
- Department of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - D. Mochihashi
- The Institute of Statistical Mathematics, Tachikawa, Japan
- SOKENDAI (The Graduate University for Advanced Studies), Tokyo, Japan
| | - T. Nagai
- Graduate School of Engineering Science, Osaka University, Toyonaka, Osaka, Japan
| | - S. Uchida
- Faculty of Languages and Cultures, Kyushu University, Fukuoka, Japan
| | - N. Inoue
- Graduate School of Information Sciences, Tohoku University, Sendai, Japan
- RIKEN Center for Advanced Intelligence Project, Chuo-ku, Japan
| | - I. Kobayashi
- Advanced Sciences, Graduate School of Humanities and Sciences, Ochanomizu University, Tokyo, Japan
| | - T. Nakamura
- Department of Mechanical Engineering and Intelligent Systems, The University of Electro-Communications, Chofu, Japan
| | - Y. Hagiwara
- Department of Information Science and Engineering, Ritsumeikan University, Kusatsu, Japan
| | - N. Iwahashi
- Department of Information and Communication Engineering, Okayama Prefectural University, Okayama, Japan
| | - T. Inamura
- SOKENDAI (The Graduate University for Advanced Studies), Tokyo, Japan
- National Institute of Informatics, Tokyo, Japan
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Hayashi K, Koto M, Ikawa H, Hagiwara Y, Tsuji H, Ogawa K, Kamada T. Feasibility of Re-irradiation using carbon ions for recurrent head and neck malignancies after carbon-ion radiotherapy. Radiother Oncol 2019; 136:148-153. [PMID: 31015117 DOI: 10.1016/j.radonc.2019.04.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 03/01/2019] [Accepted: 04/04/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND PURPOSE Locoregional recurrence after carbon-ion radiotherapy (CIRT) for primary head and neck malignancies, such as malignant mucosal melanoma, adenoid cystic carcinoma, and sarcoma, occurs occasionally. However, the treatment options are limited. We report on the toxicity and efficacy of re-irradiation using carbon ions for recurrent head and neck malignancies after CIRT. MATERIALS AND METHODS Data of 48 patients with recurrent head and neck malignancies treated with re-irradiation with CIRT at our institution (2007-2016) were retrospectively analyzed. Twenty-one patients (43.8%) had malignant mucosal melanoma, 17 (35.4%) had adenoid cystic carcinoma, six (12.5%) had bone and soft tissue sarcomas, and four patients (8.3%) had other disease types. Tumor recurrences at re-irradiation were located in the paranasal cavity (n = 18, 37.5%), nasal cavity (n = 9, 18.8%), nasopharynx (n = 4, 8.3%), orbit (n = 3, 6.3%), cavernous sinus (n = 3, 6.3%), and at other sites (n = 11, 22.9%). The median dose of initial CIRT and that at re-irradiation were 57.6 Gy and 54.0 Gy (relative biological effectiveness [RBE]), respectively. None of the patients received concurrent chemotherapy. RESULTS The median follow-up period after re-irradiation was 27.1 months. Five patients (10.4%) developed Grade 3 acute toxicities and 18 (37.5%) developed Grade ≥3 late toxicities, including Grade 5 central nervous system necrosis in one patient. The 2-year local control, locoregional control, progression-free survival, and overall survival rates were 40.5, 33.5%, 29.4%, and 59.6%, respectively. CONCLUSION Re-irradiation using carbon ions may be a reasonable treatment option with tolerable toxicity for patients with recurrent head and neck malignancies after CIRT.
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Affiliation(s)
- Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan; Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan.
| | - Hiroaki Ikawa
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Yasuhito Hagiwara
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Abstract P2-13-02: Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-13-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The RESPECT trial compared 1-year trastuzumab monotherapy with trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients. Primary objective of this study was to verify the noninferiority of 1-year trastuzumab monotherapy to trastuzumab plus chemotherapy in terms of disease free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 years was 0.45 months (reported by Sawaki at ASCO2018). This report assesses the patients-reported outcomes and health-related quality of life (HRQoL).
PATIENTS AND METHODS: The study was done at 99 hospitals in Japan. Elderly women (70 to 80 years old) with HER2-positive, stageI-IIIA invasive breast cancer treated by surgery with clear resection margins were randomly assigned to receive either 1-year trastuzumab or 1-year trastuzumab plus standard chemotherapy, stratified by age, hormone-receptor status, pathological lymph node metastasis and institution. Patients completed questionnaires at baseline, 2 months, 1year, and 3 years after protocol treatment started. The primary outcome was global HRQoL assessed using Functional Assessment of Cancer Therapy-General (FACT-G) total score, and secondary outcomes were chemotherapy-induced peripheral neuropathy (CIPN), instrumental activities of daily living (IADL), anxiety, depression, and subjective happiness. We did the analyses by intention to treat, including patients who completed questionnaires at baseline before start of protocol treatment, and 5point or more change is meaningful in FACT-G total score. This study is registered with ClinicalTrials.gov, NCT01104935.
RESULTS: Between Oct 2009 and Oct 2014, 275 patients were enrolled in the study, of whom 9 patients were excluded: 135 assigned to trastuzumab monotherapy and 131 assigned to trastuzumab plus chemotherapy. We detected significant difference between treatment groups for: clinically meaningful HRQoL deterioration rate at 2 months (31% for trastuzumab monotherapy vs 48% for trastuzumab plus chemotherapy; p=0.016) and at 1year (19% vs 38%; p=0.009), clinically meaningful HRQoL improvement rate at 2 months (38% for trastuzumab monotherapy vs 15% for trastuzumab plus chemotherapy; p<0.01) and at 1year (43% vs 25%; p=0.021), severe sensory CIPN rate at 2months (1.9% for trastuzumab monotherapy vs 14.4% for trastuzumab plus chemotherapy; p=0.001), IADL score at 1year (11.97 for trastuzumab monotherapy vs 11.54 for trastuzumab plus chemotherapy; p<0.042), Hospital Anxiety and Depression Scale score at 2months (8.92 for trastuzumab monotherapy vs 10.79 for trastuzumab plus chemotherapy; p<0.003), and subjective happiness score at 1year (12.8 for trastuzumab monotherapy vs 11.8 for trastuzumab plus chemotherapy; p<0.024).
CONCLUSION: Given the small advantage of adjuvant trastuzumab plus chemotherapy compared to trastuzumab monotherapy for elderly HER-2 positive breast cancer women, decisions about treatment should be informed by the risk for adverse health effects associated with chemotherapy.
Citation Format: Kobayashi K, Taira N, Sawaki M, Sagawa N, Baba S, Saito T, Kawahara T, Hagiwara Y, Uemura Y, Shimozuma K, Ohashi Y, Mukai H. Patient-reported outcomes with trastuzumab monotherapy versus trastuzumab plus standard chemotherapy as a postoperative adjuvant therapy in HER2-positive elderly breast cancer patients (RESPECT): A randomized, open-label, phase 3 clinical trial [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-13-02.
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Affiliation(s)
- K Kobayashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Taira
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - M Sawaki
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - N Sagawa
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - S Baba
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Saito
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - T Kawahara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Hagiwara
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Uemura
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - K Shimozuma
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Y Ohashi
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - H Mukai
- The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; Okayama University Hospital, Okayama, Japan; Aichi Cancer Center Hospital, Nagoya, Aichi, Japan; Kameda Medical Center, Kamogawa, Chiba, Japan; Sagara Hospital, Kagoshima, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan; Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Shiga, Japan; Chuo University, Bunkyo-ku, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Abstract P1-11-21: Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-11-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
OBJECTIVE: The effect of trastuzumab(Tmab) or chemotherapy on cognitive function has not been fully understood, especially in elderly breast cancer patients. The RESPECT trial compared 1-year(yr) Tmab monotherapy with Tmab plus standard chemotherapy as adjuvant therapy in elderly patients with HER2-positive breast cancer. The primary objective was to verify the noninferiority of 1-yr Tmab monotherapy compared to Tmab plus chemotherapy in terms of disease-free survival, and the planned analysis showed that the difference of restricted mean survival time between two groups at 3 yrs was 0.45 months (Sawaki at ASCO2018). The goal of this report was to assess the impact of the treatment groups on longitudinal cognitive function.
PATIENTS AND METHODS: The study was performed with patients from 99 hospitals in Japan. Elderly women with HER2-positive, stage I-IIIA invasive breast cancer surgery treated with clear resection margins were randomly assigned to either receive 1-yr Tmab or 1-yr Tmab plus standard chemotherapy. 15 institutions participated in the cognitive sub-study. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline and at 1 and 3 yrs after treatment. The primary outcome was the amount of change in the MMSE score from the baseline. A linear mixed-effects model was used for comparisons of change in the MMSE score between groups, controlling for time and baseline score. Secondary outcomes were the proportion of both suspected mild dementia (MMSE≤27) and dementia (MMSE≤23) at each time point.
RESULTS: Between October 2009 and October 2014, 275 patients were enrolled in the RESPECT trial, and 57 patients were enrolled in the cognitive function sub-study with 2 patients subsequently excluded. The 55-patient sub-study comprised 29 patients assigned to the Tmab monotherapy group and 26 patients assigned to the Tmab plus chemotherapy group. Primary analysis revealed that change in the MMSE score was not significantly different between the two groups (difference −0.6 at 1 yr and −0.9 at 3 yrs; p=0.136), whereas the baseline score was the only significant factor that had an effect on the amount of change in the MMSE score (p<0.001). The proportions of suspected mild dementia at baseline, and at 1 yr and 3 yrs were 15.4, 32.0, and 41.7% in the Tmab monotherapy group, and 45.8, 17.6, and 28.6% in the Tmab plus chemotherapy group. The proportions of suspected mild dementia at baseline were significantly higher in the Tmab plus chemotherapy group (p=0.04). The proportions of suspected dementia at baseline, and at 1 yr and 3 yrs were 0%, 0%, and 4.2% in the Tmab monotherapy group, and 4.2%, 0%, and 4.8% in the Tmab plus chemotherapy group. There were no significant differences in the proportions of suspected dementia between the treatment groups at each time point.
CONCLUSION: Postoperative chemotherapy for elderly breast cancer patients was considered to have little effect on the onset of dementia during the follow-up period of 3 yrs. Further long-term observation is necessary to obtain a significant conclusion.
Citation Format: Takahashi M, Sawaki M, Hagiwara Y, Uemura Y, Kawahara T, Shimozuma K, Ohashi Y, Saito T, Baba S, Kobayashi K, Mukai H, Taira N. Analysis of cognitive function in elderly HER2-positive breast cancer patients receiving either trastuzumab monotherapy or trastuzumab plus chemotherapy as a postoperative adjuvant treatment: A cognitive function sub-study of a randomized, open-label, phase 3 clinical trial (RESPECT trial) [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-11-21.
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Affiliation(s)
- M Takahashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - M Sawaki
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Hagiwara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Uemura
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Kawahara
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Shimozuma
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - Y Ohashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - T Saito
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - S Baba
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - K Kobayashi
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - H Mukai
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
| | - N Taira
- NHO Hokkaido Cancer Center, Sapporo, Japan; Aichi Cancer Center Hospital, Nagoya, Japan; Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan; College of Life Sciences, Ritsumeikan University, Kusatsu, Japan; Chuo University, Tokyo, Japan; Japanese Red Cross Saitama Hospital, Saitama, Japan; Sagara Hospital, Kagoshima, Japan; The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan; National Cancer Center Hospital East, Kashiwa, Japan; Okayama University Hospital, Okayama, Japan
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Shitara K, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Yoshino T. REVERCE: a randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for previously treated metastatic colorectal cancer patients. Ann Oncol 2019; 30:259-265. [PMID: 30508156 DOI: 10.1093/annonc/mdy526] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [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] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The objective of this randomized phase II trial was to evaluate efficacy and safety of the therapeutic sequence of regorafenib followed by cetuximab, compared with cetuximab followed by regorafenib, as the current standard sequence for metastatic colorectal cancer patients. PATIENTS AND METHODS Patients with KRAS exon 2 wild-type metastatic colorectal cancer after failure of fluoropyrimidine, oxaliplatin, and irinotecan were randomized to receive sequential treatment with regorafenib followed by cetuximab ± irinotecan (R-C arm), or the reverse sequence [cetuximab ± irinotecan followed by regorafenib (C-R arm)]. The primary end point was overall survival (OS). Key secondary end points included progression-free survival (PFS) with initial treatment (PFS1), PFS with second treatment (PFS2), safety, and quality of life. Exploratory end points included serial biomarker analyses, including oncogenic alterations from circulating tumor DNA or multiple serum or plasma proteins. RESULTS One-hundred one patients were randomized and eligible for efficacy analysis. Sequential treatment was successful in 86% patients in both arms. Median OS for R-C and C-R was 17.4 and 11.6 months, respectively (P = 0.0293), with a hazard ratio (HR) of 0.61 for OS [95% confidence interval (CI) 0.39-0.96]. The HR for PFS1 (regorafenib in R-C versus cetuximab in C-R) was 0.97 (95% CI 0.61-1.54), and PFS2 (C in R-C versus R in C-R) was 0.29 (95% CI 0.17-0.50). No unexpected safety signals were observed. The quality of life scores during the entire treatment period was not significantly different between the two arms. Circulating biomarker analyses showed emerging oncogenic alterations in RAS, BRAF, EGFR, HER2, and MET, which were more commonly detected after cetuximab than after regorafenib. CONCLUSIONS The therapeutic sequence of regorafenib followed by cetuximab suggests a longer OS than the current standard sequence.
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Affiliation(s)
- K Shitara
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - T Yamanaka
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - T Denda
- Division of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - Y Tsuji
- Department of Medical Oncology, Tonan Hospital, Sapporo, Japan
| | - K Shinozaki
- Division of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - Y Komatsu
- Division of Cancer Chemotherapy, Hokkaido University Hospital Cancer Center, Sapporo, Japan
| | - Y Kobayashi
- Department of Medical Oncology, Kushiro Rosai Hospital, Kushiro, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - H Okuda
- Department of Medical Oncology, Keiyukai Sapporo Hospital, Sapporo, Japan
| | - M Asayama
- Department of Gastroenterology, Saitama Cancer Center, Saitama, Japan
| | - K Akiyoshi
- Department of Clinical Oncology, Osaka City General Hospital, Osaka, Japan
| | - Y Kagawa
- Department of Surgery, Kansai Rosa Hospital, Amagasaki, Japan
| | - T Kato
- Department of Surgery, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - E Oki
- Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Ando
- School of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Faculty of Science and Engineering, Chuo University, Tokyo, Japan
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
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Kunitani Y, Goto T, Funakoshi H, Okamoto H, Hagiwara Y, Watase H, Hasegawa K. 97 The Association Between Multiple Intubation Attempts and Adverse Events in Pediatric Intubations in the Emergency Department. Ann Emerg Med 2018. [DOI: 10.1016/j.annemergmed.2018.08.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ishimaru M, Matsui H, Ono S, Hagiwara Y, Morita K, Yasunaga H. Preoperative oral care and effect on postoperative complications after major cancer surgery. Br J Surg 2018; 105:1688-1696. [DOI: 10.1002/bjs.10915] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/26/2018] [Accepted: 05/17/2018] [Indexed: 01/30/2023]
Abstract
Abstract
Background
Improving patients' oral hygiene is an option for preventing postoperative pneumonia that may be caused by aspiration of oral and pharyngeal secretions. Whether preoperative oral care by a dentist can decrease postoperative complications remains controversial. A retrospective cohort study was undertaken to assess the association between preoperative oral care and postoperative complications among patients who underwent major cancer surgery.
Methods
The nationwide administrative claims database in Japan was analysed. Patients were identified who underwent resection of head and neck, oesophageal, gastric, colorectal, lung or liver cancer between May 2012 and December 2015. The primary outcomes were postoperative pneumonia and all-cause mortality within 30 days of surgery. Patient background was adjusted for with inverse probability of treatment weighting using propensity scoring.
Results
Of 509 179 patients studied, 81 632 (16·0 per cent) received preoperative oral care from a dentist. A total of 15 724 patients (3·09 per cent) had postoperative pneumonia and 1734 (0·34 per cent) died within 30 days of surgery. After adjustment for potential confounding factors, preoperative oral care by a dentist was significantly associated with a decrease in postoperative pneumonia (3·28 versus 3·76 per cent; risk difference − 0·48 (95 per cent c.i. −0·64 to−0·32) per cent) and all-cause mortality within 30 days of surgery (0·30 versus 0·42 per cent; risk difference − 0·12 (−0·17 to −0·07) per cent).
Conclusion
Preoperative oral care by a dentist significantly reduced postoperative complications in patients who underwent cancer surgery.
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Affiliation(s)
- M Ishimaru
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - H Matsui
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - S Ono
- Department of Biostatistics and Bioinformatics, University of Tokyo, Tokyo, Japan
| | - Y Hagiwara
- Department of Biostatistics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - K Morita
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
| | - H Yasunaga
- Department of Clinical Epidemiology and Health Economics, School of Public Health, University of Tokyo, Tokyo, Japan
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25
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Yoshino T, Yamanaka T, Denda T, Tsuji Y, Shinozaki K, Komatsu Y, Kobayashi Y, Furuse J, Okuda H, Asayama M, Akiyoshi K, Kagawa Y, Kato T, Oki E, Ando T, Hagiwara Y, Ohashi Y, Shitara K. REVERCE: Randomized phase II study of regorafenib followed by cetuximab versus the reverse sequence for metastatic colorectal cancer patients previously treated with fluoropyrimidine, oxaliplatin, and irinotecan: Quality of life analysis. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.009] [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: 11/13/2022] Open
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26
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Hayakawa T, Nonaka T, Mizoguchi N, Hagiwara Y, Shibata S, Sakai R, Nakayama N, Yokose T, Nakayama Y. Radiotherapy for mucosa-associated lymphoid tissue (MALT) lymphoma of the rectum: a case report. Clin J Gastroenterol 2017; 10:431-436. [PMID: 28815477 DOI: 10.1007/s12328-017-0769-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/01/2017] [Indexed: 02/07/2023]
Abstract
Extra-nodal mucosa-associated lymphoid tissue (MALT) lymphoma is frequently involved with the upper gastrointestinal tract, but rarely involved with the rectum. We report a case of rectal MALT lymphoma treated by radiotherapy (RT) alone. A 74-year-old woman with lower abdominal pain was diagnosed with MALT lymphoma by endoscopic mucosal resection (EMR). She was diagnosed as stage IE (Ann Arbor) MALT lymphoma by diagnostic work-up and review of EMR specimens. Definitive RT was performed with curative intent, totaling 30 Gy in 15 fractions. Complete response was confirmed by colonoscopy after RT with no progression observed at 5 years. Definitive RT is effective for rectal MALT lymphoma.
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Affiliation(s)
- Toyokazu Hayakawa
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan.,Department of Radiation Oncology, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan.
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
| | - Shino Shibata
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
| | - Rika Sakai
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Norisuke Nakayama
- Department of Gastroenterological Medicine, Kanagawa Cancer Center, Yokohama, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
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27
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Shiroiwa T, Fukuda T, Shimozuma K, Mouri M, Hagiwara Y, Doihara H, Akabane H, Kashiwaba M, Watanabe T, Ohashi Y, Mukai H. Long-term health status as measured by EQ-5D among patients with metastatic breast cancer: comparison of first-line oral S-1 and taxane therapies in the randomized phase III SELECT BC trial. Qual Life Res 2016; 26:445-453. [PMID: 27517267 PMCID: PMC5288429 DOI: 10.1007/s11136-016-1388-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 12/29/2022]
Abstract
Purpose The goal of chemotherapy for metastatic breast cancer (MBC) is to prolong survival and maintain health-related quality of life. This study aimed to evaluate long-term health status of patients with MBC who participated in the phase III randomized SELECT BC trial. Methods In the SELECT BC trial, patients were randomly allocated to the S-1 or taxane (paclitaxel or docetaxel) arm. Health status was assessed by EQ-5D at pre-treatment, 3 and 6 months after randomization, and every 6 months thereafter to the extent possible. Least square mean scores were assessed to compare EQ-5D index values between groups. Time to deterioration analysis was also performed by defining the minimally important difference of EQ-5D as 0.05 or 0.1. Results The number of patients for EQ-5D analysis was 175 and 208 in the taxane and S-1 arms, respectively. Least square mean EQ-5D index values up to 60 months were 0.741 (95 % CI [0.713–0.769]) in the taxane arm and 0.748 [0.722–0.775] in the S-1 arm. The EQ-5D index value during PFS up to 12 months in the S-1 was superior to the corresponding index value in the taxane (0.812 [0.789–0.834] vs. 0.772 [0.751–0.792], P = 0.009). Time to deterioration analysis also revealed that S-1 significantly delayed the deterioration of EQ-5D index value during the period before progression (P = 0.002 and 0.003). Conclusions Our findings suggest that the EQ-5D index value was higher in patients treated with S-1 during first-line chemotherapy. Considering non-inferiority of S-1 in terms of OS, obtained quality-adjusted life years may be greater in the S-1 arm.
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Affiliation(s)
- T Shiroiwa
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan.
| | - T Fukuda
- Department of Health and Welfare Services, National Institute of Public Health, 2-3-6 Minami, Wako, Saitama, 351-0197, Japan
| | - K Shimozuma
- Department of Biomedical Sciences, College of Life Sciences, Ritsumeikan University, 1-1-1 Noji-higashi, Kusatsu, Shiga, 525-8577, Japan
| | - M Mouri
- Kanagawa Academy of Science and Technology (KAST), 3-2-1 Sakado, Takatsu-ku, Kawasaki, Kanagawa, 213-0012, Japan
| | - Y Hagiwara
- Department of Biostatistics, School of Public Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - H Doihara
- Breast and Endocrine Surgery Department, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan
| | - H Akabane
- Department of Surgery, Hokkaido P.W.F.A.C. Asahikawa-Kosei General Hospital, 24-111 Ichijo dori, Asahikawa, Hokkaido, 078 8211, Japan
| | - M Kashiwaba
- Department of Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan
| | - T Watanabe
- Department of Breast Surgery, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai, Miyagi, 983-8520, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering, Chuo University, 1-13-27 Kasuga, Bunkyo-ku, Tokyo, 112-8551, Japan
| | - H Mukai
- Division of Breast and Medical Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan
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Nakayama Y, Minohara S, Nonaka T, Nomiya T, Kusano Y, Takeshita E, Mizoguchi N, Hagiwara Y. The Ion-Beam Radiation Oncology Center in Kanagawa (i-ROCK) Carbon Ion Facility at the Kanagawa Cancer Center. Int J Part Ther 2016; 2:478-480. [PMID: 31772959 DOI: 10.14338/ijpt-15-00024.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/02/2015] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yuko Nakayama
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Shinichi Minohara
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Takuma Nomiya
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yohsuke Kusano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Eri Takeshita
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
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29
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Goto T, Gibo K, Hagiwara Y, Okubo M, Brown D, Brown C, Hasegawa K. 18 Factors Associated With First-Pass Success in Pediatric Intubation in the Emergency Department: An Analysis of Multicenter Prospective Observational Study. Ann Emerg Med 2015. [DOI: 10.1016/j.annemergmed.2015.07.047] [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: 11/16/2022]
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30
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Hagiwara Y, Dyment N, Jiang X, Huang J, Ackert-Bicknell C, Adams D, Rowe D. Fixation stability dictates the differentiation pathway of periosteal progenitor cells in fracture repair. J Orthop Res 2015; 33:948-56. [PMID: 25639792 PMCID: PMC4891973 DOI: 10.1002/jor.22816] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Revised: 12/02/2014] [Accepted: 12/19/2014] [Indexed: 02/04/2023]
Abstract
This study compared fracture repair stabilized by intramedullary pin (IMP) or external fixation (EF) in GFP reporter mice. A modified IMP was used as control while EF utilized six needles inserted transversely through the tibia and into a segment of a syringe barrel. X-rays taken at days 0, 14, and 35 showed that IMP resulted in significant three-dimensional deformity with a large callus while EF showed minimal deformity and callus formation. Cryohistological analysis of IMP at day 14 confirmed a large ColX-RFPchry+ callus surrounded by woven bone (Col3.6-GFPcyan) and TRAP+ osteoclasts with mature bone (hOC-GFPtpz) at the base. By day 35, cartilaginous components had been resorbed and an outer cortical shell (OCS) showed evidence of inward modeling. In contrast, the EF at day 14 showed no evidence of cartilage formation. Instead, periosteal-derived osteoblasts (Col3.6-GFPcyan) entered the fracture cleft and formed woven bone that spanned the marrow space. By day 35, mature bone had formed that was contiguous with the opposing cortical bone. Fracture site stability greatly affects the cellular response during repair and must be considered in the preclinical models that test therapies for improving fracture healing.
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Affiliation(s)
- Y. Hagiwara
- Department of Orthopedic Surgery, Nippon Medical School Hospital, Tokyo 113, JAPAN
| | | | | | | | - C. Ackert-Bicknell
- Dept. Orthopaedics and Rehabilitation, Center for Musculoskeletal Research, University of Rochester School of Medicine, Rochester, NY 14642
| | - D.J. Adams
- Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06030
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Dyment N, Hagiwara Y, Jiang X, Huang J, Adams D, Rowe D. Response of knee fibrocartilage to joint destabilization. Osteoarthritis Cartilage 2015; 23:996-1006. [PMID: 25680653 PMCID: PMC4757847 DOI: 10.1016/j.joca.2015.01.017] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 01/16/2015] [Accepted: 01/28/2015] [Indexed: 02/02/2023]
Abstract
OBJECTIVE A major challenge to understanding osteoarthritis (OA) pathology is identifying the cellular events that precede the onset of cartilage damage. The objective of this study is to determine the effect of joint destabilization on early changes to fibrocartilage in the joint. DESIGN/METHODS The anterior cruciate ligament was transected in collagen reporter mice (Col1CFP and ColXRFP). Mineralization labels were given every 2 weeks to measure new mineralized cartilage apposition. Novel fluorescent histology of mineralized tissue was used to characterize the changes in fibrocartilage at 2 and 4 weeks post-injury. RESULTS Changes in fibrocartilaginous structures of the joint occur as early as 2 weeks after injury and are well developed by 4 weeks. The alterations are seen in multiple entheses and in the medial surface of the femoral and tibial condyles. In the responding entheses, mineral apposition towards the ligament midsubstance results in thickening of the mineralize fibrocartilage. These changes are associated with increases in ColX-RFP, Col1-CFP reporter activity and alkaline phosphatase enzyme activity. Mineral apposition also occurs in the fibrocartilage of the non-articular regions of the medial condyles by 2 weeks and develops into osteophytes by 4 weeks post-injury. An unexpected observation is punctate expression of tartrate resistant acid phosphatase activity in unmineralized fibrochondrocytes adjacent to active appositional mineralization. DISCUSSION These observations suggest that fibrocartilage activates prior to degradation of the articular cartilage. Thus clinical and histological imaging of fibrocartilage may be an earlier indicator of disease initiation and may indicate a more appropriate time to start preventative treatment.
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Affiliation(s)
- N.A Dyment
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - Y. Hagiwara
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032,Department of Orthopedic Surgery, Nippon Medical School Hospital, Tokyo 113, JAPAN
| | - X. Jiang
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - J. Huang
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - D.J. Adams
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
| | - D.W. Rowe
- Center for Regenerative Medicine and Skeletal Development, School of Dental Medicine, Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut Health Center, Farmington, CT 06032
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Hagiwara Y, Kamisaka K, Sakui D, Adachi T, Nakane E, Inoko M, Yamada S. Physical performance is a related factor in cognitive impairment in elderly patients with heart failure. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.3302] [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: 11/15/2022]
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Nomiya T, Akamatsu H, Harada M, Ota I, Hagiwara Y, Ichikawa M, Miwa M, Kawashiro S, Hagiwara M, Chin M, Hashizume E, Nemoto K. Modified simultaneous integrated boost radiotherapy for an unresectable huge refractory pelvic tumor diagnosed as a rectal adenocarcinoma. World J Gastroenterol 2014; 20:18480-18486. [PMID: 25561820 PMCID: PMC4277990 DOI: 10.3748/wjg.v20.i48.18480] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [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: 05/14/2014] [Revised: 06/16/2014] [Accepted: 07/16/2014] [Indexed: 02/06/2023] Open
Abstract
A clinical trial of radiotherapy with modified simultaneous integrated boost (SIB) technique against huge tumors was conducted. A 58-year-old male patient who had a huge pelvic tumor diagnosed as a rectal adenocarcinoma due to familial adenomatous polyposis was enrolled in this trial. The total dose of 77 Gy (equivalent dose in 2 Gy/fraction) and 64.5 Gy was delivered to the center of the tumor and the surrounding area respectively, and approximately 20% dose escalation was achieved with the modified SIB technique. The tumor with an initial maximum size of 15 cm disappeared 120 d after the start of the radiotherapy. Performance status of the patient improved from 4 to 0. Radiotherapy with modified SIB may be effective for patients with a huge tumor in terms of tumor shrinkage/disappearance, improvement of QOL, and prolongation of survival.
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Nomiya T, Akamatsu H, Harada M, Ota I, Hagiwara Y, Ichikawa M, Miwa M, Suzuki A, Nemoto K. Modified simultaneous integrated boost radiotherapy for unresectable locally advanced breast cancer: preliminary results of a prospective clinical trial. Clin Breast Cancer 2014; 15:161-7. [PMID: 25459068 DOI: 10.1016/j.clbc.2014.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 09/27/2014] [Accepted: 09/30/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the effect of modified simultaneous integrated boost (SIB) radiotherapy for patients with extensive breast cancer. PATIENTS AND METHODS Patients with macroscopic tumor and histologically proven adenocarcinoma of the breast were enrolled in the study. Patients were included whether they had or did not have previous surgery, chemotherapy, hormone therapy, or molecular targeted therapy; patients with past history of thoracic radiotherapy were excluded. Under conditions of not exceeding the tolerance dose for normal tissue, irradiation to the tumor was increased to the maximum possible extent using the modified SIB technique. RESULTS Three breast cancer patients were treated with the modified SIB technique. All patients were diagnosed as T4b (median maximum diameter of the tumor: 16 cm; range, 15.5-22 cm), and all patients exhibited symptoms because of the extremely large tumor. The median total dose to the part of tumor tissue was 128.8 Gy (range, 110-140 Gy). Total dose to normal tissue was < 72 Gy in all patients. Although large tumors were radio-resistant, it was macroscopically confirmed that all tumors eventually disappeared. Although skin defects persisted because of tumor disappearance, there were no Grade ≥ 3 toxicities due to radiotherapy. CONCLUSION Although much care is required in delivering extremely high doses of radiotherapy to the tumor, modified SIB radiotherapy was shown to be effective against extremely large tumors that could not be controlled using conventional radiotherapy. In future, an increase in the number of study patients and establishment of the technique will be required.
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Affiliation(s)
- Takuma Nomiya
- Department of Radiation Oncology, National Institute of Radiological Sciences, Chiba, Japan.
| | - Hiroko Akamatsu
- Department of Radiation Oncology, Yamagata University Hospital, Yamagata, Japan
| | - Mayumi Harada
- Department of Radiation Oncology, Yamagata University Hospital, Yamagata, Japan
| | - Ibuki Ota
- Department of Radiation Oncology, Yamagata University Hospital, Yamagata, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Yamagata University Hospital, Yamagata, Japan
| | - Mayumi Ichikawa
- Department of Radiation Oncology, Yamagata University Hospital, Yamagata, Japan
| | - Misako Miwa
- Department of Radiation Oncology, Yamagata University Hospital, Yamagata, Japan
| | - Akihiko Suzuki
- Department of Surgery, Yamagata University Hospital, Yamagata, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Yamagata University Hospital, Yamagata, Japan
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Ide K, Yamada H, Umegaki K, Mizuno K, Kawakami N, Hagiwara Y, Matsumoto M, Yoshida H, Kim K, Shiosaki E, Yokochi T, Harada K. PP273-MON: Outstanding abstract: Lymphocyte and Plasma Vitamin Levels as Potential Biomarkers for Parkinson’s Disease Progression. Clin Nutr 2014. [DOI: 10.1016/s0261-5614(14)50607-3] [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: 10/24/2022]
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36
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Nomiya T, Kaneko T, Goto J, Harada M, Akamatsu H, Hagiwara Y, Ota I, Nemoto K. Relationship between serum reactive oxidative metabolite level and skin reaction in an irradiated rat model. Free Radic Res 2014; 48:572-9. [DOI: 10.3109/10715762.2014.894637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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37
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Morino T, Ookawa K, Haruta N, Hagiwara Y, Seki M. Effects of professional oral health care on elderly: randomized trial. Int J Dent Hyg 2014; 12:291-7. [PMID: 24502652 DOI: 10.1111/idh.12068] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To better understand the role of the professional oral health care for elderly in improving geriatric oral health, the effects of short-term professional oral health care (once per week for 1 month) on oral microbiological parameters were assessed. METHODS Parallel, open-labelled, randomize-controlled trial was undertaken in a nursing home for elderly in Shizuoka, Japan. Thirty-four dentate elderly over 74 years were randomly assigned from ID number to the intervention (17/34) and control (17/34) groups. The outcomes were changes in oral microbiological parameters (number of bacteria in unstimulated saliva; whole bacteria, Streptococcus, Fusobacterium and Prevotella: opportunistic pathogens detection: and index of oral hygiene evaluation [Dental Plaque Index, DPI]) within the intervention period. Each parameter was evaluated at before and after intervention period. Four elderly were lost from mortality (1), bone fracture (1), refused to participate (1) and multi-antibiotics usage (1). Finally, 30 elderly were analysed (14/intervention and 16/control). RESULTS At baseline, no difference was found between the control and intervention groups. After the intervention period, the percentage of Streptococcus species increased significantly in the intervention group (Intervention, 86% [12/14]; Control, 50% [8/16]: Fisher's, right-tailed, P < 0.05). Moreover, DPI significantly improved in the intervention group (Intervention, 57% [8/14]; Control, 13% [2/16]: Fisher's, two-tailed, P < 0.05). The improvement in DPI extended for 3 months after intervention. None of side effects were reported. CONCLUSION The short-term professional oral health care can improve oral conditions in the elderly.
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Affiliation(s)
- T Morino
- University of Shizuoka, Junior College, Shizuoka, Japan
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Kawashiro S, Hagiwara Y, Ota I, Ichikawa M, Miwa M, Kuroda Y, Nemoto K. Experience of a Videoconference System with Medical Information Desktop Sharing for Radiation Therapy and Evaluation of Its Usefulness. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ijmpcero.2014.31004] [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: 11/20/2022]
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Aghi M, Vogelbaum MA, Jolly DJ, Robbins JM, Ostertag D, Ibanez CE, Gruber HE, Kasahara N, Bankiewicz K, Cloughesy TF, Chang SM, Butowski N, Kesari S, Chen C, Mikkelsen T, Landolfi J, Chiocca EA, Elder JB, Foltz G, Pertschuk D, Anaizi A, Taylor C, Kosty J, Zimmer L, Theodosopoulos P, Anaizi A, Gantwerker E, Pensak M, Theodosopoulos P, Anaizi A, Grewal S, Theodosopoulos P, Zimmer L, Anaizi A, Pensak M, Theodosopoulos P, Arakawa Y, Kang Y, Murata D, Fujimoto KI, Miyamoto S, Blagia M, Paulis M, Orunesu G, Serra S, Akers J, Ramakrishnan V, Kim R, Skog J, Nakano I, Pingle S, Kalinina J, Kesari S, Breakfield X, Hochberg F, Van Meir E, Carter B, Chen C, Czech T, Nicholson J, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran F, Calaminus G, Hamer PDW, Hendriks E, Mandonnet E, Barkhof F, Zwinderman K, Duffau H, Esquenazi Y, Johnson J, Tandon N, Esquenazi Y, Friedman E, Lin Y, Zhu JJ, Tandon N, Fujimaki T, Kobayashi M, Wakiya K, Ohta M, Adachi J, Fukuoka K, Suzuki T, Yanagisawa T, Matsutani M, Mishima K, Sasaki J, Nishikawa R, Hoffermann M, Bruckmann L, Ali KM, Asslaber M, Payer F, von Campe G, Jungk C, Beigel B, Abb V, Herold-Mende C, Unterberg A, Kim JH, Cho YH, Kim CJ, Mardor Y, Nissim O, Grober Y, Guez D, Last D, Daniels D, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Zach L, Marupudi N, Mittal S, Michaud K, Cantin L, Cottin S, Dandurand C, Mohammadi A, Hawasli A, Rodriguez A, Schroeder J, Laxton A, Elson P, Tatter S, Barnett G, Leuthardt E, Moriuchi S, Dehara M, Fukunaga T, Hagiwara Y, Soda H, Imakita M, Nitta M, Maruyama T, Iseki H, Ikuta S, Tamura M, Chernov M, Okamoto S, Okada Y, Muragaki Y, Ohue S, Kohno S, Inoue A, Yamashita D, Kumon Y, Ohnishi T, Oppido P, Villani V, Vidiri A, Pace A, Pompili A, Carapella C, Orringer D, Lau D, Niknafs Y, Piquer J, Llacer JL, Rovira V, Riesgo P, Cremades A, Rotta R, Levine N, Prabhu S, Sawaya R, Weinberg J, Rao G, Tummala S, Tilley C, Rovin R, Kassam A, Schwartz C, Romagna A, Thon N, Tonn JC, Schwarz SB, Kreth FW, Sonoda Y, Shibahara I, Saito R, Kanamori M, Kumabe T, Tominaga T, Steele C, Lawrence J, Rovin R, Winn R, Rachinger W, Simon M, Dutzmann S, Feigl G, Kremenevskaya N, Thon N, Tonn JC, Whelan H, Kelly M, Jogel S, Kaufmann B, Foy A, Lew S, Quirk B, Yong RL, Wu T, Mihatov N, Shen MJ, Brown MA, Zaghloul KA, Park GE, Park JK. SURGICAL THERAPIES. Neuro Oncol 2013; 15:iii217-iii225. [PMCID: PMC3823906 DOI: 10.1093/neuonc/not191] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024] Open
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Hagiwara Y, Yanagisawa T, Atsumi C, Maki F, Shimizu T, Hasegawa Y. Cyclophosphamide-responsive cerebral amyloid angiopathy-related inflammation. A case report and review of the literature. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1210] [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: 10/26/2022]
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Kawashiro S, Nomiya T, Hagiwara Y, Ota I, Ichikawa M, Kuroda Y, Murakami M, Nemoto K. Verification of Respiratory Position Reproducibility With a Respiration Self-Monitoring Device: Results for 12 Patients With Lung Tumors. Pract Radiat Oncol 2013; 3:S16. [DOI: 10.1016/j.prro.2013.01.058] [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: 10/27/2022]
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Wada H, Nemoto K, Nomiya T, Murakami M, Suzuki M, Kuroda Y, Ichikawa M, Ota I, Hagiwara Y, Ariga H, Takeda K, Takai K, Fujimoto K, Kenjo M, Ogawa K. A phase I trial of S-1 with concurrent radiotherapy in patients with locally recurrent rectal cancer. Int J Clin Oncol 2012; 18:273-8. [PMID: 22318782 DOI: 10.1007/s10147-012-0375-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2011] [Accepted: 12/29/2011] [Indexed: 01/21/2023]
Abstract
BACKGROUND The purpose of this phase I trial of S-1 chemotherapy in combination with pelvic radiotherapy for locally recurrent rectal cancer was to determine the maximum tolerated dose (MTD), recommended dose (RD), and dose-limiting toxicity (DLT) of S-1. METHODS We enrolled 9 patients between April 2005 and March 2009. Radiotherapy (total dose, 60 Gy in 30 fractions) was given to the gross local recurrent tumor and pelvic nodal metastases using three-dimensional radiotherapy planning. We administered oral S-1 twice a day on days 1-14 and 22-35 during radiotherapy. The dose of S-1 was initially 60 mg/m(2)/day and was increased to determine the MTD and RD for this regimen. RESULTS DLT appeared at dose level 2 (70 mg/m(2)/day) in 2 patients, who experienced grade 3 enterocolitis and consequently required suspension of S-1 administration for longer than 2 weeks. Hematological toxicity was mild and reversible. At the initial evaluation, complete regression and partial regression were seen in 1 patient (11%) and 2 patients (22%), respectively. CONCLUSION This phase I trial of S-1 chemotherapy with pelvic radiotherapy for locally recurrent rectal cancer revealed that the MTD for S-1 was 70 mg/m(2)/day and the RD was 60 mg/m(2)/day.
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Affiliation(s)
- Hitoshi Wada
- Department of Radiation Oncology, Miyagi Cancer Center, Nodayama 47-1, Medeshima-shiote, Natori, 981-1293, Japan.
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Nakajima M, Miyajima M, Ogino I, Watanabe M, Hagiwara Y, Segawa T, Kobayashi K, Arai H. Brain localization of leucine-rich α2-glycoprotein and its role. Acta Neurochir Suppl 2012; 113:97-101. [PMID: 22116432 DOI: 10.1007/978-3-7091-0923-6_20] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVES We have previously reported that the level of leucine-rich alpha-2-glycoprotein (LRG) expression is specifically increased in cerebrospinal fluid (CSF) of idiopathic normal pressure hydrocephalus (INPH). The objective of this study is to examine the localization of LRG - the cerebral areas where it is expressed. METHOD The histological sections of autopsied brain specimens from ten subjects, five adult cases (mean age 43.6 years; range 34-50 years) and five senile cases (mean age 76.0 years; range 67-88 years) were prepared, multistained with antibodies against human LRG, glial fibrillary acidic protein (GFAP), CD31, and aquaporin-4 (AQP4), and reviewed for the expression sites of LRG. RESULTS Immunostains of GFAP and LRG were compared in standard brain specimens from elderly patients. The results indicated that LRG is distributed throughout the entire brain, with especially high expression in the deep cerebral cortex. In addition, the cells that express LRG showed similar morphology to astrocytes. Double staining of CD31 and LRG revealed a significant expression of LRG in the pericapillary regions. The expression was observed in resident astrocytes, as well as in the capillary vessel to which astrocytic processes grow and adhere. When age-related comparisons were made between senile and adult specimens, LRG expression increased with age. CONCLUSION LRG expression in resident astrocytes increased with age.
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Affiliation(s)
- Madoka Nakajima
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
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Hasegawa K, Hagiwara Y, Chiba T, Watase H, Brown C, Walls R, Brown D. 380 Emergency Airway Management in Japan: Interim Analysis of a Multi-Center Prospective Observational Study. Ann Emerg Med 2011. [DOI: 10.1016/j.annemergmed.2011.06.412] [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: 11/29/2022]
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Wada K, Hagiwara Y, Fukuyama K. One residue substitution in PcyA leads to unexpected changes in tetrapyrrole substrate binding. Acta Crystallogr A 2011. [DOI: 10.1107/s0108767311079876] [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: 11/10/2022] Open
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Yoshino N, Kanekiyo M, Hagiwara Y, Okamura T, Someya K, Matsuo K, Ami Y, Sato S, Yamamoto N, Honda M. Intradermal delivery of recombinant vaccinia virus vector DIs induces gut-mucosal immunity. Scand J Immunol 2010; 72:98-105. [PMID: 20618768 DOI: 10.1111/j.1365-3083.2010.02416.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Antigen-specific mucosal immunity is generally induced by the stimulation of inductive mucosal sites. In this study, we found that the replication-deficient vaccinia virus vector, DIs, generates antigen-specific mucosal immunity and systemic responses. Following intradermal injection of recombinant DIs expressing simian immunodeficiency virus gag (rDIsSIVgag), we observed increased levels of SIV p27-specific IgA and IgG antibodies in faecal extracts and plasma samples, and antibody-forming cells in the intestinal mucosa and spleen of C57BL/6 mice. Antibodies against p27 were not detected in nasal washes, saliva, and vaginal washes. The enhanced mucosal and systemic immunity persisted for 1 year of observation. Induction of Gag-specific IFN-gamma spot-forming CD8(+) T cells in the spleen, small intestinal intraepithelial lymphocytes, and submandibular lymph nodes was observed in the intradermally injected mice. Heat-inactivated rDIsSIVgag rarely induced antigen-specific humoral and T-helper immunity. Moreover, rDIsSIVgag was detected in MHC class II IA antigen-positive (IA(+)) cells at the injection site. Consequently, intradermal delivery of rDIs effectively induces antigen-specific humoral and cellular immunity in gut-mucosal tissues of mice. Our data suggest that intradermal injection of an rDIs vaccine may be useful against mucosally transmitted pathogens.
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Affiliation(s)
- N Yoshino
- Department of Microbiology, School of Medicine, Iwate Medical University, Morioka, Iwate, Japan.
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Wada T, Hagiwara A, Sasaki R, Sato T, Kobayashi K, Inaka A, Sakamoto T, Hagiwara Y, Inagaki T, Katsuno K, Takegawa R, Kimura A. Can follow-up procalcitonin measurements shorten the periods of antibiotic administrations for septic patients? Crit Care 2010. [PMCID: PMC2934230 DOI: 10.1186/cc8276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Yoshino N, Kanekiyo M, Hagiwara Y, Okamura T, Someya K, Matsuo K, Ami Y, Sato S, Yamamoto N, Honda M. Mucosal Administration of Completely Non-Replicative Vaccinia Virus Recombinant Dairen I strain Elicits Effective Mucosal and Systemic Immunity. Scand J Immunol 2008; 68:476-83. [DOI: 10.1111/j.1365-3083.2008.02168.x] [Citation(s) in RCA: 2] [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: 11/28/2022]
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Hagiwara Y, Sugishima M, Khawn H, Kinoshita H, Inomata K, Shang L, Lagarias J, Takahashi Y, Fukuyama K. Snapshots in the reaction pathway of bilin reductase PcyA. Acta Crystallogr A 2008. [DOI: 10.1107/s0108767308092143] [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: 11/11/2022] Open
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