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Yada M, Matsuda K, Kitano M, Iwai Y, Tominaga S. Cerebral Arteriovenous Malformation With Ipsilateral Middle Cerebral Artery Occlusion: A Case Report. Cureus 2023; 15:e51193. [PMID: 38283460 PMCID: PMC10817826 DOI: 10.7759/cureus.51193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
We report the case of a 29-year-old man who presented with a sudden headache. Computed tomography showed a small intraventricular hemorrhage in the left lateral ventricle. Cerebral angiograms suggested rupture of a coexisting feeder aneurysm in the left temporal cerebral arteriovenous malformation (AVM). The left proximal middle cerebral artery, a major feeding artery, was occluded near the AVM, with development of abnormal blood supply, such as in moyamoya-like vessels to the nidus. After endovascular embolization of the coexisting feeder aneurysm and feeding arteries, the patient underwent volume-staged Gamma Knife radiosurgery (GKS). Follow-up angiograms performed 4.5 years after the last GKS confirmed complete disappearance of the AVM. Around 4.8 years after GKS, the patient required surgical intervention to develop delayed cyst formation; however, the postoperative course was uneventful.
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Affiliation(s)
| | - Ko Matsuda
- Neurosurgery, Tominaga Hospital, Osaka, JPN
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Li J, Iwai Y, Isaacs TJ, Ma SJ, Elmore SNC, Kamran S, Oladeru OT. Palliative Care among Incarcerated Populations: A National Survey of Radiation Oncologists' Perspectives and Experiences. Int J Radiat Oncol Biol Phys 2023; 117:e36. [PMID: 37785237 DOI: 10.1016/j.ijrobp.2023.06.726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Incarcerated individuals carry a high disease burden, including cancer which is now the leading cause of illness-related deaths. Disparities in access to screening, care coordination, timely treatment, and comorbidities have been identified as contributors to late-stage diagnosis and poor cancer-related outcomes. As the first of its kind, we assessed oncologists' knowledge, attitudes, and practices (KAP) in providing cancer care to incarcerated patients. MATERIALS/METHODS A KAP survey on incarcerated patients with cancer was developed and piloted with volunteer radiation oncologists. Following IRB approval, the KAP survey questionnaire included physicians' demographics and Likert scale questions on practice patterns and experiences caring for incarcerated patients. The survey was distributed to 150 medical and radiation oncologists randomly selected from national societies' membership directories (ASTRO and ASCO). Data collection took place from 7/2020-12/2021, and descriptive statistics were used for analysis. RESULTS Of the 75 surveyed radiation oncologists (RO), 34 responded with a response rate of 45% among the specialty cohort. Most RO (59%) incorrectly identified "heart disease" as the leading cause of death among incarcerated patients, followed by "substance use disorder" (19%); only 9% correctly reported "cancer" as the leading cause of death. Most RO reported caring for a patient who underwent cancer treatment while incarcerated (70%) or recently incarcerated (within 6 months of release; 63%). 38% (n = 10/26) indicated incarcerated patients presented with delayed diagnosis at consultation. 58% (n = 14/24) reported that ≥50% of their patients who were incarcerated presented with cancer-related pain, and 82% (n = 18/22) indicated that ≥50% of their patients had a history of opioid use disorder. Yet 38% (n = 9/24) reported their clinic adequately treated cancer-related pain for incarcerated patients, while 54% (n = 13/24) reported their clinic needed improvement. CONCLUSION Most radiation oncologists have experience providing cancer care for incarcerated patients and acknowledge disparities in later-stage disease presentation in this patient population. Interventions are needed to ensure cancer-related pain is appropriately managed among patients experiencing incarceration. Further studies are required to understand practice patterns and ensure equitable cancer treatment for carceral populations.
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Affiliation(s)
- J Li
- State University of New York Upstate Medical University, Syracuse, NY
| | - Y Iwai
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - T J Isaacs
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
| | - S J Ma
- Roswell Park Comprehensive Cancer Center, Buffalo, NY
| | - S N C Elmore
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - S Kamran
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA
| | - O T Oladeru
- Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL
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Matsunaga S, Shuto T, Serizawa T, Aoyagi K, Hasegawa T, Kawagishi J, Yomo S, Kenai H, Nakazaki K, Moriki A, Iwai Y, Yamanaka K, Yamamoto T. Gamma Knife Radiosurgery for Metastatic Brain Tumors from Uterine Cervical and Endometrial Carcinomas: Histopathological Analysis of Survival and Local Control. A Japanese Multi-Institutional Cooperative and Retrospective Cohort Study. World Neurosurg 2023; 171:e572-e580. [PMID: 36529429 DOI: 10.1016/j.wneu.2022.12.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE A retrospective comparative analysis of the outcomes of gamma knife radiosurgery (GKRS) for brain metastases from uterine cervical carcinoma (CC) and endometrial carcinoma (EC), investigated the efficacy and prognostic factors for survival and local tumor control. Histopathological analysis was also performed. METHODS The authors retrospectively reviewed 61 patients with 260 tumors of CC and 73 patients with 302 tumors of EC who had undergone GKRS. RESULTS The survival times after GKRS had no difference between CC and EC. Uncontrolled primary cancer was significant unfavorable factor. CC resulted in significantly higher neurological death and post-GKRS neurological deterioration. New lesions appeared intracranially after GKRS, with no significant difference between CC and EC. Local tumor control rates at 6, 12, and 24 months after GKRS were 90.0%, 86.6%, and 78.0% for CC and 92.2%, 87.9%, and 86.4% for EC. Primary cancer of CC, more than 7 cm3 volume, and prescription dose less than 20 Gy were significantly correlated in control failure. Local tumor control rates were significantly lower for squamous cell carcinoma in CC. No significant differences were found between histopathological subtypes of EC. CONCLUSIONS This study established a relationship between the efficacy of GKRS for CC and EC brain metastases and the histopathological. Though, survival time after GKRS has no difference between CC and EC, CC was significantly higher neurogenic death and neurological deterioration after GKRS. Squamous cell carcinoma had a significantly lower rate of local tumor control among all CC, thereby resulting in CC having lower local tumor control than EC.
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Affiliation(s)
- Shigeo Matsunaga
- Department of Neurosurgery, Yokohama, Kanagawa, Japan; Stereotactic Radiotherapy Center, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan.
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama, Kanagawa, Japan; Stereotactic Radiotherapy Center, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Toru Serizawa
- Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo, Japan
| | - Kyoko Aoyagi
- Department of Neurosurgery, Gamma Knife House, Chiba Cerebral and Cardiovascular Center, Ichihara, Chiba, Japan
| | - Toshinori Hasegawa
- Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Komaki, Aichi, Japan
| | - Jun Kawagishi
- Department of Neurosurgery, Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Miyagi, Japan
| | - Shoji Yomo
- Division of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Nagano, Japan
| | - Hiroyuki Kenai
- Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita, Japan
| | - Kiyoshi Nakazaki
- Department of Neurosurgery, Brain Attack Center Ota Memorial Hospital, Fukuyama, Hiroshima, Japan
| | - Akihito Moriki
- Department of Neurosurgery, Mominoki Hospital, Kochi, Japan
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Tominaga Hospital, Osaka, Japan
| | - Kazuhiro Yamanaka
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Tetsuya Yamamoto
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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Iwai Y, Ikeda H, Kawashima T, Yamanaka K. Hemifacial spasm and nervus intermedius neuralgia associated with hyperfunction and hypofunction of the nervus intermedius. Interdisciplinary Neurosurgery 2022. [DOI: 10.1016/j.inat.2022.101494] [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] Open
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Hasegawa H, Shin M, Kawagishi J, Jokura H, Hasegawa T, Kato T, Kawashima M, Shinya Y, Kenai H, Kawabe T, Sato M, Serizawa T, Nagano O, Aoyagi K, Kondoh T, Yamamoto M, Onoue S, Nakazaki K, Iwai Y, Yamanaka K, Hasegawa S, Kashiwabara K, Saito N. A Practical Grading Scale for Predicting Outcomes of Radiosurgery for Dural Arteriovenous Fistulas: JLGK 1802 Study. J Stroke 2022; 24:278-287. [PMID: 35677982 PMCID: PMC9194540 DOI: 10.5853/jos.2021.03594] [Citation(s) in RCA: 2] [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] [Received: 10/14/2021] [Accepted: 03/16/2022] [Indexed: 11/11/2022] Open
Abstract
Background and Purpose To assess the long-term outcomes of intracranial dural arteriovenous fistula (DAVF) treated with stereotactic radiosurgery (SRS) alone or embolization and SRS (Emb-SRS) and to develop a grading system for predicting DAVF obliteration.
Methods This multi-institutional retrospective study included 200 patients with DAVF treated with SRS or Emb-SRS. We investigated the long-term obliteration rate and obliteration-associated factors. We developed a new grading system to estimate the obliteration rate. Additionally, we compared the outcomes of SRS and Emb-SRS by using propensity score matching.
Results The 3- and 4-year obliteration rates were 66.3% and 78.8%, respectively. The post-SRS hemorrhage rate was 2%. In the matched cohort, the SRS and Emb-SRS groups did not differ in the rates of obliteration (P=0.54) or post-SRS hemorrhage (P=0.50). In multivariable analysis, DAVF location and cortical venous reflux (CVR) were independently associated with obliteration. The new grading system assigned 2, 1, and 0 points to DAVFs in the anterior skull base or middle fossa, DAVFs with CVR or DAVFs in the superior sagittal sinus or tentorium, and DAVFs without these factors, respectively. Using the total points, patients were stratified into the highest (0 points), intermediate (1 point), or lowest (≥2 points) obliteration rate groups that exhibited 4-year obliteration rates of 94.4%, 71.3%, and 60.4%, respectively (P<0.01).
Conclusions SRS-based therapy achieved DAVF obliteration in more than three-quarters of the patients at 4 years of age. Our grading system can stratify the obliteration rate and may guide physicians in treatment selection.
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Affiliation(s)
- Hirotaka Hasegawa
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Masahiro Shin
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Jun Kawagishi
- Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Japan
| | - Hidefumi Jokura
- Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Japan
| | | | - Takenori Kato
- Department of Neurosurgery, Komaki City Hospital, Komaki, Japan
| | - Mariko Kawashima
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Yuki Shinya
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroyuki Kenai
- Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita, Japan
| | - Takuya Kawabe
- Kyoto Gamma Knife Center, Rakusai Shimizu Hospital, Kyoto, Japan
| | - Manabu Sato
- Kyoto Gamma Knife Center, Rakusai Shimizu Hospital, Kyoto, Japan
| | - Toru Serizawa
- Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo, Japan
| | - Osamu Nagano
- Gamma Knife House, Chiba Cerebral and Cardiovascular Center, Ichihara, Japan
| | - Kyoko Aoyagi
- Gamma Knife House, Chiba Cerebral and Cardiovascular Center, Ichihara, Japan
| | - Takeshi Kondoh
- Department of Neurosurgery, Shinsuma General Hospital, Kobe, Japan
| | | | - Shinji Onoue
- Department of Neurosurgery, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - Kiyoshi Nakazaki
- Department of Neurosurgery, Brain Attack Center, Ota Memorial Hospital, Fukuyama, Japan
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Kazuhiro Yamanaka
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Seiko Hasegawa
- Department of Neurosurgery, Kuroishi General Hospital, Kuroishi, Japan
| | - Kosuke Kashiwabara
- Data Science Office, Clinical Research Promotion Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
- Correspondence: Masahiro Shin Department of Neurosurgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan Tel: +81-3-5800-8853 Fax: +81-3-5800-8655 E-mail:
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Matsunaga S, Shuto T, Serizawa T, Aoyagi K, Hasegawa T, Kawagishi J, Yomo S, Kenai H, Nakazaki K, Moriki A, Iwai Y, Yamamoto T. Gamma Knife radiosurgery for metastatic brain tumors from ovarian cancer: histopathological analysis of survival and local control. A Japanese multi-institutional cooperative and retrospective cohort study. J Neurosurg 2022; 137:1-9. [PMID: 35148503 DOI: 10.3171/2021.12.jns212239] [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: 09/20/2021] [Accepted: 12/06/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Brain metastasis is rare in ovarian cancer patients. The results of Gamma Knife radiosurgery (GKRS) for the treatment of patients with brain metastases from ovarian cancer were retrospectively analyzed to derive the efficacy and prognostic factors for survival and local tumor control. Further histopathological analysis was also performed. METHODS The authors retrospectively reviewed the medical records of 118 patients with 566 tumors who had undergone GKRS at the 10 GKRS institutions in Japan. RESULTS After the initial GKRS, the median overall survival time was 18.1 months. Multivariate analysis showed that uncontrolled primary cancer (p = 0.003) and multiple intracranial metastases (p = 0.034) were significant unfavorable factors. Ten patients died of uncontrolled brain metastases at a median of 17.1 months. The 6-, 12-, and 24-month neurological death rates were 3.2%, 4.6%, and 11.9%, respectively. The 6-, 12-, and 24-month neurological deterioration rates were 7.2%, 13.5%, and 31.4%, respectively. The 6-, 12-, and 24-month distant brain control failure rates were 20.6%, 40.2%, and 42.3%, respectively. Median tumor volume was 1.6 cm3 and marginal dose was 20 Gy. The 6-, 12-, and 24-month local tumor control rates were 97.6%, 95.2%, and 88.0%, respectively. Peritumoral edema (p = 0.043), more than 7-cm3 volume (p = 0.021), and prescription dose less than 18 Gy (p = 0.014) were factors that were significantly correlated in local tumor control failure. Eight patients had symptomatic radiation injury. The 6-, 12-, and 24-month GKRS-related complication rates were 3.3%, 7.8%, and 12.2%, respectively. Primary ovarian cancer was histopathologically diagnosed for 313 tumors in 69 patients. Serous adenocarcinoma was found in 37 patients and other types in 32 patients. Median survival times were 32.3 months for the serous type and 17.4 months for other types after initial GKRS. Patients with serous-type tumors survived significantly longer than patients with other types (p = 0.039). The 6-, 12-, and 24-month local tumor control rates were 100%, 98.8%, and 98.8%, respectively. Serous-type tumors were a significantly good prognosis factor for local tumor control after GKRS (p = 0.005). CONCLUSIONS This study established a relationship between the efficacy of GKRS treatment for brain metastases and the histological type of primary ovarian cancer. GKRS for ovarian cancer brain metastasis can provide satisfactory survival and local control, especially in cases of serous adenocarcinoma.
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Affiliation(s)
- Shigeo Matsunaga
- 1Department of Neurosurgery and
- 2Stereotactic Radiotherapy Center, Yokohama Rosai Hospital, Yokohama, Kanagawa
| | - Takashi Shuto
- 1Department of Neurosurgery and
- 2Stereotactic Radiotherapy Center, Yokohama Rosai Hospital, Yokohama, Kanagawa
| | - Toru Serizawa
- 3Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo
| | - Kyoko Aoyagi
- 4Department of Neurosurgery, Gamma Knife House, Chiba Cerebral and Cardiovascular Center, Ichihara, Chiba
| | - Toshinori Hasegawa
- 5Department of Neurosurgery, Gamma Knife Center, Komaki City Hospital, Komaki, Aichi
| | - Jun Kawagishi
- 6Department of Neurosurgery, Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Miyagi
| | - Shoji Yomo
- 7Division of Radiation Oncology, Aizawa Comprehensive Cancer Center, Aizawa Hospital, Matsumoto, Nagano
| | - Hiroyuki Kenai
- 8Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita
| | - Kiyoshi Nakazaki
- 9Department of Neurosurgery, Brain Attack Center Ota Memorial Hospital, Fukuyama, Hiroshima
| | | | - Yoshiyasu Iwai
- 11Department of Neurosurgery, Osaka City General Hospital, Osaka; and
| | - Tetsuya Yamamoto
- 12Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
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Iwai Y, Ishibashi K, Yamanaka K. Gamma Knife Radiosurgery for Concurrent Trigeminal Neuralgia and Glossopharyngeal Neuralgia. Cureus 2021; 13:e20717. [PMID: 35106251 PMCID: PMC8788899 DOI: 10.7759/cureus.20717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2021] [Indexed: 11/17/2022] Open
Abstract
An 82-year-old female had suffered right facial pain since 37 years of her age. The trigeminal neuralgia (TN) was controlled by carbamazepine and peripheral nerve block. The local block was effective for two to three years once performed, and as it became less effective, the patient took carbamazepine. Four months before gamma knife radiosurgery (GKRS), TN worsened. Analysis of her blood sample revealed autoimmune hemolytic anemia. It was suspected to be related to carbamazepine, and the patient stopped taking carbamazepine. The patient suffered pharyngeal pain and had difficulty swallowing for two months before GKRS. Tube feeding was started one month before GKRS. The patient was considered in pain due to TN and glossopharyngeal neuralgia (GPN). We performed GKRS continuously on the right cisternal portion of the trigeminal nerve at a maximum radiosurgical dose of 85 Gy for TN, and on the right cisternal portion of the glossopharyngeal nerve at a maximum dose of 80 Gy for GPN on the same day. The facial pain improved the day after GKRS. Seven days after treatment, the patient could swallow without pharyngeal pain, and the gastric tube was removed. Thirteen months after GKRS, the TN re-occurred but was controlled by carbamazepine 400 mg per day. GPN did not recur at that time. Simultaneous GKRS for concurrent TN and GPN is a less invasive and useful treatment option for non-candidates for surgical interventions.
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Ishii Y, Aiba N, Ando M, Asakura N, Bierwage A, Cara P, Dzitko H, Edao Y, Gex D, Hasegawa K, Hayashi T, Hiwatari R, Hoshino T, Ikeda Y, Ishida S, Isobe K, Iwai Y, Jokinen A, Kasugai A, Kawamura Y, Kim JH, Kondo K, Kwon S, Lorenzo SC, Masuda K, Matsuyama A, Miyato N, Morishita K, Nakajima M, Nakajima N, Nakamichi M, Nozawa T, Ochiai K, Ohta M, Oyaidzu M, Ozeki T, Sakamoto K, Sakamoto Y, Sato S, Seto H, Shiroto T, Someya Y, Sugimoto M, Tanigawa H, Tokunaga S, Utoh H, Wang W, Watanabe Y, Yagi M. R&D Activities for Fusion DEMO in the QST Rokkasho Fusion Institute. Fusion Science and Technology 2021. [DOI: 10.1080/15361055.2021.1925030] [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] [Indexed: 10/20/2022]
Affiliation(s)
- Y. Ishii
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Aiba
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - M. Ando
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Asakura
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - A. Bierwage
- National Institutes for Quantum and Radiological Science and Technology, Naka Fusion Institute, Naka City, Japan
| | - P. Cara
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - H. Dzitko
- Fusion for Energy, Broader Approach, Garching, Germany
| | | | - D. Gex
- Fusion for Energy, Broader Approach, Garching, Germany
| | - K. Hasegawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hayashi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - R. Hiwatari
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Hoshino
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Ikeda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Ishida
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Isobe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Iwai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Jokinen
- IFMIF/EVEDA Project Team, Rokkasho-Vill., Japan
| | - A. Kasugai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Kawamura
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - J. H. Kim
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Kondo
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Kwon
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. C. Lorenzo
- Fusion for Energy, Broader Approach, Barcelona, Spain
| | - K. Masuda
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - A. Matsuyama
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Miyato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Morishita
- Kyoto University, Institute of Advanced Energy, Uji, Japan
| | - M. Nakajima
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - N. Nakajima
- National Institute for Fusion Science, Department of Helical Plasma Research Rokkasho Research Center, Rokkasho-Vill., Japan
| | - M. Nakamichi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Nozawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - K. Ochiai
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Ohta
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Oyaidzu
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Ozeki
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - K. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Sakamoto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Sato
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Seto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - T. Shiroto
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Someya
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Sugimoto
- NAT Corporation, Tohoku Branch Office, Rokkasho-Vill., Japan
| | - H. Tanigawa
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - S. Tokunaga
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - H. Utoh
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - W. Wang
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - Y. Watanabe
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
| | - M. Yagi
- National Institutes for Quantum and Radiological Science and Technology, Rokkasho Fusion Institute, Rokkasho-Vill., Japan
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Iwai Y, Ishibashi K, Yamanaka K. Preplanned Partial Surgical Removal Followed by Low-Dose Gamma Knife Radiosurgery for Large Vestibular Schwannomas. Acta Neurochir Suppl 2021; 128:7-13. [PMID: 34191057 DOI: 10.1007/978-3-030-69217-9_2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE The present study evaluated outcomes after preplanned partial surgical removal of a large vestibular schwannoma (VS) followed by low-dose Gamma Knife surgery (GKS). METHODS Between January 2000 and May 2015, 47 patients with a unilateral VS (median maximum diameter 32 mm) underwent preplanned partial tumor removal at our clinic. GKS for a residual lesion was done within a median time interval of 3 months. The median prescription dose was 12 Gy. The median length of subsequent follow-up was 74 months. RESULTS The actuarial tumor growth control rates without a need for additional management at 3, 5, and 15 years after GKS were 92%, 86%, and 86%, respectively. At the time of the last follow-up, the function of the ipsilateral facial nerve corresponded to House-Brackmann grade I in 92% of patients. Significant improvement of ipsilateral hearing was noted in two patients after partial tumor removal and in one after GKS. Among 16 patients who presented with ipsilateral serviceable hearing, it was preserved immediately after surgery in 81% of cases and at the time of the last follow-up in 44%. Salvage surgical treatment was required in 9% of patients. CONCLUSION Preplanned partial surgical removal followed by low-dose GKS provides a high level of functional preservation in patients with a large VS.
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Affiliation(s)
- Yoshiyasu Iwai
- Department of Neurosurgery, Tominaga Hospital, Osaka, Japan.
| | - Kenichi Ishibashi
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Kazuhiro Yamanaka
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
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Saito M, Iwai Y, Kurokawa M, Harada R, Nemoto MW, Uno T. The Relationship Between Pelvic Fractures Within the Irradiation Field Among Elderly Asian Women Who Have Received Definitive Radiation Therapy for Cervical Cancer Treatment. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1580] [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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Fujimoto A, Iwai Y, Muramatsu S, Ishikawa T, Shinkuma S, Abe R. 493 A deep neural network for the early image diagnosis of Stevens-Johnson syndrome/toxic epidermal necrolysis. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.03.502] [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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Katsumi T, Hama N, Iwai Y, Kimura K, Ansai O, Suzuki T, Abe R. Mycoplasma pneumoniae-associated Stevens-Johnson syndrome: characteristic histological features of mucosal lesion. J Eur Acad Dermatol Venereol 2020; 35:e56-e57. [PMID: 32594552 DOI: 10.1111/jdv.16796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 06/22/2020] [Indexed: 11/29/2022]
Affiliation(s)
- T Katsumi
- Division of Dermatology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
| | - N Hama
- Division of Dermatology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
| | - Y Iwai
- Division of Dermatology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
| | - K Kimura
- Division of Dermatology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
| | - O Ansai
- Division of Dermatology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
| | - T Suzuki
- Division of Dermatology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
| | - R Abe
- Division of Dermatology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
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Izumi K, Suzuki K, Hashimoto M, Endoh T, Doi K, Iwai Y, Kaneko Y, Jinzaki M, Ko S, Takeuchi T. AB1103 AUTOMATIC FINGER JOINT BONE EROSION SCORE PREDICTION CONSIDERING 2-TIME-POINT X-RAYS OF PATIENTS WITH RHEUMATOID ARTHRITIS BY DEEP LEARNING. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Medical image analysis using deep learning (DL) has been attracting attention. In previous research, we proposed a DL method for detection of joint region and evaluation for bone destruction at a single point in time in hand X-rays of patients with rheumatoid arthritis (RA) [1-2]. However, in the score of van der Heijde-modified total Sharp scores (mTSS) in X-rays, it is difficult to apply the method as it is. In mTSS, score difference between 2-time points is important, and there is a problem that the score at each time varies depending on the doctor who evaluates.Objectives:We aimed at developing an mTSS scoring method considering 2-time-point difference with a DL method.Methods:A total of 104 X-ray image sets of both hands at two time points with an interval of ≥1 year were randomly obtained from patients with RA who had visited our clinic in 2015. Well-trained doctors determined the erosion scores of MP and PIP/IP joints of each hand in X-rays according to mTSS. These evaluations of hand joints were performed using our developed annotation software tool. In the learning phase, joint images were randomly divided into five sets for 5-fold cross-validation. We utilized a convolutional neural network model, such as SSD [3], for detecting joint regions and classifying the scores (Fig 1).Figure1.The models for classification were designed in consideration of the difference in erosion scores of each patient between the 2-time points of X-rays. The loss function of the DL model was defined bellow;SCE: softmax cross entropyMSE: mean squared errort: training datay: output of DL model0: the former time point1: the latter time pointT: transpose of matrixHere, the coefficient γ is designed to reduce the error for another set of scores with equal differences. The first term of the loss function works to optimize the score at each time point, and the second term works to optimize the score difference at both time points. Thus, our method can be trained without being affected by characteristic training data.Results:The number of joints with differences in erosion score between the former and latter time points was 1 (-2 points), 9 (-1), 2015 (0), 32 (+1), 17 (+2), and 6 (+3). There were no joints with score changes of -5, -4, -3, +4, and +5 points.As a performance of predicting the difference in erosion score between the 2-time points of each patient’s X-ray, our models presented a mean error of 0.412 per each joint in one set for 5-cross validation as compared with physicians’ evaluation (Fig 2).Figure 2.Conclusion:Our DL-based models to predict hand joint erosion scores in X-rays were developed with relatively small samples. This suggests that the predictive performance may increase by collecting more training dataset. Next, we will apply our method to the prediction of joint space narrowing score.References:[1]Izumi K, Hashimoto M, Suzuki K, et al. Detecting Hand Joint Ankylosis in Radiographic Images Using Deep Learning: A Step in Developing Automatic Radiographic Scoring System for Bone Destruction.Arthritis Rheumatol2018;70 (suppl 10).[2]Izumi K, Suzuki K, Hashimoto M, et al. SAT0543 AUTOMATIC DETECTION OF HAND JOINT REGION, ANKYLOSIS AND SUBLUXATION IN RADIOGRAPHIC IMAGES USING DEEP LEARNING: DEVELOPMENT OF ARTIFICIAL INTELLIGENCE-BASED RADIOGRAPHIC EVALUATION SYSTEM FOR BONE DESTRUCTION.Annals of the Rheumatic Diseases2019;78 (suppl 2), pp. 1364-1364.[3]Liu W, Anguelov D, Szgedy C, et al. SSD: single shot multibox detector.European Conference on Computer Vision (ECCV) 2016.Acknowledgments:Izumi and Suzuki are contributed equally.Disclosure of Interests:Keisuke Izumi Grant/research support from: Asahi Kasei Pharma, Takeda Pharmaceutical Co., Ltd., Speakers bureau: Asahi Kasei Pharma Corp, Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Eli Lilly Japan K.K., Mitsubishi Tanabe Pharma Co., Kanata Suzuki Employee of: Fujitsu Laboratories Ltd., Masahiro Hashimoto: None declared, Toshio Endoh Employee of: Fujitsu Laboratories Ltd., Kentaro Doi Employee of: Fujitsu Ltd., Yuki Iwai Employee of: Fujitsu Ltd., Yuko Kaneko Speakers bureau: AbbVie, Eisai Pharmaceutical, Chugai Pharmaceutical Co., Ltd., Bristol Myers Squibb, Astellas Pharma Inc., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Janssen Pharmaceutical K.K., Eli Lilly Japan K.K., Santen Pharmaceutical Co., Ltd., Kyowa Hakko Kirin Co. Ltd. and UCB Japan Co. Ltd., Masahiro Jinzaki: None declared, Shigeru Ko Grant/research support from: Fujitsu Ltd., Tsutomu Takeuchi Grant/research support from: Astellas Pharma Inc, Chugai Pharmaceutical Co, Ltd., Daiichi Sankyo Co., Ltd., Takeda Pharmaceutical Co., Ltd., AbbVie GK, Asahikasei Pharma Corp., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Eisai Co., Ltd., AYUMI Pharmaceutical Corporation, Nipponkayaku Co. Ltd., Novartis Pharma K.K., Teijin, Consultant of: Astra Zeneca K.K., Eli Lilly Japan K.K., Novartis Pharma K.K., Mitsubishi Tanabe Pharma Co., Abbivie GK, Nipponkayaku Co.Ltd, Janssen Pharmaceutical K.K., Astellas Pharma Inc., Taiho Pharmaceutical Co. Ltd., Chugai Pharmaceutical Co. Ltd., Taisho Toyama Pharmaceutical Co. Ltd., GlaxoSmithKline K.K., UCB Japan Co. Ltd., Speakers bureau: Astellas Pharma Inc., Bristol Myers Squibb, Chugai Pharmaceutical Co., Ltd., Mitsubishi Tanabe Pharma Co., Pfizer Japan Inc., Santen Pharmaceutical Co., Ltd., Takeda Pharmaceutical Co., Ltd., Teijin Pharma Ltd., AbbVie GK, Asahi Kasei Pharma Corp., Taisho Toyama Pharmaceutical Co., Ltd., SymBio Pharmaceuticals Ltd., Janssen Pharmaceutical K.K., Celltrion Inc., Nipponkayaku Co. Ltd., and UCB Japan
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Tsugawa T, Kobayashi T, Hasegawa T, Iwai Y, Matsunaga S, Yamamoto M, Hayashi M, Kenai H, Kano T, Mori H, Nagano O, Hasegawa S, Inoue A, Nagatomo Y, Onoue S, Sato M, Yasuda S. Gamma Knife Surgery for Residual or Recurrent Craniopharyngioma After Surgical Resection: A Multi-institutional Retrospective Study in Japan. Cureus 2020; 12:e6973. [PMID: 32201653 PMCID: PMC7075476 DOI: 10.7759/cureus.6973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Objective The optimal treatment for a craniopharyngioma has been controversial. Complete resection is ideal, but it has been difficult to obtain total resection in many cases because of intimate proximity to critical structures such as the optic pathway, hypothalamus, and pituitary gland. A growing number of studies have demonstrated the utility of radiosurgery in controlling residual or recurrent craniopharyngioma. However, most of them are small series. The aim of this multi-institutional study was to clarify the efficacy and safety of Gamma Knife (Elekta, Stockholm, Sweden) surgery for patients with a craniopharyngioma. Methods This was a multi-institutional retrospective study by 16 medical centers of the Japan Leksell Gamma Knife Society. Data on patients with craniopharyngiomas treated with Gamma Knife Surgery (GKS) between 1991 and 2013 were obtained from individual institutional review board-approved databases at each center. A total of 242 patients with craniopharyngioma were included in this study. The mean age of the patients was 41 (range, 3 to 86) years. The median follow-up time was 61.4 months (range, 3 to 180 months). The mean radiosurgery target volume was 3.1 ml (range, 0.03-22.3 ml), and the mean marginal dose was 11.4 Gy (range, 8-20.4 Gy). Results Two-hundred twenty patients were alive at the time of the last follow-up visit. The three-, five-, and 10-year overall survival rates after GKS were 95.4%, 92.5%, and 82.0%, respectively. The three-, five-, and 10-year progression-free survival rates after GKS were 73.1%, 62.2%, and 42.6% respectively. The rate of radiation-induced complications was 6.2%. Conclusion GKS is effective for controlling the tumor growth of craniopharyngiomas with an acceptable complication rate.
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Affiliation(s)
- Takahiko Tsugawa
- Neurosurgery, Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital, Nagoya, JPN
| | - Tatsuya Kobayashi
- Neurosurgery, Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital, Nagoya, JPN
| | | | | | | | - Masaaki Yamamoto
- Neurosurgery, Mito Gammahouse, Katsuta Hospital, Hitachinaka, JPN
| | - Motohiro Hayashi
- Neurosurgery, Tokyo Women's Medical University Hospital, Tokyo, JPN
| | - Hiroyuki Kenai
- Neurosurgery, Nagatomi Neurosurgical Hospital, Oita, JPN
| | | | - Hisae Mori
- Neurosurgery, National Cerebral and Cardiovascular Center, Suita, JPN
| | - Osamu Nagano
- Neurosurgery, Chiba Cerebral and Cardiovascular Center, Ichihara, JPN
| | | | - Akira Inoue
- Neurosurgery, Yamagata Prefectural Central Hospital, Yamagata, JPN
| | | | - Shinji Onoue
- Neurosurgery, Ehime Prefectural Central Hospital, Matsuyama, JPN
| | - Manabu Sato
- Neurosurgery, Rakusai Shimizu Hospital, Kyoto, JPN
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Nakazaki K, Yomo S, Kondoh T, Serizawa T, Kenai H, Kawagishi J, Sato S, Nagano O, Aiyama H, Kawai H, Hasegawa T, Iwai Y, Nagatomo Y, Kida Y, Nishigaki M. Salvage gamma knife radiosurgery for active brain metastases from small-cell lung cancer after whole-brain radiation therapy: a retrospective multi-institutional study (JLGK1701). J Neurooncol 2020; 147:67-76. [PMID: 31933257 DOI: 10.1007/s11060-020-03397-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/08/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the efficacy of gamma knife radiosurgery (GKS) for brain metastases (BMs) from small-cell lung cancer after whole-brain radiotherapy (WBRT). METHODS We retrospectively analyzed the usefulness and safety of GKS in 163 patients from 15 institutions with 1-10 active BMs after WBRT. The usefulness and safety of GKS were evaluated using statistical methods. RESULTS The median age was 66 years, and 79.1% of patients were men. The median number and largest diameter of BM were 2.0 and 1.4 cm, respectively. WBRT was administered prophylactically in 46.6% of patients. The median overall survival (OS) was 9.3 months, and the neurologic mortality was 20.0%. Crude incidences of local control failure and new lesion appearance were 36.6% and 64.9%, respectively. A BM diameter ≥ 1.0 cm was a significant risk factor for local progression (hazard ratio [HR] 2.556, P = 0.039) and neurologic death (HR 4.940, P = 0.031). Leukoencephalopathy at the final follow-up was more prevalent in the therapeutic WBRT group than in the prophylactic group (P = 0.019). The symptom improvement rate was 61.3%, and neurological function was preserved for a median of 7.6 months. Therapeutic WBRT was not a significant risk factor for OS, neurological death, local control, or functional deterioration (P = 0.273, 0.490, 0.779, and 0.560, respectively). Symptomatic radiation-related adverse effects occurred in 7.4% of patients. CONCLUSIONS GKS can safely preserve neurological function and prevent neurologic death in patients with 1-10 small, active BMs after prophylactic and therapeutic WBRT.
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Affiliation(s)
- Kiyoshi Nakazaki
- Department of Neurosurgery, Brain Attack Center Ota Memorial Hospital, 3-6-28 Okinogami, Fukuyama, Hiroshima, 7200825, Japan.
| | - Shoji Yomo
- Department of Neurosurgery, Aizawa Hospital, Matsumoto, Nagano, Japan
| | - Takeshi Kondoh
- Department of Neurosurgery, Shinsuma General Hospital, Kobe, Hyogo, Japan
| | - Toru Serizawa
- Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo, Japan
| | - Hiroyuki Kenai
- Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita, Japan
| | - Jun Kawagishi
- Jiro Suzuki Memorial GammaHouse, Furukawa Seiryo Hospital, Osaki, Miyagi, Japan
| | - Sonomi Sato
- Department of Neurosurgery, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Fukushima, Japan
| | - Osamu Nagano
- Gamma Knife House, Chiba Cerebral and Cardiovascular Center, Ichihara, Chiba, Japan
| | - Hitoshi Aiyama
- Katsuta Hospital Mito GammaHouse, Hitachi-naka, Ibaraki, Japan
| | - Hideya Kawai
- Department of Neurosurgery, Research Institute for Brain and Blood-Vessels-Akita, Akita, Japan
| | | | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Yasushi Nagatomo
- Department of Neurosurgery, Kouseikai Takai Hospital, Tenri, Nara, Japan
| | - Yoshihisa Kida
- Department of Neurosurgery, Ookuma Hospital, Nagoya, Japan
| | - Masakazu Nishigaki
- Department of Human Health Sciences, School of Medicine, Kyoto University, Kyoto, Japan
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Abstract
Purpose: The authors have been treating skull base meningiomas using relatively low-dose gamma knife radiosurgery (GKS, ≤ 12 Gy) with acceptable tumor growth control and low morbidity. In the present study, volume-staged, low-dose GKS was performed for large skull base meningiomas with a maximum diameter > 4 cm. In this article, a treatment strategy for volume-staged GKS and results for large skull base meningiomas are described. Methods: Data from 27 patients with large skull base meningiomas histopathologically diagnosed as WHO grade I or diagnosed by imaging, who underwent volume-staged GKS between March 1995 and September 2018, were reviewed. Among these patients, 24 were followed-up for > six months. The tumor was located in the parasellar region in nine patients, cavernous sinus region in four, petroclival region in four, petrocavernous sinus region in four, cerebellopontine angle region in two, and in the tent in one. The mean tumor diameters ranged from 31 to 47.8 mm (median 39.4 mm), with tumor volumes between 14.7 and 49.5 cm3 (median 27.5 cm3). Results: The prescribed radiation dose was 8-12 Gy (median 10 Gy). The treatment interval between the first and second GKS was three to nine months (median 5.5 months). The median duration of follow-up after the first GKS was 84 months (range 6-204 months). Tumor volume decreased in nine (37.5%) patients, remained stable in nine (37.5%), and increased (local failure) in six (25%). The actuarial progression-free local control rate was 88% at three years, 78% at five years, 70% at 10 years, and 70% at 15 years. Neurological status improved in three (12.5%) patients, was unchanged in 16 (66.5%), and deteriorated in five (21%). Permanent radiation injury occurred in one (4%) patient. Conclusion: Volume-staged GKS demonstrated the usefulness for large skull meningiomas > 4 cm in diameter, over a long-term follow-up period.
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Nakajo K, Iwai Y, Yoshimura M, Watanabe Y, Yamanaka K. Intracavernous Hemangiopericytoma: Case Report and Review of the Literature. NMC Case Rep J 2019; 6:111-115. [PMID: 31592158 PMCID: PMC6776749 DOI: 10.2176/nmccrj.cr.2018-0300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 03/25/2019] [Indexed: 11/29/2022] Open
Abstract
Intracavernous hemangiopericytoma/solitary fibrous tumor is an extremely rare tumor, with only seven cases reported. We present a case of intracavernous hemangiopericytoma/solitary fibrous tumor and review all cases reported in the literature. A 67-year-old man experienced numbness over the left half of the face. Magnetic resonance imaging revealed a left intracavernous tumor extending into Meckel’s cave and the posterior fossa. We performed gamma knife surgery (GKS) which a prescribed dose to the tumor of 12 Gy, but tumor recurred 43 months after GKS. We performed partial tumor resection via a subtemporal interdural approach. The pathological diagnosis was hemangiopericytoma. Postoperatively, we performed second GKS with a prescribed dose of 15 Gy. Diplopia and ptosis improved markedly and the tumor initially reduced in size, but tumor regrowth was seen again 29 months after second GKS. Third GKS was performed with a prescribed dose of 15 Gy. Recurrence was not seen at 18 months after third GKS, but was identified about 2 years after third GKS. We performed fourth GKS with a prescribed dose to the residual tumor of 16 Gy. We report a rare case of intracavernous hemangiopericytoma originating in the cavernous sinus, but distinguishing between hemangiopericytoma and schwannoma is difficult for round, intracavernous tumors showing homogeneous enhancement without flow voids. GKS might be one of the options for residual and recurrent intracavernous hemangiopericytomas.
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Affiliation(s)
- Kosuke Nakajo
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Osaka, Japan
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Osaka, Japan
| | - Masaki Yoshimura
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Osaka, Japan
| | - Yusuke Watanabe
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Osaka, Japan
| | - Kazuhiro Yamanaka
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Osaka, Japan
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Nemoto MW, Iwai Y, Kanazawa A, Kurokawa M, Saito M, Harada R, Kobayashi H, Uno T. Single-Institution Experience in 3D MRI/CT-Based Brachytherapy for Cervical Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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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Koyama N, Watanabe Y, Iwai Y, Miwa C, Nagai Y, Aoshiba K, Nakamura H. Effectiveness of nanoparticle albumin-bound paclitaxel plus carboplatin in non-small lung cancer patients with malignant pleural effusion. Neoplasma 2019; 65:132-139. [PMID: 29322797 DOI: 10.4149/neo_2018_170206n78] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Malignant pleural effusion (MPE) is a common complication occurring in cancer patients, and its management affects the prognosis of these patients. Preclinical and clinical studies have reported that treatment with nanoparticle albumin-bound paclitaxel (nab-paclitaxel) plus carboplatin (CBDCA) is effective against intraperitoneal malignant tumors. To investigate the effectiveness of nab-paclitaxel plus CBDCA therapy for MPEs arising in patients with non-small cell lung cancer (NSCLC), we retrospectively analyzed the clinicopathological characteristics of 40 patients with stage IIIb or IV NSCLC who were treated with nab-paclitaxel plus CBDCA from 2013 to 2016. Out of 26 patients with MPEs who were treated with nab-paclitaxel plus CBDCA in this study, 21 patients (80.8%) had effective responses in MPEs; 6 of 21 patients exhibited complete responses (23.1%) and 15 of 21 had partial responses (57.7%). Kaplan-Meier survival curves and log-rank tests to evaluate the effectiveness of nab-paclitaxel plus CBDCA therapy against MPEs showed longer median progression-free survival (323 days vs. 26 days; p=0.009) and overall survival (not reached vs. 199 days; p=0.047) in patients with complete responses compared with those who achieved no response. There were no statistical differences between therapeutic effects on MPEs and those on systemic lesions. Nab-paclitaxel plus CBDCA therapy may be a preferred therapeutic option for patients with NSCLC who experience MPEs, and its effectiveness in treatment of MPEs may need to be evaluated separately from its therapeutic responses in systemic lesions.
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Uno T, Kobayashi H, Watanabe-Nemoto M, Harada R, Saito M, Kanazawa A, Iwai Y, Murakami K, Matsubara H. EP-1401 Practice-based clinical outcome of definitive radiation therapy for superficial esophageal cancer. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31821-3] [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: 11/26/2022]
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Kawabe T, Yamamoto M, Sato Y, Yomo S, Kondoh T, Nagano O, Serizawa T, Tsugawa T, Okamoto H, Akabane A, Aita K, Sato M, Jokura H, Kawagishi J, Shuto T, Kawai H, Moriki A, Kenai H, Iwai Y, Gondo M, Hasegawa T, Yasuda S, Kikuchi Y, Nagatomo Y, Watanabe S, Hashimoto N. Gamma Knife radiosurgery for brain metastases from pulmonary large cell neuroendocrine carcinoma: a Japanese multi-institutional cooperative study (JLGK1401). J Neurosurg 2018; 125:11-17. [PMID: 27903179 DOI: 10.3171/2016.7.gks161459] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In 1999, the World Health Organization categorized large cell neuroendocrine carcinoma (LCNEC) of the lung as a variant of large cell carcinoma, and LCNEC now accounts for 3% of all lung cancers. Although LCNEC is categorized among the non-small cell lung cancers, its biological behavior has recently been suggested to be very similar to that of a small cell pulmonary malignancy. The clinical outcome for patients with LCNEC is generally poor, and the optimal treatment for this malignancy has not yet been established. Little information is available regarding management of LCNEC patients with brain metastases (METs). This study aimed to evaluate the efficacy of Gamma Knife radiosurgery (GKRS) for patients with brain METs from LCNEC. METHODS The Japanese Leksell Gamma Knife Society planned this retrospective study in which 21 Gamma Knife centers in Japan participated. Data from 101 patients were reviewed for this study. Most of the patients with LCNEC were men (80%), and the mean age was 67 years (range 39-84 years). Primary lung tumors were reported as well controlled in one-third of the patients. More than half of the patients had extracranial METs. Brain metastasis and lung cancer had been detected simultaneously in 25% of the patients. Before GKRS, brain METs had manifested with neurological symptoms in 37 patients. Additionally, prior to GKRS, resection was performed in 17 patients and radiation therapy in 10. A small cell lung carcinoma-based chemotherapy regimen was chosen for 48 patients. The median lesion number was 3 (range 1-33). The median cumulative tumor volume was 3.5 cm3, and the median radiation dose was 20.0 Gy. For statistical analysis, the standard Kaplan-Meier method was used to determine post-GKRS survival. Competing risk analysis was applied to estimate GKRS cumulative incidences of maintenance of neurological function and death, local recurrence, appearance of new lesions, and complications. RESULTS The overall median survival time (MST) was 9.6 months. MSTs for patients classified according to the modified recursive partitioning analysis (RPA) system were 25.7, 11.0, and 5.9 months for Class 1+2a (20 patients), Class 2b (28), and Class 3 (46), respectively. At 12 months after GKRS, neurological death-free and deterioration-free survival rates were 93% and 87%, respectively. Follow-up imaging studies were available in 78 patients. The tumor control rate was 86% at 12 months after GKRS. CONCLUSIONS The present study suggests that GKRS is an effective treatment for LCNEC patients with brain METs, particularly in terms of maintaining neurological status.
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Affiliation(s)
- Takuya Kawabe
- Department of Neurosurgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto.,Katsuta Hospital Mito Gamma House, Hitachi-naka
| | | | - Yasunori Sato
- Clinical Research Center, Chiba University Graduate School of Medicine, Chiba
| | - Shoji Yomo
- Saitama Gamma Knife Center, Sanai Hospital, Saitama.,Department of Neurosurgery, Aizawa Hospital, Matsumoto
| | | | - Osamu Nagano
- Gamma Knife House, Chiba Cardiovascular Center, Ichihara
| | - Toru Serizawa
- Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo
| | | | | | | | - Kazuyasu Aita
- Department of Neurosurgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto.,Kyoto Gamma Knife Center, Rakusai Shimizu Hospital, Kyoto
| | - Manabu Sato
- Kyoto Gamma Knife Center, Rakusai Shimizu Hospital, Kyoto
| | - Hidefumi Jokura
- Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki
| | - Jun Kawagishi
- Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama
| | - Hideya Kawai
- Department of Neurosurgery, Research Institute for Brain and Blood Vessels-Akita, Akita
| | | | - Hiroyuki Kenai
- Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka
| | - Masazumi Gondo
- Gamma Center Kagoshima, Atsuchi Neurosurgical Hospital, Kagoshima
| | | | | | - Yasuhiro Kikuchi
- Department of Neurosurgery, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama; and
| | - Yasushi Nagatomo
- Department of Neurosurgery, Kouseikai Takai Hospital, Tenri, Japan
| | | | - Naoya Hashimoto
- Department of Neurosurgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto
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Shuto T, Yamamoto M, Yomo S, Kondoh T, Kobayashi T, Sato M, Okamoto H, Serizawa T, Nagano O, Kenai H, Obara T, Iwai Y, Yasuda S, Hasegawa T, Kubo K, Shidoh S, Mori K, Hayashi M, Inoue A, Onoue S, Gondo M, Matsunaga S. Gamma Knife Radiosurgery for Metastatic Brain Tumors from Malignant Melanomas: A Japanese Multi-Institutional Cooperative and Retrospective Cohort Study (JLGK1501). Stereotact Funct Neurosurg 2018; 96:162-171. [DOI: 10.1159/000489948] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/09/2018] [Indexed: 11/19/2022]
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23
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Iwai Y, Ishibashi K, Yamanaka K. Gamma Knife Radiosurgery for Trigeminal Neuralgia Associated with Osteogenesis Imperfecta. World Neurosurg 2018; 115:24-28. [DOI: 10.1016/j.wneu.2018.03.192] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 03/26/2018] [Accepted: 03/27/2018] [Indexed: 10/17/2022]
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24
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Kanai K, Yokota T, Shibuya K, Nakazato T, Kanouchi T, Iwai Y, Oyama G, Shimo Y, Shimizu T, Hattori N, Kuwabara S. Increased motor axonal persistent sodium currents is associated with rapid regional spreading in amyotrophic lateral sclerosis. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3779] [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: 11/16/2022]
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25
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Shu WM, Kawakubo Y, O’hira S, Oya Y, Hayashi T, Nakamura H, Iwai Y, Nishi MF, Gentile CA, Skinner CH, Langish S, Guttadora G, Carpe A, Young KM. Tritium Decontamination of TFTR D-T Plasma Facing Components Using an Ultra Violet Laser. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22675] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- W. M. Shu
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - Y. Kawakubo
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - S. O’hira
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - Y. Oya
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - T. Hayashi
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - H. Nakamura
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - Y. Iwai
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - M. F. Nishi
- Japan Atomic Energy Research Institute, Tokai, Ibaraki 319-1195, Japan
| | - C. A. Gentile
- Princeton Plasma Physics Laboratory, Princeton, NJ 08543, USA
| | - C. H. Skinner
- Princeton Plasma Physics Laboratory, Princeton, NJ 08543, USA
| | - S. Langish
- Princeton Plasma Physics Laboratory, Princeton, NJ 08543, USA
| | - G. Guttadora
- Princeton Plasma Physics Laboratory, Princeton, NJ 08543, USA
| | - A. Carpe
- Princeton Plasma Physics Laboratory, Princeton, NJ 08543, USA
| | - K. M. Young
- Princeton Plasma Physics Laboratory, Princeton, NJ 08543, USA
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26
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Iwai Y, Misaki Y, Hayashi T, Yamanishi T, Konishi S, Nishi M, Ninomiya R, Yanagimachi S, Senrui S, Yoshida H. The Water Detritiation System of the ITER Tritium Plant. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22759] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Y. Iwai
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - Y. Misaki
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - T. Hayashi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - T. Yamanishi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - S. Konishi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - M. Nishi
- Tritium Engineering Laboratory Japan Atomic Energy Research Institute Tokai, Ibaraki 319-1195, Japan +81-29282-6393
| | - R. Ninomiya
- Showa Engineering Co., LTD Minato-ku, Tokyo 108-0023, Japan +81-33457-5010
| | - S. Yanagimachi
- Showa Engineering Co., LTD Minato-ku, Tokyo 108-0023, Japan +81-33457-5010
| | - S. Senrui
- Showa Engineering Co., LTD Minato-ku, Tokyo 108-0023, Japan +81-33457-5010
| | - H. Yoshida
- ITER-JCT Naka, Ibaraki, 311-0102, Japan +81-29270-7710
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27
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Kobayashi K, Hayashi T, Iwai Y, Asanuma N, Nishi M. Tritium Behavior Study for Detritiation of Atmosphere in a Room. Fusion Science and Technology 2017. [DOI: 10.13182/fst02-a22672] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- K. Kobayashi
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - T. Hayashi
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - Y. Iwai
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - N. Asanuma
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
| | - M. Nishi
- Tritium Engineering Laboratory, Dept. of Fusion Engineering Research, Japan Atomic Energy Research Institute Tokai-mura, Naka-gun,Ibaraki-ken 319-1195, Japan +81-29-282-6207
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28
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Hayashi T, Isobe K, Kobayashi K, Iwai Y, Kawamura Y, Nakamura H, Shu WM, Arita T, Hoshi S, Suzuki T, Yamada M, Yamanishi T. Recent Activities on Tritium Technologies for ITER and Fusion Reactors at JAEA. Fusion Science and Technology 2017. [DOI: 10.13182/fst07-a1563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Hayashi
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - K. Isobe
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - K. Kobayashi
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - Y. Iwai
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - Y. Kawamura
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - H. Nakamura
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - W. M. Shu
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - T. Arita
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - S. Hoshi
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - T. Suzuki
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - M. Yamada
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - T. Yamanishi
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Toka-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
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29
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Cristescu IR, Travis J, Iwai Y, Kobayashi K, Murdoch D. Simulation of Tritium Spreading in Controlled Areas after a Tritium Release. Fusion Science and Technology 2017. [DOI: 10.13182/fst05-a966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Ioana-R. Cristescu
- Forschungszentrum Karlsruhe Tritium Laboratory, IKET. P.O.Box 3640, D-76021 Karlsruhe, Germany
| | - J. Travis
- Tritium Laboratory, IKET. P.O.Box 3640, D-76021 Karlsruhe, Germany
| | - Y. Iwai
- JAERI, Tokai, Ibaraki, 319-1195 Japan
| | | | - D. Murdoch
- EFDA Close Support Unit, Boltzmannstrasse 2, D-85748, Garching bei Munchen, Germany
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30
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Hayashi T, Kobayashi K, Iwai Y, Isobe K, Nakamura H, Kawamura Y, Shu W, Suzuki T, Yamada M, Yamanishi T. Tritium Safety Study Using Caisson Assembly (CATS) at TPL/JAEA. Fusion Science and Technology 2017. [DOI: 10.13182/fst08-a1822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- T. Hayashi
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - K. Kobayashi
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - Y. Iwai
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - K. Isobe
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - H. Nakamura
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - Y Kawamura
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - W. Shu
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - T. Suzuki
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - M. Yamada
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
| | - T. Yamanishi
- Tritium Technology Group, Directorates of Fusion Energy Research, Japan Atomic Energy Agency, Tokai-mura, Naka-gun, Ibaraki pref., 319-1195 JAPAN
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31
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Monai H, Ohkura M, Tanaka M, Oe Y, Konno A, Hirai H, Mikoshiba K, Itohara S, Nakai J, Iwai Y, Hirase H. P306 Calcium imaging reveals glial involvement in transcranial direct current stimulation-induced plasticity in mouse brain. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.413] [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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32
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Iwai Y, Koyama N, Watanabe Y, Miwa C, Nagai Y, Koyama S. 472P Effectiveness of nab-paclitaxel for malignant effusion in non-small cell lung cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw594.036] [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: 11/14/2022] Open
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33
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Iwai Y, Koyama N, Watanabe Y, Miwa C, Nagai Y, Koyama S. 472P Effectiveness of nab-paclitaxel for malignant effusion in nonsmall cell lung cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00630-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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34
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Yamanaka K, Iwai Y, Shuto T, Kida Y, Sato M, Hayashi M, Kondo T, Hirai H, Hori R, Kubo K, Mori H, Nagano O, Serizawa T. Treatment Results of Gamma Knife Radiosurgery for Central Neurocytoma: Report of a Japanese Multi-Institutional Cooperative Study. World Neurosurg 2016; 90:300-305. [PMID: 26987638 DOI: 10.1016/j.wneu.2016.03.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/05/2016] [Accepted: 03/07/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Central neurocytoma (CN) is a rare benign neuronal tumor, and a limited number of reports have described the usefulness of radiosurgery for a relatively large group of patients. We evaluated the effectiveness and outcomes of Gamma Knife radiosurgery (GKS) for CN in a Japanese multi-institutional study. METHODS We performed retrospective analysis of 36 patients with CN who were treated with GKS in 12 institutes in Japan. All patients underwent surgery before GKS. The median tumor volume at GKS was 4.9 mL (range, 0.07-23.4 mL), and the median radiation dose prescribed to the tumor margin was 15 Gy (range, 10-20 Gy). The median follow-up period was 54.5 months (range, 3-180 months). RESULTS The local tumor progression-free survival rates at 5 and 10 years were 94% and 86%, respectively. Three patients developed distant dissemination 16-90 months later. Overall progression-free survival was unrelated to the prescribed dose (<15 Gy vs. ≥15 Gy, P = 0.62), tumor size (<6 mL vs. ≥6 mL, P = 0.46), gender (P = 0.36), age (<30 vs. ≥30 years, P = 0.37), target of GKS (residual vs. recurrence, P = 0.90), and type of enhancement (homogeneous vs. inhomogeneous, P = 0.19). Two permanent complications occurred with 1 intratumoral hemorrhage and 1 radiation injury. CONCLUSIONS GKS is effective for CN because of its high rate of long-term local tumor control. GKS may have a potential role as a primary treatment for asymptomatic, relatively small tumors in the absence of hydrocephalus without surgical resection.
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Affiliation(s)
- Kazuhiro Yamanaka
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan.
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Kanagawa, Japan
| | - Yoshihisa Kida
- Department of Neurosurgery, Komaki City Hospital, Komaki, Aichi, Japan
| | - Mitsuya Sato
- Department of Neurosurgery, Kitanihon Neurosurgical Hospital, Gosen, Niigata, Japan
| | - Motohiro Hayashi
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Takeshi Kondo
- Department of Neurosurgery, Shin-Suma Hospital, Kobe, Hyogo, Japan
| | - Hisao Hirai
- Department of Neurosurgery, Koto Memorial Hospital, Higashioumi, Shiga, Japan
| | - Rentaro Hori
- Department of Neurosurgery, Shiokawa Hospital, Suzuka, Mie, Japan
| | - Kenji Kubo
- Department of Neurosurgery, Koyo Hospital, Wakayama, Japan
| | - Hisae Mori
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
| | - Osamu Nagano
- Department of Neurosurgery, Chiba Cardiovascular Center, Ichihara, Chiba, Japan
| | - Toru Serizawa
- Tsukiji Neurological Clinic, Tokyo Gamma Unit Center, Tokyo, Japan
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Hasegawa T, Kato T, Kida Y, Hayashi M, Tsugawa T, Iwai Y, Sato M, Okamoto H, Kano T, Osano S, Nagano O, Nakazaki K. Gamma Knife surgery for patients with facial nerve schwannomas: a multiinstitutional retrospective study in Japan. J Neurosurg 2016; 124:403-10. [DOI: 10.3171/2015.3.jns142677] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT
The aim of this study was to explore the efficacy and safety of stereotactic radiosurgery for patients with facial nerve schwannomas (FNSs).
METHODS
This study was a multiinstitutional retrospective analysis of 42 patients with FNSs treated with Gamma Knife surgery (GKS) at 1 of 10 medical centers of the Japan Leksell Gamma Knife Society (JLGK1301). The median age of the patients was 50 years. Twenty-nine patients underwent GKS as the initial treatment, and 13 patients had previously undergone surgery. At the time of the GKS, 33 (79%) patients had some degree of facial palsy, and 21 (50%) did not retain serviceable hearing. Thirty-five (83%) tumors were solid, and 7 (17%) had cystic components. The median tumor volume was 2.5 cm3, and the median prescription dose to the tumor margin was 12 Gy.
RESULTS
The median follow-up period was 48 months. The last follow-up images showed partial remission in 23 patients and stable tumors in 19 patients. Only 1 patient experienced tumor progression at 60 months, but repeat GKS led to tumor shrinkage. The actuarial 3- and 5-year progression-free survival rates were 100% and 92%, respectively. During the follow-up period, 8 patients presented with newly developed or worsened preexisting facial palsy. The condition was transient in 3 of these patients. At the last clinical follow-up, facial nerve function improved in 8 (19%) patients, remained stable in 29 (69%), and worsened in 5 (12%; House-Brackmann Grade III in 4 patients, Grade IV in 1 patient). With respect to hearing function, 18 (90%) of 20 evaluated patients with a pure tone average of ≤ 50 dB before treatment retained serviceable hearing.
CONCLUSIONS
GKS is a safe and effective treatment option for patients with either primary or residual FNSs. All patients, including 1 patient who required repeat GKS, achieved good tumor control at the last follow-up. The incidence of newly developed or worsened preexisting facial palsy was 12% at the last clinical follow-up. In addition, the risk of hearing deterioration as an adverse effect of radiation was low. These results suggest that GKS is a safe alternative to resection.
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Affiliation(s)
| | - Takenori Kato
- 1Department of Neurosurgery, Komaki City Hospital, Komaki
| | - Yoshihisa Kida
- 2Department of Neurosurgery, Kamiiida Daiichi General Hospital, Nagoya
| | - Motohiro Hayashi
- 3Department of Neurosurgery, Tokyo Women’s Medical University, Tokyo
| | | | - Yoshiyasu Iwai
- 5Department of Neurosurgery, Osaka City General Hospital, Osaka
| | - Mitsuya Sato
- 6Department of Neurosurgery, Kitanihon Neurosurgical Hospital, Gosen
| | | | - Tadashige Kano
- 8Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Isesaki
| | - Seiki Osano
- 9Department of Neurosurgery, Shonan Fujisawa Tokushukai Hospital, Fujisawa
| | - Osamu Nagano
- 10Department of Neurosurgery, Chiba Cerebral and Cardiovascular Center, Ichihara; and
| | - Kiyoshi Nakazaki
- 11Department of Neurosurgery, Brain Attack Center, Ota Memorial Hospital, Fukuyama, Japan
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36
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Hasegawa T, Kato T, Kida Y, Sasaki A, Iwai Y, Kondoh T, Tsugawa T, Sato M, Sato M, Nagano O, Nakaya K, Nakazaki K, Kano T, Hasui K, Nagatomo Y, Yasuda S, Moriki A, Serizawa T, Osano S, Inoue A. Gamma Knife surgery for patients with jugular foramen schwannomas: a multiinstitutional retrospective study in Japan. J Neurosurg 2016; 125:822-831. [PMID: 26799304 DOI: 10.3171/2015.8.jns151156] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This study aimed to explore the efficacy and safety of stereotactic radiosurgery in patients with jugular foramen schwannomas (JFSs). METHODS This study was a multiinstitutional retrospective analysis of 117 patients with JFSs who were treated with Gamma Knife surgery (GKS) at 18 medical centers of the Japan Leksell Gamma Knife Society. The median age of the patients was 53 years. Fifty-six patients underwent GKS as their initial treatment, while 61 patients had previously undergone resection. At the time of GKS, 46 patients (39%) had hoarseness, 45 (38%) had hearing disturbances, and 43 (36%) had swallowing disturbances. Eighty-five tumors (73%) were solid, and 32 (27%) had cystic components. The median tumor volume was 4.9 cm3, and the median prescription dose administered to the tumor margin was 12 Gy. Five patients were treated with fractionated GKS and maximum and marginal doses of 42 and 21 Gy, respectively, using a 3-fraction schedule. RESULTS The median follow-up period was 52 months. The last follow-up images showed partial remission in 62 patients (53%), stable tumors in 42 patients (36%), and tumor progression in 13 patients (11%). The actuarial 3- and 5-year progression-free survival (PFS) rates were 91% and 89%, respectively. The multivariate analysis showed that pre-GKS brainstem edema and dumbbell-shaped tumors significantly affected PFS. During the follow-up period, 20 patients (17%) developed some degree of symptomatic deterioration. This condition was transient in 12 (10%) of these patients and persistent in 8 patients (7%). The cause of the persistent deterioration was tumor progression in 4 patients (3%) and adverse radiation effects in 4 patients (3%), including 2 patients with hearing deterioration, 1 patient with swallowing disturbance, and 1 patient with hearing deterioration and hypoglossal nerve palsy. However, the preexisting hoarseness and swallowing disturbances improved in 66% and 63% of the patients, respectively. CONCLUSIONS GKS resulted in good tumor control in patients with either primary or residual JFSs. Although some patients experienced some degree of symptomatic deterioration after treatment, persistent adverse radiation effects were seen in only 3% of the entire series at the last follow-up. Lower cranial nerve deficits were extremely rare adverse radiation effects, and preexisting hoarseness and swallowing disturbances improved in two-thirds of patients. These results indicated that GKS was a safe and reasonable alternative to surgical resection in selected patients with JFSs.
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Affiliation(s)
| | - Takenori Kato
- Department of Neurosurgery, Komaki City Hospital, Komaki
| | - Yoshihisa Kida
- Department of Neurosurgery, Kamiiida Daiichi General Hospital, Nagoya
| | - Ayaka Sasaki
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka
| | | | | | - Manabu Sato
- Department of Neurosurgery, Rakusai Shimizu Hospital, Kyoto
| | - Mitsuya Sato
- Department of Neurosurgery, Kitanihon Neurosurgical Hospital, Gosen
| | - Osamu Nagano
- Department of Neurosurgery, Chiba Cerebral and Cardiovascular Center, Ichihara
| | - Kotaro Nakaya
- Department of Neurosurgery, Atami Tokoro Memorial Hospital, Atami
| | - Kiyoshi Nakazaki
- Department of Neurosurgery, Brain Attack Center, Ota Memorial Hospital, Fukuyama
| | - Tadashige Kano
- Department of Neurosurgery, Institute of Brain and Blood Vessels, Mihara Memorial Hospital, Isesaki
| | - Koichi Hasui
- Department of Neurosurgery, Okamura Isshindow Hospital, Okayama
| | | | | | | | - Toru Serizawa
- Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo
| | - Seiki Osano
- Department of Neurosurgery, Shonan Fujisawa Tokushukai Hospital, Fujisawa; and
| | - Akira Inoue
- Department of Neurosurgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
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Misawa S, Sato Y, Katayama K, Hanaoka H, Sawai S, Beppu M, Nomura F, Shibuya K, Sekiguchi Y, Iwai Y, Watanabe K, Amino H, Ohwada C, Takeuchi M, Sakaida E, Nakaseko C, Kuwabara S. Vascular endothelial growth factor as a predictive marker for POEMS syndrome treatment response: retrospective cohort study. BMJ Open 2015; 5:e009157. [PMID: 26560063 PMCID: PMC4654348 DOI: 10.1136/bmjopen-2015-009157] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE POEMS (polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes) syndrome is a rare multisystem disease characterised by plasma cell dyscrasia and overproduction of vascular endothelial growth factor (VEGF). VEGF is assumed to be useful in monitoring disease activity, because VEGF levels usually decrease after treatment. However, there is no study to investigate whether the extent of decrease in VEGF correlates with clinical outcome. We tested the predictive efficacy of serum VEGF levels in POEMS syndrome. METHOD This was an institutional review board approved retrospective observational cohort study of 20 patients with POEMS monitored regularly for more than 12 months (median follow-up, 87 months) after treatment onset using our prospectively accumulated database of POEMS from 1999 to 2015. Patients were treated by autologous peripheral blood stem cell transplantation or thalidomide administration. Serum VEGF was measured by ELISA. Outcome measures included clinical and laboratory findings and relapse-free survival. RESULTS Serum VEGF levels decreased rapidly after treatment, and stabilised by 6 months post treatment. Patients with normalised serum VEGF levels (<1040 pg/mL) at 6 months showed prolonged relapse-free survival (HR=12.81, 95% CI 2.691 to 90.96; p=0.0001) and greater later clinical improvement. The rate of serum VEGF reduction over the first 6 months post treatment correlated with increased grip strength, serum albumin levels, and compound muscle action potential amplitudes at 12 months. CONCLUSIONS Serum VEGF level at 6 months post treatment is a predicative biomarker for disease activity and prognosis in POEMS syndrome. Serum VEGF could be used as a surrogate endpoint for relapse-free survival or clinical or laboratory improvement of POEMS syndrome for clinical trials.
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Affiliation(s)
- S Misawa
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Sato
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - K Katayama
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - H Hanaoka
- Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - S Sawai
- Department of Molecular Diagnosis, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - M Beppu
- Department of Molecular Diagnosis, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - F Nomura
- Department of Molecular Diagnosis, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K Shibuya
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Sekiguchi
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Y Iwai
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K Watanabe
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - H Amino
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - C Ohwada
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - M Takeuchi
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - E Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - C Nakaseko
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - S Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan
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Iwai Y, Ishibashi K, Watanabe Y, Uemura G, Yamanaka K. Functional Preservation After Planned Partial Resection Followed by Gamma Knife Radiosurgery for Large Vestibular Schwannomas. World Neurosurg 2015; 84:292-300. [DOI: 10.1016/j.wneu.2015.03.012] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 10/23/2022]
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Habu M, Tokimura H, Hirano H, Yasuda S, Nagatomo Y, Iwai Y, Kawagishi J, Tatewaki K, Yunoue S, Campos F, Kinoshita Y, Shimatsu A, Teramoto A, Arita K. Pituitary metastases: current practice in Japan. J Neurosurg 2015; 123:998-1007. [PMID: 26186025 DOI: 10.3171/2014.12.jns14870] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECT With advancement of cancer treatment and development of neuroimaging techniques, contemporary clinical pictures of pituitary metastases (PMs) must have changed from past reports. The goal of this paper was to elucidate the clinical features of PMs and current clinical practice related to those lesions. In this retrospective study, questionnaires were sent to 87 physicians who had treated PMs in Japan. RESULTS Between 1995 and 2010, 201 patients with PMs were treated by the participating physicians. The diagnosis of PM was histologically verified in 69 patients (34.3%). In the other 132 patients (65.7%), the PM was diagnosed by their physicians based on neuroimaging findings and clinical courses. The most frequent primary tumor was lung (36.8%), followed by breast (22.9%) and kidney (7.0%) cancer. The average interval between diagnosis of primary cancer and detection of PM was 2.8 ± 3.9 (SD) years. Major symptoms at diagnosis were visual disturbance in 30.3%, diabetes insipidus in 27.4%, fatigue in 25.4%, headache in 20.4%, and double vision in 17.4%. Major neuroimaging features were mass lesion in the pituitary stalk (63.3%), constriction of tumor at the diaphragmatic hiatus (44.7%), hypothalamic mass lesion (17.4%), and hyperintensity in the optic tract (11.4%). Surgical treatment was performed in 26.9% of patients, and 74.6% had radiation therapy; 80.0% of patients who underwent radiotherapy had stereotactic radiotherapy. The median survival time was 12.9 months in total. Contributing factors for good prognosis calculated by Cox proportional hazard analysis were younger age, late metastasis to the pituitary gland, smaller PM size, and radiation therapy. The Kaplan-Meier survival was significantly better in patients with breast cancer and renal cell cancer than in those with lung cancer. CONCLUSIONS At the time of this writing, approximately 60% (120/201) of PMs had been treated by stereotactic radiation therapy in Japan. The median survival time was much longer than that reported in past series. To confirm the changes of clinical features and medical practice, a prospective and population-based survey is mandatory.
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Affiliation(s)
- Mika Habu
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima
| | - Hiroshi Tokimura
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima
| | - Hirofumi Hirano
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima
| | | | | | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka
| | - Jun Kawagishi
- Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki
| | - Koshi Tatewaki
- Yokohama CyberKnife Center, Shinryoku Neourosurgical Clinic, Yokohama
| | - Shunji Yunoue
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima
| | - Francia Campos
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima
| | - Yasuyuki Kinoshita
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima
| | - Akira Shimatsu
- Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto; and
| | | | - Kazunori Arita
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Sakuragaoka, Kagoshima
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Kano H, Shuto T, Iwai Y, Sheehan J, Yamamoto M, McBride HL, Sato M, Serizawa T, Yomo S, Moriki A, Kohda Y, Young B, Suzuki S, Kenai H, Duma C, Kikuchi Y, Mathieu D, Akabane A, Nagano O, Kondziolka D, Lunsford LD. Stereotactic radiosurgery for intracranial hemangioblastomas: a retrospective international outcome study. J Neurosurg 2015; 122:1469-78. [DOI: 10.3171/2014.10.jns131602] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECT
The purpose of this study was to evaluate the role of stereotactic radiosurgery (SRS) in the management of intracranial hemangioblastomas.
METHODS
Six participating centers of the North American Gamma Knife Consortium and 13 Japanese Gamma Knife centers identified 186 patients with 517 hemangioblastomas who underwent SRS. Eighty patients had 335 hemangioblastomas associated with von Hippel–Lindau disease (VHL) and 106 patients had 182 sporadic hemangioblastomas. The median target volume was 0.2 cm3 (median diameter 7 mm) in patients with VHL and 0.7 cm3 (median diameter 11 mm) in those with sporadic hemangioblastoma. The median margin dose was 18 Gy in VHL patients and 15 Gy in those with sporadic hemangioblastomas.
RESULTS
At a median of 5 years (range 0.5–18 years) after treatment, 20 patients had died of intracranial disease progression and 9 patients had died of other causes. The overall survival after SRS was 94% at 3 years, 90% at 5 years, and 74% at 10 years. Factors associated with longer survival included younger age, absence of neurological symptoms, fewer tumors, and higher Karnofsky Performance Status. Thirty-three (41%) of the 80 patients with VHL developed new tumors and 17 (16%) of the106 patients with sporadic hemangioblastoma had recurrences of residual tumor from the original tumor. The 5-year rate of developing a new tumor was 43% for VHL patients, and the 5-year rate of developing a recurrence of residual tumor from the original tumor was 24% for sporadic hemangioblastoma patients. Factors associated with a reduced risk of developing a new tumor or recurrences of residual tumor from the original tumor included younger age, fewer tumors, and sporadic rather than VHL-associated hemangioblastomas. The local tumor control rate for treated tumors was 92% at 3 years, 89% at 5 years, and 79% at 10 years. Factors associated with an improved local tumor control rate included VHL-associated hemangioblastoma, solid tumor, smaller tumor volume, and higher margin dose. Thirteen patients (7%) developed adverse radiation effects (ARE) after SRS, and one of these patients died due to ARE.
CONCLUSIONS
When either sporadic or VHL-associated tumors were observed to grow on serial imaging studies, SRS provided tumor control in 79%–92% of tumors.
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Affiliation(s)
- Hideyuki Kano
- Departments of 1Neurological Surgery, University of Pittsburgh, Pennsylvania
| | | | | | | | | | | | | | | | | | | | | | - Byron Young
- 12University of Kentucky, Lexington, Kentucky
| | | | | | | | | | - David Mathieu
- 17Université de Sherbrooke, Centre de Recherche Clinique Étienne-LeBel, Sherbrooke, Quebec, Canada; and
| | | | | | | | - L. Dade Lunsford
- Departments of 1Neurological Surgery, University of Pittsburgh, Pennsylvania
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Kida Y, Hasegawa T, Iwai Y, Shuto T, Satoh M, Kondoh T, Hayashi M. Radiosurgery for symptomatic cavernous malformations: A multi-institutional retrospective study in Japan. Surg Neurol Int 2015; 6:S249-57. [PMID: 26005588 PMCID: PMC4434491 DOI: 10.4103/2152-7806.157071] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 10/29/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND A group study for symptomatic cavernous malformation (CM) treated with gamma knife (GK) surgery was performed. METHODS A total of 298 cases collected from 23 GK centers across Japan were included. Hemorrhage was the most common manifestation, followed by seizures and neurological deficits. Most of the lesions were located in the brainstem and basal ganglia, followed by the cerebral or cerebellar hemispheres. The CMs, which had a mean diameter of 14.8 mm, were treated using GK surgery with a mean marginal dose of 14.6 Gy. RESULTS In terms of hemorrhage-free survival (HFS), a marked dissociation was confirmed between the hemorrhage and seizure groups, while no obvious difference was noted between sexes. Superficial CMs located in cerebellum or lobar regions responded to the treatment better than deeply located CMs in the basal ganglia or brainstem. No significant difference of dose-dependent response was seen for three different ranges of marginal dose: Less than 15 Gy, between 15 and 20 Gy, and more than 20 Gy. Complications were more frequent after a marginal dose of over 15 Gy and in patients with lesions more than 15 mm in diameter. The rates of annual hemorrhage were estimated to be 7.4% during the first 2 years after radiosurgery and 2.8% thereafter. The overall hemorrhage rate after radiosurgery was 4.4%/year/patient. CONCLUSION The risk of hemorrhage is considerably reduced after GK treatment. The HFS as well as annual hemorrhage rate after GK treatment was apparently superior to that after conservative treatment for symptomatic CMs. To optimize the success of GK treatment, it is important to reduce the incidence of complications.
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Affiliation(s)
- Yoshihisa Kida
- Department of Neurosurgery, General Kamiiida Daiichi Hospital, Scientific Committee of Japanese Gamma Knife Society, Japan
| | - Toshinori Hasegawa
- Department of Neurosurgery, Komaki City Hospital, Scientific Committee of Japanese Gamma Knife Society, Japan
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka General Medical Center, Scientific Committee of Japanese Gamma Knife Society, Japan
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama Rosai Hospital, Scientific Committee of Japanese Gamma Knife Society, Japan
| | - Manabu Satoh
- Department of Neurosurgery, Rakusai Shimizu Hospital, Scientific Committee of Japanese Gamma Knife Society, Japan
| | - Takeshi Kondoh
- Department of Neurosurgery, Shinsuma General Hospital, Scientific Committee of Japanese Gamma Knife Society, Japan
| | - Motohiro Hayashi
- Department of Neurosurgery, Tokyo Women's Medical University, Scientific Committee of Japanese Gamma Knife Society, Japan
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Nomoto A, Sakumi A, Takahashi W, Igaki H, Iwai Y, Yoda K, Nakagawa K. PD-0451: Plan comparison of volumetric modulated arc therapy with gamma knife radiosurgery for multiple brain metastases. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40447-5] [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: 11/29/2022]
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43
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Amatsu H, Aiba T, Nakano T, Koshimo N, Kinoshita A, Uemura G, Kanemura N, Iwai Y. [An endoscopic transnasal transsphenoidal biopsy for pituitary gland Langerhans cell histiocytosis in a child: a case report]. ACTA ACUST UNITED AC 2015; 117:1349-55. [PMID: 25731016 DOI: 10.3950/jibiinkoka.117.1349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Endoscopic transnasal transsphenoidal surgery is gaining wide acceptance as the first-line treatment of pituitary tumors in adults, as this procedure is minimally invasive and associated with good outcomes. On the other hand, conventional transcranial and sublabial approaches are chosen for infants as their small anatomical structures pose some difficulty. This study reports on the case of a 5-year-old boy who had a Langerhans cell histiocytosis appearing in the sella. The biopsy was performed using the endoscopic transnasal transsphenoidal approach, and the patient has not exhibited any post-operative complications. Although the patient was a fairly young child, the endoscopic transnasal transsphenoidal approach resulted in fewer complications as compared to the transcranial and translabial approaches. Otolaryngologists, therefore, should view this approach more positively. The indication for pediatric skull base diseases can be expected to expand to include endoscopic transnasal surgery.
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44
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Sakumi A, Yamamoto K, Haga A, Okuma K, Igaki H, Iwai Y, Yoda K, Nakagawa K. Impact of a Low Transmission Multileaf Collimator on the Parotid Grand Dose in Head and Neck Volumetric Modulated Arc Therapy Planning: A Dose-Volume Histogram Comparison Between 2-Step Adaptive and Simultaneously Integrated Boost Techniques. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2499] [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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45
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Kanai K, Yokota T, Shibuya K, Kanouchi T, Iwai Y, Misawa S, Oyama G, Shimo Y, Fujimaki M, Kagamihara Y, Shimizu T, Hattori N, Kuwabara S. P856: The effects of motor axonal potassium currents on the disease progression of amyotrophic lateral sclerosis. Clin Neurophysiol 2014. [DOI: 10.1016/s1388-2457(14)50886-3] [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: 10/25/2022]
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46
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Yamamoto M, Serizawa T, Shuto T, Akabane A, Higuchi Y, Kawagishi J, Yamanaka K, Sato Y, Jokura H, Yomo S, Nagano O, Kenai H, Moriki A, Suzuki S, Kida Y, Iwai Y, Hayashi M, Onishi H, Gondo M, Sato M, Akimitsu T, Kubo K, Kikuchi Y, Shibasaki T, Goto T, Takanashi M, Mori Y, Takakura K, Saeki N, Kunieda E, Aoyama H, Momoshima S, Tsuchiya K. Stereotactic radiosurgery for patients with multiple brain metastases (JLGK0901): a multi-institutional prospective observational study. Lancet Oncol 2014; 15:387-95. [PMID: 24621620 DOI: 10.1016/s1470-2045(14)70061-0] [Citation(s) in RCA: 887] [Impact Index Per Article: 88.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND We aimed to examine whether stereotactic radiosurgery without whole-brain radiotherapy (WBRT) as the initial treatment for patients with five to ten brain metastases is non-inferior to that for patients with two to four brain metastases in terms of overall survival. METHODS This prospective observational study enrolled patients with one to ten newly diagnosed brain metastases (largest tumour <10 mL in volume and <3 cm in longest diameter; total cumulative volume ≤15 mL) and a Karnofsky performance status score of 70 or higher from 23 facilities in Japan. Standard stereotactic radiosurgery procedures were used in all patients; tumour volumes smaller than 4 mL were irradiated with 22 Gy at the lesion periphery and those that were 4-10 mL with 20 Gy. The primary endpoint was overall survival, for which the non-inferiority margin for the comparison of outcomes in patients with two to four brain metastases with those of patients with five to ten brain metastases was set as the value of the upper 95% CI for a hazard ratio (HR) of 1·30, and all data were analysed by intention to treat. The study was finalised on Dec 31, 2012, for analysis of the primary endpoint; however, monitoring of stereotactic radiosurgery-induced complications and neurocognitive function assessment will continue for the censored subset until the end of 2014. This study is registered with the University Medical Information Network Clinical Trial Registry, number 000001812. FINDINGS We enrolled 1194 eligible patients between March 1, 2009, and Feb 15, 2012. Median overall survival after stereotactic radiosurgery was 13·9 months [95% CI 12·0-15·6] in the 455 patients with one tumour, 10·8 months [9·4-12·4] in the 531 patients with two to four tumours, and 10·8 months [9·1-12·7] in the 208 patients with five to ten tumours. Overall survival did not differ between the patients with two to four tumours and those with five to ten (HR 0·97, 95% CI 0·81-1·18 [less than non-inferiority margin], p=0·78; pnon-inferiority<0·0001). Stereotactic radiosurgery-induced adverse events occurred in 101 (8%) patients; nine (2%) patients with one tumour had one or more grade 3-4 event compared with 13 (2%) patients with two to four tumours and six (3%) patients with five to ten tumours. The proportion of patients who had one or more treatment-related adverse event of any grade did not differ significantly between the two groups of patients with multiple tumours (50 [9%] patients with two to four tumours vs 18 [9%] with five to ten; p=0·89). Four patients died, mainly of complications relating to stereotactic radiosurgery (two with one tumour and one each in the other two groups). INTERPRETATION Our results suggest that stereotactic radiosurgery without WBRT in patients with five to ten brain metastases is non-inferior to that in patients with two to four brain metastases. Considering the minimal invasiveness of stereotactic radiosurgery and the fewer side-effects than with WBRT, stereotactic radiosurgery might be a suitable alternative for patients with up to ten brain metastases. FUNDING Japan Brain Foundation.
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Affiliation(s)
| | - Toru Serizawa
- Tokyo Gamma Unit Center, Tsukiji Neurological Clinic, Tokyo, Japan
| | - Takashi Shuto
- Department of Neurosurgery, Yokohama Rosai Hospital, Yokohama, Japan
| | - Atsuya Akabane
- Gamma Knife Center, NTT Medical Center Tokyo, Tokyo, Japan
| | - Yoshinori Higuchi
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Jun Kawagishi
- Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Japan
| | - Kazuhiro Yamanaka
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasunori Sato
- Clinical Research Center, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Hidefumi Jokura
- Jiro Suzuki Memorial Gamma House, Furukawa Seiryo Hospital, Osaki, Japan
| | - Shoji Yomo
- Saitama Gamma Knife Center, Sanai Hospital, Saitama, Japan
| | - Osamu Nagano
- Gamma Knife House, Chiba Cardiovascular Center, Ichihara, Japan
| | - Hiroyuki Kenai
- Department of Neurosurgery, Nagatomi Neurosurgical Hospital, Oita, Japan
| | - Akihito Moriki
- Department of Neurosurgery, Mominoki Hospital, Kochi, Japan
| | - Satoshi Suzuki
- Department of Neurosurgery, Steel Memorial Yawata Hospital, Kitakyushu, Japan
| | - Yoshihisa Kida
- Department of Neurosurgery, Komaki City Hospital, Komaki, Japan
| | - Yoshiyasu Iwai
- Department of Neurosurgery, Osaka City General Hospital, Osaka, Japan
| | - Motohiro Hayashi
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Hiroaki Onishi
- Department of Neurosurgery, Asanogawa General Hospital, Kanazawa, Japan
| | - Masazumi Gondo
- Gamma Center Kagoshima, Atsuchi Neurosurgical Hospital, Kagoshima, Japan
| | - Mitsuya Sato
- Department of Neurosurgery, Kitanihon Neurosurgical Hospital, Gosen, Japan
| | - Tomohide Akimitsu
- Department of Neurosurgery, Takanobashi Central Hospital, Hiroshima, Japan
| | - Kenji Kubo
- Department of Neurological Surgery, Koyo Hospital, Wakayama, Japan
| | - Yasuhiro Kikuchi
- Department of Neurosurgery, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Japan
| | - Toru Shibasaki
- Department of Neurosurgery, Hidaka Hospital, Takasaki, Japan
| | - Tomoaki Goto
- Department of Neurosurgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan
| | - Masami Takanashi
- Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Japan
| | - Yoshimasa Mori
- Nagoya Radiosurgery Center, Nagoya Kyoritsu Hospital, Nagoya, Japan
| | - Kintomo Takakura
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - Naokatsu Saeki
- Department of Neurological Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Etsuo Kunieda
- Department of Radiation Oncology, Tokai University, Isehara, Japan
| | - Hidefumi Aoyama
- Department of Radiology, Niigata University Graduate School of Medicine and Dental Sciences, Niigata, Japan
| | - Suketaka Momoshima
- Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuhiro Tsuchiya
- Department of Radiology, Kyorin University Faculty of Medicine, Tokyo, Japan
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Uchida Y, Iwai Y, Akita T, Mitome T, Suzuki K, Tamura R, Nishiyama N. Magnetically transportable core–shell emulsion droplets with an antioxidative all-organic paramagnetic liquid shell. J Mater Chem B 2014; 2:4130-4133. [DOI: 10.1039/c4tb00546e] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Nitroxide radical liquid microcapsules as an all-organic flexible antioxidative magnetic carrier for nanoliter cargoes have been successfully fabricated.
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Affiliation(s)
- Y. Uchida
- Graduate School of Engineering Science
- Osaka University
- Toyonaka, Japan
- Japan Science and Technology Agency
- Saitama 332-0012, Japan
| | - Y. Iwai
- Graduate School of Engineering Science
- Osaka University
- Toyonaka, Japan
| | - T. Akita
- Graduate School of Engineering Science
- Osaka University
- Toyonaka, Japan
| | - T. Mitome
- Graduate School of Engineering Science
- Osaka University
- Toyonaka, Japan
| | - K. Suzuki
- Graduate School of Environmental and Human Studies
- Kyoto University
- Kyoto 606-8501, Japan
| | - R. Tamura
- Graduate School of Environmental and Human Studies
- Kyoto University
- Kyoto 606-8501, Japan
| | - N. Nishiyama
- Graduate School of Engineering Science
- Osaka University
- Toyonaka, Japan
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48
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Miyabe Y, Miyabe C, Iwai Y, Takayasu A, Fukuda S, Yokoyama W, Nagai J, Jona M, Tokuhara Y, Ohkawa R, Albers HM, Ovaa H, Aoki J, Chun J, Yatomi Y, Ueda H, Miyasaka M, Miyasaka N, Nanki T. THU0106 Lysophosphatidic Acid Receptor LPA1 is Essential for Development of Arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.634] [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: 11/04/2022]
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Sakumi A, Mizuno K, Nishijima Y, Uesaka M, Haga A, Iwai Y, Yoda K, Nakagawa K. PO-0873: Evaluation of an intrafraction 4D cone-beam CT (CBCT) imaging system. Radiother Oncol 2013. [DOI: 10.1016/s0167-8140(15)33179-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Hirohata T, Asano K, Ogawa Y, Takano S, Amano K, Isozaki O, Iwai Y, Sakata K, Fukuhara N, Nishioka H, Yamada S, Fujio S, Arita K, Takano K, Tominaga A, Hizuka N, Ikeda H, Osamura RY, Tahara S, Ishii Y, Kawamata T, Shimatsu A, Teramoto A, Matsuno A. DNA mismatch repair protein (MSH6) correlated with the responses of atypical pituitary adenomas and pituitary carcinomas to temozolomide: the national cooperative study by the Japan Society for Hypothalamic and Pituitary Tumors. J Clin Endocrinol Metab 2013; 98:1130-6. [PMID: 23365123 DOI: 10.1210/jc.2012-2924] [Citation(s) in RCA: 83] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Temozolomide (TMZ) is an alkylating agent and was a first-line chemotherapeutic agent for malignant gliomas. Recently, TMZ has been documented to be effective against atypical pituitary adenomas (APAs) and pituitary carcinomas (PCs). OBJECTIVE The clinical and pathological characteristics of APAs and PCs treated with TMZ in Japan were surveyed and analyzed retrospectively. DESIGN Members of the Japan Society of Hypothalamic and Pituitary Tumors were surveyed regarding the clinical characteristics of APAs and PCs treated with TMZ. Stored tumor samples were gathered from the responders and were assessed by the immunohistochemistry of Ki-67, O(6)-methyl-guanine-DNA methyltransferase, p53, MSH6, and anterior pituitary hormones. Responses to TMZ treatment were defined as complete response (CR), partial response (PR), progressive disease (PD), and stable disease (SD) according to RECIST (Response Evaluation Criteria in Solid Tumors) version 2.0. SUBJECTS Three samples from 3 subjects with APA and 11 samples from 10 subjects with PC were available. RESULTS The 13 subjects had APAs and PCs consisting of 5 prolactin-producing tumors, 5 ACTH-producing tumors, and 3 null cell adenomas. The clinical response to TMZ treatment was as follows: 4 cases of CR and PR (31%), 2 cases of SD (15%), 6 cases of recurrence after CR and PR (46%), and 1 case of PD (8%). However, considerable subjects had recurrent disease after a response to TMZ. The immunohistochemical findings of Ki-67, O(6)-methyl-guanine-DNA methyltransferase, and p53 did not show any significant correlation with the efficacy of TMZ. However, the immunopositivity of MSH6 was positively correlated with TMZ response (P = .015, Fisher's exact test). CONCLUSIONS This study showed that preserving MSH6 function was contributory to the effectiveness of TMZ in malignant pituitary neoplasms. It is necessary to survey more cases and evaluate multifactor analyses.
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Affiliation(s)
- Toshio Hirohata
- Department of Neurosurgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
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