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Takakusagi Y, Koge H, Kano K, Shima S, Tsuchida K, Mizoguchi N, Yoshida D, Kamada T, Katoh H. Five-year clinical outcomes of scanning carbon-ion radiotherapy for prostate cancer. PLoS One 2024; 19:e0290617. [PMID: 38457424 PMCID: PMC10923478 DOI: 10.1371/journal.pone.0290617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 08/12/2023] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Carbon-ion radiotherapy (CIRT) has been associated with favorable clinical outcomes in patients with prostate cancer. At our facility, all patients are treated using scanning CIRT (sCIRT). We retrospectively analyzed five-year clinical outcomes of prostate cancer treated with sCIRT to investigate treatment efficacy and toxicity. METHODS In this study, we included 253 consecutive prostate cancer patients treated with sCIRT at the Kanagawa Cancer Center from December 2015 to December 2017. The total dose of sCIRT was set at 51.6 Gy (relative biological effect) in 12 fractions over three weeks. We employed the Phoenix definition for biochemical relapse. The overall survival (OS), biochemical relapse-free (bRF) rate, and cumulative incidence of late toxicity were estimated using the Kaplan-Meier method. Toxicity was assessed using the Common Terminology Criteria for Adverse Events version 4.0. RESULTS The median age of the patients was 70 years (range: 47-86 years). The median follow-up duration was 61.1 months (range: 4.1-80.3 months). Eight (3.2%), 88 (34.8%), and 157 (62.1%) patients were in the low-risk, intermediate-risk, and high-risk groups, respectively, according to the D'Amico classification system. The five-year OS and bRF were 97.5% and 93.3%, respectively. The five-year bRF rates for the low-risk, intermediate-risk, and high-risk groups were 87.5%, 93.7%, and 93.4%, respectively (p = 0.7215). The five-year cumulative incidence of Grade 2 or more late genitourinary and gastrointestinal toxicity was 7.4% and 1.2%, respectively. CONCLUSION The results of this study show that sCIRT has a favorable therapeutic effect and low toxicity in the treatment of prostate cancer.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
- Department of Radiation Oncology, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Hiroaki Koge
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
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Ito Y, Hamaguchi T, Takashima A, Mizusawa J, Shimada Y, Shiozawa M, Mizoguchi N, Kodaira T, Komori K, Ohue M, Konishi K, Teraishi F, Kinouchi M, Murata K, Fujita F, Watanabe M, Iinuma G, Ishida F, Saida Y, Matsuda T, Katayama H, Fukuda H, Kanemitsu Y. Definitive S-1/mitomycin-C chemoradiotherapy for stage II/III anal canal squamous cell carcinoma: a phase I/II dose-finding and single-arm confirmatory study (JCOG0903). Int J Clin Oncol 2023:10.1007/s10147-023-02361-7. [PMID: 37286878 DOI: 10.1007/s10147-023-02361-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 05/18/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Definitive chemoradiotherapy (CRT) with 5-fluorouracil plus mitomycin-C is a standard treatment for stage II/III squamous cell carcinoma of the anal canal (SCCA). We performed this dose-finding and single-arm confirmatory trial of CRT with S-1 plus mitomycin-C to determine the recommended dose (RD) of S-1 and evaluate its efficacy and safety for locally advanced SCCA. METHODS Patients with clinical stage II/III SCCA (UICC 6th) received CRT comprising mitomycin-C (10 mg/m2 on days 1 and 29) and S-1 (60 mg/m2/day at level 0 and 80 mg/m2/day at level 1 on days 1-14 and 29-42) with concurrent radiotherapy (59.4 Gy). Dose-finding used a 3 + 3 cohort design. The primary endpoint of the confirmatory trial was 3-year event-free survival. The sample size was 65, with one-sided alpha of 5%, power of 80%, and expected and threshold values of 75% and 60%, respectively. RESULTS Sixty-nine patients (dose-finding, n = 10; confirmatory, n = 59) were enrolled. The RD of S-1 was determined as 80 mg/m2/day. Three-year event-free survival in 63 eligible patients who received the RD was 65.0% (90% confidence interval 54.1-73.9). Three-year overall, progression-free, and colostomy-free survival rates were 87.3%, 85.7%, and 76.2%, respectively; the complete response rate was 81% on central review. Common grade 3/4 acute toxicities were leukopenia (63.1%), neutropenia (40.0%), diarrhea (20.0%), radiation dermatitis (15.4%), and febrile neutropenia (3.1%). No treatment-related deaths occurred. CONCLUSIONS Although the primary endpoint was not met, S-1/mitomycin-C chemoradiotherapy had an acceptable toxicity profile and favorable 3-year survival and could be a treatment option for locally advanced SCCA. CLINICAL TRIAL INFORMATION jRCTs031180002.
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Affiliation(s)
- Yoshinori Ito
- Department of Radiation Oncology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-Ku, Tokyo, 142-8666, Japan.
| | - Tetsuya Hamaguchi
- Department of Gastroenterological Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Atsuo Takashima
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - Junki Mizusawa
- Japan Clinical Oncology Group Data Center, National Cancer Center Hospital, Tokyo, Japan.
| | - Yasuhiro Shimada
- Division of Clinical Oncology, Kochi Health Sciences Center, Kochi, Japan
| | - Manabu Shiozawa
- Gastrointestinal Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Koji Komori
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Masayuki Ohue
- Department of Gastroenterological Surgery, Osaka International Cancer Institute, Osaka, Japan
| | - Koji Konishi
- Department of Radiation Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Fuminori Teraishi
- Department of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan
| | | | - Kohei Murata
- Department of Surgery, Suita Municipal Hospital, Suita, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masahiko Watanabe
- Department of Surgery, Kitasato University School of Medicine, Sagamihara, Japan
| | - Gen Iinuma
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan
| | - Fumio Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan
| | - Yoshihisa Saida
- Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Takahisa Matsuda
- Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Katayama
- Japan Clinical Oncology Group Operations Office, National Cancer Center Hospital, Tokyo, Japan
| | - Haruhiko Fukuda
- Japan Clinical Oncology Group Data Center, National Cancer Center Hospital, Tokyo, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
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Takakusagi Y, Koge H, Kano K, Shima S, Tsuchida K, Mizoguchi N, Yoshida D, Kamada T, Katoh H. Safety of Carbon-ion Radiotherapy for Prostate Cancer After Rectal Cancer Surgery. Anticancer Res 2023; 43:2691-2695. [PMID: 37247892 DOI: 10.21873/anticanres.16435] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 03/27/2023] [Accepted: 03/28/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND/AIM The safety of carbon-ion radiotherapy (CIRT) for patients with prostate cancer after rectal cancer surgery remains unknown. This is a retrospective analysis of the safety of CIRT in patients with prostate cancer after rectal cancer surgery. PATIENTS AND METHODS The subjects were 13 consecutive patients with prostate cancer who underwent CIRT after rectal cancer surgery at the Kanagawa Cancer Center from December 2015 to April 2022. A total dose of 51.6 Gy (relative biological effectiveness) was administered in 12 fractions over 3 weeks. The criteria stated in the Common Terminology Criteria for Adverse Events, version 5.0, were used to assess toxicity. Fisher's exact test was performed to assess the associations between patient clinical factors and rectal toxicity. RESULTS The median patient age was 71 years (range=66-83 years). The median observation period was 27.4 months (range=10.6-82.4 months). The median duration from rectal surgery to CIRT was 6.9 years (1.0-16.8 years). Five (38.5%) and six (46.2%) patients had a planning target volume (PTV)-adjacent rectal anastomosis and diabetes mellitus, respectively, and two (15.4%) patients had both. Grades 1 and 2 late gastrointestinal toxicities were observed in one case each. Development of gastrointestinal toxicity was significantly associated with both a PTV adjacent rectal anastomosis and diabetes mellitus (p=0.013). CONCLUSION Late gastrointestinal toxicity was tolerable in patients with prostate cancer treated with CIRT after rectal cancer surgery. Patients with both a PTV adjacent rectal anastomosis and diabetes mellitus were more likely to experience late gastrointestinal toxicity.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroaki Koge
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
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Takakusagi Y, Koge H, Kano K, Shima S, Tsuchida K, Mizoguchi N, Yoshida D, Kamada T, Katoh H. Clinical Outcomes of Intensity-modulated Carbon-ion Radiotherapy for Bone and Soft Tissue Tumors. Anticancer Res 2023; 43:2777-2781. [PMID: 37247930 DOI: 10.21873/anticanres.16446] [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: 03/02/2023] [Revised: 03/27/2023] [Accepted: 03/30/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND/AIM Carbon-ion radiotherapy (CIRT) for bone and soft tissue tumors (BSTs) has been reported to have favorable clinical outcomes. Intensity-modulated CIRT (IMCT) techniques have been developed to further reduce dose delivery to adjacent organs compared to conventional CIRT. We retrospectively analyzed the clinical results of IMCT for BSTs and investigated treatment efficacy and toxicity. PATIENTS AND METHODS This study included 9 consecutive BSTs patients who underwent IMCT at the Kanagawa Cancer Center from January 2016 to April 2021. IMCT was administered at a dose of 60.8-70.4 Gy (relative biological effect) in 16 fractions. The time to event was calculated from the initiation of IMCT. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 5.0. RESULTS The median age was 49 (range=16-71) years. The median observation period was 57.6 (range=7.0-77.8) months. There were 7 and 2 cases for IMCT because of proximity to the spinal cord and intestinal tract, respectively. There was one death during the observation period, which occurred 7.0 months after the initiation of treatment. Clinical recurrence occurred in 3 patients at 1.3, 17.8, and 22.4 months after the initiation of treatment, respectively. Acute toxicity of Grade 2 or higher was seen in 2 patients with Grade 2 pharyngeal mucositis. Late toxicities of Grade 2 or higher included 1 case each of Grade 2 neuralgia and peripheral neuropathy, as well as 1 case of Grade 3 fracture. CONCLUSION IMCT for BSTs showed good local therapeutic efficacy and tolerable toxicity in patients with bone and soft tissue tumors.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroaki Koge
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
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Shiba S, Takakusagi Y, Mizoguchi N, Tsuchida K, Shima S, Kano K, Koge H, Yoshida D, Kamada T, Katoh H. Carbon-ion Radiotherapy for Inoperable Solitary Fibrous Tumor of the Skull Base: A Case Report. In Vivo 2023; 37:908-911. [PMID: 36881080 PMCID: PMC10026639 DOI: 10.21873/invivo.13161] [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: 01/07/2023] [Revised: 01/21/2023] [Accepted: 01/24/2023] [Indexed: 03/08/2023]
Abstract
BACKGROUND/AIM The curative treatment for solitary fibrous tumors (SFTs) consists of surgery. However, surgery for SFTs in the skull base is difficult due to the anatomy and curative surgery may not be possible. Carbon-ion radiotherapy (C-ion RT) might be useful in the treatment of inoperable SFTs in the skull base because of its biological and physical nature. This study presents the clinical outcomes of C-ion RT for an inoperable SFT of the skull base. CASE REPORT A 68-year-old female patient experienced hoarseness, deafness on the right side, right facial nerve paralysis, and dysphagia. Magnetic resonance imaging revealed a tumor located in the right cerebello-pontine angle with destruction of the petrous bone, and immunohistochemical studies of the biopsy specimen showed a grade 2 SFT. Firstly, the patient underwent tumor embolization and surgery. However, 5 months after surgery, magnetic resonance imaging revealed regrowth of residual tumor. Subsequently, the patient was referred to our hospital for C-ion RT because curative surgery was unsuitable. The patient received 64 Gy (relative biological effectiveness) of C-ion RT in 16 fractions. Two years after C-ion RT, the tumor showed a partial response. The patient was still alive at the last follow-up without evidence of local recurrence, distant metastasis, or late toxicities. CONCLUSION These findings suggest that C-ion RT is a suitable treatment option for inoperable SFTs of the skull base.
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Affiliation(s)
- Shintaro Shiba
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan;
- Department of Radiation Oncology, Shonan Kamakura General Hospital, Kamakura, Japan
| | - Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroaki Koge
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
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Takakusagi Y, Takayama Y, Kusano Y, Koge H, Kano K, Shima S, Tsuchida K, Mizoguchi N, Yoshida D, Kamada T, Miyakawa S, Imura K, Katoh H. Carbon-Ion Radiotherapy Using Metal Artifact Reduction Computed Tomography in a Patient with Prostate Cancer with Bilateral Hip Prostheses: A Case Report. Case Rep Oncol 2022; 15:894-901. [PMID: 36825095 PMCID: PMC9941787 DOI: 10.1159/000526932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Carbon-ion radiotherapy (CIRT) for prostate cancer is both safe and efficacious; beam range calculations use relative stopping power ratio, which is derived from computed tomography (CT) values. However, hip prostheses are made of high atomic number materials and show severe artifacts on CT images. Therefore, it is not possible to accurately calculate dose distribution for CIRT in patients with prostate cancer with hip prostheses. Here, we describe the management of a 77-year-old man with prostate cancer who had previously undergone bilateral hip replacement. CIRT, in combination with androgen deprivation therapy, was recommended as definitive treatment for prostate cancer. Planning CT, magnetic resonance (MRI), and CT images with metal artifact reduction (MAR) were acquired for CIRT planning. MRI and MAR images were superimposed on the planning CT to delineate target volume and organs at risk. The radiation treatment plan consisted of a total dose of 51.6 Gy (relative biological effect) to be delivered in 12 fractions over 3 weeks, and the patient was irradiated in the supine and prone positions with a vertical beam, on alternating days. CIRT was completed as scheduled. No adverse events were observed during treatment or at 3 months after treatment initiation. While we show that CIRT may be a treatment option for patients with prostate cancer with bilateral hip prostheses, further studies are needed to evaluate treatment efficacy and late toxicity and to determine how CIRT can be administered to patients with prostate cancer with bilateral hip prostheses.
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Affiliation(s)
- Yosuke Takakusagi
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan,*Yosuke Takakusagi,
| | - Yoshiki Takayama
- bSection of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Yohsuke Kusano
- bSection of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroaki Koge
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Kio Kano
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Satoshi Shima
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Keisuke Tsuchida
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Daisaku Yoshida
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Tadashi Kamada
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Shin Miyakawa
- bSection of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Koh Imura
- bSection of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroyuki Katoh
- aDepartment of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
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Kusano Y, Katoh H, Minohara S, Fujii H, Miyasaka Y, Takayama Y, Imura K, Kusunoki T, Miyakawa S, Kamada T, Serizawa I, Takakusagi Y, Mizoguchi N, Tsuchida K, Yoshida D. Robust treatment planning in scanned carbon-ion radiotherapy for pancreatic cancer: Clinical verification using in-room computed tomography images. Front Oncol 2022; 12:974728. [PMID: 36106121 PMCID: PMC9465304 DOI: 10.3389/fonc.2022.974728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeCarbon-ion beam (C-beam) has a sharp dose distribution called the Bragg peak. Carbon-ion radiation therapy, such as stereotactic body radiotherapy in photon radiotherapy, can be completed in a short period by concentrating the radiation dose on the tumor while minimizing the dose to organs at-risk. However, the stopping position of C-beam is sensitive to density variations along the beam path and such variations can lower the tumor dose as well as cause the delivery of an unexpectedly high dose to the organs at risk. We evaluated the clinical efficacy of a robust planning technique considering gastrointestinal gas (G-gas) to deliver accurate radiation doses in carbon-ion radiotherapy for pancreatic cancer.Materials and methodsWe focused on the computed tomography (CT) value replacement method. Replacement signifies the overwriting of CT values in the CT images. The most effective replacement method for robust treatment planning was determined by verifying the effects of the three replacement patterns. We selected 10 consecutive patients. Pattern 1 replaces the CT value of the G-gas contours with the value of the region without G-gas (P1). This condition indicates a no-gas state. Pattern 2 replaces each gastrointestinal contour using the mean CT value of each contour (P2). The effect of G-gas was included in the replacement value. Pattern 3 indicates no replacement (P3). We analyzed variations in the target coverage (TC) and homogeneity index (HI) from the initial plan using in-room CT images. We then performed correlation analysis on the variations in G-gas, TC, and HI to evaluate the robustness against G-gas.ResultsAnalysis of variations in TC and HI revealed a significant difference between P1 and P3 and between P2 and P3. Although no statistically significant difference was observed between P1 and P2, variations, including the median, tended to be fewer in P2. The correlation analyses for G-gas, TC, and HI showed that P2 was less likely to be affected by G-gas.ConclusionFor a treatment plan that is robust to G-gas, P2 mean replacement method should be used. This method does not necessitate any particular software or equipment, and is convenient to implement in clinical practice.
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Affiliation(s)
- Yohsuke Kusano
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
- *Correspondence: Yohsuke Kusano,
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinichi Minohara
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Hajime Fujii
- Accelerator Engineering Corporation, Kanagawa Office, Chiba, Japan
| | - Yuya Miyasaka
- Department of Heavy Particle Medical Science, Yamagata University Graduate School of Medical Science, Yamagata, Japan
| | - Yoshiki Takayama
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Koh Imura
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Terufumi Kusunoki
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Shin Miyakawa
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
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8
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Takakusagi Y, Serizawa I, Koge H, Kano K, Shima S, Tsuchida K, Mizoguchi N, Yoshida D, Katoh H, Hiruma T, Kamada T. Clinical Outcomes of Scanning Carbon-ion Radiotherapy for Soft Tissue Sarcoma of the Extremities. Anticancer Res 2022; 42:3701-3706. [PMID: 35790269 DOI: 10.21873/anticanres.15859] [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: 05/30/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Carbon-ion radiotherapy (CIRT) has been reported to obtain favorable results in the treatment of bone and soft tissue malignancies; however, studies on CIRT for soft tissue sarcomas (STS) of the extremities are limited. Here, we have retrospectively evaluated the therapeutic efficacy and adverse events associated with scanning CIRT (sCIRT) for STS of the extremities at our institution. PATIENTS AND METHODS Thirteen consecutive patients with STS who underwent sCIRT between January 2017 and January 2020 were included in the study. The total dose of sCIRT was set at 67.2-70.4 Gy (RBE), which was provided in 16 fractions. Overall survival (OS), progression-free survival (PFS), and local control (LC) were estimated using the Kaplan-Meier method. Toxicity was evaluated using Common Terminology Criteria for Adverse Events v5.0. RESULTS The cohort consisted of 10 males and 3 females with a median age of 69 years (range=38-95 years). Median duration of observation was 31.8 months (range=7.4-56.4 months). Tumors were localized to the upper extremity in 2 cases and to the lower extremity in 11 cases. Median maximum tumor diameter was 11.7 cm (range=3.0-36.6 cm), while 3-year OS, PFS, and LC were 61.5%, 44.9%, and 79.1%, respectively. Acute toxicity of grade 3 or higher was not observed. Late toxicity included grade 3 peripheral nerve palsy and decreased range of motion in 1 and 1 patient each. Late toxicity of Grade 4 or higher was not observed. CONCLUSION sCIRT for STS of the extremities demonstrates favorable therapeutic results with acceptable toxicity.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan;
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroaki Koge
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Toru Hiruma
- Department of Musculoskeletal Tumor Surgery, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
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9
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Takakusagi Y, Katoh H, Kano K, Anno W, Tsuchida K, Mizoguchi N, Serizawa I, Yoshida D, Kamada T. Correction to: Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer. Radiat Oncol 2022; 17:101. [PMID: 35606764 PMCID: PMC9128278 DOI: 10.1186/s13014-022-02032-3] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
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10
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Takakusagi Y, Kano K, Shima S, Tsuchida K, Mizoguchi N, Katoh H, Kamada T, Taniuchi R, Iino M, Aoshika T, Saito S, Yoshida D. Clinical Outcomes of Radiotherapy in Elderly and Younger Patients With T4 Esophageal Cancer: A Retrospective Single-center Analysis. Anticancer Res 2022; 42:2095-2104. [PMID: 35347033 DOI: 10.21873/anticanres.15691] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/17/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The standard of treatment for esophageal cancer with adjacent organ invasion (T4) has not been established. We retrospectively analyzed the clinical outcomes of radiotherapy (RT) in elderly and younger patients with T4 esophageal cancer. PATIENTS AND METHODS Sixty-nine patients with T4 esophageal cancer who underwent RT at the Kanagawa Cancer Center between January 2014 and November 2020 were included in this study. Patients aged ≥70 years were defined as the elderly group and those aged <70 years were defined as the younger group. The total dose of RT was set at 60 Gy in 30 fractions. Chemotherapy combined with 5-fluorouracil and cisplatin was administered concurrently with RT in general. The overall survival (OS) rate was estimated using the Kaplan-Meier method. Adverse events were assessed using CTCAE v4.0. RESULTS The median survival time (MST) of the elderly group (n=35) was 21.5 months, and the OS rates at 1, 3, and 5 years were 63.7%, 31.3%, and 15.6%, respectively. The MST of the younger group (n=34) was 12.5 months, and the OS rates at 1, 3, and 5 years were 52.2%, 29.4%, and 29.4%, respectively. No significant difference in OS was observed between the two groups (p=0.767). Toxicities were not significantly different between the two groups except for thrombocytopenia and esophageal fistula (p=0.012 and p=0.022, respectively). CONCLUSION The clinical outcomes of RT for T4 esophageal cancer in elderly patients were generally similar to those in the younger group.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan;
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
| | - Risa Taniuchi
- Department of Radiation Oncology, Yokohama City University School of Medicine, Kanagawa, Japan
| | - Misaki Iino
- Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Tomomi Aoshika
- Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Satoshi Saito
- Department of Radiation Oncology, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa, Japan
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11
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Serizawa I, Kusano Y, Kano K, Shima S, Tsuchida K, Takakusagi Y, Mizoguchi N, Kamada T, Yoshida D, Katoh H. Three cases of retroperitoneal sarcoma in which bioabsorbable spacers (bioabsorbable polyglycolic acid spacers) were inserted prior to carbon ion radiotherapy. J Radiat Res 2022; 63:296-302. [PMID: 35152291 PMCID: PMC8944322 DOI: 10.1093/jrr/rrac002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/17/2021] [Indexed: 06/14/2023]
Abstract
From August 2019 to August 2020, we inserted polyglycolic acid (PGA) spacers and administered carbon ion radiotherapy (CIRT) to three cases of retroperitoneal sarcoma at our hospital. We aimed to investigate its utility and safety for retroperitoneal sarcoma. We analyzed changes in PGA spacer volume and corresponding computed tomography (CT) values in addition to the dose distribution using in-room CT images that were obtained during treatment. We assessed adverse events and investigated the suitability, safety and effectivity of PGA spacer insertion. During treatment, changes in PGA spacer volumes and CT values were confirmed. Volumes increased in patients with a folded PGA spacer, and it increased 1.6-fold by the end of irradiation compared with planning CT. The CT values decreased by 20-50 Hounsfield units at the end of irradiation compared to the planning CT. Dose distribution evaluation showed that the dose to the gastrointestinal tract adjacent to the tumor was maintained below the tolerable dose, and a sufficient dose was delivered to the target by PGA spacer insertion. One case of subileus caused during abdominal surgery for PGA spacer insertion occurred. No other adverse events, such as digestive disorders, were observed. CIRT with PGA spacer insertion for retroperitoneal sarcomas is safe and effective. For cases in which there is no option but to perform irradiation using a PGA spacer, precautionary measures such as verification of dose distributions using CT images are necessary.
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Affiliation(s)
- Itsuko Serizawa
- Corresponding author. Itsuko Serizawa, MD, PhD, Department of Radiation Oncology, Kanagawa Cancer Center, 241-8515, Asahi-ku, Yokohama, Kanagawa, Japan. Tel: +81 455202222; Fax: +81 455202202; E-mail:
| | - Yohsuke Kusano
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama 241-8515, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Kanagawa 241-8515, Japan
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12
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Takakusagi Y, Suga M, Kusano Y, Kano K, Shima S, Tsuchida K, Mizoguchi N, Serizawa I, Yoshida D, Kamada T, Minohara S, Katoh H. Evaluation of Safety for Scanning Carbon-Ion Radiotherapy in Hemodialysis Patients With Prostate Cancer. Cureus 2022; 14:e22214. [PMID: 35308759 PMCID: PMC8925932 DOI: 10.7759/cureus.22214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/05/2022] Open
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13
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Takakusagi Y, Usui K, Mizoguchi N, Nagatsuka J, Hikage T, Kodama Y, Ezura T, Kusunoki T, Oizumi Y. Comparison of Moderate Hypofractionated Volumetric-Modulated Arc Therapy Plans With and Without Flattening Filter for Localized Prostate Cancer. Cureus 2021; 13:e18034. [PMID: 34671522 PMCID: PMC8520568 DOI: 10.7759/cureus.18034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 12/24/2022] Open
Abstract
Background/Aim The aim of this study was to compare volumetric-modulated arc therapy (VMAT) radiation plans between conventional VMAT with flattening filter (cFF-VMAT) and flattening filter-free VMAT (FFF-VMAT) for localized prostate cancer. Materials and methods Ten patients with localized prostate cancer who underwent cFF-VMAT at Yokosuka General Hospital Uwamachi, Yokosuka, Japan, from July 2020 to October 2020 were enrolled. Dose-volume histogram (DVH) parameters of the target volume, normal organs, monitor units (MU), and beam-on time (BOT) were compared between cFF-VMAT and FFF-VMAT plans. Results No significant difference was observed for DVH parameters for the target volume. No significant difference was observed in all parameters for the bladder and rectum between the cFF-VMAT and FFF-VMAT groups. The mean values of MU were 686 ± 52 and 784 ± 80 in cFF-VMAT and FFF-VMAT, respectively (p < 0.001). The mean BOT was 97.0 ± 6.6 s and 72.9 ± 1.4 s for cFF-VMAT and FFF-VMAT, respectively (p < 0.001). Conclusion DVH parameters of the target volume and normal organs were not significantly different between the cFF-VMAT and FFF-VMAT plans. In FFF-VMAT, MU was significantly higher, and the BOT was significantly shorter than those in cFF-VMAT.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | - Keisuke Usui
- Department of Radiation Oncology, Juntendo University, Tokyo, JPN
| | | | - Jun Nagatsuka
- Department of Radiology, Yokosuka General Hospital Uwamachi, Yokosuka, JPN
| | - Takeshi Hikage
- Department of Radiology, Yokosuka General Hospital Uwamachi, Yokosuka, JPN
| | - Yasuhiko Kodama
- Department of Radiology, Yokosuka General Hospital Uwamachi, Yokosuka, JPN
| | - Takatomo Ezura
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, JPN
| | - Terufumi Kusunoki
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, JPN
| | - Yukio Oizumi
- Department of Radiation Oncology, Yokosuka General Hospital Uwamachi, Yokosuka, JPN
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14
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Takakusagi Y, Oike T, Shirai K, Sato H, Kano K, Shima S, Tsuchida K, Mizoguchi N, Serizawa I, Yoshida D, Kamada T, Katoh H. Validation of the Reliability of Machine Translation for a Medical Article From Japanese to English Using DeepL Translator. Cureus 2021. [PMID: 34659989 PMCID: PMC8494522 DOI: 10.7759/cureus.17778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background The reliability of DeepL Translator (DeepL GmbH, Cologne, Germany) for the translation for medical articles has not been verified yet. In this study, we investigated the accuracy of machine translation from Japanese to English for a medical article using the DeepL Translator. Methodology The subject of this study was an English-language medical article translated from Japanese, which had already been published. The original Japanese manuscript was translated into English using DeepL Translator. The translated English article was then back-translated into Japanese by three researchers. In turn, three other researchers compared the back-translated Japanese sentences with the original Japanese manuscript and calculated the percentage of sentences that retained the intended meaning. Results The mean ± standard deviation of the match rate for the entire article was 94.0 ± 2.9%. The match rate in the Results section was significantly higher than that in the other sections; while the match rate in the Materials and Methods section was significantly lower than the rate in the other sections. Compound sentences and sentences with an unclear subject and predicate appeared to be significant predictors for mismatched translation. Conclusions The translation for a medical article from Japanese to English was performed accurately by DeepL Translator.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | - Takahiro Oike
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, JPN
| | - Katsuyuki Shirai
- Department of Radiology, Saitama Medical Center, Jichi Medical University, Omiya, JPN
| | - Hiro Sato
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, JPN
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | - Satoshi Shima
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | | | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, JPN
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15
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Yoshida D, Kusunoki T, Takayama Y, Kusano Y, Minohara S, Kano K, Anno W, Tsuchida K, Takakusagi Y, Mizoguchi N, Serizawa I, Ebara T, Katoh H. Comparison of Dose Distribution Between VMAT-SBRT and Scanning Carbon-ion Radiotherapy for Early-stage NSCLC. Anticancer Res 2021; 41:4571-4575. [PMID: 34475085 DOI: 10.21873/anticanres.15270] [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: 06/29/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM The purpose of this study was to compare the dose distribution between scanning carbon-ion radiotherapy (sCIRT) and volumetric-modulated arc therapy with stereotactic body radiation therapy (VMAT-SBRT) for stage I non-small cell lung cancer (NSCLC). PATIENTS AND METHODS Fifteen patients with early-stage NSCLC who underwent sCIRT at Kanagawa Cancer Center between 2018-2020 were enrolled. Dose-volume histogram parameters of the planned target volume and normal organs for sCIRT and VMAT-SBRT were evaluated. RESULTS The homogeneity index of the target volume of sCIRT was significantly lower than that of VMAT-SBRT. The dose of sCIRT was significantly lower than that of VMAT-SBRT at low volumes in the lung, heart, spinal cord, and esophagus. CONCLUSION The dose distribution of sCIRT for early-stage NSCLC was better than that of VMAT-SBRT.
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Affiliation(s)
- Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan; .,Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Terufumi Kusunoki
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshiki Takayama
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Yohsuke Kusano
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinichi Minohara
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan.,Radiation Oncology Department, The Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takeshi Ebara
- Department of Radiation Oncology, Kyorin University, School of Medicine, Tokyo, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
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16
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Takakusagi Y, Yoshida D, Kusano Y, Kano K, Anno W, Tsuchida K, Mizoguchi N, Serizawa I, Katoh H, Imura K, Takayama Y, Minohara S, Kamada T. Dosimetric Comparison Between Carbon-ion Radiotherapy and Photon Radiotherapy for Stage I Esophageal Cancer. In Vivo 2021; 35:447-452. [PMID: 33402495 DOI: 10.21873/invivo.12277] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/09/2020] [Accepted: 10/12/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIM The present study aimed to compare the radiation dose distribution of carbon-ion radiotherapy (CIRT) for stage I esophageal cancer with three-dimensional conformal radiotherapy (3DCRT) and volumetric modulated arc therapy (VMAT). PATIENTS AND METHODS Fifteen patients with cT1bN0M0 esophageal cancer who received 3DCRT at Kanagawa Cancer Center between January 2014 and April 2019 were enrolled. The dose-volume histogram parameters of the target volume and normal organs planned with CIRT, 3DCRT, and VMAT were evaluated. RESULTS The homogeneity index for the target volume of CIRT was significantly lower than that of 3DCRT and VMAT. In addition, the radiation dose of CIRT to the heart, lungs, spinal cord, and skin was significantly lower than that of 3DCRT and VMAT. CONCLUSION Favorable dose distributions with CIRT were demonstrated compared with 3DCRT and VMAT for esophageal cancer.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan;
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yohsuke Kusano
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Koh Imura
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Yoshiki Takayama
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Shinichi Minohara
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
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17
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Tsuchida K, Minohara S, Kusano Y, Kano K, Anno W, Takakusagi Y, Mizoguchi N, Serizawa I, Yoshida D, Imura K, Takayama Y, Kamada T, Katoh H, Ohno T. Interfractional robustness of scanning carbon ion radiotherapy for prostate cancer: An analysis based on dose distribution from daily in-room CT images. J Appl Clin Med Phys 2021; 22:130-138. [PMID: 34046997 PMCID: PMC8200452 DOI: 10.1002/acm2.13275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 01/03/2023] Open
Abstract
Purpose We analyzed interfractional robustness of scanning carbon ion radiotherapy (CIRT) for prostate cancer based on the dose distribution using daily in‐room computed tomography (CT) images. Materials and Methods We analyzed 11 consecutive patients treated with scanning CIRT for localized prostate cancer in our hospital between December 2015 and January 2016. In‐room CT images were taken under treatment conditions in every treatment session. The dose distribution on each in‐room CT image was recalculated, while retaining the pencil beam arrangement of the initial treatment plan. Then, the dose–volume histogram (DVH) parameters including the percentage of the clinical target volume (CTV) with 95% and 90% of the prescribed dose area (V95% of CTV, V90% of CTV) and V80% of rectum were calculated. The acceptance criteria for the CTV and rectum were set at V95% of CTV ≥95%, V90% of CTV ≥98%, and V80% of rectum < 10 ml. Results V95% of CTV, V90% of CTV, and V80% of rectum for the reproduced plans were 98.8 ± 3.49%, 99.5 ± 2.15%, and 4.39 ± 3.96 ml, respectively. Acceptance of V95% of CTV, V90% of CTV, and V80% of rectum was obtained in 123 (94%), 125 (95%) and 117 sessions (89%), respectively. Acceptance of the mean dose of V95% of CTV, V90% of CTV, and V80% of rectum for each patient was obtained in 10 (91%), 10 (91%), and 11 patients (100%), respectively. Conclusions We demonstrated acceptable interfractional robustness based on the dose distribution in scanning CIRT for prostate cancer.
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Affiliation(s)
- Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan.,Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Shinichi Minohara
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yohsuke Kusano
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Koh Imura
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yoshiki Takayama
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tatsuya Ohno
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
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18
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Takakusagi Y, Kusunoki T, Kano K, Anno W, Tsuchida K, Mizoguchi N, Serizawa I, Katoh H, Kamada T, Ezura T, Shirai K, Yoshida D. Dosimetric Comparison of Radiation Therapy Using Hybrid-VMAT Technique for Stage I Esophageal Cancer. Anticancer Res 2021; 41:1951-1958. [PMID: 33813401 DOI: 10.21873/anticanres.14962] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM This study focused on the hybrid-volumetric modulated arc therapy (hVMAT) for stage I esophageal cancer and compared the effects on dose distribution induced by changes in the ratio of three-dimensional conformal radiotherapy (3DCRT) to VMAT. PATIENTS AND METHODS Fifteen patients who underwent 3DCRT for cT1bN0M0 esophageal cancer at Kanagawa Cancer Center from January 2014 to April 2019 were included in the study. The dose-volume histogram (DVH) parameters of the target volume and normal organs were evaluated in the 3DCRT, hVMAT, and VMAT treatment plans. RESULTS The homogeneity index of the target volume was significantly lower for hVMAT. In hVMAT, as the ratio of VMAT increased, the volume of low-dose region in the heart and lung increased, whereas the volume of the middle- to high-dose region decreased. As the ratio of VMAT increased, the mean dose in the heart decreased, whereas the mean dose in the lung increased. CONCLUSION Favorable dose concentration was obtained for the target volume in hVMAT for stage I esophageal cancer. Altering the ratio of VMAT significantly changed the DVH parameters in normal organs.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan;
| | - Terufumi Kusunoki
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Takatomo Ezura
- Section of Medical Physics and Engineering, Kanagawa Cancer Center, Yokohama, Japan
| | - Katsuyuki Shirai
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
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Takakusagi Y, Oike T, Kano K, Anno W, Tsuchida K, Mizoguchi N, Serizawa I, Yoshida D, Katoh H, Kamada T. Prostate-specific antigen dynamics after neoadjuvant androgen-deprivation therapy and carbon ion radiotherapy for prostate cancer. PLoS One 2020; 15:e0241636. [PMID: 33156884 PMCID: PMC7647067 DOI: 10.1371/journal.pone.0241636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 10/16/2020] [Indexed: 11/18/2022] Open
Abstract
Background This study aimed to explain the dynamics of prostate-specific antigen (PSA) levels in patients with prostate cancer who were treated with carbon ion radiotherapy (CIRT) and neoadjuvant androgen-deprivation therapy (ADT). Methods Eighty-five patients with intermediate-risk prostate cancer who received CIRT and neoadjuvant ADT from December 2015 to December 2017 were analyzed in the present study. The total dose of CIRT was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. The PSA bounce was defined as a ≥0.4 ng/ml increase of PSA levels from the nadir, followed by any decrease. PSA failure was defined using the Phoenix criteria. Results The median patient age was 68 (range, 48–81) years. The median follow-up duration was 33 (range, 20–48) months. The clinical T stage was T1c, T2a, and T2b in 27, 44, and 14 patients, respectively. The Gleason score was 6 in 3 patients and 7 in 82 patients. The median pretreatment PSA level was 7.37 (range, 3.33–19.0) ng/ml. All patients received neoadjuvant ADT for a median of 6 (range, 2–117) months. PSA bounces were observed in 39 patients (45.9%), occurring a median of 12 (range, 6–30) months after CIRT. PSA failure was observed in eight patients (9.4%), occurring a median of 21 (range, 15–33) months after CIRT. The 3-year PSA failure-free survival rate was 88.5%. No clinical recurrence was observed during the follow-up period. Younger age and lower T stage were significant predictors of PSA bounce. Younger age was a significant predictor of PSA failure. Conclusions In this study, we identified the significant predictors of the occurrence of PSA bounce and failure. Further follow-up is needed to reveal the clinical significance of PSA dynamics.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Takahiro Oike
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
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Takakusagi Y, Katoh H, Kano K, Anno W, Tsuchida K, Mizoguchi N, Serizawa I, Yoshida D, Kamada T. Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer. Radiat Oncol 2020; 15:127. [PMID: 32460889 PMCID: PMC7254700 DOI: 10.1186/s13014-020-01575-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/18/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Carbon-ion radiotherapy (CIRT) for prostate cancer was initiated at Kanagawa Cancer Center in 2015. The present study analyzed the preliminary clinical outcomes of CIRT for prostate cancer. METHODS The clinical outcomes of 253 patients with prostate cancer who were treated with CIRT delivered using the spot scanning method between December 2015 and December 2017 were retrospectively analyzed. The irradiation dose was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. Biochemical relapse was defined using the Phoenix definition. Toxicities were assessed according to CTCAE version 4.0. RESULTS The median patient age was 70 (47-86) years. The median follow-up duration was 35.3 (4.1-52.9) months. According to the D'Amico classification system, 8, 88, and 157 patients were classified as having low, intermediate, and high risks, respectively. Androgen deprivation therapy was administered in 244 patients. The biochemical relapse-free rate in the low-, intermediate-, and high-risk groups at 3 years was 87.5, 88.0, and 97.5%, respectively (P = 0.036). Grade 2 acute urinary toxicity was observed in 12 (4.7%) patients. Grade 2 acute rectal toxicity was not observed. Grade 2 late urinary toxicity and grade 2 late rectal toxicity were observed in 17 (6.7%) and 3 patients (1.2%), respectively. Previous transurethral resection of the prostate was significantly associated with late grade 2 toxicity in univariate analysis. The predictive factor for late rectal toxicity was not detected. CONCLUSION The present study demonstrated that CIRT using the spot scanning method for prostate cancer produces favorable outcomes.
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Affiliation(s)
- Yosuke Takakusagi
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Hiroyuki Katoh
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.
| | - Kio Kano
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Wataru Anno
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Keisuke Tsuchida
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Itsuko Serizawa
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Daisaku Yoshida
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tadashi Kamada
- Department of Radiation Oncology, Kanagawa Cancer Center, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
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Sekino Y, Okumura T, Fukumitsu N, Iizumi T, Miyauchi D, Mizoguchi N, Murofushi K, Ohnishi K, Mizumoto M, Nonaka T, Nakai K, Ishikawa H, Tsuboi K, Sakurai H. EP-1420 Utility of FIB-4 index for hepatocellular carcinoma patients treated with proton beam therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31840-7] [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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22
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Shimizu S, Okumura T, Mizoguchi N, Numajiri H, Murofushi K, Onishi K, Oshiro Y, Mizumoto M, Nonaka T, Ishikawa H, Sakurai H. EP-1444 Clinical results of proton beam therapy for unresectable intrahepatic cholangiocarcinoma. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31864-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: 11/16/2022]
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23
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Ishikawa H, Nonaka T, Ohnishi K, Ohno T, Mizoguchi N, Murofushi K, Iizumi T, Sekino Y, Okumura T, Sakurai H. Long-Term Follow-Up Results of Concurrent Chemo-Proton Therapy for Esophageal Cancer. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.519] [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: 11/15/2022]
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24
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Hori Y, Kubota A, Yokose T, Furukawa M, Matsushita T, Takita M, Mitsunaga S, Mizoguchi N, Nonaka T, Nakayama Y, Oridate N. Predictive Significance of Tumor Depth and Budding for Late Lymph Node Metastases in Patients with Clinical N0 Early Oral Tongue Carcinoma. Head Neck Pathol 2017; 11:477-486. [PMID: 28374102 PMCID: PMC5677061 DOI: 10.1007/s12105-017-0814-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/27/2017] [Indexed: 12/11/2022]
Abstract
In clinical N0 early oral tongue carcinoma, treatment of occult lymph node metastasis is controversial. The purpose of this study was to assess the histopathological risk factors for predicting late lymph node metastasis in early oral tongue carcinoma. We retrospectively reviewed 48 patients with early oral tongue squamous cell carcinoma. Associations between the histopathological factors (depth of tumor, differentiation, blood vessel invasion, lymphatic invasion, and tumor budding) and late lymph metastasis were analyzed. Although the univariate analysis identified blood vessel invasion, lymphatic invasion, and high-grade tumor budding as predictive factors for neck recurrence (p < 0.001), the Cox proportional hazards model identified high-grade tumor budding as an independent predictive factor (p < 0.01). The combination of a tumor depth ≥ 3 mm and high-grade tumor budding yielded high diagnostic accuracy. Tumor depth and budding grade were identified as histopathological risk factors for late neck recurrence in clinical N0 early oral tongue carcinoma.
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Affiliation(s)
- Yukiko Hori
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.
| | - Akira Kubota
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Madoka Furukawa
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Takeshi Matsushita
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Morihito Takita
- Department of Clinical Trial Management, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Sachiyo Mitsunaga
- Department of Oral Maxillofacial Surgery, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobuhiko Oridate
- Department of Otolaryngology Head and Neck Surgery, Yokohama City University, Yokohama, Kanagawa, Japan
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Suzuki-Shibata S, Yamamoto Y, Yoshida T, Mizoguchi N, Nonaka T, Kubota A, Narimatsu H, Miyagi Y, Kobayashi T, Kaneta T, Inoue T. Prognostic value of volumetric FDG PET/CT parameters in patients with oral tongue squamous cell carcinoma who were treated by superselective intra-arterial chemoradiotherapy. Jpn J Radiol 2017; 35:740-747. [PMID: 29039110 DOI: 10.1007/s11604-017-0686-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 07/22/2017] [Accepted: 09/25/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed to evaluate the predictive and prognostic value of FDG PET/CT-based volumetric parameters in patients with oral tongue squamous cell carcinoma (OTSCC) treated by superselective intra-arterial chemoradiotherapy (IA-CRT). METHODS We conducted a retrospective study including 33 patients with biopsy-proven OTSCC between May 2007 and February 2016. All of the patients were treated by IA-CRT. Pretreatment SUVmax and metabolic tumor volume (MTV) of the primary tumor were measured. The SUV thresholds of 2.5 and 5.0 were used. Progression-free survival (PFS) and overall survival (OS) were chosen as endpoints to evaluate prognosis. Univariate and multivariate analyses were performed to assess the potential independent effect of FDG PET/CT parameters. RESULTS The median follow-up for surviving patients was 40.7 months (range 6.0-107.5 months). In univariate and multivariate analyses, SUVmax and MTV (5.0) were independent prognostic factors for PFS. In univariate analysis, SUVmax failed to predict OS. MTV (5.0) was a significant prognostic factor for OS, but multivariate analysis failed to show statistical independence because it could not exclude the possibility of an artifact due to N stage. CONCLUSIONS FDG PET/CT-based volumetric parameters may be significant prognostic markers for survival of patients with OTSCC who are treated by IA-CRT.
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Affiliation(s)
- Satoko Suzuki-Shibata
- Department of Diagnostic and Interventional Radiology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan.
| | - Yayoi Yamamoto
- Department of Diagnostic and Interventional Radiology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tetsuo Yoshida
- Department of Diagnostic and Interventional Radiology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Akira Kubota
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Hiroto Narimatsu
- Cancer Preservation and Control Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Yohei Miyagi
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Toshiaki Kobayashi
- Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-Ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tomohiro Kaneta
- Department of Radiology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Tomio Inoue
- Department of Radiology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan
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26
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Hayakawa T, Nonaka T, Mizoguchi N, Hagiwara Y, Shibata S, Sakai R, Nakayama N, Yokose T, Nakayama Y. Radiotherapy for mucosa-associated lymphoid tissue (MALT) lymphoma of the rectum: a case report. Clin J Gastroenterol 2017; 10:431-436. [PMID: 28815477 DOI: 10.1007/s12328-017-0769-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 08/01/2017] [Indexed: 02/07/2023]
Abstract
Extra-nodal mucosa-associated lymphoid tissue (MALT) lymphoma is frequently involved with the upper gastrointestinal tract, but rarely involved with the rectum. We report a case of rectal MALT lymphoma treated by radiotherapy (RT) alone. A 74-year-old woman with lower abdominal pain was diagnosed with MALT lymphoma by endoscopic mucosal resection (EMR). She was diagnosed as stage IE (Ann Arbor) MALT lymphoma by diagnostic work-up and review of EMR specimens. Definitive RT was performed with curative intent, totaling 30 Gy in 15 fractions. Complete response was confirmed by colonoscopy after RT with no progression observed at 5 years. Definitive RT is effective for rectal MALT lymphoma.
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Affiliation(s)
- Toyokazu Hayakawa
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan.,Department of Radiation Oncology, School of Medicine, Kitasato University, Sagamihara, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan.
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
| | - Shino Shibata
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
| | - Rika Sakai
- Department of Medical Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - Norisuke Nakayama
- Department of Gastroenterological Medicine, Kanagawa Cancer Center, Yokohama, Japan
| | - Tomoyuki Yokose
- Department of Pathology, Kanagawa Cancer Center, Yokohama, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Kanagawa, Japan
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27
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Kitani Y, Kubota A, Furukawa M, Hori Y, Nakayama Y, Nonaka T, Mizoguchi N, Kitani Y, Hatakeyama H, Oridate N. Impact of combined modality treatment with radiotherapy and S-1 on T2N0 laryngeal cancer: Possible improvement in survival through the prevention of second primary cancer and distant metastasis. Oral Oncol 2017; 71:54-59. [PMID: 28688691 DOI: 10.1016/j.oraloncology.2017.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/20/2017] [Accepted: 05/27/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND In patients with head and neck cancer, the management of second primary cancer (SPC) is particularly important for improving survival because of its high incidence and associated mortality. We evaluated the impact of combination chemotherapy on survival and SPC. METHOD We retrospectively analyzed data from 49 patients treated with definitive radiation therapy (RT) for T2N0M0 laryngeal squamous cell carcinoma between 2003 and 2011. Among them, 22 patients received combined modality treatment with radiotherapy and S-1 (RT+CT group). RESULTS The median follow-up period was 71months (32-111months). A significant difference in overall survival (OS, P<0.01) was observed between the RT+CT group (n=22) and the RT alone group (n=27) though no significant differences were observed in local control and disease specific survival. Univariate analyses showed that an older age (P<0.05) and a higher grade (P<0.05) were associated with OS. Multivariate analysis identified chemotherapy as the most significant predictor of survival (OR, 0.056; 95% CI, 0.008-0.353, P<0.01). A significantly lower incidence of distant metastasis (DM)+SPC (5-year incidence: 5% vs. 19%, P<0.05) and fewer deaths from these causes (1 vs. 8: P<0.05) were observed in the RT+CT group. Multivariate analysis showed that chemotherapy was the most significant factor for the incidence of DM+SPC (OR, 0.074; 95% CI, 0.0065-0.84; P<0.05). CONCLUSION The findings of this study suggest the possibility that combined modality treatment with radiotherapy and S-1 improve survival by preventing distant metastasis and second primary cancer.
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Affiliation(s)
- Yosuke Kitani
- Department of Otorhinolaryngology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan.
| | - Akira Kubota
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan
| | - Madoka Furukawa
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan
| | - Yukiko Hori
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa 241-8515, Japan
| | - Yuka Kitani
- Department of Otorhinolaryngology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
| | - Hiromitsu Hatakeyama
- Department of Otorhinolaryngology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama 232-0024, Japan
| | - Nobuhiko Oridate
- Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan
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Nakayama Y, Minohara S, Nonaka T, Nomiya T, Kusano Y, Takeshita E, Mizoguchi N, Hagiwara Y. The Ion-Beam Radiation Oncology Center in Kanagawa (i-ROCK) Carbon Ion Facility at the Kanagawa Cancer Center. Int J Part Ther 2016; 2:478-480. [PMID: 31772959 DOI: 10.14338/ijpt-15-00024.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 09/02/2015] [Indexed: 11/21/2022] Open
Affiliation(s)
- Yuko Nakayama
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Shinichi Minohara
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Takuma Nomiya
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yohsuke Kusano
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Eri Takeshita
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
| | - Yasuhito Hagiwara
- Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Kanagawa, Japan
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29
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Inoue-Nishimoto T, Hanafusa T, Hirohata A, Mabuchi-Kiyohara E, Mizoguchi N, Matsumoto K, Sakamoto S, Ishii N, Hashimoto T, Ikegami R. IgG/IgA pemphigus representing pemphigus vegetans caused by low titres of IgG and IgA antibodies to desmoglein 3 and IgA antibodies to desmocollin 3. J Eur Acad Dermatol Venereol 2015; 30:1229-31. [PMID: 25865168 DOI: 10.1111/jdv.13158] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T Inoue-Nishimoto
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - T Hanafusa
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - A Hirohata
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - E Mabuchi-Kiyohara
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - N Mizoguchi
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - K Matsumoto
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - S Sakamoto
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
| | - N Ishii
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - T Hashimoto
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Fukuoka, Japan
| | - R Ikegami
- Department of Dermatology, Japan Community Healthcare Organization Osaka Hospital, Osaka, Japan
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Kitani Y, Kubota A, Furukawa M, Sato K, Nakayama Y, Nonaka T, Mizoguchi N. Primary definitive radiotherapy with or without chemotherapy for squamous cell carcinoma of the temporal bone. Eur Arch Otorhinolaryngol 2015; 273:1293-8. [PMID: 25822291 DOI: 10.1007/s00405-015-3616-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
We aimed to evaluate the impact of concurrent chemoradiotherapy (CCRT) on the survival of patients with squamous cell carcinoma of the temporal bone. We retrospectively analyzed the data of 13 consecutive patients who were treated by definitive radiation therapy (RT) or CCRT as the initial treatment between 1999 and 2012. There were 5 patients with stage II disease, 5 with stage III, and 3 with stage IV, as classified according to the University of Pittsburgh system. Among these, 2, 4, and 3 patients, respectively, were treated by CCRT; whereas the remaining (3 patients with stage II and 1 with stage III) were treated by RT alone. Median follow-up duration was 39 months (12-106 months) in all cases, and 61.5 months (17-70 months) in censored cases. The 5-year overall survival (OS) rates were 51 % in all patients, and 40, 100, and 0 % in patients with stage II, stage III, and stage IV disease, respectively. In patients with stage II and III disease, the 5-year OS rates were 80 % in the CCRT group and 50 % in the RT-alone group. We found better prognosis in patients with stage II and III disease who were treated by CCRT. Only 2 patients treated by CCRT experienced adverse events more than grade 3, which were neutropenia and dermatitis. There was no late adverse event of bony necrosis. Our study results indicate that CCRT is safe and very effective as a first-line treatment for stage II and III squamous cell carcinoma of the temporal bone.
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Affiliation(s)
- Yosuke Kitani
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Japan.
| | - Akira Kubota
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Madoka Furukawa
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Kaname Sato
- Department of Head and Neck Surgery, Kanagawa Cancer Center, Yokohama, Japan
| | - Yuko Nakayama
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Tetsuo Nonaka
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Nobutaka Mizoguchi
- Department of Radiation Oncology, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
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Mizoguchi N, Tsuji H, Toyama S, Kamada T, Tsujii H, Nakayama Y, Mizota A, Ohnishi Y. Carbon-ion radiotherapy for locally advanced primary or postoperative recurrent epithelial carcinoma of the lacrimal gland. Radiother Oncol 2015; 114:373-7. [DOI: 10.1016/j.radonc.2015.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 01/18/2015] [Accepted: 01/18/2015] [Indexed: 11/30/2022]
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Nonaka T, Nakayama Y, Mizoguchi N, Shiomi M. Radiation Therapy for Squamous Cell Carcinoma of the Cervical Esophagus. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.1141] [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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Sato K, Kubota A, Furukawa M, Kitani Y, Nakayama Y, Nonaka T, Mizoguchi N, Shiomi M. Definitive radiotherapy for early-stage hypopharyngeal squamous cell carcinoma. Eur Arch Otorhinolaryngol 2014; 272:2001-6. [PMID: 24939176 DOI: 10.1007/s00405-014-3132-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Accepted: 05/29/2014] [Indexed: 12/20/2022]
Abstract
The present study analyzed the outcomes of patients with early-stage hypopharyngeal squamous cell carcinoma (HPSCC) treated with radical radiotherapy (RT) or concurrent chemoradiotherapy (CCRT). We retrospectively reviewed the clinical records of 33 patients with early-stage HPSCC who underwent RT or CCRT between January 1999 and December 2011. Of the 33 patients who were treated, 12 had Stage I and 21 had Stage II disease. Patients with Stage I were typically treated with RT, while patients with Stage II were treated with CCRT (concurrent chemotherapy: 5FU, cisplatin or TS-1). The median follow-up period was 81 months, ranging from 15 to 155 months. The 5-year overall survival rates, cause specific survival rates, locoregional control rates, and progression-free survival rates were 58, 75, 56, and 49 %, respectively. Of the 33 patients, 51 % experienced second primary malignancies. Esophageal carcinoma occurred in several cases, and was diagnosed either during screening after treatment for the second primary malignancy or simultaneously with the second primary malignancy. Advanced-stage second malignancies significantly influenced the survival of the patients and the control rate for HPSCC. Treatment emphasizing the quality of life after treatment is needed, if a poor prognosis is expected because of advanced-stage second primary malignancy.
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Affiliation(s)
- Kaname Sato
- Department of Head and Neck Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan,
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Toyama S, Tsuji H, Mizoguchi N, Nomiya T, Kamada T, Tokumaru S, Mizota A, Ohnishi Y, Tsujii H. Long-term results of carbon ion radiation therapy for locally advanced or unfavorably located choroidal melanoma: usefulness of CT-based 2-port orthogonal therapy for reducing the incidence of neovascular glaucoma. Int J Radiat Oncol Biol Phys 2013; 86:270-6. [PMID: 23414768 DOI: 10.1016/j.ijrobp.2012.12.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Revised: 12/16/2012] [Accepted: 12/21/2012] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine the long-term results of carbon ion radiation therapy (C-ion RT) in patients with choroidal melanoma, and to assess the usefulness of CT-based 2-port irradiation in reducing the risk of neovascular glaucoma (NVG). METHODS AND MATERIALS Between January 2001 and February 2012, a total of 116 patients with locally advanced or unfavorably located choroidal melanoma received CT-based C-ion RT. Of these patients, 114 were followed up for more than 6 months and their data analyzed. The numbers of T3 and T2 patients (International Union Against Cancer [UICC], 5th edition) were 106 and 8, respectively. The total dose of C-ion RT varied from 60 to 85 GyE, with each dose given in 5 fractions. Since October 2005, 2-port therapy (51 patients) has been used in an attempt to reduce the risk of NVG. A dose-volume histogram analysis was also performed in 106 patients. RESULTS The median follow-up was 4.6 years (range, 0.5-10.6 years). The 5-year overall survival, cause-specific survival, local control, distant metastasis-free survival, and eye retention rates were 80.4% (95% confidence interval 89.0%-71.8%), 82.2% (90.6%-73.8%), 92.8% (98.5%-87.1%), 72.1% (81.9%-62.3%), and 92.8% (98.1%-87.5%), respectively. The overall 5-year NVG incidence rate was 35.9% (25.9%-45.9%) and that of 1-port group and 2-port group were 41.6% (29.3%-54.0%) and 13.9% (3.2%-24.6%) with statistically significant difference (P<.001). The dose-volume histogram analysis showed that the average irradiated volume of the iris-ciliary body was significantly lower in the non-NVG group than in the NVG group at all dose levels, and significantly lower in the 2-port group than in the 1-port group at high dose levels. CONCLUSIONS The long-term results of C-ion RT for choroidal melanoma are satisfactory. CT-based 2-port C-ion RT can be used to reduce the high-dose irradiated volume of the iris-ciliary body and the resulting risk of NVG.
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Affiliation(s)
- Shingo Toyama
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan
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Goto Y, Kodaira T, Fuwa N, Mizoguchi N, Nakahara R, Nomura M, Tomita N, Tachibana H. Alternating chemoradiotherapy in patients with nasopharyngeal cancer: prognostic factors and proposal for individualization of therapy. J Radiat Res 2013; 54:98-107. [PMID: 22923747 PMCID: PMC3534273 DOI: 10.1093/jrr/rrs071] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Revised: 07/15/2012] [Accepted: 07/17/2012] [Indexed: 06/01/2023]
Abstract
The purpose of this study is to assess the efficacy of alternating chemoradiation in patients with nasopharyngeal cancer. From 1990-2006, 100 patients with nasopharyngeal cancer were treated with alternating chemoradiation at the Aichi Cancer Center. Of these, 4, 2, 23, 34, 13 and 23 patients were staged as I, IIA, IIB, III, IVA and IVB, respectively. The median radiation doses for primary tumors and metastatic lymph nodes were 66.6 Gy (range, 50.4-80.2 Gy) and 66 Gy (range, 40.4-82.2 Gy), respectively. A total of 82 patients received chemotherapy with both cisplatin and 5-fluorouracil (5-FU), while 14 patients received nedaplatin (CDGP) and 5-FU. With a median follow-up of 65.9 months, the 5-year rates of overall survival (OAS) and progression-free survival (PFS) were 78.1% and 68.3%, respectively. On multivariate analysis (MVA), elderly age, N3, and WHO type I histology proved to be significantly unfavorable prognostic factors of OAS. As for PFS, there were T4, N3, and WHO type I histology in MVA. Acute toxicities of hematologic and mucositis/dermatitis ≥ Grade 3 were relatively high (32%); however, they were well-managed. Late toxicities of ≥ Grade 3 were three (3%) mandibular osteomyelitis and one (1%) lethal mucosal bleeding. Results for alternating chemoradiation for nasopharyngeal carcinoma are promising. In order to improve outcomes, usage of intensity-modulated radiation therapy and application of active anticancer agents are hopeful treatments, especially for groups with poor prognosis factors with WHO type I histopathology, T4 and/or N3 disease.
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Affiliation(s)
- Yoko Goto
- Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya 464-8681, Japan.
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Nakayama Y, Nonaka T, Mizoguchi N, Shiomi M, Saito H, Oshita F, Yamada K, Ito H, Nakayama H, Yokose T. Prognostic Value of Histopathological Response to Preoperative Therapy for the Patients With Non-small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Toyama S, Tsuji H, Mizoguchi N, Kamada T, Tsujii H, Tokumaru S, Onishi Y. Long-term Result of Carbon-ion Radiation Therapy for Locally Advanced or Unfavorably Located Choroidal Melanoma: CT Based 2-port Orthogonal Therapy Can Reduce the Incidence of Neovascular Glaucoma. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mizoguchi N, Tsuji H, Toyama S, Kamada T, Tsujii H, Nakayama Y, Ohnishi Y. Carbon-ion Radiation Therapy for Locally Advanced Primary or Postoperative Recurrent Epithelial Carcinoma of Lacrimal Gland: A Phase I/II Dose-escalation Study. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.738] [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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Nakahara R, Kodaira T, Furutani K, Tachibana H, Tomita N, Inokuchi H, Mizoguchi N, Goto Y, Ito Y, Naganawa S. Treatment outcomes of definitive chemoradiotherapy for patients with hypopharyngeal cancer. J Radiat Res 2012; 53:906-915. [PMID: 22843377 PMCID: PMC3483853 DOI: 10.1093/jrr/rrs052] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Revised: 05/28/2012] [Accepted: 06/13/2012] [Indexed: 06/01/2023]
Abstract
We analyzed the efficacy of definitive chemoradiotherapy (CRT) for patients with hypopharyngeal cancer (HPC). Subjects comprised 97 patients who were treated with definitive CRT from 1990 to 2006. Sixty-one patients (62.9%) with resectable disease who aimed to preserve the larynx received induction chemotherapy (ICT), whereas 36 patients (37.1%) with resectable disease who refused an operation or who had unresectable disease received primary alternating CRT or concurrent CRT (non-ICT). The median dose to the primary lesion was 66 Gy. The median follow-up time was 77 months. The 5-year rates of overall survival (OS), progression-free survival (PFS), local control (LC), and laryngeal preservation were 68.7%, 57.5%, 79.1%, and 70.3%, respectively. The T-stage was a significant prognostic factor in terms of OS, PFS and LC in both univariate and multivariate analyses. The 5-year rates of PFS were 45.4% for the ICT group and 81.9% for the non-ICT group. The difference between these groups was significant with univariate analysis (P = 0.006). Acute toxicity of Grade 3 to 4 was observed in 34 patients (35.1%). Grade 3 dysphagia occurred in 20 patients (20.6%). Twenty-nine (29.8%) of 44 patients with second primary cancer had esophageal cancer. Seventeen of 29 patients had manageable superficial esophageal cancer. The clinical efficacy of definitive CRT for HPC is thought to be promising in terms of not only organ preservation but also disease control. Second primary cancer may have a clinical impact on the outcome for HPC patients, and special care should be taken when screening at follow-up.
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Affiliation(s)
- Rie Nakahara
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Aichi, Japan.
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Fujita S, Kitayama T, Mizoguchi N, Oi Y, Koshikawa N, Kobayashi M. Spatiotemporal profiles of transcallosal connections in rat insular cortex revealed by in vivo optical imaging. Neuroscience 2012; 206:201-11. [DOI: 10.1016/j.neuroscience.2012.01.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Revised: 01/06/2012] [Accepted: 01/07/2012] [Indexed: 11/26/2022]
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Tomita N, Fuwa N, Ariji Y, Kodaira T, Mizoguchi N. Factors associated with nodal metastasis in nasopharyngeal cancer: an approach to reduce the radiation field in selected patients. Br J Radiol 2010; 84:265-70. [PMID: 20959372 DOI: 10.1259/bjr/47164832] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The purpose of this study was to investigate factors associated with lymph node (LN) metastasis to identify which nasopharyngeal cancer (NPC) patients can undergo a reduction in the prophylactic radiation field. MRI of biopsy-proven NPC patients was evaluated to determine primary tumour extension and the existence of LN metastasis. METHODS Sex, age, pathological type, T stage, primary tumour size, existence beyond the midline of the nasopharynx at the primary site and parapharyngeal extension of the primary tumour were assessed regarding their impact on the laterality of LN metastasis using the χ(2) test. RESULTS Of the 167 patients, 149 (89%) showed nodal involvement. The existence beyond the midline of the nasopharynx was significantly associated with the laterality of LN metastasis (p<0.0001). Most patients (82%) with primary tumour presence within the midline showed only ipsilateral LN metastasis or no LN metastasis. In addition, contralateral LN metastases were seen only at Level II and the retropharyngeal LN among most of other patients. CONCLUSION These results suggest that LN areas other than Level II and the retropharyngeal LN on the contralateral side could be omitted in patients with primary tumour presence within the midline and without the contralateral Level II or the retropharyngeal LN. Whether disease control is compromised by reducing the radiation field for subclinical diseases is a problem that should be solved in the future by prospective study.
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Affiliation(s)
- Natsuo Tomita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
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Inokuchi H, Kodaira T, Tachibana H, Nakamura T, Tomita N, Nakahara R, Takada A, Mizoguchi N, Tamaki T, Fuwa N. Clinical usefulness of [18F] fluoro-2-deoxy-D-glucose uptake in 178 head-and-neck cancer patients with nodal metastasis treated with definitive chemoradiotherapy: consideration of its prognostic value and ability to provide guidance for optimal selection of patients for planned neck dissection. Int J Radiat Oncol Biol Phys 2010; 79:747-55. [PMID: 20434274 DOI: 10.1016/j.ijrobp.2009.11.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2009] [Revised: 11/03/2009] [Accepted: 11/18/2009] [Indexed: 12/17/2022]
Abstract
PURPOSE To evaluate the clinical effectiveness of pretreatment [18F] fluoro-2-deoxy-D-glucose-positron emission tomography for head-and-neck squamous cell carcinoma patients with nodal metastasis treated with chemoradiotherapy. METHODS AND MATERIALS Between March 2002 and December 2006, 178 patients with head-and-neck squamous cell carcinoma and nodal metastasis underwent fluoro-2-deoxy-D-glucose positron emission tomography before chemoradiotherapy. Fluoro-2-deoxy-D-glucose uptake by both the primary lesion and the neck node was measured using the standard uptake value (SUV). The overall survival, disease-free survival, local control, nodal progression-free survival, and distant metastasis-free survival rates were calculated, and several prognostic factors were evaluated. RESULTS The patients with a nodal SUV≥6.00 had a significantly lower 3-year disease-free survival rate than those with a lower SUV (44% vs. 69%, p=.004). On multivariate analysis, a high SUV of nodal disease also proved to be a significantly unfavorable factor for disease-free survival (p=.04, 95% confidence interval [CI], 1.02-3.23), nodal progression-free survival (p=.05; 95% CI, 1.00-4.15), and distant metastasis-free survival (p=.016; 95% CI, 1.25-8.92). Among the patients with a greater nodal SUV (≥6.00), those treated with planned neck dissection had better nodal progression-free survival than those in the observation group (p=.04, hazard ratio, 2.36; 95% CI, 1.00-5.85). CONCLUSION Among head-and-neck squamous cell carcinoma patients treated with chemoradiotherapy, the pretreatment SUV of nodal disease was one of the strongest prognostic factors and also provided important information for the selection of patients suitable for planned neck dissection.
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Affiliation(s)
- Haruo Inokuchi
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
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Tomita N, Kodaira T, Furutani K, Tachibana H, Nakahara R, Mizoguchi N, Hayashi N. Early salvage radiotherapy for patients with PSA relapse after radical prostatectomy. J Cancer Res Clin Oncol 2009; 135:1561-7. [PMID: 19479278 DOI: 10.1007/s00432-009-0603-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Accepted: 05/13/2009] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess the effectiveness of early salvage radiotherapy (RT) for patients with prostate-specific antigen (PSA) relapse after radical prostatectomy (RP) retrospectively. METHODS Fifty-one patients underwent salvage RT for biochemical relapse of prostate cancer initially treated with RP. All patients had persistent or rising PSA >0.20 ng/ml at some point after surgery, or three successive PSA elevations after a postoperative nadir if PSA was < or =0.20 ng/ml. Most (96%) of pre-RT PSA were less or equal to 0.50 ng/ml, and median value was 0.25 ng/ml (range, 0.05-0.90 ng/ml). Median RT dose was 60 Gy (range, 50-66 Gy). Multivariate Cox regression analysis was performed for PSA before RP and salvage RT, margin status, seminal vesicle involvement, extracapsular invasion, Gleason score, PSA doubling time (PSADT), and RT dose to identify significant predictors of biochemical outcome. RESULTS Median follow-up was 36 months. The 3-year biochemical no evidence of disease rate (bNED) was 55.1%. On multivariate analysis only the following factors were significantly associated with improved bNED: PSADT >3.0 months (P = 0.008), Gleason score < or =7 (P = 0.01), and RT dose > or =60 Gy (P = 0.028). CONCLUSIONS Although a total dose of 60 Gy was effective at a low pre-RT PSA levels with short follow-up, an RT dose > or =60 Gy resulted in superior biochemical outcomes even in patients with a pre-RT PSA < or =0.50 ng/ml.
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Affiliation(s)
- Natsuo Tomita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya 464-8681, Japan.
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Tomita N, Kodaira T, Tachibana H, Nakamura T, Mizoguchi N, Takada A. Favorable outcomes of radiotherapy for early-stage mucosa-associated lymphoid tissue lymphoma. Radiother Oncol 2009; 90:231-5. [PMID: 19135751 DOI: 10.1016/j.radonc.2008.12.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Revised: 11/28/2008] [Accepted: 12/08/2008] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study was to evaluate the efficacy of radiation therapy (RT) for early-stage mucosa-associated lymphoid tissue (MALT) lymphoma. MATERIALS AND METHODS Patients with stage IotaE (n=48) and stage capital PE, CyrillicE (n=2) MALT lymphoma treated with RT were reviewed. The primary tumor originated in the stomach in 20 patients, in the orbit in 9 patients, in the conjunctiva or eyelid and the parotid glands in 6 patients each, and 9 patients in the others. The median total RT dose was 32Gy (range, 25.6-50Gy). The median follow-up time was 50 months. RESULTS Although disease did not recur in the RT field in any patient regardless of the total dose, disease recurred outside the RT field in the seven patients. As all recurrences were localized, salvage RT was performed for each recurrence and achieved complete response without recurrence in the field. The 5-year overall survival, local control, and progression-free survival rates were 96.6%, 100%, and 82.2%, respectively. CONCLUSIONS A total dose of 25-30Gy is appropriate for local control of MALT lymphoma. RT is also an effective salvage therapy in cases of localized recurrence.
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Affiliation(s)
- Natsuo Tomita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
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Nakamura T, Hatooka S, Kodaira T, Tachibana H, Tomita N, Nakahara R, Inokuchi H, Mizoguchi N, Takada A, Shinoda M, Fuwa N. Determination of the irradiation field for clinical T1-T3N0M0 thoracic/abdominal esophageal cancer based on the postoperative pathological results. Jpn J Clin Oncol 2008; 39:86-91. [PMID: 19042946 DOI: 10.1093/jjco/hyn131] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE In patients with thoracic/abdominal esophageal cancer with no clinical evidence of lymph node metastasis, there is no consensus about whether the irradiation field should include regional lymph nodes. In this study, the extent of the irradiation field for clinical stage T1-3N0M0 esophageal cancer was determined based on the postoperative pathological results. METHODS From July 1989 to June 2008, 103 patients diagnosed with clinical stage T1-3N0M0 thoracic/abdominal esophageal cancer underwent standard esophagectomy and regional lymph node dissection at the Aichi Cancer Center Hospital. Of these 103 patients, the pathological results of the resected specimens could be confirmed in 95 (92%) patients. The pathological lymphatic spread was reviewed retrospectively, and the extent of the irradiation field was determined based on the postoperative pathological results. RESULTS Of 95 patients with clinical stage T1-3N0M0 esophageal cancer, 40 (42.1%) had pathological lymph node metastases, and the frequency of nodal metastases was studied by tumor location. The rates of lymph node metastases for the upper, middle, lower and abdominal esophagus were 37.5%, 32.5%, 46% and 70%, respectively. CONCLUSIONS Pathological lymph nodes metastases are often seen after operation in clinical stage T1-3N0M0 esophageal cancer. In the present study, the optimal lymph nodes to be included in the irradiation field were determined according to the primary site in the esophagus.
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Affiliation(s)
- Tatsuya Nakamura
- Department of Radiation Oncology, Southern Tohoku Proton Therapy Center, 7-172, Yatsuyamada, Koriyama City, Fukushima 963-8052, Japan.
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Nakamura T, Kodaira T, Tachibana H, Tomita N, Tomoda T, Nakahara R, Inokuchi H, Mizoguchi N, Takada A, Fuwa N. Chemoradiotherapy for locally recurrent nasopharyngeal carcinoma: treatment outcome and prognostic factors. Jpn J Clin Oncol 2008; 38:803-9. [PMID: 18840881 DOI: 10.1093/jjco/hyn104] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To evaluate the treatment outcome of patients with locally recurrent nasopharyngeal carcinoma (NPC) treated with re-irradiation and chemotherapy. METHODS Between 1991 and 2004, 36 patients with locally recurrent NPC received re-irradiation and chemotherapy. The median re-irradiation dose was 37.9 Gy; the median total dose of prior irradiation and re-irradiation was 104.4 Gy. The outcome is studied retrospectively and also evaluated the prognostic factors and toxicities. RESULTS With a median follow-up of 40 months, 3-year overall survival (OS) was 58.3% and 3-year progression-free survival (PFS) was 25.0%. Patients aged <50 and of early stage at recurrence had a significantly better OS and PFS. Over Grade 3 of late toxicities were seen in patients received a total dose of >110 Gy. CONCLUSIONS Age and stage at recurrence were identified as prognostic factors for OS and PFS. Patients received external beam radiation therapy at a total dose of more than 110 Gy should be careful for severe late toxicities, and it is thought to be the optimal dose for recurrent tumor.
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Affiliation(s)
- Tatsuya Nakamura
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.
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47
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Aono Y, Saigusa T, Watanabe S, Iwakami T, Mizoguchi N, Ikeda H, Ishige K, Tomiyama K, Oi Y, Ueda K, Rausch WD, Waddington JL, Ito Y, Koshikawa N, Cools AR. Role of alpha adrenoceptors in the nucleus accumbens in the control of accumbal noradrenaline efflux: a microdialysis study with freely moving rats. J Neural Transm (Vienna) 2007; 114:1135-42. [PMID: 17533511 DOI: 10.1007/s00702-007-0745-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2007] [Accepted: 04/12/2007] [Indexed: 11/25/2022]
Abstract
Microdialysis technique was used to study the effects of the locally applied alpha adrenoceptor agonist phenylephrine and antagonist phentolamine on the basal noradrenaline efflux as well as on the noradrenaline uptake inhibitor desipramine-elicited noradrenaline efflux in the nucleus accumbens (NAc) of freely moving rats. Tetrodotoxin reduced basal noradrenaline efflux by 72%, whereas desipramine increased it by 204%. Phenylephrine reduced the basal noradrenaline efflux by 32% and phentolamine blocked this effect. Phentolamine elevated the basal noradrenaline efflux by 150% and phenylephrine counteracted this effect. The desipramine-elicited noradrenaline efflux was not affected by phenylephrine, but enhanced by phentolamine. Desipramine counteracted the effects of phenylephrine and potentiated those of phentolamine. These results indicate that the accumbal noradrenaline efflux is under inhibitory control of alpha adrenoceptors that are suggested to be presynaptically located on adrenergic nerve terminals in the NAc. Furthermore, this study suggests that the conformational state of alpha adrenoceptors varies across the available amount of noradrenaline. The clinical impact of these data is discussed.
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Affiliation(s)
- Y Aono
- Department of Pharmacology, Nihon University School of Dentistry, Chiyoda-ku, Tokyo, Japan
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48
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Abstract
BACKGROUND Early diagnosis and treatment of homocystinuria with methionine-free or low methionine formulae significantly improve prognosis in children found by newborn screening and treated soon after birth. Betaine (Bet) supplementation is also an effective strategy for dietary treatment of homocystinuria. However, previous reports on diet therapy have only examined methionine and cysteine concentrations but not those of Bet and homocysteine (Hcy) in infant diets. METHODS We measured Bet and Hcy concentrations in three methionine-free formulae, five infant starter formulae, and 33 samples of human breast milk from 10 mothers. RESULTS In methionine-free formulae, Hcy but not Bet was isolated. However, in human breast milk and infant starter formulae, both Bet and Hcy were detected. However, the Bet concentration was not sufficient for the treatment. CONCLUSIONS Our study suggests that methionine-free formulae should have Hcy eliminated and be fortified with Bet to the concentration of 150 mg/dL for the treatment of homocystinuria.
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Affiliation(s)
- A Sakamoto
- Department of Pediatrics, Hiroshima University School of Medicine, Kasumi 1-2-3, Minami-ku Hiroshima, 734-8551, Japan.
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49
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Abstract
UNLABELLED Magnetic response imaging has demonstrated increased signal intensities within the basal ganglia in patients with hepatic encephalopathy; the densities are considered to represent manganese deposition. We measured whole blood manganese concentrations in nine children with congenital portosystemic venous shunts detected by screening tests for galactosaemia. Beyond 1 year of age, these patients showed significantly higher manganese concentrations than controls (2.40 +/- 0.43 versus 1.48 +/- 0.38 micrograms/dl; P = 0.0001). Four of the nine patients were studied by magnetic response imaging. T1-weighted images showed increased signal intensities in the basal ganglia of those four patients, suggesting manganese accumulation. CONCLUSION Children with congenital portosystemic venous shunts showed manganese elevations in blood and magnetic response imaging changes in the basal ganglia. These children should avoid excessive manganese intake.
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Affiliation(s)
- N Mizoguchi
- Department of Paediatrics, Hiroshima University, Faculty of Medicine, 1-2-3, Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
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50
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Abstract
Congenital porto left renal venous (PRV) shunt was found to be the cause of galactosaemia in four galactosaemic neonates detected by mass screening (Paigen method). The patients did not have hereditary galactosaemias and were diagnosed as having galactosaemia of unknown cause, because porto-systemic venous (PS) shunts had not been recognized. At the time of diagnosis, hypergalactosaemia was not severe (0.44-0.55 mmol/L; 8-10 mg/dl) and plasma concentration of total bile acids (TBA) did not suggest a PS shunt (46-50 micromol/L). However, slightly but consistently increased concentrations of galactose and TBA strongly suggested the presence of a PS shunt, and careful ultrasonographic investigation revealed PRV shunt. We conclude that PRV shunt should be suspected in patients with hypergalactosaemia of unknown cause.
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Affiliation(s)
- N Mizoguchi
- Department of Pediatrics, Hiroshima University School of Medicine, Japan
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