Updated on 2024/07/16

写真a

 
OHTA Atsushi
 
Organization
University Medical and Dental Hospital Radiation Oncology Lecturer
Title
Lecturer
External link

Degree

  • 博士(医学) ( 2017.3   新潟大学 )

Research Interests

  • radiation oncology

Research Areas

  • Life Science / Radiological sciences

Research History

  • Niigata University   Radiation Oncology, University Medical and Dental Hospital   Lecturer

    2022.11

  • Niigata University   University Medical and Dental Hospital Radiation Oncology   Assistant Professor

    2017.4 - 2022.10

  • Niigata University   University Medical and Dental Hospital Radiation Oncology   Specially Appointed Assistant Professor

    2016.8 - 2017.3

Education

  • Niigata University   Faculty of Medicine   School of Medicine

    2000.4 - 2006.3

      More details

    Country: Japan

    researchmap

Professional Memberships

  • Japanese Society for Radiation Oncology

    2011.6

      More details

  • Japan Radiological Society

    2008.4

      More details

 

Papers

  • Verification of Qfix Encompass™ couch modeling using the Acuros XB algorithm and HypeArc™ using a high-spatial-resolution two-dimensional diode array. International journal

    Takumi Yamada, Hisashi Nakano, Satoshi Tanabe, Tatsuya Sakai, Shunpei Tanabe, Tetsuya Oka, Hironori Sakai, Tomoya Oshikane, Toshimichi Nakano, Atsushi Ohta, Tsutomu Kanazawa, Motoki Kaidu, Hiroyuki Ishikawa

    Medical dosimetry : official journal of the American Association of Medical Dosimetrists   2023.7

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    We modeled the Qfix Encompass™ immobilization system and further verified the calculated dose distribution of the AcurosXB (AXB) dose calculation algorithm using SRS MapCHECKⓇ (SRSMC) in the HyperArc™ (HA) clinical plan. An Encompass system with a StereoPHAN™ QA phantom was scanned by SOMATOM go.Sim and imported to an Eclipse™ treatment planning system to create a treatment plan for Encompass modeling. The Encompass modeling was performed in the StereoPHAN with a pinpoint ion chamber for 6 MV and 6 MV flattening filter free (6 MV FFF), and 2 × 2 cm2, 4 × 4 cm2, and 6 × 6 cm2 irradiation field sizes. The dose calculation algorithm used was AXB ver. 15.5 with a 1.0 mm calculation grid size. The Hounsfield unit (HU) values of the Encompass modeling were set to 400, -100, -200, and -300 for Encompass, and -400, -600, -700, and -800 for the Encompass base. We evaluated the dose distribution after Encompass modeling by SRSMC using gamma analysis in 12 patients. We adopted HU values of -200 for Encompass, -800 for Encompass base for 6 MV, and -200 for Encompass and -700 for Encompass. Base for 6 MV FFF was adopted as the HU values for the Encompass modeling based on the measurement results. The proposed Encompass modeling resulted in a mean pass rate evaluation >98% for both 6 MV and 6 MV FFF when the 1%/1 mm criterion was used, demonstrating that the proposed HU value can be adopted to calculate more accurate dose distributions.

    DOI: 10.1016/j.meddos.2023.06.002

    PubMed

    researchmap

  • Multicomponent mathematical model for tumor volume calculation with setup error using single-isocenter stereotactic radiotherapy for multiple brain metastases

    Hisashi Nakano, Takehiro Shiinoki, Satoshi Tanabe, Toshimichi Nakano, Takeshi Takizawa, Satoru Utsunomiya, Madoka Sakai, Shunpei Tanabe, Atsushi Ohta, Motoki Kaidu, Teiji Nishio, Hiroyuki Ishikawa

    Physical and Engineering Sciences in Medicine   2023.3

     More details

    Publishing type:Research paper (scientific journal)   Publisher:Springer Science and Business Media LLC  

    DOI: 10.1007/s13246-023-01241-8

    researchmap

    Other Link: https://link.springer.com/article/10.1007/s13246-023-01241-8/fulltext.html

  • The Relationship between the Contouring Time of the Metal Artifacts Area and Metal Artifacts in Head and Neck Radiotherapy Reviewed

    Kouji Katsura, Satoshi Tanabe, Hisashi Nakano, Madoka Sakai, Atsushi Ohta, Motoki Kaidu, Marie Soga, Taichi Kobayashi, Masaki Takamura, Takafumi Hayashi

    Tomography   9 ( 1 )   98 - 104   2023.1

     More details

    Publishing type:Research paper (scientific journal)   Publisher:MDPI AG  

    (1) Background: The impacts of metal artifacts (MAs) on the contouring workload for head and neck radiotherapy have not yet been clarified. Therefore, this study evaluated the relationship between the contouring time of the MAs area and MAs on head and neck radiotherapy treatment planning. (2) Methods: We used treatment planning computed tomography (CT) images for head and neck radiotherapy. MAs were classified into three severities by the percentage of CT images containing MAs: mild (<25%), moderate (25–75%), and severe (>75%). We randomly selected nine patients to evaluate the relationship between MAs and the contouring time of the MAs area. (3) Results: The contouring time of MAs showed moderate positive correlations with the MAs volume and the number of CT images containing MAs. Interobserver reliability of the extracted MAs volume and contouring time were excellent and poor, respectively. (4) Conclusions: Our study suggests that the contouring time of MAs areas is related to individual commitment rather than clinical experience. Therefore, the development of software combining metal artifact reduction methods with automatic contouring methods is necessary to reducing interobserver variability and contouring workload.

    DOI: 10.3390/tomography9010009

    researchmap

  • Reduced-dose WBRT combined with SRS for 1–4 brain metastases aiming at minimizing neurocognitive function deterioration without compromising brain tumor control Reviewed

    Toshimichi Nakano, Hidefumi Aoyama, Shunsuke Onodera, Hiroshi Igaki, Yasuo Matsumoto, Ayae Kanemoto, Shigetoshi Shimamoto, Masayuki Matsuo, Hidekazu Tanaka, Natsuo Oya, Tomohiko Matsuyama, Atsushi Ohta, Katsuya Maruyama, Takahiro Tanaka, Nobutaka Kitamura, Kohei Akazawa, Katsuya Maebayashi

    Clinical and Translational Radiation Oncology   37   116 - 129   2022.11

     More details

    Publishing type:Research paper (scientific journal)   Publisher:Elsevier BV  

    DOI: 10.1016/j.ctro.2022.09.005

    researchmap

  • The impact of target positioning error and tumor size on radiobiological parameters in robotic stereotactic radiosurgery for metastatic brain tumors.

    Takeshi Takizawa, Satoshi Tanabe, Hisashi Nakano, Satoru Utsunomiya, Madoka Sakai, Katsuya Maruyama, Shigekazu Takeuchi, Toshimichi Nakano, Atsushi Ohta, Motoki Kaidu, Hiroyuki Ishikawa, Kiyoshi Onda

    Radiological physics and technology   2022.3

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    This study aimed to evaluate the effect of target positioning error (TPE) on radiobiological parameters, such as tumor control probability (TCP) and normal tissue complication probability (NTCP), in stereotactic radiosurgery (SRS) for metastatic brain tumors of different sizes using CyberKnife. The reference SRS plans were created using the circular cone of the CyberKnife for each spherical gross tumor volume (GTV) with diameters (φ) of 5, 7.5, 10, 15, and 20 mm, contoured on computed tomography images of the head phantom. Subsequently, plans involving TPE were created by shifting the beam center by 0.1-2.0 mm in three dimensions relative to the reference plans using the same beam arrangements. Conformity index (CI), generalized equivalent uniform dose (gEUD)-based TCP, and NTCP of estimated brain necrosis were evaluated for each plan. When the gEUD parameter "a" was set to - 10, the CI and TCP for the reference plan at the φ5-mm GTV were 0.90 and 80.8%, respectively. The corresponding values for plans involving TPE of 0.5-mm, 1.0-mm, and 2.0-mm were 0.62 and 77.4%, 0.40 and 62.9%, and 0.12 and 7.2%, respectively. In contrast, the NTCP for all GTVs were the same. The TCP for the plans involving a TPE of 2-mm was 7.2% and 68.8% at the φ5-mm and φ20-mm GTV, respectively. The TPEs corresponding to a TCP reduction rate of 3% at the φ5-mm and φ20-mm GTV were 0.41 and 0.99 mm, respectively. TPE had a significant effect on TCP in SRS for metastatic brain tumors using CyberKnife, particularly for small GTVs.

    DOI: 10.1007/s12194-022-00655-5

    PubMed

    researchmap

  • Radiobiological evaluation considering setup error on single‐isocenter irradiation in stereotactic radiosurgery

    Hisashi Nakano, Satoshi Tanabe, Ryuta Sasamoto, Takeshi Takizawa, Satoru Utsunomiya, Madoka Sakai, Toshimichi Nakano, Atsushi Ohta, Motoki Kaidu, Hiroyuki Ishikawa

    Journal of Applied Clinical Medical Physics   22 ( 7 )   266 - 275   2021.6

     More details

    Publishing type:Research paper (scientific journal)   Publisher:Wiley  

    DOI: 10.1002/acm2.13322

    researchmap

    Other Link: https://onlinelibrary.wiley.com/doi/full-xml/10.1002/acm2.13322

  • A comparative study of high-dose-rate brachytherapy boost combined with external beam radiation therapy versus external beam radiation therapy alone for high-risk prostate cancer. International journal

    Tomoya Oshikane, Motoki Kaidu, Eisuke Abe, Atsushi Ohta, Hirotake Saito, Toshimichi Nakano, Moe Honda, Satoshi Tanabe, Satoru Utsunomiya, Ryuta Sasamoto, Fumio Ishizaki, Takashi Kasahara, Tsutomu Nishiyama, Yoshihiko Tomita, Hidefumi Aoyama, Hiroyuki Ishikawa

    Journal of radiation research   62 ( 3 )   525 - 532   2021.4

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    We aimed to compare the outcomes of high-dose-rate brachytherapy (HDR-BT) boost and external beam radiation therapy (EBRT) alone for high-risk prostate cancer. This was a single-center, retrospective and observational study. Consecutive patients who underwent initial radical treatment by HDR-BT boost or EBRT alone from June 2009 to May 2016 at the Niigata University Medical and Dental Hospital, Japan were included. A total of 96 patients underwent HDR-BT boost, and 61 underwent EBRT alone. The prescription dose of HDR-BT boost was set to 18 Gy twice a day with EBRT 39 Gy/13 fractions. The dose for EBRT alone was mostly 70 Gy/28 fractions. The high-risk group received >6 months of prior androgen deprivation therapy. Overall survival, biochemical-free survival, local control and distant metastasis-free survival rates at 5 years were analyzed. The incidence of urological and gastrointestinal late adverse events of Grade 2 and above was also summarized. In the National Comprehensive Cancer Network (NCCN) high-risk calssification, HDR-BT boost had a significantly higher biochemical-free survival rate at 5 years (98.9% versus 90.7%, P = 0.04). Urethral strictures were more common in the HDR-BT boost group. We will continuously observe the progress of the study patients and determine the longer term results.

    DOI: 10.1093/jrr/rrab006

    PubMed

    researchmap

  • Maximum distance in single-isocenter technique of stereotactic radiosurgery with rotational error using margin-based analysis.

    Hisashi Nakano, Satoshi Tanabe, Takumi Yamada, Satoru Utsunomiya, Takeshi Takizawa, Madoka Sakai, Ryuta Sasamoto, Hironori Sakai, Toshimichi Nakano, Hirotake Saito, Atsushi Ohta, Motoki Kaidu, Hiroyuki Ishikawa

    Radiological physics and technology   14 ( 1 )   57 - 63   2021.3

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    Through geometrical simulation, we evaluated the effect of rotational error in patient setup on geometrical coverage and calculated the maximum distance between the isocenter and target, where the clinical PTV margin secures geometrical coverage with a single-isocenter technique. We used simulated spherical GTVs with diameters of 1.0 (GTV 1), 1.5 (GTV 2), 2.0 (GTV 3), and 3.0 cm (GTV 4). The location of the target center was set such that the distance between the target and isocenter ranged from 0 to 15 cm. We created geometrical coverage vectors so that each target was entirely covered by 100% of the prescribed dose. The vectors of the target positions were simultaneously rotated within a range of 0°-2.0° around the x-, y-, and z-axes. For each rotational error, the reduction in geometrical coverage of the targets was calculated and compared with that obtained for a rotational error of 0°. The tolerance value of the geometrical coverage reduction was defined as 5% of the GTV. The maximum distance that satisfied the 5% tolerance value for different values of rotational error at a clinical PTV margin of 0.1 cm was calculated. When the rotational errors were 0.5° for a 0.1 cm PTV margin, the maximum distances were as follows: GTV 1: 7.6 cm; GTV 2: 10.9 cm; GTV 3: 14.3 cm; and GTV 4: 21.4 cm. It might be advisable to exclude targets that are > 7.6 cm away from the isocenter with a single-isocenter technique to satisfy the tolerance value for all GTVs.

    DOI: 10.1007/s12194-020-00602-2

    PubMed

    researchmap

  • Calculated relative biological effectiveness (RBE) for initial DNA double-strand breaks (DSB) from flattening filter and flattening filter-free 6 MV X-ray fields

    Hisashi Nakano, Daisuke Kawahara, Satoshi Tanabe, Satoru Utsunomiya, Takeshi Takizawa, Madoka Sakai, Toshimichi Nakano, Atsushi Ohta, Motoki Kaidu, Hiroyuki Ishikawa

    BJR|Open   3 ( 1 )   20200072 - 20200072   2021.1

     More details

    Publishing type:Research paper (scientific journal)   Publisher:British Institute of Radiology  

    <sec><title>Objectives:</title> We evaluated the radiobiological effectiveness based on the yields of DNA double-strand breaks (DSBs) of field induction with flattening filter (FF) and FF-free (FFF) photon beams.

    </sec><sec><title>Methods:</title> We used the particle and heavy ion transport system (PHITS) and a water equivalent phantom (30 × 30 × 30 cm<sup>3</sup>) to calculate the physical qualities of the dose-mean lineal energy (y<sub>D</sub>) with 6 MV FF and FFF. The relative biological effectiveness based on the yields of DNA-DSBs (RBE<sub>DSB</sub>) was calculated for standard radiation such as 220 kVp X-rays by using the estimating yields of SSBs and DSBs. The measurement points used to calculate the in-field y<sub>D</sub> and RBE<sub>DSB</sub> were located at a depth of 3, 5, and 10 cm in the water equivalent phantom on the central axis. Measurement points at 6, 8, and 10 cm in the lateral direction of each of the three depths from the central axis were set to calculate the out-of-field y<sub>D</sub> and RBE<sub>DSB</sub>.

    </sec><sec><title>Results:</title> The RBE<sub>DSB</sub> of FFF in-field was 1.7% higher than FF at each measurement depth. The RBE<sub>DSB</sub> of FFF out-of-field was 1.9 to 6.4% higher than FF at each depth measurement point. As the distance to out-of-field increased, the RBE<sub>DSB</sub> of FFF rose higher than those of FF. FFF has a larger RBE<sub>DSB</sub> than FF based on the yields of DNA-DSBs as the distance to out-of-field increased.

    </sec><sec><title>Conclusions:</title> The out-of-field radiobiological effect of FFF could thus be greater than that of FF since the spreading of the radiation dose out-of-field with FFF could be a concern compared to the FF.

    </sec><sec><title>Advances in knowledge:</title> The RBE<sub>DSB</sub> of FFF of out-of-field might be larger than FF.

    </sec>

    DOI: 10.1259/bjro.20200072

    researchmap

  • Radiobiological effects of the interruption time with Monte Carlo Simulation on multiple fields in photon beams. International journal

    Hisashi Nakano, Daisuke Kawahara, Satoshi Tanabe, Satoru Utsunomiya, Takeshi Takizawa, Madoka Sakai, Hirotake Saito, Atsushi Ohta, Motoki Kaidu, Hiroyuki Ishikawa

    Journal of applied clinical medical physics   21 ( 12 )   288 - 294   2020.12

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    PURPOSE: The interruption time is the irradiation interruption that occurs at sites and operations such as the gantry, collimator, couch rotation, and patient setup within the field in radiotherapy. However, the radiobiological effect of prolonging the treatment time by the interruption time for tumor cells is little evaluated. We investigated the effect of the interruption time on the radiobiological effectiveness with photon beams based on a modified microdosimetric kinetic (mMK) model. METHODS: The dose-mean lineal energy yD (keV/µm) of 6-MV photon beams was calculated by the particle and heavy ion transport system (PHITS). We set the absorbed dose to 2 or 8 Gy, and the interruption time (τ) was set to 1, 3, 5, 10, 30, and 60 min. The biological parameters such as α0, β0, and DNA repair constant rate (a + c) values were acquired from a human non-small-cell lung cancer cell line (NCI-H460) for the mMK model. We used two-field and four-field irradiation with a constant dose rate (3 Gy/min); the photon beams were paused for interruption time τ. We calculated the relative biological effectiveness (RBE) to evaluate the interruption time's effect compared with no interrupted as a reference. RESULTS: The yD of 6-MV photon beams was 2.32 (keV/µm), and there was little effect by changing the water depth (standard deviation was 0.01). The RBE with four-field irradiation for 8 Gy was decreased to 0.997, 0.975, 0.900, and 0.836 τ = 1, 10, 30, 60 min, respectively. In addition, the RBE was affected by the repair constant rate (a + c) value, the greater the decrease in RBE with the longer the interruption time when the (a + c) value was large. CONCLUSION: The ~10-min interruption of 6-MV photon beams did not significantly impact the radiobiological effectiveness, since the RBE decrease was <3%. Nevertheless, the RBE's effect on tumor cells was decreased about 30% by increasing the 60 min interruption time at 8 Gy with four-field irradiation. It is thus necessary to make the interruption time as short as possible.

    DOI: 10.1002/acm2.13110

    PubMed

    researchmap

  • Effect of setup error in the single-isocenter technique on stereotactic radiosurgery for multiple brain metastases. International journal

    Hisashi Nakano, Satoshi Tanabe, Satoru Utsunomiya, Takumi Yamada, Ryuta Sasamoto, Toshimichi Nakano, Hirotake Saito, Takeshi Takizawa, Hironori Sakai, Atsushi Ohta, Eisuke Abe, Motoki Kaidu, Hidefumi Aoyama

    Journal of applied clinical medical physics   21 ( 12 )   155 - 165   2020.12

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    In conventional stereotactic radiosurgery (SRS), treatment of multiple brain metastases using multiple isocenters is time-consuming resulting in long dose delivery times for patients. A single-isocenter technique has been developed which enables the simultaneous irradiation of multiple targets at one isocenter. This technique requires accurate positioning of the patient to ensure optimal dose coverage. We evaluated the effect of six degrees of freedom (6DoF) setup errors in patient setups on SRS dose distributions for multiple brain metastases using a single-isocenter technique. We used simulated spherical gross tumor volumes (GTVs) with diameters ranging from 1.0 to 3.0 cm. The distance from the isocenter to the target's center was varied from 0 to 15 cm. We created dose distributions so that each target was entirely covered by 100% of the prescribed dose. The target's position vectors were rotated from 0°-2.0° and translated from 0-1.0 mm with respect to the three axes in space. The reduction in dose coverage for the targets for each setup error was calculated and compared with zero setup error. The calculated margins for the GTV necessary to satisfy the tolerance values for loss of GTV coverage of 3% to 10% were defined as coverage-based margins. In addition, the maximum isocenter to target distance for different 6DoF setup errors was calculated to satisfy the tolerance values. The dose coverage reduction and coverage-based margins increased as the target diameter decreased, and the distance and 6DoF setup error increased. An increase in setup error when a single-isocenter technique is used may increase the risk of missing the tumor; this risk increases with increasing distance from the isocenter and decreasing tumor size.

    DOI: 10.1002/acm2.13081

    PubMed

    researchmap

  • Dosimetric comparison of analytic anisotropic algorithm and Acuros XB algorithm in VMAT plans for high-grade glioma. International journal

    Takeshi Takizawa, Satoshi Tanabe, Satoru Utsunomiya, Hisashi Nakano, Takumi Yamada, Hironori Sakai, Atsushi Ohta, Hirotake Saito, Toshimichi Nakano, Eisuke Abe, Motoki Kaidu, Hidefumi Aoyama

    Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB)   73   73 - 82   2020.5

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    PURPOSE: To investigate the dosimetric impact between the anisotropic analytical algorithm (AAA) and the Acuros XB (AXB) algorithm in volumetric-modulated arc therapy (VMAT) plans for high-grade glioma (HGG). METHODS: We used a heterogeneous phantom to quantify the agreement between the measured and calculated doses from the AAA and from the AXB. We then analyzed 14 patients with HGG treated by VMAT, using the AAA. We newly created AXB plans for each corresponding AAA plan under the following conditions: (1) re-calculation for the same number of monitor units with an identical beam and leaf setup, and (2) re-optimization under the same conditions of dose constraints. The dose coverage for the planning target volume (PTV) was evaluated by dividing the coverage into the skull, air, and soft-tissue regions. RESULTS: Compared to the results obtained with the AAA, the AXB results were in good agreement with the measured profiles. The dose differences in the PTV between the AAA and re-calculated AXB plans were large in the skull region contained in the target. The dose difference in the PTV in both types of plan was significantly correlated with the volume of the skull contained in the target (r = 0.71, p = 0.0042). A re-optimized AXB plan's dose difference was lower vs. the re-calculated AXB plan's. CONCLUSIONS: We observed dose differences between the AAA and AXB plans, in particular in the cases in which the skull region of the target was large. Considering the phantom measurement results, the AXB algorithm should be used in VMAT plans for HGG.

    DOI: 10.1016/j.ejmp.2020.04.007

    PubMed

    researchmap

  • The neurocognitive function change criteria after whole-brain radiation therapy for brain metastasis, in reference to health-related quality of life changes: a prospective observation study. International journal

    Toshimichi Nakano, Hidefumi Aoyama, Hirotake Saito, Satoshi Tanabe, Kensuke Tanaka, Katsuya Maruyama, Tomoya Oshikane, Atsushi Ohta, Eisuke Abe, Motoki Kaidu

    BMC cancer   20 ( 1 )   66 - 66   2020.1

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    BACKGROUND: We sought to construct the optimal neurocognitive function (NCF) change criteria sensitive to health-related quality of life (HR-QOL) in patients who have undergone whole-brain radiation therapy (WBRT) for brain metastasis. METHODS: We categorized the patients by the changes of NCF into groups of improvement versus deterioration if at least one domain showed changes that exceeded the cut-off while other domains remained stable. The remaining patients were categorized as stable, and the patients who showed both significant improvement and deterioration were categorized as 'both.' We examined the clinical meaning of NCF changes using the cut-off values 1.0, 1.5, and 2.0 SD based on the percentage of patients whose HR-QOL changes were ≥ 10 points. RESULTS: Baseline, 4-month and 8-month data were available in 78, 41 (compliance; 85%), and 29 (81%) patients, respectively. At 4 months, improvement/stable/deterioration/both was seen in 15%/12%/41%/32% of the patients when 1.0 SD was used; 19%/22%/37%/22% with 1.5 SD, and 17%/37%/37%/9% with 2.0 SD. The HR-QOL scores on the QLQ-C30 functional scale were significantly worse in the deterioration group versus the others with 1.0 SD (p = 0.013) and 1.5 SD (p = 0.015). With 1.5 SD, the HR-QOL scores on the QLQ-BN20 was significantly better in the improvement group versus the others (p = 0.033). However, when 'both' was included in 'improvement' or 'deterioration,' no significant difference in HR-QOL was detected. CONCLUSIONS: The NCF cut-off of 1.5 SD and the exclusion of 'both' patients from the 'deterioration' and 'improvement' groups best reflects HR-QOL changes.

    DOI: 10.1186/s12885-020-6559-3

    PubMed

    researchmap

  • The association between oral candidiasis and severity of chemoradiotherapy-induced dysphagia in head and neck cancer patients: A retrospective cohort study. International journal

    Hirotake Saito, Ryusuke Shodo, Keisuke Yamazaki, Kouji Katsura, Yushi Ueki, Toshimichi Nakano, Tomoya Oshikane, Nobuko Yamana, Satoshi Tanabe, Satoru Utsunomiya, Atsushi Ohta, Eisuke Abe, Motoki Kaidu, Ryuta Sasamoto, Hidefumi Aoyama

    Clinical and translational radiation oncology   20   13 - 18   2020.1

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    Background and purpose: Concurrent chemoradiotherapy (CCRT) for head and neck cancer (HNC) is a risk factor for oral candidiasis (OC). As Candida spp. are highly virulent, we conducted a retrospective study to determine whether OC increases the severity of dysphagia related to mucositis in HNC patients. Patients and methods: We retrospectively analyzed the cases of consecutive patients with carcinomas of the oral cavity, pharynx, and larynx who underwent CCRT containing cisplatin (CDDP) at our hospital. The diagnosis of OC was based on gross mucosal appearance. We performed a multivariate analysis to determine whether OC was associated with the development of grade 3 dysphagia in the Radiation Therapy Oncology Group (RTOG) Acute Toxicity Criteria. The maximum of the daily opioid doses was compared between the patients with and without OC. Results: We identified 138 HNC patients. OC was observed in 51 patients (37%). By the time of their OC diagnosis, 19 (37%) had already developed grade 3 dysphagia. Among the 30 patients receiving antifungal therapy, 12 (40%) showed clinical deterioration. In the multivariate analysis, OC was independently associated with grade 3 dysphagia (OR 2.75; 95%CI 1.22-6.23; p = 0.015). The patients with OC required significantly higher morphine-equivalent doses of opioids (45 vs. 30 mg/day; p = 0.029). Conclusion: Candida infection causes refractory dysphagia. It is worth investigating whether antifungal prophylaxis reduces severe dysphagia related to candidiasis.

    DOI: 10.1016/j.ctro.2019.10.006

    PubMed

    researchmap

  • 多発脳転移に対する単一アイソセンタ照射法における患者セットアップの並進誤差が線量不確かさに及ぼす影響

    中野 永, 棚邊 哲史, 宇都宮 悟, 中野 智成, 斎藤 紘丈, 滝澤 健司, 山田 巧, 坂井 裕則, 太田 篤, 阿部 英輔, 海津 元樹, 青山 英史

    定位的放射線治療   24   81 - 89   2020.1

     More details

    Language:Japanese   Publisher:日本定位放射線治療学会  

    researchmap

  • 消化器癌脳転移に対する定位照射の治療成績

    斎藤 紘丈, 中野 智成, 押金 智哉, 太田 篤, 阿部 英輔, 海津 元樹, 青山 英史

    定位的放射線治療   24   73 - 79   2020.1

     More details

    Language:Japanese   Publisher:日本定位放射線治療学会  

    定位放射線治療を受けた消化器癌(胃、小腸、大腸、肝臓、胆、膵)からの脳転移患者の治療成績について検討した。25名の消化器癌脳転移患者が当科を受診し、生存期間中央値は5.1ヵ月であった。25名のうち定位照射を施行されたのは5人(男性4人、女性1人、中央値77歳)で、原発巣は肝臓4人、直腸1人であった。初診時の病期はstage Iが1人、stage IIIが4人、不明が1人であり、4人が脳転移診断時に頭蓋外転移をすでに有していた。治療方針は定位照射単独が3人、定位+全脳照射が1人、定位+全脳照射+手術が1人であった。定位照射の線量分割は22Gy/1回が5病変、28Gy/4回が2病変、32Gy/4回が2病変、30.4Gy/4回が1病変であった。定位照射後の一次治療効果判定はPDが3人、制御が1人、体幹部転移の増大のため未評価が1人であった。適切な画像フォローアップおよび体幹部転移のコントロールを改善することが予後改善につながる可能性があると考えられた。

    researchmap

  • The impact of the three degrees-of-freedom fiducial marker-based setup compared to soft tissue-based setup in hypofractionated intensity-modulated radiotherapy for prostate cancer. International journal

    Satoshi Tanabe, Satoru Utsunomiya, Eisuke Abe, Hiraku Sato, Atsushi Ohta, Hironori Sakai, Takumi Yamada, Motoki Kaidu, Hidefumi Aoyama

    Journal of applied clinical medical physics   20 ( 6 )   53 - 59   2019.6

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    PURPOSE: We evaluated the setup accuracy of a three-degree-of-freedom fiducial marker (3DOF-FM)-based setup compared to a soft tissue (ST)-based setup in hypofractionated intensity-modulated radiotherapy (IMRT) for prostate cancer. MATERIALS AND METHODS: We analyzed the setup accuracy for 17 consecutive prostate cancer patients with three implanted FMs who underwent hypofractionated IMRT. The 3DOF-ST-based setup using cone-beam computed tomography (CT) was performed after a six DOF-bony structure (BS)-based setup using an ExacTrac x-ray system. The 3DOF-FM-based matching using the ExacTrac x-ray system was done during the BS- and ST-based setups. We determined the mean absolute differences and the correlation between the FM- and ST-based translational shifts relative to the BS-based setup position. The rotational mean shifts detected by the ExacTrac x-ray system were also evaluated. RESULTS: The mean differences in the anterior-posterior (AP), superior-inferior (SI), and left-right (LR) dimensions were 0.69, 0.0, and 0.30 mm, respectively. The Pearson correlation coefficients for both shifts were 0.92 for AP, 0.91 for SI, and 0.68 for LR. The percentages of shift agreements within 2 mm were 85% for AP, 93% for SI, and 99% for LR. The absolute values of rotational shifts were 0.1° for AP, 0.3°, and 1.2° for LR. CONCLUSIONS: The setup accuracy of the 3DOF-FM-based setup has the potential to be interchangeable with a ST-based setup. Our data are likely to be useful in clinical practice along with the popularization of the hypofractionated IMRT in prostate cancer.

    DOI: 10.1002/acm2.12603

    PubMed

    researchmap

  • Complementary Relation Between the Improvement of Dose Delivery Technique and PTV Margin Reduction in Dose-Escalated Radiation Therapy for Prostate Cancer. International journal

    Satoru Utsunomiya, Jun Yamamoto, Satoshi Tanabe, Mayu Oishi, Aruha Satsuma, Motoki Kaidu, Eisuke Abe, Atsushi Ohta, Naotaka Kushima, Hidefumi Aoyama

    Practical radiation oncology   9 ( 3 )   172 - 178   2019.5

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    PURPOSE: The purpose of this study is to demonstrate quantitatively the complementary relationship between the introduction of intensity modulated radiation therapy (IMRT) and planning target volume (PTV) margin reduction with an image guided technique in reducing the risk of rectal toxicity in dose-escalating prostate radiation therapy. METHODS AND MATERIALS: Three-dimensional conformal radiation therapy (CRT) and IMRT plans were generated for 10 patients with prostate cancer based on 2 PTV margin protocols (10/8 mm and 6/5 mm) and 2 dose prescriptions (70 Gy and 78 Gy). The normal tissue complication probability (NTCP) for each of the 8 scenarios was calculated using the Lyman-Kutcher-Burman model to estimate the risk of rectal and bladder late toxicity. The conformity and homogeneity indices of PTVs were calculated for each plan. RESULTS: The IMRT plans showed superiority in conformity and inferiority in homogeneity over 3-dimensional CRT plans. The rectal NTCPs were increased 3.5 to 4.1 times when the prescribed total dose was changed from 70 Gy to 78 Gy and the dose delivery and the image guided radiation therapy techniques remained unchanged. PTV margin reduction was shown to reduce the value of rectal NTCP significantly. Overall, implementing the IMRT technique alone could reduce the NTCP values only by 2.1% to 7.3% from those of 3-dimensional CRT. The introduction of both IMRT and PTV margin reduction was found to be necessary for rectal NTCP to remain <5% in the dose escalation from 70 to 78 Gy. CONCLUSIONS: The complementary relationship between the introduction of IMRT and PTV margin reduction was proven. We found that both approaches need to be implemented to safely deliver a curative dose in dose-escalating prostate radiation therapy.

    DOI: 10.1016/j.prro.2019.02.001

    PubMed

    researchmap

  • Selection criteria for 3D conformal radiotherapy versus volumetric-modulated arc therapy in high-grade glioma based on normal tissue complication probability of brain. International journal

    Satoshi Tanabe, Haruna Takahashi, Hirotake Saito, Atsushi Ohta, Toshimichi Nakano, Ryuta Sasamoto, Miki Shioi, Satoru Utsunomiya, Eisuke Abe, Motoki Kaidu, Hidefumi Aoyama

    Journal of radiation research   60 ( 2 )   249 - 256   2019.3

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    There are no quantitative selection criteria for identifying high-grade glioma (HGG) patients who are suited for volumetric-modulated arc therapy (VMAT). This study aimed to develop selection criteria that can be used for the selection of the optimal treatment modality in HGG. We analyzed 20 patients with HGG treated by 3D conformal radiotherapy (3DCRT). First, VMAT plans were created for each patient retrospectively. For each plan, the normal tissue complication probability (NTCP) for normal brain was calculated. We then divided the patients based on the NTCPs of the 3DCRT plans for normal brain, using the threshold of 5%. We compared the NTCPs of the two plans and the gross tumor volumes (GTVs) of the two groups. For the GTVs, we used receiver operating characteristic curves to identify the cut-off value for predicting NTCP < 5%. We determined the respective correlations between the GTV and the GTV's largest cross-sectional diameter and largest cross-sectional area. In the NTCP ≥ 5% group, the NTCPs for the VMAT plans were significantly lower than those for the 3DCRT plans (P = 0.0011). The NTCP ≥ 5% group's GTV was significantly larger than that of the NTCP < 5% group (P = 0.0016), and the cut-off value of the GTV was 130.5 cm3. The GTV was strongly correlated with the GTV's largest cross-sectional diameter (R2 = 0.82) and largest cross-sectional area (R2 = 0.94), which produced the cut-off values of 7.5 cm and 41 cm2, respectively. It was concluded that VMAT is more appropriate than 3DCRT in cases in which the GTV is ≥130.5 cm3.

    DOI: 10.1093/jrr/rry106

    PubMed

    researchmap

  • 悪性神経膠腫のVMAT治療計画における2つの線量計算アルゴリズム Analytic Anisotropic AlgorithmとAcuros XBの違いが線量分布へ与える影響

    滝澤 健司, 棚邊 哲史, 宇都宮 悟, 久島 尚隆, 中野 永, 太田 篤, 斎藤 紘丈, 中野 智成, 阿部 英輔, 海津 元樹, 青山 英史

    定位的放射線治療   23   43 - 54   2019.1

     More details

    Language:Japanese   Publisher:日本定位放射線治療学会  

    悪性神経膠腫に対する強度変調回転放射線治療(VMAT)の治療計画におけるAnalytical Anisotropic Algorithm(AAA)とAcuros XB(AXB)の線量分布の違いを明らかにし、AXBの臨床的意義を明らかにすることを目的とした。悪性神経膠腫に対してVMATが施行された連続16症例を対象とした。計画標的体積(PTV)60のD95%およびV95%はAXB治療計画の方が有意に低く、各々効果量は大きかった。CTV60のD95%およびV95%は各々AXB治療計画の方が有意に低く、D95%の効果量は中等度で、V95%の効果量は小さかった。PTV60_skullのD95%およびV95%はAXB治療計画の方が有意に低く、各々効果量は大きかった。一方、PTV60_airについては、D95%はAXB治療計画の方が有意に高かったが、V95%の有意差は認められず、各々効果量は小さかった。また、頭蓋骨体積とPTV60、PTV50の各々の線量差に対する相関係数は0.66、0.71と高い正の相関が認められ、PTV内の頭蓋骨体積の割合が大きいほど線量差は大きくなった。

    researchmap

  • Effects of Catheter Tip Location on the Spread of Sensory Block Caused by a Continuous Thoracic Paravertebral Block: A Prospective, Randomized, Controlled, Double-Blind Study. International journal

    Takayuki Yoshida, Yoshiko Watanabe, Takeshi Hashimoto, Atsushi Ohta, Tatsuo Nakamoto

    BioMed research international   2019   1051629 - 1051629   2019

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    Single injections in the anterior region of the thoracic paravertebral space (TPVS) have been reported to generate a multisegmental longitudinal spreading pattern more frequently than those in the posterior region of the TPVS. In this trial, we examined the hypothesis that a continuous thoracic paravertebral block (TPVB) administered through a catheter inserted into the anterior region of the TPVS allows a wider sensory block dispersion. Fifty consecutive patients undergoing video-assisted thoracic surgery were enrolled. Before the surgery, an infusion catheter was inserted into the TPVS through a needle placed adjacent to either the parietal pleura (group A) or internal intercostal membrane (group P) using an ultrasound-guided intercostal transverse approach according to a randomized allocation schedule. A chest radiograph was obtained postoperatively after injection of 10 mL of radiopaque dye through the catheter. Thereafter, 20 mL of 0.375% levobupivacaine was injected via the catheter, followed by commencement of continuous TPVB with 0.25% levobupivacaine at 8 mL/h. The primary outcome was the number of blocked dermatomes at 24 h after surgery. The secondary outcomes included radiopaque dye spreading patterns, the number of segments reached by the radiopaque dye, the number of blocked dermatomes at 2 h after surgery, and pain scores. The median (interquartile range [range]) number of blocked dermatomes 24 h after surgery was 3 (2.75-4 [1-6]) in group A (n = 22) and 2 (1.5-3 [0-7]) in group P (n = 25; p = 0.037). No significant differences in the other outcomes were found between the groups. In conclusion, a continuous TPVB administered using a catheter supposedly inserted into the anterior region of the TPVS allows a wider sensory block dispersion than a catheter inserted into the posterior region of the TPVS. This trial is registered with the UMIN Clinical Trials Registry (UMIN000018578).

    DOI: 10.1155/2019/1051629

    PubMed

    researchmap

  • Definitive chemoradiotherapy with low-dose continuous 5-fluorouracil reduces hematological toxicity without compromising survival in esophageal squamous cell carcinoma patients. International journal

    Hirotake Saito, Atsushi Ohta, Eisuke Abe, Motoki Kaidu, Miki Shioi, Toshimichi Nakano, Tomoya Oshikane, Kensuke Tanaka, Katsuya Maruyama, Naotaka Kushima, Satoshi Tanabe, Satoru Utsunomiya, Ryuta Sasamoto, Hidefumi Aoyama

    Clinical and translational radiation oncology   9   12 - 17   2018.2

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    Background and purpose: To compare chemoradiotherapy (CRT) with low-dose continuous 5-fluorouracil (5FU) to CRT with 5FU+cisplatin (CDDP) for esophageal squamous cell carcinoma (ESCC) in a retrospective cohort study. Methods and materials: We reviewed the cases of Stage I-IV ESCC patients who underwent definitive CRT in 2000-2014. Concomitant chemotherapy was one of the three regimens: (1) high-dose intermittent 5FU and CDDP (standard-dose FP: SDFP), (2) low-dose continuous 5FU and CDDP (LDFP), or (3) low-dose continuous 5FU (LD5FU). The general selection criteria for chemotherapy were: SDFP for patients aged <70 yrs; LDFP for those aged 70-74 yrs; LD5FU for those aged ≥75 yrs or with performance status (PS) ≥3. Propensity scores were derived with chemotherapy (LD5FU vs. 5FU+CDDP) as the dependent variable. Results: In a multivariate analysis, chemotherapy (LD5FU vs. SDFP, p = .24; LDFP vs. SDFP, p = .52) did not affect the overall survival (OS). LD5FU caused significantly less grade 3-4 leukopenia (9%) compared to SDFP (47%) and LDFP (44%) (p < .001). In a propensity-matched analysis, LD5FU affected neither OS (HR 1.06; 95%CI 0.55-2.05; p = .87) nor progression-free survival (HR 0.95, 95%CI 0.50-1.81; p = .87). Conclusion: CRT with low-dose continuous 5FU may be a less toxic option for elderly ESCC patients.

    DOI: 10.1016/j.ctro.2017.12.003

    PubMed

    researchmap

  • 前立腺癌に対する高線量率組織内照射 5年経過例の尿道狭窄の検討

    丸山 克也, 海津 元樹, 阿部 英輔, 田中 研介, 太田 篤, 塩井 美希, 斎藤 紘丈, 中野 智成, 青山 英史, 笹本 龍太

    Japanese Journal of Radiology   36 ( Suppl. )   11 - 11   2018.2

     More details

    Language:Japanese   Publisher:(公社)日本医学放射線学会  

    researchmap

  • Respiratory gating and multifield technique radiotherapy for esophageal cancer.

    Atsushi Ohta, Motoki Kaidu, Satoshi Tanabe, Satoru Utsunomiya, Ryuta Sasamoto, Katsuya Maruyama, Kensuke Tanaka, Hirotake Saito, Toshimichi Nakano, Miki Shioi, Haruna Takahashi, Naotaka Kushima, Eisuke Abe, Hidefumi Aoyama

    Japanese journal of radiology   35 ( 3 )   95 - 100   2017.3

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    PURPOSE: To investigate the effects of a respiratory gating and multifield technique on the dose-volume histogram (DVH) in radiotherapy for esophageal cancer. METHODS AND MATERIALS: Twenty patients who underwent four-dimensional computed tomography for esophageal cancer were included. We retrospectively created the four treatment plans for each patient, with or without the respiratory gating and multifield technique: No gating-2-field, No gating-4-field, Gating-2-field, and Gating-4-field plans. We compared the DVH parameters of the lung and heart in the No gating-2-field plan with the other three plans. RESULT: In the comparison of the parameters in the No gating-2-field plan, there are significant differences in the Lung V5Gy, V20Gy, mean dose with all three plans and the Heart V25Gy-V40Gy with Gating-2-field plan, V35Gy, V40Gy, mean dose with No Gating-4-field plan and V30Gy-V40Gy, and mean dose with Gating-4-field plan. The lung parameters were smaller in the Gating-2-field plan and larger in the No gating-4-field and Gating-4-field plans. The heart parameters were all larger in the No gating-2-field plan. CONCLUSION: The lung parameters were reduced by the respiratory gating technique and increased by the multifield technique. The heart parameters were reduced by both techniques. It is important to select the optimal technique according to the risk of complications.

    DOI: 10.1007/s11604-016-0606-7

    PubMed

    researchmap

  • Two-fraction high-dose-rate brachytherapy within a single day combined with external beam radiotherapy for prostate cancer: single institution experience and outcomes. International journal

    Junyang Liu, Motoki Kaidu, Ryuta Sasamoto, Fumio Ayukawa, Nobuko Yamana, Hiraku Sato, Kensuke Tanaka, Gen Kawaguchi, Atsushi Ohta, Katsuya Maruyama, Eisuke Abe, Takashi Kasahara, Tsutomu Nishiyama, Yoshihiko Tomita, Hidefumi Aoyama

    Journal of radiation research   57 ( 3 )   280 - 7   2016.6

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    We investigated the outcomes of treatment for patients with localized prostate cancer (PCa) treated with 3D conformal radiation therapy (3D-CRT) followed by two-fraction high-dose-rate brachytherapy within a single day (2-fr.-HDR-BT/day) at a single institution. A total of 156 consecutive Asian males (median age, 67 years) were enrolled. To compare our findings with those of other studies, we analyzed our results using the D'Amico classification, assigning the patients to low- ( N =: 5; 3.2%), intermediate- ( N =: 36; 23.1%) and high-risk ( N =: 115; 73.7%) groups (Stage T3 PCa patients were classified as high-risk). One patient in the D'Amico low-risk group (20%), 13 intermediate-risk patients (36.1%) and 99 high-risk patients (86.1%) underwent androgen deprivation therapy. We administered a prescription dose of 39 Gy in 13 fractions of 3D-CRT combined with 18 Gy of HDR-BT in two 9-Gy fractions delivered within a single day. We did not distinguish between risk groups in determining the prescription dose. The median follow-up period was 38 months. Of the 156 patients, one died from primary disease and five died from other diseases. The 3-year overall survival (OS) rates were 100%, 100% and 93.7%, and the 3-year 'biochemical no evidence of disease (bNED)' rates were 100%, 100% and 96.9% for the D'Amico low-, intermediate- and high-risk groups, respectively. No patient developed ≥ Grade 3 early toxicity. The Grade 3 late genitourinary toxicity rate was 2.6%, and no ≥ Grade 3 late gastrointestinal toxicity occurred. The efficacy and safety of this study were satisfactory, and longer-term follow-up is necessary.

    DOI: 10.1093/jrr/rrw003

    PubMed

    researchmap

  • 前立腺癌に対する体外照射を併用した高線量率小線源療法 4年間の経験(HIGH-DOSE-RATE BRACHYTHERAPY WITH EXTERNAL BEAM RADIOTHERAPY FOR PROSTATE CANCER: 4-YEAR EXPERIECE)

    劉 君陽, 海津 元樹, 鮎川 文夫, 小日向 美華, 山名 展子, 佐藤 啓, 田中 研介, 川口 弦, 太田 篤, 丸山 克也, 阿部 英輔, 青山 英史, 笹本 龍太

    Japanese Journal of Radiology   34 ( Suppl. )   5 - 5   2016.2

     More details

    Language:Japanese   Publisher:(公社)日本医学放射線学会  

    researchmap

  • Superiority of a soft tissue-based setup using cone-beam computed tomography over a bony structure-based setup in intensity-modulated radiotherapy for prostate cancer. International journal

    Hiraku Sato, Eisuke Abe, Satoru Utsunomiya, Motoki Kaidu, Nobuko Yamana, Kensuke Tanaka, Atsushi Ohta, Mika Obinata, Junyang Liu, Gen Kawaguchi, Katsuya Maruyama, Fumio Ayukawa, Hidefumi Aoyama

    Journal of applied clinical medical physics   16 ( 5 )   239–245   2015.9

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    The purpose of this study was to test the superiority of a soft tissue-based setup using cone-beam computed tomography (CBCT) to a bony structure-based setup using the ExacTrac system in intensity-modulated radiotherapy (IMRT) for prostate cancer. We studied 20 patients with localized prostate cancer who received IMRT between November 2010 and February 2012. After the initial setup, the pelvic bony structure-based setup and ExacTrac system were applied. After that, CBCT and a soft tissue-based setup were used. A shift in the isocenter between the ExacTrac-based and CBCT-based setup was recorded in the anterior-posterior (AP), superior-inferior (SI), and left-right (LR) axes. The shift was considered an interfractional prostate shift. Post-treatment CBCT was also taken once a week to measure the intrafractional prostate shift, based on the coordinates of the isocenter between pre- and post-treatment CBCT. The planning target volume (PTV) margins were determined using van Herk's method. We measured the elapsed time required for soft tissue matching and the entire treatment time using CBCT. The means ± standard deviation (SD) of the inter- and intrafractional shifts were 0.9 ± 2.8 mm and -0.3 ± 1.4 mm in the AP, 0.9 ± 2.2 mm and -0.1 ± 1.2 mm in the SI, and 0.1 ± 0.7 mm and -0.1 ± 0.7 mm in the LR directions. The PTV margins in the cases of bony structure-based and soft tissue-based setups were 7.3 mm and 2.7 mm in the AP, 5.8 mm and 2.3 mm in the SI, and 1.9 mm and 1.2 mm in the LR directions. Even though the median elapsed time using CBCT was expanded in 5.9 min, the PTV margins were significantly reduced. We found the calculated PTV margins in the soft tissue-based setup using CBCT were small, and this arrangement was superior to the bony structure-based setup in prostate IMRT.

    DOI: 10.1120/jacmp.v16i5.5448

    PubMed

    researchmap

  • The effectiveness of endoscopic submucosal dissection followed by chemoradiotherapy for superficial esophageal cancer. International journal

    Gen Kawaguchi, Ryuta Sasamoto, Eisuke Abe, Atsushi Ohta, Hiraku Sato, Kensuke Tanaka, Katsuya Maruyama, Motoki Kaizu, Fumio Ayukawa, Nobuko Yamana, Junyang Liu, Manabu Takeuchi, Masaaki Kobayashi, Hidefumi Aoyama

    Radiation oncology (London, England)   10   31 - 31   2015.1

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    BACKGROUND: To evaluate the risks and benefits of endoscopic submucosal dissection (ESD) in addition to chemoradiotherapy (CRT) for the treatment of superficial esophageal squamous cell carcinoma (SESCC). METHODS AND MATERIALS: We retrospectively reviewed the treatment outcomes of 47 patients with SESCC treated between October 2000 and December 2011. Sixteen patients with invasion into the submucosal layer (T1b) or the muscularis mucosa (m3) with positive vascular invasion were treated with CRT after ESD (ESD-CRT group). The lymph node area was irradiated to a total dose of 40-44 Gy and a boost radiation was administered if PET-positive lymph nodes or positive margins were observed. The remaining 31 patients received definitive CRT only (dCRT group). RESULTS: The radiation field was significantly larger in the ESD-CRT group; the "long T" was used in 11 patients (35.4%) in the dCRT group and 15 (93.7%) in the ESD-CRT group (p = 0.0001). The total radiation dose was smaller in the ESD-CRT group; 40 Gy was used in 10 patients (62.5%) in the ESD-CRT group and all but one patient in the dCRT group received ≥60 Gy (p = 0.00001). The 3-year overall survival rates in the dCRT and ESD-CRT groups were 63.2% and 90.0% respectively (p = 0.118). Recurrence developed in nine patients (29.0%) in the dCRT group and one (6.3%) in the ESD-CRT group. Local recurrence was observed in six patients (19%) in the dCRT group and none in the ESD-CRT-group (p = 0.029). Pericardial effusion (≥Grade 3) occurred in three patients (9.7%) in the dCRT group and none in the ESD-CRT group. CONCLUSIONS: ESD followed by CRT is an effective and safe approach for SESCC at m3 or T1b. This combination of ESD and CRT improves the local control rate, and it could decrease the number of cardiac toxicities due to a radiation-dose reduction relative to CRT alone.

    DOI: 10.1186/s13014-015-0337-4

    PubMed

    researchmap

  • Main bronchial diverticula in the subcarinal region: their relation to airflow limitations. International journal

    Takeshi Higuchi, Naoya Takahashi, Motoi Shiotani, Suguru Sato, Atsushi Ohta, Haruo Maeda, Haruhiko Nakajima, Kazuhiko Itoh, Hiroki Tsukada

    Acta radiologica (Stockholm, Sweden : 1987)   53 ( 1 )   44 - 8   2012.2

     More details

    Language:English   Publishing type:Research paper (scientific journal)  

    BACKGROUND: To date, bronchial diverticula have generally been treated as a pathological condition associated with chronic obstructive pulmonary disease (COPD), although only a limited amount of published information is available on the relationship between bronchial diverticula as depicted by multidetector computed tomography (MDCT) and airflow limitations. PURPOSE: To evaluate the relationship between airflow limitations and main bronchial diverticula in the subcarinal region using spirometry and thin-section MDCT. MATERIAL AND METHODS: A total of 189 consecutive adult patients were retrospectively evaluated based on spirometry and thin-section MDCT of the chest. All examinations were performed at our institution between June and October 2008. The study group included 70 women and 119 men with a mean age of 65 years (range 19-86 years). The relationship between the FEV(1)% and bronchial diverticula in the subcarinal region was analyzed (Student's t-test). RESULTS: The indications for conducting the examinations were pulmonary diseases (82 patients), cardiovascular diseases (22), extrapulmonary malignancies (74), and other conditions (11). A total of 84/189 (44.4%) patients showed bronchial diverticula, and the FEV(1)% of 70/84 (83.3%) patients was above 70. The FEV(1)% of patients with lesions ranged from 26.0 to 97.8 (mean 76.8), whereas the range was 28.1-94.4 (mean 73.7) in those without lesions. There was no significant association between the FEV(1)% and the presence of subcarinal bronchial diverticula (P > 0.05). CONCLUSION: Our data demonstrate that thin-section chest CT commonly demonstrates main bronchial diverticula in the subcarinal region in patients without airflow limitations. We propose that the presence of a small number of tiny bronchial diverticula under the carina may not be a criterion for the diagnosis of COPD.

    DOI: 10.1258/ar.2011.110222

    PubMed

    researchmap

▶ display all

Research Projects

  • Radiogenomicsによる直腸癌側方リンパ節転移の高精度予測モデルの開発

    Grant number:22K08890

    2022.4 - 2025.3

    System name:科学研究費助成事業

    Research category:基盤研究(C)

    Awarding organization:日本学術振興会

    中野 雅人, 島田 能史, 若井 俊文, 中野 麻恵, 松本 瑛生, 田島 陽介, 山井 大介, 太田 篤, 安部 舜

      More details

    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    researchmap

  • 直腸癌化学放射線療法後の臨床的完全奏効に対する新規サーベイランス方法の確立

    Grant number:21K08703

    2021.4 - 2024.3

    System name:科学研究費助成事業

    Research category:基盤研究(C)

    Awarding organization:日本学術振興会

    島田 能史, 奥田 修二郎, 太田 篤, 大橋 瑠子, 若井 俊文, 竹内 志穂, 中野 雅人, 凌 一葦

      More details

    Grant amount:\4160000 ( Direct Cost: \3200000 、 Indirect Cost:\960000 )

    直腸癌に対する術前化学放射線療法(Chemoradiotherapy: CRT)で臨床的完全奏効が得られた症例に対して、積極的に非手術を選択する治療戦略(Watch and Wait: W&W)が注目されている。
    申請者らは、「癌組織で検出される遺伝子変異は、血中循環腫瘍DNA(circulating tumor DNA: ctDNA)でも同様に検出可能である。そして、癌組織およびctDNAから遺伝子変異を検出することによって、W&Wにおける新たなサーベイランスの体系を構築できる」と考えて本研究を立案した。本研究の目的は、「直腸癌に対するCRT後のW&Wにおいて、個々の遺伝子変異に基づいた新しいサーベイランスの研究基盤を確立すること」である。
    「W&Wのサーベイランスにおいてターゲットとなる遺伝子変異の探索」において、術前CRTを未施行の下部直腸癌を対象として、がん遺伝子パネル検査の結果を参照し、遺伝子変異プロファイルを検索した。その結果、下部直腸癌において、変異の頻度の高い遺伝子およびバリアントが抽出された。これらの遺伝子変異は、個別化されたW&Wのサーベイランスにおいてターゲットとなりうる遺伝子変異であると考えられる。
    「直腸癌のCRTにおけるバイオマーカーの探索」において、術前CRTを施行した26症例を対象として、遺伝子変異と術前CRTの治療効果との関係を解析した。その結果、術前CRTの治療効果と関連する遺伝子変異プロファイルが検出された。これらの遺伝子変異プロファイルは、術前CRTを行うべき症例選択に有用である可能性がある。

    researchmap