2024/12/12 更新

写真a

ササモト リユウタ
笹本 龍太
SASAMOTO Ryuta
所属
教育研究院 医歯学系 保健学系列 教授
保健学研究科 保健学専攻 教授
医学部 保健学科 放射線技術科学専攻 教授
職名
教授
外部リンク

学位

  • 博士(医学) ( 2007年1月   新潟大学 )

研究キーワード

  • 放射線腫瘍学

研究分野

  • ライフサイエンス / 放射線科学

経歴

  • 新潟大学   医学部 保健学科 放射線技術科学専攻   教授

    2012年4月 - 現在

  • 新潟大学   保健学研究科 保健学専攻   教授

    2012年4月 - 現在

  • 新潟大学   放射線科   講師

    2008年8月 - 2012年3月

  • 新潟大学   医歯学総合病院   助教

    2003年10月 - 2008年7月

所属学協会

 

論文

  • Prediction of patient‐specific quality assurance for volumetric modulated arc therapy using radiomics‐based machine learning with dose distribution 査読

    Natsuki Ishizaka, Tomotaka Kinoshita, Madoka Sakai, Shunpei Tanabe, Hisashi Nakano, Satoshi Tanabe, Sae Nakamura, Kazuki Mayumi, Shinya Akamatsu, Takayuki Nishikata, Takeshi Takizawa, Takumi Yamada, Hironori Sakai, Motoki Kaidu, Ryuta Sasamoto, Hiroyuki Ishikawa, Satoru Utsunomiya

    Journal of Applied Clinical Medical Physics   2023年11月

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    掲載種別:研究論文(学術雑誌)  

    DOI: 10.1002/acm2.14215

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  • DCNNによる腹部CT冠状断面画像における外傷性出血有無の自動分類 査読

    宮澤 幸太郎, 近藤 世範, 能登 義幸, 酒井 健一, 高橋 直也, 笹本 龍太

    医用画像情報学会雑誌   40 ( 3 )   56 - 60   2023年9月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.11318/mii.40.56

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  • Deep learning‐based detection and classification of multi‐leaf collimator modeling errors in volumetric modulated radiation therapy

    Sae Nakamura, Madoka Sakai, Natsuki Ishizaka, Kazuki Mayumi, Tomotaka Kinoshita, Shinya Akamatsu, Takayuki Nishikata, Shunpei Tanabe, Hisashi Nakano, Satoshi Tanabe, Takeshi Takizawa, Takumi Yamada, Hironori Sakai, Motoki Kaidu, Ryuta Sasamoto, Hiroyuki Ishikawa, Satoru Utsunomiya

    Journal of Applied Clinical Medical Physics   2023年8月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    Abstract

    Purpose

    The purpose of this study was to create and evaluate deep learning‐based models to detect and classify errors of multi‐leaf collimator (MLC) modeling parameters in volumetric modulated radiation therapy (VMAT), namely the transmission factor (TF) and the dosimetric leaf gap (DLG).

    Methods

    A total of 33 clinical VMAT plans for prostate and head‐and‐neck cancer were used, assuming a cylindrical and homogeneous phantom, and error plans were created by altering the original value of the TF and the DLG by ± 10, 20, and 30% in the treatment planning system (TPS). The Gaussian filters of and 1.0 were applied to the planar dose maps of the error‐free plan to mimic the measurement dose map, and thus dose difference maps between the error‐free and error plans were obtained. We evaluated 3 deep learning‐based models, created to perform the following detections/classifications: (1) error‐free versus TF error, (2) error‐free versus DLG error, and (3) TF versus DLG error. Models to classify the sign of the errors were also created and evaluated. A gamma analysis was performed for comparison.

    Results

    The detection and classification of TF and DLG error were feasible for ; however, a considerable reduction of accuracy was observed for depending on the magnitude of error and treatment site. The sign of errors was detectable by the specifically trained models for and 1.0. The gamma analysis could not detect errors.

    Conclusions

    We demonstrated that the deep learning‐based models could feasibly detect and classify TF and DLG errors in VMAT dose distributions, depending on the magnitude of the error, treatment site, and the degree of mimicked measurement doses.

    DOI: 10.1002/acm2.14136

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  • Relationship between absorbed dose and changes in liver volume after chemoradiotherapy for esophageal cancer.

    Yusaku Miki, Naoya Takahashi, Satoru Utsunomiya, Ryuta Sasamoto

    Japanese journal of radiology   2022年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    PURPOSE: The liver is the largest organ in the abdomen and is often irradiated in radiotherapy for non-hepatic malignancies. As most of the studies on changes in liver volume are on hepatocellular carcinoma based on liver dysfunction, there are few studies on healthy liver. In this study, we investigated the relationship between absorbed dose and changes in liver volume after chemoradiotherapy for esophageal cancer in patients without apparent pre-treatment liver dysfunction. MATERIALS AND METHODS: Liver volume was compared between pre-treatment, acute (< 4 months) and late post-treatment (≥ 4 and < 13 months) phases in 12 patients using abdominal plain CT images. Volume changes were evaluated separately for the right and left lobes. We investigated the relationship between the volume change and VxGy (percentage of volume received x Gy or more dose). In addition, volume change for each absorbed dose was investigated using deformable image registration. RESULTS: The volume of the left lobe showed a significant decrease between pre-treatment and acute post-treatment phases (p < 0.001), while the volume of right lobe and between acute and late post-treatment phase of left lobe did not. The mean value of the volume reduction rate of the left lobe was 51.1% and equivalent to the mean value of V30Gy. As a result of the volume change for each absorbed dose, the volume reduction rate increased as the absorbed dose increased, and a significant volume loss was observed at doses above 11 Gy. CONCLUSION: Volume of the liver significantly decreased only in the acute phase after chemoradiotherapy for esophageal cancer. The tolerable dose for a healthy liver is generally considered to be 30 Gy, but attention should be paid to lower doses to avoid radiation-induced liver injury.

    DOI: 10.1007/s11604-022-01375-x

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  • 新潟大学医歯学総合病院医学物理グループ 新潟大学大学院保健学研究科医学物理士養成コースの紹介

    宇都宮 悟, 棚邊 哲史, 中野 永, 坂井 まどか, 田邊 俊平, 滝澤 健司, 久島 尚隆, 成田 啓廣, 早川 岳英, 笹本 龍太

    医学物理   41 ( 4 )   195 - 200   2021年12月

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    記述言語:日本語   出版者・発行元:公益社団法人 日本医学物理学会  

    DOI: 10.11323/jjmp.41.4_195

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  • 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年6月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    DOI: 10.1002/acm2.13322

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    その他リンク: 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

    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年5月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Oxford University Press (OUP)  

    <title>Abstract</title>
    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 &amp;gt;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

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  • 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年3月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Science and Business Media LLC  

    DOI: 10.1007/s12194-020-00602-2

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    その他リンク: http://link.springer.com/article/10.1007/s12194-020-00602-2/fulltext.html

  • Detecting MLC modeling errors using radiomics‐based machine learning in patient‐specific QA with an EPID for intensity‐modulated radiation therapy

    Madoka Sakai, Hisashi Nakano, Daisuke Kawahara, Satoshi Tanabe, Takeshi Takizawa, Akihiro Narita, Takumi Yamada, Hironori Sakai, Masataka Ueda, Ryuta Sasamoto, Motoki Kaidu, Hidefumi Aoyama, Hiroyuki Ishikawa, Satoru Utsunomiya

    Medical Physics   48 ( 3 )   991 - 1002   2021年3月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    DOI: 10.1002/mp.14699

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    その他リンク: https://onlinelibrary.wiley.com/doi/full-xml/10.1002/mp.14699

  • Effect of setup error in the single‐isocenter technique on stereotactic radiosurgery for multiple brain metastases

    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年12月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Wiley  

    DOI: 10.1002/acm2.13081

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    その他リンク: https://onlinelibrary.wiley.com/doi/full-xml/10.1002/acm2.13081

  • 等価正方形照射野への変換法の違いがファントム散乱係数の深さ方向に与える影響の検討 : 線形加速器Synergyにおける計測

    早川, 岳英, 山田, 巧, 坂井, 裕則, 笹本, 龍太, 石川, 玉樹, 吉田, 泰久

    新潟大学保健学雑誌   17 ( 1 )   35 - 46   2020年3月

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    記述言語:日本語   掲載種別:研究論文(大学,研究機関等紀要)   出版者・発行元:新潟大学医学部保健学科  

    X線治療の計算によるMU独立検証で等価正方形照射野(等価正方形辺)は,検証の精度に影響するため重要である.等価正方形辺は深さやエネルギーに依存しないと仮定されている.しかし,先行研究で線形加速器Clinac-iX(Varian社製)の矩形照射野で求めたファントム散乱係数S_pの測定値と,同じ矩形照射野を等価正方形辺に変換して求めたS_pの推定値の差は深さによって変わる深さ依存があり,その仮定は有効ではなかった.また,Day法やA/P法に比べARC法の等価正方形辺はその深さ依存が小さいことも報告された.本研究は,Clinac-iXとガントリヘッドの構造が異なる線形加速器Synergy(Elekta社製)で,同じ方法によりS_pの測定値と推定値の差を調べた.その結果,Synergyでも深さ依存が見られ,ARC法がDay法やA/P法に比べて小さく,S_pの推定精度が良いことが示された.
    In X-ray therapy, equivalent square field (side of equivalent square field) is important because it influences the accuracy of monitor unit (MU) independent verification by calculation. It is assumed that equivalent square field does not depend on depth and X-ray energy. However, in Clinac-iX (manufactured by Varian Co.) linear accelerator of previous research, the difference between measured value of S_p obtained by measuring rectangular field and estimated value of S_p obtained from equivalent square field of same rectangular field indicated depth dependency that varied with depth, and it was suggested that the assumption was not valid. And it was reported that the depth dependency in side of equivalent square of ARC method was smaller than Day method and A/P method. In this study, using Synergy (manufactured by Elekta Co.) that was linear accelerator with different structure in the gantry head of Clinac-iX investigated the difference between measured value and estimated value of S_p by the same method of previous research. As result, the depth dependency was found also in Synergy, and it was shown that side of equivalent square of ARC method was smaller than Day method and A/P method, and the estimation accuracy of S_p was better.

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    その他リンク: http://id.ndl.go.jp/bib/030405007

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

    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年1月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier {BV}  

    DOI: 10.1016/j.ctro.2019.10.006

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  • 当院の前立腺癌照射法別治療成績の各リスク分類・因子における比較検討 外照射併用HDR-BT vs. IMRT単独

    押金 智哉, 海津 元樹, 阿部 英輔, 丸山 克也, 太田 篤, 斎藤 紘丈, 中野 智成, 後藤 侑世, 青山 英史, 棚邊 哲史, 宇都宮 悟, 笹本 龍太

    臨床放射線   64 ( 6 )   831 - 840   2019年5月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

    当院における前立腺癌の放射線治療成績を三次元原体照射(3D-CRT)併用高線量率組織内照射(HDR-BT)と強度変調放射線治療(IMRT)について遡及的にまとめ、各リスク分類やリスク因子別に検討し、どのような症例が3D-CRT併用HDR-BTの良い適応となるのかを探索した。HDR-BTまたはIMRTを施行した前立腺癌の初発根治治療目的の連続症例を対象とした。症例の内訳はHDR-BT 230例、IMRT 140例である。HDR-BT群とIMRT群における5年時点での全生存率、生化学的非再発生存率、局所制御率は各94.7%/95.2%、95.2%/93.7%、98.4%/95.2%であり、両群間に有意差はなかった。CAPRA分類が高リスクの症例ではHDR-BTの局所制御率がIMRTよりも有意に高く、CAPRA中リスクの症例では全生存率、生化学的非再発生存率、局所制御率に有意差はなかった。D'Amico分類での高リスク症例、NCCN分類での高リスク以上の症例でも、両者には有意差がなかった。このほか、年齢、Tステージ、グリソンスコア、PSA、生検陽性本数で解析を行った結果、両群の差が統計学的有意となる因子は5年時点では見いだせなかった。

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    その他リンク: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01565&link_issn=&doc_id=20190531180011&doc_link_id=10.18888%2Frp.0000000891&url=https%3A%2F%2Fdoi.org%2F10.18888%2Frp.0000000891&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

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

    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年3月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Oxford University Press (OUP)  

    DOI: 10.1093/jrr/rry106

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  • Clarkson 法によるMLC 不整形照射野の深さを考慮したファントム散乱係数の推定精度の検討

    早川 岳英, 山田 巧, 坂井 裕則, 笹本 龍太

    日本放射線技術学会雑誌   75 ( 12 )   1426 - 1436   2019年

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    記述言語:日本語   出版者・発行元:公益社団法人 日本放射線技術学会  

    DOI: 10.6009/jjrt.2019_jsrt_75.12.1426

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    その他リンク: http://id.ndl.go.jp/bib/030183658

  • ウェブカメラを用いた胸腹部呼吸波形のモニタリング法の開発 査読

    李鎔範, 早川岳英, 笹本龍太

    日本放射線技術学会雑誌   74 ( 11 )   1286 - 1292   2018年11月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:公益社団法人 日本放射線技術学会  

    DOI: 10.6009/jjrt.2018_JSRT_74.11.1286

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    その他リンク: http://id.ndl.go.jp/bib/029359646

  • 照射位置の偶然誤差による線量分布の変化に対して照射野の形状が及ぼす影響 査読

    笹本龍太

    新潟大学保健学雑誌   15 ( 1 )   57 - 65   2018年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:新潟大学医学部保健学科  

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

    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年2月

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    掲載種別:研究論文(学術雑誌)   出版者・発行元:Elsevier BV  

    DOI: 10.1016/j.ctro.2017.12.003

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  • 悪性神経膠腫における正常脳の正常組織障害発生確率を用いた強度変調回転放射線療法の適応基準の検討

    高橋 春奈, 棚邊 哲史, 斎藤 紘丈, 太田 篤, 中野 智成, 笹本 龍太, 宇都宮 悟, 阿部 英輔, 梅津 元樹, 青山 英史

    定位的放射線治療   22   125 - 133   2018年1月

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    記述言語:日本語   出版者・発行元:日本定位放射線治療学会  

    悪性神経膠腫において強度変調回転放射線療法(VMAT)がより有効である症例の選別基準の方法を構築することを目的として、VMATと三次元原体照射法(3DCRT)の治療計画を放射線誘発性脳壊死のリスク指標とした正常組織障害発生確率(NTCP)を用いて比較した。3DCRTで放射線治療が施行された20例を対象とした。PTVinitialについては、Conformity index(CI)に関してVMATが3DCRTよりも有意に向上しており、PTVboostについてもCIはVMATが有意に向上した。正常脳の平均線量については両治療計画間に有意差は認められなかった。3DCRTにおける正常脳のNTCP 5%未満の群においては、3DCRTとVMATのNTCPの中央値は各々1.2%、0.8%であり有意差は認められなかった。しかし、3DCRTにおける正常脳NTCP 5%以上の群においてはそれぞれ9.6%、4.0%であり、VMATで有意に減少した。また、肉眼的標的体積はNTCP 5%以上の群で大きく、カットオフ値は130.5ccであった。

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  • 新潟大学医歯学総合病院の呼吸同期システムにおけるTime Delayの検討 査読

    笹本龍太, 宇都宮悟, 早川岳英

    新潟大学保健学雑誌   14 ( 1 )   9 - 15   2017年3月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:新潟大学医学部保健学科  

    放射線治療の呼吸同期照射において,同期信号の発生からビームオン・オフまでには遅延時間(timedelay)がある.今回,time delayの計測に適した動体ファントムの運動パターンと,新潟大学医歯学総合病院の呼吸同期照射システムにおけるtime delayを明らかにすることを目的として検討を行った.動体ファントムの運動波形はサイン波形と等速波形とし,運動幅は30 mmとした.ラジオクロミックフィルムを動体ファントムに乗せ,直径4 mm coneで連続照射を行ったところ,フィルム上の照射陰影はサイン波形で31.7±0.2mm,等速波形で30.4±0.1 mmであり,等速波形の方が実際の運動幅に近く,測定精度が高かった.次に等速波形を用いた10-40%位相の同期照射を行い,照射陰影の長さを理論値と比較したところ,time delayはビームオンで0.11±0.01秒,ビームオフで0.07±0.00秒であった.In respiratory gated radiotherapy, there are time delays between the target entering the gated region and treatment beam on, and between the target exiting the gated region and treatment beam off. The aim of this study was to clarify the appropriate motion profile of motion phantom for measuring the time delays, and to measure the beam on and beam off time delays in respiratory gated radiotherapy system at Niigata University Medical and Dental Hospital. We irradiated radiochromic films on the motion phantom using 4 mm diameter cone without gating. As a motion profile for the motion phantom (motion width: 30.0 mm), a sinusoidal profile and a constant velocity profile ware used. Measured length of the exposure streaks on the films were more accurate with the constant velocity profile than those with the sinusoidal profile (30.4±0.1 mm vs. 31.7±0.2 mm). Then we used the constant velocity profile for gating irradiation with a gating phase range of 10-40%, and compared the exposure streak length with a theoretical value. The calculated beam on time delay was 0.11±0.01 sec, and the beam off time delay was 0.07±0.00 sec.

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    その他リンク: http://hdl.handle.net/10191/47192

  • Respiratory gating and multifield technique radiotherapy for esophageal cancer 査読

    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年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Springer Tokyo  

    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

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  • パーソナルコンピュータ上で動作するDICOMデータのCT画像からの体積測定プログラムの開発と評価(PC用のDICOM体積測定プログラムの開発と評価)(The development and assessment of program for volume measurement for CT images of: DICOM data running on a personal computer: (Development and assessment of volume measurement program for DICOM on PC)) 査読

    Takahashi Naoya, Kobayashi Arashi, Nishihama Saori, Minamizawa Natsuki, Suzuki Noriko, Higuchi Takeshi, Ohkubo Masaki, Narita Akihiro, Sasamoto Ryuta

    新潟大学保健学雑誌   14 ( 1 )   27 - 33   2017年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:新潟大学医学部保健学科  

    著者等は数値計算言語(MATLAB)を使ってPC上で動作するDICOM画像から体積を算出するプログラムを開発し、その有用性と正確度を検討した。CTの水平断像上に関心領域(ROI)を設置し、設定した閾値で必要な領域を抽出して三次元表示し、体積測定を行うこととした。本プログラムを用いて、64列CTで実施した死後CT検査5例について、肝、脾、腎を抽出した。ImageJにて目的とする臓器にROIを設定して面積を算出し、厚さを乗じて体積を測定した。臓器ごとに、ImageJにて求めた体積に最も近い値が得られるように閾値を決定した。著者等が開発したプログラムとImageJで測定した平均体積は、肝がそれぞれ1690.3±505.1cm3と107.9±60.7cm3、脾が107.9±60.7cm3と105.5±62.4cm3、腎が141.1±26.4cm3と143.9±32.1cm3であり、有意差は認められなかった。体積測定に要した平均時間は開発したプログラムの方が有意に短かった。著者等が開発したPC上で動作するDICOM画像の体積測定プログラムを用いると、簡便かつ正確に臓器の体積を測定することが可能であった。

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    その他リンク: http://dspace.lib.niigata-u.ac.jp/dspace/bitstream/10191/47194/1/14%281%29_27-33.pdf

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

    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 - 287   2016年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Oxford University Press  

    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

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  • 治療計画用CTの空間分解能がMU値計算に与える影響 微小肺結節シミュレーション画像を用いた検討

    重田 尚吾, 笹本 龍太, 大久保 真樹, 早川 岳英, 沼田 彩美, 和田 真一, 宇都宮 悟, 青山 英史, 棚邊 哲史

    日本放射線技術学会東北部会雑誌   ( 25 )   176 - 176   2016年1月

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    記述言語:日本語   出版者・発行元:(公社)日本放射線技術学会-東北支部  

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  • Initial implementation of the conversion from the energy-subtracted CT number to electron density in tissue inhomogeneity corrections: An anthropomorphic phantom study of radiotherapy treatment planning 査読

    Masayoshi Tsukihara, Yoshiyuki Noto, Ryuta Sasamoto, Takahide Hayakawa, Masatoshi Saito

    MEDICAL PHYSICS   42 ( 3 )   1378 - 1388   2015年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:AMER ASSOC PHYSICISTS MEDICINE AMER INST PHYSICS  

    Purpose: To achieve accurate tissue inhomogeneity corrections in radiotherapy treatment planning, the authors had previously proposed a novel conversion of the energy-subtracted computed tomography (CT) number to an electron density (Delta HU-rho(e) conversion), which provides a single linear relationship between Delta HU and rho(e) over a wide range of rho(e). The purpose of this study is to present an initial implementation of the Delta HU-rho(e) conversion method for a treatment planning system (TPS). In this paper, two example radiotherapy plans are used to evaluate the reliability of dose calculations in the Delta HU-rho(e) conversion method.
    Methods: CT images were acquired using a clinical dual-source CT (DSCT) scanner operated in the dual-energy mode with two tube potential pairs and an additional tin (Sn) filter for the high-kV tube (80-140 kV/Sn and 100-140 kV/Sn). Single-energy CT using the same DSCT scanner was also performed at 120 kV to compare the Delta HU-rho(e) conversion method with a conventional conversion from a CT number to rho(e) (Hounsfield units, HU-rho(e) conversion). Lookup tables for.e calibration were obtained from the CT image acquisitions for tissue substitutes in an electron density phantom (EDP). To investigate the beam-hardening effect on dosimetric uncertainties, two EDPs with different sizes (a body EDP and a head EDP) were used for the rho(e) calibration. Each acquired lookup table was applied to two radiotherapy plans designed using the XiO TPS with the superposition algorithm for an anthropomorphic phantom. The first radiotherapy plan was for an oral cavity tumor and the second was for a lung tumor.
    Results: In both treatment plans, the performance of the Delta HU-rho(e) conversion was superior to that of the conventional HU-rho(e) conversion in terms of the reliability of dose calculations. Especially, for the oral tumor plan, which dealt with dentition and bony structures, treatment planning with the HU-rho(e) conversion exhibited apparent discrepancies between the dose distributions and dose-volume histograms (DVHs) of the body-EDP and head-EDP calibrations. In contrast, the dose distributions and DVHs of the body-EDP and head-EDP calibrations coincided with each other almost perfectly in the Delta HU-rho(e) conversion for 100-140 kV/Sn. The difference between the V100' s (the mean planning target volume receiving 100% of the prescribed dose; a DVH parameter) of the body-EDP and head-EDP calibrations could be reduced to less than 1% using the H Delta U-rho(e) conversion, but exceeded 11% for the HU-rho(e) conversion.
    Conclusions: The Delta HU-rho(e) conversion can be implemented for currently available TPS's without any modifications or extensions. The Delta HU-rho(e) conversion appears to be a promising method for providing an accurate and reliable inhomogeneity correction in treatment planning for any ill-conditioned scans that include (i) the use of a calibration EDP that is nonequivalent to the patient's body tissues, (ii) a mismatch between the size of the patient and the calibration EDP, or (iii) a large quantity of high-density and high-atomic-number tissue structures. (C) 2015 American Association of Physicists in Medicine.

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  • The effectiveness of endoscopic submucosal dissection followed by chemoradiotherapy for superficial esophageal cancer. 国際誌

    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年1月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    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

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  • Salvage endoscopic submucosal dissection in patients with local failure after chemoradiotherapy for esophageal squamous cell carcinoma. 国際誌

    Manabu Takeuchi, Masaaki Kobayashi, Satoru Hashimoto, Ken-Ichi Mizuno, Gen Kawaguchi, Ryuta Sasamoto, Hidefumi Aoyama, Yutaka Aoyagi

    Scandinavian journal of gastroenterology   48 ( 9 )   1095 - 101   2013年9月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: For locoregional failure after chemoradiotherapy (CRT) in patients with esophageal squamous cell carcinoma (ESCC), salvage esophagectomy and endoscopic mucosal resection have disadvantages, such as a high morbidity rate and a high local recurrence rate, respectively. The aim of this study was to clarify the efficacy of salvage endoscopic submucosal dissection (ESD) for locoregional failure of CRT. METHODS: A total of 19 lesions in 19 patients were treated with salvage ESD; 15 lesions were local recurrences at the primary site and 4 lesions were residual. All lesions were intramucosal or submucosal tumors without metastases. A case-control study was retrospectively evaluated to clarify whether the clinical outcomes of salvage ESD were equivalent to those of control primary ESD. RESULTS: No significant differences were observed between salvage ESD and primary ESD in short-term outcomes, including procedure time. For salvage ESD, the complete en bloc resection rate was 94.7% (18 of 19), and no severe complications were observed. At a median follow up of 54.6 (range: 5-98) months after salvage ESD, the local recurrence rate was 0%. However, three patients (15.8%) died due to lymph node and distant metastases and six patients (31.5%) died from other diseases, including radiation pneumonitis, pyothorax or respiratory failure with no recurrence of ESCC. The 3-year overall survival rate for all 19 patients was 74%. CONCLUSIONS: ESD represents an acceptable treatment option for recurrent or residual ESCC because of its improvement in local control, when local failure after CRT is limited to the submucosal layer without metastases.

    DOI: 10.3109/00365521.2013.822092

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  • 限局性の前立腺癌に対する高線量率組織内照射療法による急性期有害事象の検討

    海津 元樹, 丸山 克也, 小日向 美華, 山名 展子, 西山 勉, 笠原 隆, 佐藤 啓, 田中 研介, 川口 弦, 阿部 英輔, 笹本 龍太, 青山 英史

    臨床放射線   58 ( 5 )   717 - 723   2013年5月

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    記述言語:日本語   出版者・発行元:金原出版(株)  

    2009年6月〜2011年4月に前立腺癌に対し、外照射と高線量率組織内照射の組み合わせで根治的な放射線治療を施行した64例を対象に、急性期の有害事象、主に尿路障害および消化管障害の発生頻度について調査した。対象はリンパ節および遠隔転移のない前立腺癌でUICC分類T1〜T3までの症例とした。Common Terminology Criteria Version4.0(CTCAE Ver4.0)でグレード(G)1以上の尿路障害は55例みられた。そのうちG2以上は8例で、内訳はG2頻尿3例、G2尿路痛2例、G2尿閉2例、G3前立腺痛1例であった。G1以上の消化管障害は34例で、G2以上は2例存在し、いずれも下痢症状であった。消化管以外の有害事象としてG2腰痛2例、G3意識消失発作2例、G1足背浮腫1例がみられた。意識消失発作はいずれも迷走神経反射によるもので、補液、硫酸アトロピン投与で軽快した。なお、アプリケータ抜去直後数日間は血尿が全例必発となり、出血量に応じ一時的な血圧低下が起こる症例もみられた。これらの項目は侵襲的な操作に伴い起こる有害事象のため集計から除いた。

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  • 新潟大学における、前立腺癌高線量率組織内照射療法の初期治療経験

    笠原 隆, 西山 勉, 笹本 龍太, 海津 元樹, 丸山 克也, 小日向 美華, 青山 英史, 高橋 公太

    泌尿器外科   25 ( 8 )   1663 - 1666   2012年8月

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    記述言語:日本語   出版者・発行元:医学図書出版(株)  

    当院では、2009年より前立腺癌に対する放射線外照射併用による高線量率組織内照射療法(HDRBT)を開始した。初期経験(58例)における治療成績およびQOLの変化について検討した。周術期合併症(grade 2)が8例で認められた。追跡期間中央値20ヵ月にて、再発は1例のみであった。QOLに関しては、包括的尺度の一部および排尿機能においてHDRBT施行後早期より有意に低下したが、いずれも時間経過とともに改善する傾向が認められた。(著者抄録)

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  • Clinical practice and outcome of radiotherapy for esophageal cancer between 1999 and 2003: the Japanese Radiation Oncology Study Group (JROSG) Survey 査読

    Yasumasa Nishimura, Ryuta Koike, Kazuhiko Ogawa, Ryuta Sasamoto, Yuji Murakami, Yoshiyuki Itoh, Yoshiharu Negoro, Satoshi Itasaka, Toru Sakayauchi, Tetsuro Tamamoto

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   17 ( 1 )   48 - 54   2012年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    To determine the clinical results of radiotherapy (RT) for esophageal cancer in Japan.
    A questionnaire-based survey was conducted for esophageal cancer treated by definitive RT between 1999 and 2003. Clinical results of definitive RT for patients were collected from 9 major institutions. Only patients with good performance status (PS 0-2) who received a total dose of 50 Gy or more were included. Patients were classified into three groups: (A) stage I, (B) resectable stages II-III, (C) unresectable stages III-IVA. For group A, all patients treated by RT alone or chemo-radiotherapy (CRT) were included. For groups B and C, only those treated by CRT were included.
    In total, 167 patients were included in group A, 239 in group B, and 244 in group C. Approximately half of the patients in group A were treated by CRT. The median total RT dose ranged from 60 to 66 Gy. The median and range of the 5-year overall survival rates were 56% (48-83%) for group A, 29% (12-52%) for group B, and 19% (0-31%) for group C, respectively. A wide disparity in overall survival rates was noted among the institutions. A significant correlation between the number of patients treated per year and the 5-year overall survival rate was noted for groups B and C (both p &lt; 0.05).
    Although the overall survival rates for stage I esophageal cancer were excellent, a significant disparity in survival rates was noted among the institutions for stage II-IVA tumors treated by CRT.

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  • Endoscopic submucosal dissection as salvage therapy of local and superficial recurrence after chemoradiotherapy for esophageal cancer

    Manabu Takeuchi, Masaaki Kobayashi, Ryuta Sasamoto, Satoru Hashimoto, Yuichi Sato, Gen Watanabe, Rintaro Narisawa, Yoichi Ajioka, Yutaka Aoyagi

    Endoscopic Forum for Digestive Disease   26 ( 2 )   151 - 156   2010年10月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    A male in his seventies was referred to our hospital for treatment of superficial esophageal cancer. Esophagoscopy showed a circumferential reddish depressed and elevated lesion, about 7 cm in diameter located in the area from the middle to lower thoracic esophagus, and the depth of invasion was diagnosed as submucosal massive invasion. Chemoradiotherapy (CRT) that consisted of 66 Gy irradiation and low dose FP was performed and complete response was recognized. After 10 months of CRT, esophagoscopy revealed local recurrence at the primary site. Because the depth of invasion was sm2 by using EUS, we performed endoscopic submucosal dissection (ESD) for local recurrence lesion as salvage treatment. The lesion was successfully resected en-bloc fashion, with no complications. Histopathologically, the tumor was squamous cell carcinoma, with tumor size being 9x6 mm, pT1 b-SM (950 μm) , ly0, v0, HM0, VM0. For 41 months after ESD, the patient has been alive with no recurrence. Salvage esophagectomy for persistent or recurrent locoregional disease after CRT for esophageal cancer has a curative potential but is associated with high morbidity. Salvage ESD that enables the complete en bloc resection without complications provides an effective therapeutic option for locoregional failure after CRT.

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  • Elevation of serum carcinoembryonic antigen level in a patient with hypothyroidism after radiation therapy for cervical esophageal cancer 査読

    Gen Kawaguchi, Eisuke Abe, Ryuta Sasamoto, Keisuke Sasai

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   15 ( 1 )   104 - 108   2010年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    We report the case of a 51-year-old woman who showed elevation of serum carcinoembryonic antigen (CEA) level 14 months after chemoradiation therapy for her cervical esophageal cancer. Close examination demonstrated that the patient was suffering from hypothyroidism probably due to the chemoradiation therapy. The serum CEA level decreased after starting supplementary treatment with oral levothyroxine. The exact mechanism underlying the elevated level of CEA observed in a patient with hypothyroidism is unclear. However, we should be aware of the possibility of transient elevation of CEA affected by thyroid function in patients after radiation therapy for head and neck cancer.

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  • An esophageal squamous cell carcinoma patient with high serum granulocyte-colony stimulating factor level: Report of a case

    Tadashi Tanabe, Tatsuo Kanda, Noriko Ishihara, Shin-Ichi Kosugi, Atsushi Matsuki, Gen Watanabe, Ryuta Sasamoto, Katsuyoshi Hatakeyama

    Esophagus   6 ( 4 )   253 - 258   2009年12月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    We present herein a case of a patient who was clinically diagnosed as having a granulocyte-colony stimulating factor (G-CSF)-producing tumor on the basis of the close correlation of the hematological parameters with the tumor status and his high serum G-CSF level. A 76-year-old male patient underwent transthoracic radical esophagectomy for advanced carcinoma of the lower esophagus. His leukocyte count and serum G-CSF level were markedly high at 24 260/μl and 134 pg/ml, respectively, before the operation. By immunohistochemical staining of the resected tumor, focal but obvious expression of G-CSF was demonstrated in the cytoplasm of cancer cells, and neutrophilic infiltration was histologically observed in adjacent struma of the tumor invasion front. After surgery, the leukocyte count decreased to a nearly normal level but increased again when the disease recurred in the pleura and lymph nodes 5 months later. Although palliative chemoradiotherapy decreased the leukocyte count to a normal level transiently, leukocyte count again markedly increased when metastatic disease occurred. The leukocyte count reached 78 060/μl the day before the patient died. © 2009 Japan Esophageal Soceity and Springer Japan.

    DOI: 10.1007/s10388-009-0206-z

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  • Retrospective review of surgery and definitive chemoradiotherapy in patients with squamous cell carcinoma of the thoracic esophagus aged 75 years or older. 国際誌

    Shin-Ichi Kosugi, Ryuta Sasamoto, Tatsuo Kanda, Atsushi Matsuki, Katsuyoshi Hatakeyama

    Japanese journal of clinical oncology   39 ( 6 )   360 - 6   2009年6月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    OBJECTIVE: The aim of this study was to review the treatment outcomes of surgery and definitive chemoradiotherapy (CRT) in elderly patients with squamous cell carcinoma of the thoracic esophagus. METHODS: A total of 64 patients aged 75 or older were retrospectively reviewed; 40 were treated with surgery and 24 with CRT. The CRT group included eight patients with unresectable disease and four patients medically unfit for surgery. Surgery included esophagectomy with lymphadenectomy and CRT consisted of 60-70 Gy of radiation concurrent with 5-fluorouracil alone or combined with cisplatin. Short- and long-term outcomes and survival of each modality were assessed. RESULTS: In the surgery group, 33 patients (82.5%) had co-morbid conditions. Complete resection rate was 90.0%. An overall post-operative complication rate was 65.0% and in-hospital mortality was seen in three patients (7.5%). In the CRT group, complete response rate was 41.7%. Leukopenia was most common Grade 3 hematological toxicity. Treatment-related deaths caused by acute toxicities occurred in three patients (12.5%), whereas those caused by late toxicities in four (16.7%). For cStage I disease in the surgery group, the overall 1-, 3- and 5-year survival rate were 90.9%, 63.6% and 54.5%, respectively, with a median survival time of 78.7 months. For cStages II-IV, the median survival time of the surgery and the CRT group was 18.7 and 12.8 months, respectively. CONCLUSIONS: The short- and long-term outcomes of surgery for the elderly seemed acceptable; however, definitive CRT may be a promising treatment modality. Further investigation may alter the sphere of influence in the field of esophageal cancer treatment in the elderly.

    DOI: 10.1093/jjco/hyp030

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  • Long-term results of chemoradiotherapy for locally advanced esophageal cancer, using daily low-dose 5-fluorouracil and cis-diammine-dichloroplatinum (CDDP) 査読

    Ryuta Sasamoto, Kunio Sakai, Hideki Inakoshi, Hiroo Sueyama, Mari Saito, Tadashi Sugita, Emiko Tsuchida, Takeshi Ito, Yasuo Matsumoto, Tadayoshi Yamanoi, Eisuke Abe, Nobuko Yamana, Keisuke Sasai

    INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY   12 ( 1 )   25 - 30   2007年2月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)   出版者・発行元:SPRINGER TOKYO  

    Background We evaluated the efficacy and toxicity of radiation combined with daily, low-dose protracted chemotherapy for locally advanced esophageal cancer.
    Methods. We analyzed data for 68 patients with locally advanced esophageal cancer, including 1.8 surgical candidates. Standard fractionation (total dose range, 60 to 70Gy) was used for radiotherapy. The chemotherapy consisted of a daily 5-fluorouracil dose of 250mg/m(2), with a cis-diamminedichloro-platinum dose of 3 mg/m(2) administered on radiotherapy days.
    Results. Sixty-four patients (94%) received at least 60Gy. Grade 3 acute hematological toxicity was observed in 13 (19%) patients; there was no grade 4 hematological toxicity. Complete response, partial response, no change, and progressive disease were obtained in 22, 35, 7, and 4 patients, respectively. Minimum follow-up for surviving patients was 45 months. Locoregional progression-free rates at 3 and 5 years were 47% and 47%. Four patients died of late cardiac toxicity; the primary site for all 4 patients was the middle thoracic esophagus. Overall survival rates at 2, 3, and 5 years were 40%, 32%, and 20%. The 3- and 5-year survival rates in patients with T2-3M0 disease were 43% and 27%, and the rates were 24% and 15% in patients with T4/M1.
    Conclusion. Given the large proportion of patients in this study with inoperable disease (roughly three quarters), our treatment seemed to provide equivalent efficacy and less hematological toxicity than standard-dose chemoradiotherapy.

    DOI: 10.1007/s10147-006-0617-y

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  • Risk factors for enlargement of cardiac silhouette on chest radiography after radiotherapy for esophageal cancer 査読

    Ryuta Sasamoto, Emiko Tsuchida, Tadashi Sugita, Yasuo Matsumoto, Eisuke Abe, Keisuke Sasai

    Radiation Medicine - Medical Imaging and Radiation Oncology   24 ( 6 )   431 - 437   2006年7月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Purpose. To evaluate the incidence and risk factors of enlargement of cardiac silhouette on chest radiographs after radiotherapy for esophageal cancer. Materials and methods. We analyzed 67 patients with esophageal cancer who received external beam radiation therapy with a total dose of ≥50 Gy and were followed for ≥6 months. Sixteen patients received radiation alone, and the remaining 51 received chemoradiotherapy. The difference between the cardiothoracic ratio (CTR) on the pretreatment chest radiograph and that on the posttreatment radiograph with maximum cardiac silhouette for each patient was used for the analysis. Results. The average maximum increase in CTR for the entire group was 4.5%, which was statistically significant. Only the area of the cardiac silhouette in the initial radiation field was a significant risk factor for enlargement of the cardiac silhouette. Pericardial effusions were observed in all patients who underwent computed tomography with severe enlargement of the cardiac silhouette. Conclusion. The CTR value significantly increased after radiotherapy for esophageal cancer. Radiation-induced pericardial effusion may be the main cause of enlargement of the cardiac silhouette. The irradiated cardiac area was the only significant risk factor for enlargement of the cardiac silhouette
    the use of chemotherapy was not. © Japan Radiological Society 2006.

    DOI: 10.1007/s11604-006-0050-1

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  • Results of radiation therapy for superficial esophageal cancer using the standard radiotherapy method recommended by the Japanese Society of Therapeutic Radiology and Oncology (JASTRO) Study Group

    Kenji Nemoto, Shogo Yamada, Masamichi Nishio, Masahiko Aoki, Ryuji Nakamura, Yasuo Matsumoto, Ryuta Sasamoto, Yoshihiro Saitoh, Makoto Takayama, Norio Mitsuhashi, Kohtaro Gomi, Naoto Kanesaka, Masao Kobayashi, Hiroshi Ohnishi, Shigeru Sasaki, Hiroyasu Tamamura, Michihide Mitsumori, Yasumasa Nishimura, Kayoko Tsujino, Mitsuhiro Takemoto, Nobue Uchida, Michinori Yamamoto, Yoshiyuki Shioyama, Kohichi Hirakawa, Seiji Ono

    Anticancer Research   26 ( 2 B )   1507 - 1512   2006年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background: Superficial esophageal cancer (SEC) is defined as esophageal cancer limited to the submucosal layers, including mucosal cancer and submucosal cancer, and is squamous cell carcinoma in most patients. In 2000, the Japanese Society of Therapeutic Radiology and Oncology (JASTRO) Study Group for SEC published a consensus guideline of standard radiotherapy methods. In this study, the interim treatment outcomes of SEC patients, who had received radiation therapy following the standard radiotherapy methods, were investigated. Patients and Methods: From 2000 to 2003, a total of 141 SEC patients were treated in 24 institutions in Japan. Results: The 1-, 2- and 3-year survival rates were 95%, 90% and 90%, respectively, for patients with mucosal cancer and 90%, 81% and 70%, respectively, for patients with submucosal cancer. The overall survival was better in patients who had undergone chemotherapy than in patients who had received radiation therapy alone, though the difference was not statistically significant. The clinical target volume (CTV) did not influence overall survival and intracavitary irradiation did not influence the local control rate in either patients with mucosal or submucosal cancer. Radiation-induced esophageal ulcer was not observed in this series. Conclusion: The standard radiotherapy methods are safe and effective for treating SEC. However, the usefulness of chemotherapy and intracavitary irradiation and the optimal setting of the CTV should be clarified by future randomized trials.

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  • Concurrent chemoradiotherapy using low-dose continuous infusion of 5-fluorouracil for postoperative regional lymph node recurrence of esophageal squamous cell carcinoma 査読

    Emiko Tsuchida, Kunio Sakai, Yasuo Matsumoto, Tadashi Sugita, Ryuta Sasamoto, Tadayoshi Yamanoi, Hiroo Sueyama, Takeshi Ito, Keisuke Sasai

    Esophagus   2 ( 1 )   25 - 31   2005年3月

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Background. Radiotherapy plays an important role in salvaging patients who suffer locoregional recurrence
    however, it displays poor prognosis. Because concurrent chemoradiotherapy offers superior treatment results compared to radiotherapy alone in patients with localized esophageal cancer, to improve survival rates, we treated patients displaying postoperative regional lymph node recurrence of esophageal squamous cell carcinoma using radiotherapy combined with protracted low-dose continuous infusion of 5-fluorouracil (5-FU). Methods. Between January 1992 and December 2001, 14 patients with postoperative regional lymph node recurrence of esophageal squamous cell carcinoma were treated with concurrent chemoradiotherapy. Radiotherapy was delivered at 1.8-2.0 Gy/day, for a total dose of 56-70Gy (median, 60Gy). Chemotherapy was administered 5 days/week as continuous infusion of 5-FU (250-300mg/m2) for at least 5 weeks. Median follow-up time was 27 months. Results. Twelve patients demonstrated partial response, and 2 patients displayed stable disease. Response rate was therefore 86% (12/14). In-field recurrence occurred in 3 patients. Involved lymph nodes that recurred in the irradiation field were ≥40 mm in maximum diameter and invaded into the surrounding normal tissues. Local progression-free rate at 2 years was 72%. As an initial failure, 6 patients displayed out-field recurrence. Disease progression-free rate at 2 years was 42%. Overall survival rates at 1 and 2 years were 85% and 57%, respectively. Conclusions. Concurrent chemoradiotherapy using low-dose continuous infusion of 5-FU was effective for patients with postoperative regional lymph node recurrence of esophageal squamous cell carcinoma. Close follow-up is crucial, and further investigation is required to prevent outfield recurrence. © Japan Esophageal Society and Springer-Verlag 2005.

    DOI: 10.1007/s10388-005-0035-7

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  • JASTRO研究グループによる標準的放射線治療法を用いた食道表在癌の治療成績、中間報告

    根本建二, 山田章吾ほ, 西村 恭昌

    日放腫会誌   17 ( 3 )   187 - 193   2005年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    JASTRO研究グループによる標準的放射線治療法を用いた食道表在癌の治療成績の中間報告を行なった。

    DOI: 10.11182/jastro.17.187

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  • A case report of giant cell reparative granuloma treated with radiation therapy

    Yasuo Matsumoto, Tadayoshi Yamanoi, Emiko Tsuchida, Tadashi Sugita, Ryuta Sasamoto

    Journal of JASTRO   15 ( 2 )   151 - 154   2003年6月

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)  

    Giant cell reparative granuloma (GCRG) was first reported by Jaffe as a benign non-neoplastic process linked to intraosseous hemorrhage. These lesions in the jaw and the short tubular bones of the hands and feet frequently recur after surgery. We report a rare case: a 51-year-old male with a recurrent GCRG of the left temporal bone showing a good clinical response after 20-Gy irradiation. Although surgery is considered to be the first-line therapy for GCRG, if it has a high morbididy rate or brings a poor outcome, low dose radiotherapy with 15-20 Gy may be an alternative method.

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  • 食道癌の放射線療法後または化学放射線療法後における心拡大に関する臨床的検討 査読

    笹本龍太

    日本放射線腫瘍学会誌   14 ( 3 )   153 - 160   2002年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:Japanese Society for Therapeutic Radiology and Oncology  

    【背景・目的】近年, 食道癌に村する化学放射線療法は手術に匹敵するともいえる治療成績が報告されてきており, 今後それに伴う晩期障害が問題となってくることが予想される. 従来我々は5FU及び5FU+CDDPの少量持続静注併用放射線治療を行っているが, 長期生存例の中に心拡大を呈する症例を少なからず経験している, 今回その頻度と関遮因子を遡及的に明らかにすることを検討の目的とした.<BR>【対象・方法】1期~IVA期までの食道癌症例中, 50Gy以上照射され6ヶ帰以上画像的な追跡が可能であった5蓋例を対象とした. 内訳は照射単独群16例, 化学療法併用群35例. 心拡大については照射前の心胸郭比 (CTR) と照射後最大のCTRの差, および10%以上の増加例 (有意な心拡大) について検討した. 胸水については中等量以上の貯留例を検討した. また, 心臓に対する照射面積と標的線量の積を心臓面積線量と定義し, CTRの変化との関連についても検討した.<BR>【結果】いずれの治療群でも照射前に比して照射後にはCTRの有意な増加が認められた. 有意な心鉱大は全体で18%. 照射単独例で6%, 化学療法併用例では23%であり, 化学療法併用例で高頻度であった. 心臓面積線量0.4m<SUP>2</SUP>・Gy以上の症例では0.4m<SUP>2</SUP>・Gy未満の症例に比して有意にCTR増加が大きかった. 中等量以上の胸水貯留は5例 (10%) にみられ, 全例化学療法併用群であった.CTRの増加と共に胸水が増加する例が3例, 更にCTRの増加が胸水貯留に先行する症例が2例見られたことから, 胸水跡留には慢性心外膜炎に伴う心タンポナーデの関与が示唆された. 加えて, 右側のみの群留例がなく全例が左側あるいは両側性であったことから, 胸膜に対する照射の直接的な影響も推察された.<BR>【結語】食道癌の放射線治療後, CTRが10%以上増加する例は重8%あり, 心臓に対する照射量と化学療法の併用が影響していた.中等量以上の胸水貯留は10%にみられ, 慢性心外膜炎に伴う心タンポナーデ及び放射線胸膜炎の関与が示唆された.

    DOI: 10.11182/jastro1989.14.153

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  • Radiation therapy for low-grade gliomas: An analysis of prognostic factors and complications 査読

    Emiko Tsuchida, Kunio Sakai, Ryuta Sasamoto, Yasuo Matsumoto, Tadashi Sugita, Takeshi Ito

    Journal of JASTRO   13 ( 3 )   163 - 169   2001年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    Purpose: To evaluate the results of radiotherapy for low-grade gliomas focusing on the factors influencing progression-free rate, survival, and late complications. Materials and Methods: Forty-two patients consisting of 24 grade II astrocytomas and 18 oligoastrocytomas were treated with radiotherapy at Niigata University Hospital between 1982 and 1997. The patients ranged in age from 3 to 75 years (median: 39 years), of whom 8 were ≦ 15 years old. Twenty-six patients underwent tumor removal and 22 received chemotherapy mainly combined with radiotherapy. Radiotherapy was delivered in 2-Gy fractions to the tumor bed defined by CT or MRI usually with a 2-cm margin for a total dose ranging between 44 and 66 Gy (median: 50 Gy). Median follow-up time was 74.5 months (range: 4–193 months), and the progression-free rate and survival were calculated using the Kaplan-Meier method. Variables examined for prognostic significance included patient's age. gender. Karnofsky performance status (KPS), tumor location, pathology, maximum tumor diameter, calcification, enhancement with contrast material on CT or MRI, extent of tumor resection, radiation parameters (total dose and safety margin), interruption of radiotherapy, and chemotherapy. A log-rank test was used to analyze the statistical significance of differences in factors. Results: Tumor recurrence occurred in 10 adult patients. The 5- and the 10-year progression-free rates were 73% and 67% respectively. Seven were in-field recurrence, two were marginal, and one was a new lesion in the opposite cerebral hemisphere isolated from the original tumor. Nineteen patients had died at the time of the last follow-up and seven died of tumor progression. The overall survival at 5 and 10 years were 80% and 48% respectively. The cause-specific survival at 5 and 10 years were 92% and 73% respectively. Our analysis revealed that patient's age, extent of tumor resection, safety margin, and maximum tumor diameter were the significant factors influencing the progression-free rate. The factors influencing overall survival were age. maximum tumor diameter, and KPS. Age and extent of tumor resection were significant factors in cause-specific survival. Deterioration of quality of life occurred in 9 adult patients mainly due to dementia after radiotherapy. Most of them had the large frontal tumor and received chemotherapy. Conclusions: Radiotherapy was effective in the treatment of low-grade gliomas. An effort to reduce complications is required, because 9 of 34 adult patients suffered from dementia after radiotherapy in this study. The management of low-grade gliomas in adult patients is still controversial. Standardization of treatment strategy considering prognostic factors is awaited. © 2001, Japanese Society for Therapeutic Radiology and Oncology. All rights reserved.

    DOI: 10.11182/jastro1989.13.163

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  • 舌及び口底癌の術後放射線治療患者に対する口腔衛生管理-急性放射線粘膜炎に対する有効性- 査読

    勝良剛詞, 益子典子, 杉田 公, 林 孝文, 酒井邦夫, 土田恵美子, 松本康男, 笹本龍太

    日放腫会誌   12 ( 3 )   229 - 235   2000年

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    記述言語:英語   掲載種別:研究論文(学術雑誌)  

    DOI: 10.11182/jastro1989.12.229

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  • CTガイド下経皮肺生検による肺腺癌組織構築診断の試み 査読

    笹本龍太, 古泉直也, 酒井邦夫, 木原好則, 斎藤友雄, 森田哲郎, 松月由子, 薄田浩幸, 内藤 眞, 江村 巌

    肺癌   38 ( 2 )   99 - 107   1998年

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    記述言語:日本語   掲載種別:研究論文(学術雑誌)   出版者・発行元:日本肺癌学会  

    今回我々は,肺小型腺癌の組織構築に関するNoguchi分類の術前診断の可能性を検討するため,切除された肺腺癌で術前にCTガイド下経度肺生検を施行されていた17症例について,生検組織と切除標本組織の組織構築をNoguchi分類に準じてretrospectiveに比較検討した.生検標本のNoguchi分類が切除標本のNoguchi分類と一致したのは17例中7例(41.2%)であり,現時点ではCTガイド下経度肺生検でNoguchi分類を術前に診断するのは困難で,術中迅速病理診断が必要と思われた.また検討症例中に,生検により線維化を生じたと思われる症例があり,Noguchi分類の判定の際に留意すべきと考えられた.

    DOI: 10.2482/haigan.38.99

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  • 低線量率イリジウム線源による気管支腔内照射について3施設の集計

    斎藤 眞理, 笹本 龍太, 横山 晶, 栗田 雄三, 三間 聡, 塚田 裕子, 山下 孝, 古川 雅彦, 不破 信和

    The Journal of JASTRO   10 ( 2 )   135 - 143   1998年

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    記述言語:日本語   出版者・発行元:Japanese Society for Therapeutic Radiology and Oncology  

    低線量率192Ir線源を用いた気管, 気管支の腔内照射が施行された症例を3施設から集計し検討した. 治療方法・症例<BR>1987年4月から1996年11月までに133例149病巣の気管気管支に病巣のある癌に対し腔内照射が施行されていた.<BR>1例を除いて, すべて肺癌であった. 治療の目的は, 根治から姑息例まで多岐にわたっていたが, 内視鏡的肺門部早期癌 (早期癌), 肺癌手術後の気管気管支壁内再発例 (手術後再発例), 早期癌を除く肺癌 (進行癌) の症例が多かった.<BR>放射線治療は外照射と腔内照射の併用を原則としていた. 外照射はライナック4~10MVX線, 腔内照射は<SUP>192</SUP>Ir thin wire (1480 MBq) を使用, 多くの症例の一回線量は外照射1.8~2.2Gy, 腔内照射4.0~6.0Gyで施行されていた. 総線量は施設, 症例ごとにばらつきがあった.<BR>結果<BR>治療線量と再発率, 生存率に有意差はなかったが, 早期癌では腫瘍径が20mmを越す症例で再発が有意に多かった.<BR>放射線障害としては, 放射線肺炎, 気管支狭窄, 粘膜潰瘍, 出血などがあり, 致死的障害は2例であった.<BR>早期癌では腔内照射線量<25Gy, 外照射線量>40Gy, 総線量>65Gyで障害の発生が有意に高かった.<BR>早期癌の5年overall survival 52.1%, cause specifi csurvival 85.8%, disease free rate 82.2%であり, 手術後再発例の手術施行時からおよび本治療開始時からの5年overall survivalはそれぞれ54.7%, 29.3%, cause specinc survivalは62.1%, 39.4%, 進行癌では3年overall survival, 20.1%, cause specific survival 38.4%であった.<BR>まとめ<BR>本治療法は早期癌や手術後再発例のように病巣が小さく, 気管, 気管支壁周囲に限局している症例には良い適応と思われた.<BR>早期癌について再発, 障害について有意差のある結果が示されたが, 投与線量の偏り, 障害の評価などの問題があり, また, 手術後再発例や進行癌については治療数が少く, それぞれの症例群について線量と再発, 放射線障害などを十分に検討することができなかった. 投与線量, 障害の評価についての基準を設け, prospectiveな検討が必要である.

    DOI: 10.11182/jastro1989.10.135

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MISC

共同研究・競争的資金等の研究

  • 放射線皮膚障害に対応した効果的なスキンケアのエビデンス検証

    研究課題/領域番号:22H03385

    2022年4月 - 2025年3月

    制度名:科学研究費助成事業

    研究種目:基盤研究(B)

    提供機関:日本学術振興会

    柿原 奈保子, 佐藤 茉美, 佐藤 英世, 笹本 龍太

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    配分額:16120000円 ( 直接経費:12400000円 、 間接経費:3720000円 )

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  • 頭頚部癌・食道癌の放射線感受性予測とその修飾法の開発に関する基礎的臨床的研究

    研究課題/領域番号:16390335

    2004年 - 2006年

    制度名:科学研究費助成事業

    研究種目:基盤研究(B)

    提供機関:日本学術振興会

    笹井 啓資, 松本 俊治, 土田 恵美子, 笹本 龍太

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    頭頸部癌や食道癌の治療では、侵襲の少ない放射線治療による根治治療に大きな期待が寄せられている。しかし、放射線治療あるいは化学療法併用放射線治療でも治癒困難な症例が多数存在し、可及的早期に放射線治療の可否や方法の適否を判断する必要がある。事前の研究で、食道癌術前放射線治療症例においてc-erbB2の発現が放射線治療一次効果と強く相関することを明らかにし、in vitroでc-erbB2に対するモノクロナール抗体が放射線効果を増強することを示唆する結果を得た。本研究はこれらの追試を行い、さらに臨床応用に近づけることを目的とした。
    食道癌細胞株6種類を用いてc-erbB2阻害よる放射線増感効果をコロニー法を用いて検索した。c-erbB2の阻害剤としてトラスツズマブの他、EGFR阻害剤AG1478および他のチロシンキナーゼ阻害剤を検討したが、いずれの薬剤でも放射線の増感効果は認めず、むしろ防護効果が認められた。また附属の実験として、インターフェロンαと放射線との相乗効果に関して検討したが、有意な効果は得られなかった。
    化学放射線療法を施行したIIAからIV期食道癌68症例を対象に予後因子の検討を行った。22例がCR、35例がPRであった。42例が再発し41例が癌死した。5年全生存率20%であり、T2-T3MO症例30例では5年全生存率27%であった。このT2-T3MO症例中23例について病理組織標本の再検討を行ったが、有意な結果は得られなかった。また合併症に関しては諸因子を検討した結果、照射範囲のみが有意であった。
    予後予測方法の開発を目的に微小核形成試験法の食道癌への応用の可否を検討した。放射線感受性・DNA量・染色体数などの細胞の特徴が異なるヒト食道扁平上皮癌細胞株を用い、微小核形成試験法で得られた微小核頻度とコロニー形成法で得られた細胞生存率の相関について調べ放射線感受性予測の可能性を検討した。DNA量・染色体数などで補正を行っても、他の腫瘍細胞に関する報告とは異なり食道癌の放射線感受性予測が微小核形成試験では困難であることが明らかになった。

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