Researcher Profile and Settings

Master

Affiliation (Master)

• Faculty of Medicine　Internal Medicine　Department of Radiology

Affiliation (Master)

• Faculty of Medicine　Internal Medicine　Department of Radiology

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Profile and Settings

Profile and Settings

• Name (Japanese)

  KATOH

• Name (Kana)

  NORIO

• Name

  201301027217187261

Alternate Names

http://kaken.nii.ac.jp/d/r/80572495.ja.html

Achievement

Research Areas

• Life sciences / Radiology

Research Experience

• 2020/04 - Today 北海道大学 医学(系)研究科(研究院) 准教授
• 2009/04 - 2020/03 北海道大学 医学(系)研究科(研究院) 助教

Education

• 2004/04 - 2008/03  Hokkaido University  Graduate School of Medicine
• 1994/04 - 2000/03  Hokkaido University  School of Medicine

Awards

• 2019/09 日本癌学会 JCA-CHAAO Award
   

  受賞者: 白土 博樹;清水 伸一;鬼丸 力也;品川 尚文;阿保 大介;加藤 徳雄;梅垣 菊男;石川 正純;宮本 直樹;青山 英史
• 2013/10 日本放射線腫瘍学会 梅垣賞
   

  受賞者: 加藤徳雄

Published Papers

• Quality of life improvement after radiotherapy for bone metastases assessed using real-world data: a secondary analysis of a Nationwide Multicenter Cohort Study.

  Nobuko Utsumi, Tetsuo Saito, Naoto Shikama, Takeo Takahashi, Hideyuki Harada, Naoki Nakamura, Shuichi Ueno, Akifumi Notsu, Hiroki Shirato, Kazunari Yamada, Haruka Uezono, Yutaro Koide, Hikaru Kubota, Takuya Yamazaki, Kei Ito, Joichi Heianna, Yukinori Okada, Ayako Tonari, Norio Katoh, Hitoshi Wada, Yasuo Ejima, Kayo Yoshida, Takashi Kosugi, Shigeo Takahashi, Takafumi Komiyama, Nobue Uchida, Misako Miwa, Miho Watanabe, Hisayasu Nagakura, Hiroko Ikeda, Isao Asakawa, Naoyuki Shigematsu

  Japanese journal of clinical oncology 2024/10/30 [Refereed][Not invited]
   

  OBJECTIVE: Single-center studies or randomized controlled trials have evaluated the impact of radiotherapy for bone metastases on quality of life (QOL). We investigated the real-world impact of radiotherapy for bone metastases on QOL using nationwide multicenter cohort data. METHODS: We conducted a prospective observational study at 26 centers in Japan. Of 333 patients who received radiotherapy for bone metastases between December 2020 and March 2021, 232 (70%) were enrolled in the study. Patient-reported QOL was evaluated at enrollment and at two- and six-month follow-up using the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 15-Palliative and the EORTC QOL Questionnaire Bone Metastases module (QLQ-BM22). Possible predictors (patient-, tumor -, and treatment-related factors) of QOL improvement were screened using logistic regression models. RESULTS: QOL scores showed significant improvement at two-month follow-up in seven (global health status/QOL, emotional functioning, pain, insomnia, painful sites, pain characteristics and functional interference) of the 14 scales. Of these seven scales, mean improvement ≥ the minimal clinically important difference (defined by a change of 10 or more on the 0 to 100 scale) was seen in four scales (pain, insomnia, pain characteristics and functional interference). We did not find any predictors of QOL improvement in the functional interference scale of QLQ-BM22. CONCLUSION: Radiotherapy for bone metastases performed in daily practice is effective in improving some scales of QOL.
• Investigation of interfractional range variation owing to anatomical changes with beam directions based on water equivalent thickness in proton therapy for pancreatic cancer.

  Yuhei Kikkawa, Hideaki Ueda, Yusuke Uchinami, Norio Katoh, Hidefumi Aoyama, Yoichi M Ito, Kohei Yokokawa, Ye Chen, Taeko Matsuura, Naoki Miyamoto, Seishin Takao

  Journal of radiation research 2024/10/08 [Refereed][Not invited]
   

  To assess the interfractional anatomical range variations (ARVs) with beam directions and their impact on dose distribution in intensity modulated proton therapy, we analyzed water equivalent thickness (WET) from 10 patients with pancreatic cancer. The distributions of the interfractional WET difference ($\Delta{\mathrm{WET } }^{\theta }$) across 360° were visualized using polar histograms. Interfractional ARVs were evaluated using the mean absolute error and ΔWET pass rate, indicating the percentage of $\Delta \mathrm{WE},{\mathrm{T } }^{\theta }$ < thresholds. The impact on dose distribution in proton therapy was evaluated based on two treatment plans for 40 Gy(RBE)/5 fractions: 'Plan A', using two beam angles, in which the target was closest to the body surface among four perpendicular directions; and 'Plan B', using two beam angles with small ARVs. Analysis revealed individual variations in angular trends of interfractional ARVs. Three distinct trends were identified: Group 1 exhibited small ARVs around posterior directions; Group 2 exhibited small ARVs except ~60°; Group 3 demonstrated minimal ARVs only ~90°. In dose evaluation, while 150° and 210° were selected in Plan B for 9 out of 10 patients, for the remaining patient, 60° and 90° were chosen. Comparing dose volume histogram parameters for all patients, Plan B significantly reduced target coverage loss while maintaining organ-at-risk sparing comparable to Plan A. These results demonstrated that selecting beam angles with small interfractional ARVs for each patient enhances the robustness of dose distribution, reducing target coverage loss.
• Application of motion prediction based on a long short-term memory network for imaging dose reduction in real-time tumor-tracking radiation therapy.

  Kazuki Numakura, Seishin Takao, Taeko Matsuura, Kouhei Yokokawa, Ye Chen, Yusuke Uchinami, Hiroshi Taguchi, Norio Katoh, Hidefumi Aoyama, Satoshi Tomioka, Naoki Miyamoto

  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) 125 104507 - 104507 2024/09 [Refereed][Not invited]
   

  PURPOSE: To demonstrate the possibility of using a lower imaging rate while maintaining acceptable accuracy by applying motion prediction to minimize the imaging dose in real-time image-guided radiation therapy. METHODS: Time-series of three-dimensional internal marker positions obtained from 98 patients in liver stereotactic body radiation therapy were used to train and test the long-short-term memory (LSTM) network. For real-time imaging, the root mean squared error (RMSE) of the prediction on three-dimensional marker position made by LSTM, the residual motion of the target under respiratory-gated irradiation, and irradiation efficiency were evaluated. In the evaluation of the residual motion, the system-specific latency was assumed to be 100 ms. RESULTS: Except for outliers in the superior-inferior (SI) direction, the median/maximum values of the RMSE for imaging rates of 7.5, 5.0, and 2.5 frames per second (fps) were 0.8/1.3, 0.9/1.6, and 1.2/2.4 mm, respectively. The median/maximum residual motion in the SI direction at an imaging rate of 15.0 fps without prediction of the marker position, which is a typical clinical setting, was 2.3/3.6 mm. For rates of 7.5, 5.0, and 2.5 fps with prediction, the corresponding values were 2.0/2.6, 2.2/3.3, and 2.4/3.9 mm, respectively. There was no significant difference between the irradiation efficiency with and that without prediction of the marker position. The geometrical accuracy at lower frame rates with prediction applied was superior or comparable to that at 15 fps without prediction. In comparison with the current clinical setting for real-time image-guided radiation therapy, which uses an imaging rate of 15.0 fps without prediction, it may be possible to reduce the imaging dose by half or more. CONCLUSIONS: Motion prediction can effectively lower the frame rate and minimize the imaging dose in real-time image-guided radiation therapy.
• Multi-institutional prospective observational study of radiotherapy for metastatic bone tumor.

  Hideyuki Harada, Naoto Shikama, Akifumi Notsu, Hiroki Shirato, Kazunari Yamada, Haruka Uezono, Yutaro Koide, Hikaru Kubota, Takuya Yamazaki, Kei Ito, Joichi Heianna, Yukinori Okada, Ayako Tonari, Norio Katoh, Hitoshi Wada, Yasuo Ejima, Kayo Yoshida, Takashi Kosugi, Shigeo Takahashi, Takafumi Komiyama, Nobue Uchida, Misako Miwa, Miho Watanabe, Hisayasu Nagakura, Hiroko Ikeda, Tetsuo Saito, Isao Asakawa, Takeo Takahashi, Naoyuki Shigematsu

  Journal of radiation research 2024/08/20 [Refereed][Not invited]
   

  Purpose of this study is to evaluate patient characteristics, treatments and outcomes in bone metastasis radiotherapy practice. Patients for whom radiotherapy for bone metastasis was planned at 26 institutions in Japan between December 2020 and March 2021 were consecutively registered in this prospective, observational study. Study measures included patient characteristics, pain relief, skeletal-related events (SREs), overall survival and incidence of radiation-related adverse events. Pain was evaluated using a numerical rating scale (NRS) from 0 to 10. Irradiated dose was analyzed by the biologically effective dose (BED) assuming α/β = 10. Overall, 232 patients were registered; 224 patients and 302 lesions were fully analyzed. Eastern Cooperative Oncology Group Performance Status was 0/1/2/3/4 in 23%/38%/22%/13%/4%; 59% of patients had spinal metastases and 84% had painful lesions (NRS ≥ 2). BED was <20 Gy (in 27%), 20-30 Gy (24%), 30-40 Gy (36%) and ≥ 40 Gy (13%); 9% of patients were treated by stereotactic body radiotherapy. Grade 3 adverse events occurred in 4% and no grade 4-5 toxicity was reported. Pain relief was achieved in 52% at 2 months. BED is not related to pain relief. The cumulative incidence of SREs was 6.5% (95% confidence interval (CI) 3.1-9.9) at 6 months; no factors were significantly associated with SREs. With spinal lesions, 18% of patients were not ambulatory at baseline and 50% of evaluable patients in this group could walk at 2 months. The 6-month overall survival rate was 70.2% (95% CI 64.2-76.9%). In conclusion, we report real-world details of radiotherapy in bone metastasis.
• Clinical application of real-time tumor-tracking for stereotactic volumetric modulated arc therapy for liver tumors.

  Naoki Miyamoto, Norio Katoh, Takahiro Kanehira, Kohei Yokokawa, Ryusuke Suzuki, Yusuke Uchinami, Hiroshi Taguchi, Daisuke Abo, Hidefumi Aoyama

  Physics and imaging in radiation oncology 31 100623 - 100623 2024/07 [Refereed][Not invited]
   

  Real-time tumor-tracking volumetric modulated arc therapy (RT-VMAT) enabling beam-gating based on continuous X-ray tracking of the three-dimensional position of internal markers is relevant for moving tumors. Dose-volume characteristics and treatment time were evaluated in ten consecutive patients who underwent liver stereotactic body radiation therapy with RT-VMAT. Target dose conformity and sparing of the stomach and the intestine were improved comparing RT-VMAT with RT-3D conformal radiotherapy. The mean treatment time for each fraction was less than 10 min. RT-VMAT could be effective, especially for targets located adjacent to organs at risk.
• A Single-Institution Prospective Study To Evaluate the Safety and Efficacy of Real- Time Image-Gated Spot-Scanning Proton Therapy (RGPT) for Prostate Cancer.

  Kentaro Nishioka, Takayuki Hashimoto, Takashi Mori, Yusuke Uchinami, Rumiko Kinoshita, Norio Katoh, Hiroshi Taguchi, Koichi Yasuda, Yoichi M Ito, Seishin Takao, Masaya Tamura, Taeko Matsuura, Shinichi Shimizu, Hiroki Shirato, Hidefumi Aoyama

  Advances in radiation oncology 9 (5) 101464 - 101464 2024/05 [Refereed]
   

  PURPOSE: In real-time image-gated spot-scanning proton therapy (RGPT), the dose distribution is distorted by gold fiducial markers placed in the prostate. Distortion can be suppressed by using small markers and more than 2 fields, but additional fields may increase the dose to organs at risk. Therefore, we conducted a prospective study to evaluate the safety and short-term clinical outcome of RGPT for prostate cancer. METHODS AND MATERIALS: Based on the previously reported frequency of early adverse events (AE) and the noninferiority margin of 10%, the required number of cases was calculated to be 43 using the one-sample binomial test by the Southwest Oncology Group statistical tools with the one-sided significance level of 2.5% and the power 80%. Patients with localized prostate cancer were enrolled and 3 to 4 pure gold fiducial markers of 1.5-mm diameter were inserted in the prostate. The prescribed dose was 70 Gy(relative biologic effectiveness) in 30 fractions, and treatment was performed with 3 fields from the left, right, and the back, or 4 fields from either side of slightly anterior and posterior oblique fields. The primary endpoint was the frequency of early AE (≥grade 2) and the secondary endpoint was the biochemical relapse-free survival rate and the frequency of late AE. RESULTS: Forty-five cases were enrolled between 2015 and 2017, and all patients completed the treatment protocol. The median follow-up period was 63.0 months. The frequency of early AE (≥grade 2) was observed in 4 cases (8.9%), therefore the noninferiority was verified. The overall 5-year biochemical relapse-free survival rate was 88.9%. As late AE, grade 2 rectal bleeding was observed in 8 cases (17.8%). CONCLUSIONS: The RGPT for prostate cancer with 1.5-mm markers and 3- or 4- fields was as safe as conventional proton therapy in early AE, and its efficacy was comparable with previous studies.
• Proton Beam Therapy for Intrahepatic Cholangiocarcinoma: A Multicenter Prospective Registry Study in Japan.

  Masashi Mizumoto, Kazuki Terashima, Hirokazu Makishima, Motohisa Suzuki, Takashi Ogino, Takahiro Waki, Hiromitsu Iwata, Hiroyasu Tamamura, Yusuke Uchinami, Tetsuo Akimoto, Tomoaki Okimoto, Takashi Iizumi, Masao Murakami, Norio Katoh, Kazushi Maruo, Kei Shibuya, Hideyuki Sakurai

  Liver cancer 13 (2) 161 - 168 2235-1795 2024/04 [Refereed][Not invited]
   

  <b><i>Introduction:</i></b> Intrahepatic cholangiocarcinoma (ICC) can be treated with chemotherapy in unresectable cases, but outcomes are poor. Proton beam therapy (PBT) may provide an alternative treatment and has good dose concentration that may improve local control. <b><i>Methods:</i></b> Fifty-nine patients who received initial PBT for ICC from May 2016 to June 2018 at nine centers were included in the study. The treatment protocol was based on the policy of the Japanese Society for Radiation Oncology. Forty patients received 72.6–76 Gy (RBE) in 20–22 fr, 13 received 74.0–76.0 Gy (RBE) in 37–38 fr, and 6 received 60–70.2 Gy (RBE) in 20–30 fr. Overall survival (OS) and progression-free survival (PFS) were estimated by Kaplan-Meier analysis. <b><i>Results:</i></b> The 59 patients (35 men, 24 women; median age: 71 years; range: 41–91 years) had PS of 0 (<i>n</i> = 47), 1 (<i>n</i> = 10), and 2 (<i>n</i> = 2). Nine patients had hepatitis and all 59 cases were considered inoperable. The Child-Pugh class was A (<i>n</i> = 46), B (<i>n</i> = 7), and unknown (<i>n</i> = 6); the median maximum tumor diameter was 5.0 cm (range 2.0–15.2 cm); and the clinical stage was I (<i>n</i> = 12), II (<i>n</i> = 19), III (<i>n</i> = 10), and IV (<i>n</i> = 18). At the last follow-up, 17 patients were alive (median follow-up: 36.7 months; range: 24.1–49.9 months) and 42 had died. The median OS was 21.7 months (95% CI: 14.8–34.4 months). At the last follow-up, 37 cases had recurrence, including 10 with local recurrence. The median PFS was 7.5 months (95% CI: 6.1–11.3 months). In multivariable analyses, Child-Pugh class was significantly associated with OS and PFS, and Child-Pugh class and hepatitis were significantly associated with local recurrence. Four patients (6.8%) had late adverse events of grade 3 or higher. <b><i>Conclusion:</i></b> PBT gives favorable treatment outcomes for unresectable ICC without distant metastasis and may be particularly effective in cases with large tumors.
• Probability of normal tissue complications for hematologic and gastrointestinal toxicity in postoperative whole pelvic radiotherapy for gynecologic malignancies using intensity-modulated proton therapy with robust optimization.

  Takaaki Yoshimura, Ryota Yamada, Rumiko Kinoshita, Taeko Matsuura, Takahiro Kanehira, Hiroshi Tamura, Kentaro Nishioka, Koichi Yasuda, Hiroshi Taguchi, Norio Katoh, Keiji Kobashi, Takayuki Hashimoto, Hidefumi Aoyama

  Journal of radiation research 2024/03/17 [Refereed]
   

  This retrospective treatment-planning study was conducted to determine whether intensity-modulated proton therapy with robust optimization (ro-IMPT) reduces the risk of acute hematologic toxicity (H-T) and acute and late gastrointestinal toxicity (GI-T) in postoperative whole pelvic radiotherapy for gynecologic malignancies when compared with three-dimensional conformal radiation therapy (3D-CRT), intensity-modulated X-ray (IMXT) and single-field optimization proton beam (SFO-PBT) therapies. All plans were created for 13 gynecologic-malignancy patients. The prescribed dose was 45 GyE in 25 fractions for 95% planning target volume in 3D-CRT, IMXT and SFO-PBT plans and for 99% clinical target volume (CTV) in ro-IMPT plans. The normal tissue complication probability (NTCP) of each toxicity was used as an in silico surrogate marker. Median estimated NTCP values for acute H-T and acute and late GI-T were 0.20, 0.94 and 0.58 × 10-1 in 3D-CRT; 0.19, 0.65 and 0.24 × 10-1 in IMXT; 0.04, 0.74 and 0.19 × 10-1 in SFO-PBT; and 0.06, 0.66 and 0.15 × 10-1 in ro-IMPT, respectively. Compared with 3D-CRT and IMXT plans, the ro-IMPT plan demonstrated significant reduction in acute H-T and late GI-T. The risk of acute GI-T in ro-IMPT plan is equivalent with IMXT plan. The ro-IMPT plan demonstrated potential clinical benefits for reducing the risk of acute H-T and late GI-T in the treatment of gynecologic malignances by reducing the dose to the bone marrow and bowel bag while maintaining adequate dose coverage to the CTV. Our results indicated that ro-IMPT may reduce acute H-T and late GI-T risk with potentially improving outcomes for postoperative gynecologic-malignancy patients with concurrent chemotherapy.
• Impact of adaptive radiotherapy on survival in locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiotherapy.

  Yusuke Uchinami, Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Noboru Nishikawa, Rumiko Kinoshita, Kentaro Nishioka, Norio Katoh, Takashi Mori, Manami Otsuka, Naoki Miyamoto, Ryusuke Suzuki, Keiji Kobashi, Yasushi Shimizu, Jun Taguchi, Nayuta Tsushima, Satoshi Kano, Akihiro Homma, Hidefumi Aoyama

  Radiation oncology journal 42 (1) 74 - 82 2024/03 [Refereed]
   

  PURPOSE: To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS: Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival. RESULTS: The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541). CONCLUSION: Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.
• Real-time tumor-tracking radiotherapy with SyncTraX for primary liver tumors requiring isocenter shift†.

  Yusuke Uchinami, Naoki Miyamoto, Daisuke Abo, Ryo Morita, Koji Ogawa, Tatsuhiko Kakisaka, Ryusuke Suzuki, Tomohiko Miyazaki, Hiroshi Taguchi, Norio Katoh, Hidefumi Aoyama

  Journal of radiation research 2023/11/22 [Refereed][Not invited]
   

  The SyncTraX series enables real-time tumor-tracking radiotherapy through the real-time recognition of a fiducial marker using fluoroscopic images. In this system, the isocenter should be located within approximately 5-7.5 cm from the marker, depending on the version, owing to the limited field of view. If the marker is placed away from the tumor, the isocenter should be shifted toward the marker. This study aimed to investigate stereotactic body radiotherapy (SBRT) outcomes of primary liver tumors treated with SyncTraX in cases where the isocenter was shifted marginally or outside the planning target volume (PTV). Twelve patients with 13 liver tumors were included in the analysis. Their isocenter was shifted toward the marker and was placed marginally or outside the PTV. The prescribed doses were generally 40 Gy in four fractions or 48 Gy in eight fractions. The overall survival (OS) and local control (LC) rates were calculated using the Kaplan-Meier method. All patients completed the scheduled SBRT. The median distance between the fiducial marker and PTV centroid was 56.0 (interquartile range [IQR]: 52.7-66.7) mm. By shifting the isocenter toward the marker, the median distance between the marker and isocenter decreased to 34.0 (IQR: 33.4-39.7) mm. With a median follow-up period of 25.3 (range: 6.9-70.0) months, the 2-year OS and LC rates were 100.0% (95% confidence interval: 100-100). An isocenter shift makes SBRT with SyncTraX feasible in cases where the fiducial marker is distant from the tumor.
• Daily fraction dose-adjusted radiotherapy policy to avoid prolonging the overall treatment time for early glottic squamous cell carcinoma: a single-institutional retrospective study.

  Yasuhiro Dekura, Koichi Yasuda, Hideki Minatogawa, Yusuke Uchinami, Nayuta Tsushima, Takayoshi Suzuki, Satoshi Kano, Takashi Mori, Kentaro Nishioka, Keiji Kobashi, Norio Katoh, Akihiro Homma, Hidefumi Aoyama

  Journal of radiation research 2023/11/10 [Refereed][Not invited]
   

  The objective of this study was to determine the outcomes of radical radiotherapy for early glottic squamous cell carcinoma (EGSCC) with the policy of increasing the fraction size during radiotherapy when the overall treatment time (OTT) was expected to be prolonged. Patients diagnosed with clinical T1-2N0M0 EGSCC, who were treated with radical radiotherapy between 2008 and 2019 at Hokkaido University Hospital, were included. Patients received 66 Gy in 33 fractions for T1 disease and 70 Gy in 35 fractions for T2 disease as our standard regimen (usual group [UG]). If the OTT was expected to extend for >1 week, the dose fraction size was increased from 2.0 to 2.5 Gy from the beginning or during radiotherapy (adjusted group [AG]). At this time, we performed a statistical analysis between UG and AG. In total, 116 patients were identified, and the treatment schedules of 29 patients were adjusted. The median follow-up was 60.9 months. In the T1 group, the cumulative 5-year local failure rate was 12.0% in the AG and 15.4% in the UG, and in the T2 group, the rate was 40.7% in the AG and 25.3% in the UG. There were no significant differences between the AG and UG. Similarly, no significant differences were observed for overall survival and progression-free survival rates. Our single-institutional retrospective analysis of EGSCC patients suggested that a method of adjusting the radiotherapy schedule to increase fraction size from the beginning or during the course may be effective in maintaining treatment outcomes.
• Factors associated with quality of life in patients receiving palliative radiotherapy for bone metastases: a secondary cross-sectional analysis of data from a prospective multicenter observational study.

  Tetsuo Saito, Naoto Shikama, Takeo Takahashi, Hideyuki Harada, Shuichi Ueno, Akifumi Notsu, Hiroki Shirato, Kazunari Yamada, Haruka Uezono, Yutaro Koide, Hikaru Kubota, Takuya Yamasaki, Kei Ito, Joichi Heianna, Yukinori Okada, Ayako Tonari, Norio Katoh, Hitoshi Wada, Yasuo Ejima, Kayo Yoshida, Takashi Kosugi, Shigeo Takahashi, Takafumi Komiyama, Nobue Uchida, Misako Miwa, Miho Watanabe, Hisayasu Nagakura, Hiroko Ikeda, Isao Asakawa, Naoyuki Shigematsu

  The British journal of radiology 20230351 - 20230351 2023/10/03 [Refereed][Not invited]
   

  OBJECTIVE: To identify factors significantly associated with quality of life (QOL) and determine if these associations are strong enough to predict certain aspects of QOL without measuring them. METHODS: We conducted an exploratory secondary analysis of baseline data of 224 patients (enrolled between December 2020 and March 2021) from a previously published prospective observational study on radiotherapy for bone metastases at 26 centres. Using univariable linear regression, we assessed the association between patient/treatment factors and QOL scale scores as measured by the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 15-Palliative (QLQ-C15-PAL) and the EORTC QOL Questionnaire Bone Metastases module (QLQ-BM22). RESULTS: Age and sex were not significantly associated with QOL. Worse performance status, higher pain scores, and opioid and single-fraction use were significantly associated with most QOL scales; these four factors were associated with worse global QOL, worse functioning status, and more severe symptoms. The coefficients of determination for most QOL scales were less than 0.2, indicating that most of the variability in QOL scores was not explained by any of the explanatory variables. CONCLUSION: Performance status, pain intensity, and opioid and single-fraction use were significantly associated with most QOL scales. However, the associations were not strong enough to estimate QOL. ADVANCES IN KNOWLEDGE: To date, the association between treatment factors and QOL in patients with bone metastases has not been fully studied. We identified the factors that were significantly associated with QOL and found that these associations were not strong enough to predict QOL.
• Proton beam therapy for hepatocellular carcinoma: Multicenter prospective registry study in Japan.

  Masashi Mizumoto, Hiroyuki Ogino, Toshiyuki Okumura, Kazuki Terashima, Masao Murakami, Takashi Ogino, Hiroyasu Tamamura, Tetsuo Akimoto, Takahiro Waki, Norio Katoh, Masayuki Araya, Tsuyoshi Onoe, Masaru Takagi, Hiromitsu Iwata, Haruko Numajiri, Tomoaki Okimoto, Yusuke Uchinami, Kazushi Maruo, Kei Shibuya, Hideyuki Sakurai

  International journal of radiation oncology, biology, physics 2023/09/29 [Refereed][Not invited]
   

  INTRODUCTION: A prospective multicenter registry study was started in May 2016 in Japan to evaluate the efficacy and safety of proton beam therapy (PBT) for hepatocellular carcinoma (HCC). METHODS: Patients who received PBT for HCC from May 2016 to June 2018 were registered in the database of the Particle Beam Therapy Committee and Subcommittee of the Japanese Society for Radiation Oncology (JASTRO). Overall survival (OS), progression-free survival (PFS) and local recurrence were evaluated. RESULTS: Of the 755 registered cases, 576 with initial PBT and no duplicate cancer were evaluated. At final follow-up, 322 patients were alive and 254 had died. The median follow-up period for survivors was 39 months (0-58 months). The median OS time of the 576 patients was 48.8 months (95% CI 42.0-55.6 months) and the 1-, 2-, 3- and 4-year OS rates were 83.8% (95% CI 80.5-86.6%), 68.5% (64.5-72.2%), 58.2% (53.9-62.2%), and 50.1% (44.9-55.0%), respectively. Recurrence was observed in 332 cases, including local recurrence in 45 cases. The median PFS time was 14.7 months (95% CI 12.4-17.0 months) and the 1-, 2-, 3- and 4-year PFS rates were 55.2% (95% CI 51.0-59.2%), 37.5% (33.5-41.5%), 30.2% (26.3-34.2%), and 22.8% (18.5-27.4%), respectively. The 1-, 2-, 3- and 4-year OS rates were significantly higher for tumor size <5 vs. 5-10 cm (p<0.001) and <5 vs. ≥10 cm (p<0.001); Child-Pugh score A/B vs. C (p<0.001); and distance of the tumor from the gastrointestinal tract <1 vs. 1-2 cm (p<0.008) and <1 vs. >2 cm (p<0.001). At final follow-up, 27 patients (4.7%) had late adverse events of grade 3 or higher, with liver failure (n=7) and dermatitis (n=7) being most common. CONCLUSION: This multicenter prospective data registry indicated that PBT for HCC gives good therapeutic effects (3-year local control rate of 90%) with a low risk of severe late adverse events.
• The Japanese nationwide cohort data of proton beam therapy for liver oligometastasis in esophagogastric cancer patients.

  Hisashi Yamaguchi, Nobuyoshi Fukumitsu, Haruko Numajiri, Hiroyuki Ogino, Norio Katoh, Tomoaki Okimoto, Motohisa Suzuki, Hideyuki Sakurai

  Journal of radiation research 2023/09/11 [Refereed][Not invited]
   

  A nationwide multicenter cohort study on particle therapy was launched by the Japanese Society for Radiation Oncology in Japan in May 2016. We analyzed the outcome of proton beam therapy (PBT) for liver oligometastasis of esophagogastric cancers. Cases in which PBT was performed at all PBT facilities in Japan between May 2016 and February 2019 were enrolled. The patients were selected based on the following criteria: controlled primary cancer, liver recurrence without extrahepatic tumors and no more than three liver lesions. Twenty-two males and two females with a median age of 69 (range, 52-80) years and 35 lesions were included. This study included 6 patients with esophageal and 18 patients with gastric cancer. The median lesion size, fraction size and biological effective dose (BED)10 were 32 (7-104) mm, 3.8 gray (relative biological effect)/fractions (Gy (RBE)/fr) (2-8 Gy (RBE)/fr) and 96.9 (88.8-115.2) Gy, respectively. The median follow-up period was 18 (4-47) months. The 1-, 2- and 3-year overall survival (OS) rates were 75, 51.8 and 45.3%, respectively, and the median OS was 25.3 months. The 1-, 2- and 3-year cumulative local recurrence (LR) rates were 3, 6 and 6%, respectively. Patients' age (P < 0.01), performance status (P = 0.017) and tumor size (P = 0.024) were significant OS-related factors. No Grade 3 or higher adverse events (AEs) were observed. Owing to the low incidence of AEs and the low LR cumulative incidence, PBT is a feasible option for liver oligometastasis of esophagogastric cancers.
• Predicting the daily gastrointestinal doses of stereotactic body radiation therapy for pancreatic cancer based on the shortest distance between the tumor and the gastrointestinal tract using daily computed tomography images

  Yusuke Uchinami, Takahiro Kanehira, Keiji Nakazato, Yoshihiro Fujita, Fuki Koizumi, Shuhei Takahashi, Manami Otsuka, Koichi Yasuda, Hiroshi Taguchi, Kentaro Nishioka, Naoki Miyamoto, Kohei Yokokawa, Ryusuke Suzuki, Keiji Kobashi, Keita Takahashi, Norio Katoh, Hidefumi Aoyama

  BJR|Open 5 (1) 2023/08 [Refereed][Not invited]
   

  Objectives: We aimed to investigate whether daily computed tomography (CT) images could predict the daily gastroduodenal, small intestine, and large intestine doses of stereotactic body radiation therapy (SBRT) for pancreatic cancer based on the shortest distance between the gross tumor volume (GTV) and gastrointestinal (GI) tract. Methods: Twelve patients with pancreatic cancer received SBRT of 40 Gy in five fractions. We recalculated the reference clinical SBRT plan (PLAN_ref) using daily CT images and calculated the shortest distance from the GTV to each GI tract. The maximum dose delivered to 0.5 cc (D_0.5cc) was evaluated for each planning at-risk volume of the GI tract. Spearman’s correlation test was used to determine the association between the daily change in the shortest distance (Δshortest distance) and the ratio of ΔD_0.5cc dose to D_0.5cc dose in PLAN_ref (ΔD_0.5cc/PLAN_ref) for quantitative analysis. Results: The median shortest distance in PLAN_ref was 0 mm in the gastroduodenum (interquartile range, 0–2.7), 16.7 mm in the small intestine (10.0–23.7), and 16.7 mm in the large intestine (8.3–28.1 mm). The D_0.5cc of PLAN_ref in the gastroduodenum was >30 Gy in all patients, with 10 (83.3%) having the highest dose. A significant association was found between the Δshortest distance and ΔD_0.5cc/ PLAN_ref in the small or large intestine (p < 0.001) but not in the gastroduodenum (p = 0.404). Conclusions: The gastroduodenum had a higher D_0.5cc and predicting the daily dose was difficult. Daily dose calculations of the GI tract are recommended for safe SBRT. Advances in knowledge: This study aimed to predict the daily doses in SBRT for pancreatic cancer from the shortest distance between the GTV and the gastrointestinal tract. Daily changes in the shortest distance can predict the daily dose to the small or large intestines, but not to the gastroduodenum.
• Proton beam therapy for extrahepatic biliary tract cancer: Analysis with prospective multi-institutional patients' registration database, Proton-Net.

  Hideya Yamazaki, Kei Shibuya, Takuya Kimoto, Motohisa Suzuki, Masao Murakami, Kazuki Terashima, Tomoaki Okimoto, Takashi Iizumi, Hideyuki Sakurai, Masaru Wakatsuki, Osamu Suzuki, Norio Katoh, Takeshi Arimura, Takashi Ogino, Masaru Takagi, Masayuki Araya, Takahiro Waki, Sae Matsumoto, Hiroyuki Ogino, Takumi Fukumoto, Masayuki Ohtsuka

  Clinical and translational radiation oncology 41 100634 - 100634 2023/07 [Refereed]
   

  BACKGROUND AND PURPOSE: To examine the role of proton beam therapy (PBT) in the treatment of extrahepatic biliary tract cancer (EBC). METHODS AND MATERIALS: We analyzed the data accumulated in the Proton-Net database, which prospectively registered all individual patient data treated with PBT in all Japanese proton institutions from May 2016 to June 2019. The primary endpoint was overall survival (OS), and the secondary endpoints were local control (LC), progression-free survival (PFS), and toxicity. RESULTS: Ninety-three patients with unresectable and/or recurrent EBC were treated with PBT using a median prescribed dose of 67.5 Gy (RBE) (range, 50-72.6 Gy) in 25 (22-30 fractions). With a median follow-up of 16.3 months, the median survival time was 20.1 months and the 2-year OS was 37.8%. Two-year PFS and LC rates were 20.6% and 66.5%, respectively. Poor liver function (Child-Pugh B, C), a narrower distance between the tumor and digestive tract (2 cm >), and a larger tumor diameter (2 cm <) were identified as poor prognostic factors for OS. PBT-related grade 3 ≤ acute and late adverse events occurred in 5.4% and 4.3% of patients, respectively, including one gastrointestinal late toxicity (duodenal ulcer). CONCLUSIONS: This is the largest prospectively accumulated series of PBT for EBC, and PBT showed favorable outcomes with acceptable toxicity profiles.
• Comprehensive analysis of Japanese nationwide cohort data of particle beam therapy for pulmonary, liver and lymph node oligometastases: particle beam therapy versus high-precision X-ray radiotherapy.

  Norihiro Aibe, Hiroyuki Ogino, Masaru Wakatsuki, Kei Fujikawa, Satoshi Teramukai, Nobuyoshi Fukumitsu, Shintaro Shiba, Naoyoshi Yamamoto, Akihiro Nomoto, Takashi Ono, Masanosuke Oguri, Hisashi Yamaguchi, Haruko Numajiri, Kei Shibuya, Shohei Okazaki, Yuhei Miyasaka, Noriyuki Okonogi, Kazutoshi Murata, Hitoshi Tatebe, Atsushi Motegi, Tomoaki Okimoto, Takayuki Yoshino, Masaki Mandai, Norio Katoh, Hiroshi Tsuji, Hideyuki Sakurai

  Journal of radiation research 64 (Supplement_1) i69-i83  2023/06/16 [Refereed]
   

  Japanese national oncological experts convened to evaluate the efficacy and safety of particle beam therapy (PT) for pulmonary, liver and lymph node oligometastases (P-OM, L-OM and LN-OM, respectively) and to conduct a statistically comparative analysis of the local control (LC) rate and overall survival (OS) rate of PT versus those of X-ray stereotactic body radiotherapy (X-SBRT) and X-ray intensity-modulated radiotherapy (X-IMRT). They conducted [1] an analysis of the efficacy and safety of metastasis-directed therapy with PT for P-OM, L-OM and LN-OM using a Japanese nationwide multi-institutional cohort study data set; [2] a systematic review of X-ray high-precision radiotherapy (i.e. X-SBRT/X-IMRT) and PT for P-OM, L-OM and LN-OM; and [3] a statistical comparison between LC and OS of the cohort data set in PT and that of the extracted historical data set in X-SBRT/X-IMRT from the preceding systematic review. Safety was evaluated as the incidence of grade ≥ 3 adverse events, while statistical comparisons of LC and OS were conducted by estimating the incidence rate ratios (IRR) for local progression and mortality, respectively. This study demonstrated that PT provided durable LC (3-year LC rate: 72.8-83.2%) with acceptable OS (3-year OS rate: 38.5-68.1%) and risk of severe toxicity incidence of 0.8-3.5% in radical metastasis-directed therapy for P-OM, L-OM and LN-OM. Compared to LC with X-SBRT or X-IMRT, LC with PT was potentially superior for P-OM; superior for L-OM; and equivalent for LN-OM. In particular, this study demonstrated that PT may be a new treatment option for L-OM tumors measuring > 5 cm.
• PO-2122 Effect of early fractional lymphocyte loss on lymphopenia probability models for NSCLC

  T. Kanehira, H. Taguchi, N. Katoh, Y. Uchinami, T. Yoshimura, M. Tamura, R. Suzuki, T. Hashimoto, H. Aoyama

  Radiotherapy and Oncology 182 S1909 - S1911 0167-8140 2023/05
• Effectiveness of CT-image guidance in proton therapy for liver cancer and the importance of daily dose monitoring for tumors and organs at risk.

  Yoshikazu Maeda, Keiji Kobashi, Yoshitaka Sato, Hiroyasu Tamamura, Kazutaka Yamamoto, Keiichiro Matsushita, Makoto Sasaki, Hitoshi Tatebe, Tomoko Asahi, Sae Matsumoto, Shigeyuki Takamatsu, Koichi Miyazaki, Rintaro Fujimoto, Yusuke Uchinami, Norio Katoh, Hidefumi Aoyama

  Medical physics 50 (6) 3274 - 3288 2023/04/26 [Refereed]
   

  BACKGROUND: It is important to have precise image guidance throughout proton therapy in order to take advantage of the therapy's physical selectivity. PURPOSE: We evaluated the effectiveness of computed tomography (CT)-image guidance in proton therapy for patients with hepatocellular carcinoma (HCC) by assessing daily proton dose distributions. The importance of daily CT image-guided registration and daily proton dose monitoring for tumors and organs at risk (OARs) was investigated. METHODS: A retrospective analysis was conducted using 570 sets of daily CT (dCT) images throughout whole treatment fractions for 38 HCC patients who underwent passive scattering proton therapy with either a 66 cobalt gray equivalent (GyE)/10 fractions (n = 19) or 76 GyE/20 fractions (n = 19) protocol. The actual daily delivered dose distributions were estimated by forward calculation using the dCT sets, their corresponding treatment plans, and the recorded daily couch correction information. We then evaluated the daily changes of the dose indices D99% , V30GyE , and Dmax for the tumor volumes, non-tumorous liver, and other OARs, that is, stomach, esophagus, duodenum, colon, respectively. Contours were created for all dCT sets. We validated the efficacy of the dCT-based tumor registrations (hereafter, "tumor registration") by comparing them with the bone registration and diaphragm registration as a simulation of the treatment based on the positioning using the conventional kV X-ray imaging. The dose distributions and the indices of three registrations were obtained by simulation using the same dCT sets. RESULTS: In the 66 GyE/10 fractions, the daily D99% value in both the tumor and diaphragm registrations agreed with the planned value with 3%-6% (SD), and the V30GyE value for the liver agreed within ±3%; the indices in the bone registration showed greater deterioration. Nevertheless, tumor-dose deterioration occurred in all registration methods for two cases due to daily changes of body shape and respiratory condition. In the 76 GyE/20 fractions, in particular for such a treatment that the dose constraints for the OARs have to be cared in the original planning, the daily D99% in the tumor registration was superior to that in the other registration (p < 0.001), indicating the effectiveness of the tumor registration. The dose constraints, set in the plan as the maximum dose for OARs (i.e., duodenum, stomach, colon, and esophagus) were maintained for 16 patients including seven treated with re-planning. For three patients, the daily Dmax increased gradually or changed randomly, resulting in an inter-fractional averaged Dmax higher than the constraints. The dose distribution would have been improved if re-planning had been conducted. The results of these retrospective analyses indicate the importance of daily dose monitoring followed by adaptive re-planning when needed. CONCLUSIONS: The tumor registration in proton treatment for HCC was effective to maintain the daily dose to the tumor and the dose constraints of OARs, particularly in the treatment where the maintenance for the dose constraints needs to be considered throughout the treatment. Nevertheless daily proton dose monitoring with daily CT imaging is important for more reliable and safer treatment.
• Multicenter retrospective study of Stereotactic body radiotherapy for patients with previously untreated initial small hepatocellular carcinoma

  Yoshiko Doi, Yasushi Nagata, Yasuo Matsumoto, Kazushi Numata, Ryu Sasaki, Takashi Yamada, Hiroshi Igaki, Toshiyuki Imagumbai, Norio Katoh, Tadamasa Yoshitake, Takuya Shimizuguchi, Den Fujioka, Minoru Inoue, Yutaro Koide, Tomoki Kimura, Yoshinori Ito

  Hepatology Research 1386-6346 2023/04/10 [Refereed]
  
• Evaluation of short-term gastrointestinal motion and its impact on dosimetric parameters in stereotactic body radiation therapy for pancreatic cancer

  Yusuke Uchinami, Takahiro Kanehira, Yoshihiro Fujita, Naoki Miyamoto, Kohei Yokokawa, Fuki Koizumi, Motoyasu Shido, Shuhei Takahashi, Manami Otsuka, Koichi Yasuda, Hiroshi Taguchi, Keiji Nakazato, Keiji Kobashi, Norio Katoh, Hidefumi Aoyama

  Clinical and Translational Radiation Oncology 39 100576 - 100576 2405-6308 2023/03 [Refereed]
  
• Brain metastases in Japanese NSCLC patients: prognostic assessment and the use of osimertinib and immune checkpoint inhibitors-retrospective study.

  Hajime Higaki, Kentaro Nishioka, Manami Otsuka, Noboru Nishikawa, Motoyasu Shido, Hideki Minatogawa, Yukiko Nishikawa, Rikiya Takashina, Takayuki Hashimoto, Norio Katoh, Hiroshi Taguchi, Rumiko Kinoshita, Koichi Yasuda, Takashi Mori, Yusuke Uchinami, Fuki Koizumi, Yoshihiro Fujita, Shuhei Takahashi, Takahiro Hattori, Noriaki Nishiyama, Hidefumi Aoyama

  Radiation oncology (London, England) 18 (1) 25 - 25 2023/02/07 [Refereed]
   

  BACKGROUND: The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA) has not been validated for use with Japanese non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) and the factors impacting survival need to be assessed. METHODS: We retrospectively analyzed 294 NSCLC patients who were newly diagnosed with BM between 2013 and 2020 and had received radiotherapy for BM initially at the Hokkaido Cancer Center. We evaluated the effect on the prognosis of Lung-molGPA items, the expression of PD-L1 (classified as high, low, and no expression), and the treatment history. The main outcome was the survival measured from the day of the diagnosis of BM, and log-rank tests were performed to evaluate the results. RESULTS: The median overall survival (OS) times for adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, 2.5‒3.0, and 3.5‒4.0) were 5.5, 14.8, 28.3, and 39.0 months (p < 0.0001), respectively. The median survival times for non-adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, and 2.5‒3.0) were 3.2, 11.0, and 16.0 months (p = 0.0011), respectively. In adenocarcinoma patients with gene mutations, osimertinib significantly improved the outcome (median OS: 34.2 and 17.6 months with and without osimertinib, respectively (p = 0.0164)). There was no significant difference in the OS between patients who were initially treated with tyrosine-kinase inhibitor for BM and those who initially received radiotherapy (p = 0.5337). In patients tested for PD-L1 expression, the median survival times after the diagnosis of BM were 5.6, 22.5, and 9.3 months for the high-, low- and no-expression groups (p = 0.2198), respectively. Also, in patients with high PD-L1 expressions, those with ICI had survival (median OS, 8.6 months) than those without (median OS, 3.6 months). CONCLUSIONS: We confirmed that Lung-molGPA successfully classified Japanese NSCLC patients with BM by the prognosis. Osimertinib prolonged survival of EGFR-positive NSCLC patients with BM, and ICI was effective in patients with high PD-L1 expressions.
• Study of hepatic toxicity in small liver tumors after photon or proton therapy based on factors predicting the benefits of proton.

  Yusuke Uchinami, Norio Katoh, Daisuke Abo, Ryo Morita, Hiroshi Taguchi, Yoshihiro Fujita, Takahiro Kanehira, Ryusuke Suzuki, Naoki Miyamoto, Seishin Takao, Taeko Matsuura, Takuya Sho, Koji Ogawa, Tatsuya Orimo, Tatsuhiko Kakisaka, Keiji Kobashi, Hidefumi Aoyama

  The British journal of radiology 96 (1144) 20220720 - 20220720 2023/01/12 [Refereed][Not invited]
   

  OBJECTIVES: In a previous study of hepatic toxicity, the following three factors were identified to predict the benefits of proton beam therapy (PBT) for hepatocellular carcinomas (HCC) with a maximum diameter of ≤5 cm and Child-pugh grade A (CP-A): number of tumors (one vs ≥2), the location of tumors (hepatic hilum or others), and the sum of the diameters of lesions. The aim of this study is to analyze the association between these three factors and hepatic toxicity. METHODS: We retrospectively reviewed patients of CP-A treated with PBT or photon stereotactic body radiotherapy (X-ray radiotherapy, XRT) for HCC ≤5 cm. For normal liver dose, the V5, V10, V20 (volumes receiving 5, 10, and 20 Gy at least), and the mean dose was evaluated. The albumin-bilirubin (ALBI) and CP score changes from the baseline were evaluated at 3 and 6 months after treatment. RESULTS: In 89 patients (XRT: 48, PBT: 41), those with two or three (2-3) predictive factors were higher normal liver doses than with zero or one (0-1) factor. In the PBT group, the ALBI score worsened more in patients with 2-3 factors than those with 0-1 factor, at 3 months (median 0.26 vs 0.02, p = 0.032) and at 6 months (median: 0.35 vs 0.10, p = 0.009). The ALBI score change in the XRT group and CP score change in either modality were not significantly different in the number of predictive factors. CONCLUSIONS: The predictive factor numbers predicted the ALBI score change in PBT but not in XRT. ADVANCES IN KNOWLEDGE: This study suggest that the number of predictive factors previously identified (0-1 vs 2-3) were significantly associated with dosimetric parameters of the normal liver in both modalities. In the proton group, the number of predictive factors was associated with a worsening ALBI score at 3 and 6 months, but these associations were not found in the photon SBRT group.
• Income and Employment of Patients at the Start of and During Follow-up After Palliative Radiation Therapy for Bone Metastasis.

  Hiroki Shirato, Hideyuki Harada, Yukako Iwasaki, Akifumi Notsu, Kazunari Yamada, Haruka Uezono, Yutaro Koide, Hitoshi Wada, Hikaru Kubota, Naoto Shikama, Takuya Yamazaki, Kei Ito, Joichi Heianna, Yukinori Okada, Ayako Tonari, Shigeo Takahashi, Takashi Kosugi, Yasuo Ejima, Norio Katoh, Kayo Yoshida, Takafumi Komiyama, Nobue Uchida, Misako Miwa, Miho Watanabe, Hisayasu Nagakura, Tetsuo Saito, Hiroko Ikeda, Isao Asakawa, Tateishi Seiichiro, Takeo Takahashi, Naoyuki Shigematsu

  Advances in radiation oncology 8 (4) 101205 - 101205 2023 [Refereed][Not invited]
   

  PURPOSE: The aim of this study was to understand the income and employment status of patients at the start of and during follow-up after palliative radiation therapy for bone metastasis. METHODS AND MATERIALS: From December 2020 to March 2021, a prospective multi-institutional observational study was conducted to investigate income and employment of patients at the start of administration of radiation therapy for bone metastasis and at 2 and 6 months after treatment. Of 333 patients referred to radiation therapy for bone metastasis, 101 were not registered, mainly because of their poor general condition, and another 8 were excluded from the follow-up analysis owing to ineligibility. RESULTS: In 224 patients analyzed, 108 had retired for reasons unrelated to cancer, 43 had retired for reasons related to cancer, 31 were taking leave, and 2 had lost their jobs at the time of registration. The number of patients who were in the working group was 40 (30 with no change in income and 10 with decreased income) at registration, 35 at 2 months, and 24 at 6 months. Younger patients (P = 0), patients with better performance status (P = 0), patients who were ambulatory (P = .008), and patients with lower scores on a numerical rating scale of pain (P = 0) were significantly more likely to be in the working group at registration. There were 9 patients who experienced improvements in their working status or income at least once in the follow-up after radiation therapy. CONCLUSIONS: The majority of patients with bone metastasis were not working at the start of or after radiation therapy, but the number of patients who were working was not negligible. Radiation oncologists should be aware of the working status of patients and provide appropriate support for each patient. The benefit of radiation therapy to support patients continuing their work and returning to work should be investigated further in prospective studies.
• Technical Note: Performance evaluation of volumetric imaging based on motion modeling by principal component analysis

  Suzuka Asano, Keishi Oseki, Seishin Takao, Koichi Miyazaki, Kohei Yokokawa, Taeko Matsuura, Hiroshi Taguchi, Norio Katoh, Hidefumi Aoyama, Kikuo Umegaki, Naoki Miyamoto

  Medical Physics 0094-2405 2022/12/03 [Refereed]
  
• Particle Beam Therapy for Intrahepatic and Extrahepatic Biliary Duct Carcinoma: A Multi-Institutional Retrospective Data Analysis.

  Hideya Yamazaki, Takuya Kimoto, Motohisa Suzuki, Masao Murakami, Osamu Suzuki, Masaru Takagi, Norio Katoh, Takeshi Arimura, Takashi Ogino, Hiroyuki Ogino

  Cancers 14 (23) 2022/11/28 [Refereed]
   

  To examine the efficacy and toxicity of particle beam therapy (PT) for biliary duct carcinoma (BDC) and compare the outcomes between extrahepatic BDC (eBDC) and intrahepatic BDC (iBDC). We analyzed multi-institutional data from May 2009 to December 2019. The primary endpoint was overall survival (OS), and the secondary endpoints were local control (LC), progression-free survival (PFS) and toxicity. We included 150 patients with unresectable BDC treated with PT using a median prescribed dose of 70.2 GyRBE (range, 44-77 GyRBE) in 25 fractions (range, 10-38 fractions). With a median follow-up of 13.0 months, median survival time (MST) was 21 months, and 2-year OS was 44.8%. For eBDC and iBDC, the MSTs were 20 and 23 months, respectively. Two-year PFS and LC rates were 20.6% and 66.5%, respectively. Vascular invasion, prescribed dose and serum tumor marker level (carcinoembryonic antigen: CEA) were identified as poor prognostic factors for OS. A higher radiation dose EQD2 ≥ 67 Gy showed superior OS, with a hazard ratio of 0.341. The radiation dose of PT is an important predisposing factor for overall survival. The MST for patients with eBDC given a higher radiation dose was 25 months, compared to 15 months for those given the lower dose and 23 months for patients with iBDC (all iBDC given higher doses). iBDC and eBDC duct carcinomas showed equivalent outcomes with PT, especially when treated with a high radiation dose. In detailed analysis, baseline CEA level in iBDC, and radiation dose and GTV in eBDC were statistically significant predicators for OS. Acute and late toxicity grade ≥3 occurred in 2.2% and 2.7% of patients, respectively, including two late grade-5 toxicities. In conclusion, PT showed good efficacy for BDC, both eBDC and iBDC, with a low incidence of severe toxicity.
• Detailed analysis of failure patterns using deformable image registration in hypopharyngeal cancer patients treated with sequential boost intensity-modulated radiotherapy.

  Manami Otsuka, Koichi Yasuda, Yusuke Uchinami, Nayuta Tsushima, Takayoshi Suzuki, Satoshi Kano, Ryusuke Suzuki, Naoki Miyamoto, Hideki Minatogawa, Yasuhiro Dekura, Takashi Mori, Kentaro Nishioka, Jun Taguchi, Yasushi Shimizu, Norio Katoh, Akihiro Homma, Hidefumi Aoyama

  Journal of medical imaging and radiation oncology 67 (1) 98 - 110 2022/11/14 [Refereed]
   

  INTRODUCTION: Sequential boost intensity-modulated radiotherapy (SQB-IMRT) uses two different planning CTs (pCTs) and treatment plans. SQB-IMRT is a form of adaptive radiotherapy that allows for responses to changes in the shape of the tumour and organs at risk (OAR). On the other hand, dose accumulation with the two plans can be difficult to evaluate. The purpose of this study was to analyse patterns of loco-regional failure using deformable image registration (DIR) in hypopharyngeal cancer patients treated with SQB-IMRT. METHODS: Between 2013 and 2019, 102 patients with hypopharyngeal cancer were treated with definitive SQB-IMRT at our institution. Dose accumulation with the 1st and 2nd plans was performed, and the dose to the loco-regional recurrent tumour volume was calculated using the DIR workflow. Failure was classified as follows: (i) in-field (≥95% of the recurrent tumour volume received 95% of the prescribed dose); (ii) marginal (20-95%); or (iii) out-of-field (<20%). RESULTS: After a median follow-up period of 25 months, loco-regional failure occurred in 34 patients. Dose-volume histogram analysis showed that all loco-regional failures occurred in the field within 95% of the prescribed dose, with no marginal or out-of-field recurrences observed. CONCLUSION: The dosimetric analysis using DIR showed that all loco-regional failures were within the high-dose region. More aggressive treatment may be required for gross tumours.
• A study on predicting cases that would benefit from proton beam therapy in primary liver tumors of less than or equal to 5 cm based on the estimated incidence of hepatic toxicity

  Yusuke Uchinami, Norio Katoh, Ryusuke Suzuki, Takahiro Kanehira, Masaya Tamura, Seishin Takao, Taeko Matsuura, Naoki Miyamoto, Yoshihiro Fujita, Fuki Koizumi, Hiroshi Taguchi, Koichi Yasuda, Kentaro Nishioka, Isao Yokota, Keiji Kobashi, Hidefumi Aoyama

  Clinical and Translational Radiation Oncology 35 70 - 75 2405-6308 2022/07 [Refereed]
  
• Real-time CT image generation based on voxel-by-voxel modeling of internal deformation by utilizing the displacement of fiducial markers.

  Risa Hayashi, Koichi Miyazaki, Seishin Takao, Kohei Yokokawa, Sodai Tanaka, Taeko Matsuura, Hiroshi Taguchi, Norio Katoh, Shinichi Shimizu, Kikuo Umegaki, Naoki Miyamoto

  Medical physics 48 (9) 5311 - 5326 2021/09 [Refereed]
   

  PURPOSE: To show the feasibility of real-time CT image generation technique utilizing internal fiducial markers that facilitate the evaluation of internal deformation. METHODS: In the proposed method, a linear regression model that can derive internal deformation from the displacement of fiducial markers is built for each voxel in the training process before the treatment session. Marker displacement and internal deformation are derived from the four-dimensional computed tomography (4DCT) dataset. In the treatment session, the three-dimensional deformation vector field is derived according to the marker displacement, which is monitored by the real-time imaging system. The whole CT image can be synthesized by deforming the reference CT image with a deformation vector field in real-time. To show the feasibility of the technique, image synthesis accuracy and tumor localization accuracy were evaluated using the dataset generated by extended NURBS-Based Cardiac-Torso (XCAT) phantom and clinical 4DCT datasets from six patients, containing 10 CT datasets each. In the validation with XCAT phantom, motion range of the tumor in training data and validation data were about 10 and 15 mm, respectively, so as to simulate motion variation between 4DCT acquisition and treatment session. In the validation with patient 4DCT dataset, eight CT datasets from the 4DCT dataset were used in the training process. Two excluded inhale CT datasets can be regarded as the datasets with large deformations more than training dataset. CT images were generated for each respiratory phase using the corresponding marker displacement. Root mean squared error (RMSE), normalized RMSE (NRMSE), and structural similarity index measure (SSIM) between the original CT images and the synthesized CT images were evaluated as the quantitative indices of the accuracy of image synthesis. The accuracy of tumor localization was also evaluated. RESULTS: In the validation with XCAT phantom, the mean NRMSE, SSIM, and three-dimensional tumor localization error were 7.5 ± 1.1%, 0.95 ± 0.02, and 0.4 ± 0.3 mm, respectively. In the validation with patient 4DCT dataset, the mean RMSE, NRMSE, SSIM, and three-dimensional tumor localization error in six patients were 73.7 ± 19.6 HU, 9.2 ± 2.6%, 0.88 ± 0.04, and 0.8 ± 0.6 mm, respectively. These results suggest that the accuracy of the proposed technique is adequate when the respiratory motion is within the range of the training dataset. In the evaluation with a marker displacement larger than that of the training dataset, the mean RMSE, NRMSE, and tumor localization error were about 100 HU, 13%, and <2.0 mm, respectively, except for one case having large motion variation. The performance of the proposed method was similar to those of previous studies. Processing time to generate the volumetric image was <100 ms. CONCLUSION: We have shown the feasibility of the real-time CT image generation technique for volumetric imaging.
• Validation of dose distribution for liver tumors treated with real-time-image gated spot-scanning proton therapy by log data based dose reconstruction.

  Takahiro Yamada, Seishin Takao, Hidenori Koyano, Hideaki Nihongi, Yusuke Fujii, Shusuke Hirayama, Naoki Miyamoto, Taeko Matsuura, Kikuo Umegaki, Norio Katoh, Isao Yokota, Hiroki Shirato, Shinichi Shimizu

  Journal of radiation research 62 (4) 626 - 633 2021/07/10 [Refereed]
   

  In spot scanning proton therapy (SSPT), the spot position relative to the target may fluctuate through tumor motion even when gating the radiation by utilizing a fiducial marker. We have established a procedure that evaluates the delivered dose distribution by utilizing log data on tumor motion and spot information. The purpose of this study is to show the reliability of the dose distributions for liver tumors treated with real-time-image gated SSPT (RGPT). In the evaluation procedure, the delivered spot information and the marker position are synchronized on the basis of log data on the timing of the spot irradiation and fluoroscopic X-ray irradiation. Then a treatment planning system reconstructs the delivered dose distribution. Dose distributions accumulated for all fractions were reconstructed for eight liver cases. The log data were acquired in all 168 fractions for all eight cases. The evaluation was performed for the values of maximum dose, minimum dose, D99, and D5-D95 for the clinical target volumes (CTVs) and mean liver dose (MLD) scaled by the prescribed dose. These dosimetric parameters were statistically compared between the planned dose distribution and the reconstructed dose distribution. The mean difference of the maximum dose was 1.3% (95% confidence interval [CI]: 0.6%-2.1%). Regarding the minimum dose, the mean difference was 0.1% (95% CI: -0.5%-0.7%). The mean differences of D99, D5-D95 and MLD were below 1%. The reliability of dose distributions for liver tumors treated with RGPT-SSPT was shown by the evaluation of the accumulated dose distributions.
• Treatment Outcomes of Stereotactic Body Radiation Therapy Using Real-time Tumor-tracking Radiotherapy System for Hepatocellular Carcinomas.

  Yusuke Uchinami, Norio Katoh, Daisuke Abo, Hiroshi Taguchi, Koichi Yasuda, Kentaro Nishioka, Takeshi Soyama, Ryo Morita, Naoki Miyamoto, Ryusuke Suzuki, Takuya Sho, Masato Nakai, Koji Ogawa, Tatsuhiko Kakisaka, Tatsuya Orimo, Toshiya Kamiyama, Shinichi Shimizu, Hidefumi Aoyama

  Hepatology research : the official journal of the Japan Society of Hepatology 51 (8) 870 - 879 2021/04/24 [Refereed][Not invited]
   

  AIM: To report the outcomes of stereotactic body radiotherapy (SBRT) using a real-time tumor-tracking radiotherapy (RTRT) system for hepatocellular carcinoma (HCC) patients. METHODS: From January 2005 to July 2018, 63 patients with 74 lesions with a maximum diameter ≤52 mm were treated by SBRT using the RTRT system. No patient with a Child-Pugh Score ≥9 was included and 85.6% had a score of 5 or 6. Using the biological effective dose (BED) with α/β ratio of 10 (BED10 ), the median dose in BED10 at the reference point was 76.8 Gy (range: 60-122.5). Overall survival (OS) and local control (LC) rates were assessed using the Kaplan-Meier method. RESULTS: With a median follow up period of 24.6 months (range: 0.9-118.4), the 1-year and 2-year OS rates were 86.8% (95% confidence interval [95% CI]; 75.8-93.3) and 71.1% (57.8-81.6), respectively. The 2-year OS was 89.6% in patients with the baseline modified albumin-bilirubin (mALBI) grade =1 and 61.7% in patients with grade ≥2a. In the multivariate analysis, the mALBI grade (=1 vs ≥2a) was a significant factor for OS (p=0.028, 95%CI: 1.11-6.18). The 1-year and 2-year LC rates were 100% (100-100) and 92.0% (77.5-97.5). The LC rates were significantly higher in the BED10 ≥100 Gy group than in the BED10 <100 Gy (2-year 100% vs 86.5%, p=0.049) at the reference point. CONCLUSION: This retrospective study of SBRT using RTRT for HCC showed favorable outcomes with lower incidence of toxicities, especially in patients treated with BED10 ≥100 Gy to the reference point. This article is protected by copyright. All rights reserved.
• Assessment of the confidence interval in the multivariable normal tissue complication probability model for predicting radiation-induced liver disease in primary liver cancer.

  Anussara Prayongrat, Natchalee Srimaneekarn, Sira Sriswasdi, Yoichi M Ito, Norio Katoh, Masaya Tamura, Yasuhiro Dekura, Chie Toramatsu, Chonlakiet Khorprasert, Napapat Amornwichet, Petch Alisanant, Yuichi Hirata, Anthony Hayter, Hiroki Shirato, Shinichi Shimizu, Keiji Kobashi

  Journal of radiation research 62 (3) 483 - 493 2021/04/24 [Refereed]
   

  We developed a confidence interval-(CI) assessing model in multivariable normal tissue complication probability (NTCP) modeling for predicting radiation-induced liver disease (RILD) in primary liver cancer patients using clinical and dosimetric data. Both the mean NTCP and difference in the mean NTCP (ΔNTCP) between two treatment plans of different radiotherapy modalities were further evaluated and their CIs were assessed. Clinical data were retrospectively reviewed in 322 patients with hepatocellular carcinoma (n = 215) and intrahepatic cholangiocarcinoma (n = 107) treated with photon therapy. Dose-volume histograms of normal liver were reduced to mean liver dose (MLD) based on the fraction size-adjusted equivalent uniform dose. The most predictive variables were used to build the model based on multivariable logistic regression analysis with bootstrapping. Internal validation was performed using the cross-validation leave-one-out method. Both the mean NTCP and the mean ΔNTCP with 95% CIs were calculated from computationally generated multivariate random sets of NTCP model parameters using variance-covariance matrix information. RILD occurred in 108/322 patients (33.5%). The NTCP model with three clinical and one dosimetric parameter (tumor type, Child-Pugh class, hepatitis infection status and MLD) was most predictive, with an area under the receiver operative characteristics curve (AUC) of 0.79 (95% CI 0.74-0.84). In eight clinical subgroups based on the three clinical parameters, both the mean NTCP and the mean ΔNTCP with 95% CIs were able to be estimated computationally. The multivariable NTCP model with the assessment of 95% CIs has potential to improve the reliability of the NTCP model-based approach to select the appropriate radiotherapy modality for each patient.
• Multicenter prospective study of stereotactic body radiotherapy for previously untreated solitary primary hepatocellular carcinoma: The STRSPH study.

  Tomoki Kimura, Atsuya Takeda, Naoko Sanuki, Keisuke Ariyoshi, Takuhiro Yamaguchi, Toshiyuki Imagumbai, Norio Katoh, Takahisa Eriguchi, Yohei Oku, Shuichi Ozawa, Yuichiro Tsurugai, Masaki Kokubo, Shinichi Shimizu, Satoshi Ishikura

  Hepatology research : the official journal of the Japan Society of Hepatology 51 (4) 461 - 471 2021/04 [Refereed]
   

  AIM: To prospectively evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for patients with previously untreated solitary primary hepatocellular carcinoma (HCC). METHODS: The main eligibility criteria included the following: (1) primary solitary HCC; (2) no prior treatment for HCC; (3) Child-Turcotte-Pugh score of seven or less; and (4) unsuitability for or refusal of surgery and radiofrequency ablation (RFA). The prescribed dose of SBRT was 40 Gy in five fractions. The primary endpoint was 3-year overall survival (OS); the secondary endpoints included local progression-free survival (LPFS), local control (LC), and adverse events. The accrual target was 60 patients, expecting a 3-year OS of 70% with a 50% threshold. RESULTS: Between 2014 and 2018, 36 patients were enrolled; enrollment was closed early because of slow accrual. The median tumor size was 2.3 cm. The median follow-up at the time of evaluation was 20.8 months. The 3-year OS was 78% (95% confidence interval [CI]: 53%-90%). The 3-year LPFS and LC proportion were 73% (95% CI: 48%-87%) and 90% (95% CI: 65%-97%), respectively. Grade 3 or higher SBRT-related toxicities were observed in four patients (11%), and grade five toxicities were not observed. CONCLUSIONS: This study showed acceptably low incidence of SBRT-related toxicities. LC and OS after SBRT were comparable for previously untreated solitary HCC for patients unfit for resection and RFA. Although a definitive conclusion cannot be drawn by this study, the promising results indicate that SBRT may be an alternative option in the management of early HCC.
• Analysis of acute-phase toxicities of intensity-modulated proton therapy using a model-based approach in pharyngeal cancer patients.

  Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Seishin Takao, Masaya Tamura, Nayuta Tsushima, Takayoshi Suzuki, Satoshi Kano, Takatsugu Mizumachi, Takashi Mori, Kentaro Nishioka, Motoyasu Shido, Norio Katoh, Hiroshi Taguchi, Noriyuki Fujima, Rikiya Onimaru, Isao Yokota, Keiji Kobashi, Shinichi Shimizu, Akihiro Homma, Hiroki Shirato, Hidefumi Aoyama

  Journal of radiation research 62 (2) 329 - 337 2021/03/10 [Refereed]
   

  Pharyngeal cancer patients treated with intensity-modulated proton therapy (IMPT) using a model-based approach were retrospectively reviewed, and acute toxicities were analyzed. From June 2016 to March 2019, 15 pharyngeal (7 naso-, 5 oro- and 3 hypo-pharyngeal) cancer patients received IMPT with robust optimization. Simulation plans for IMPT and intensity-modulated X-ray therapy (IMXT) were generated before treatment. We also reviewed 127 pharyngeal cancer patients with IMXT in the same treatment period. In the simulation planning comparison, all of the normal-tissue complication probability values for dysphagia, dysgeusia, tube-feeding dependence and xerostomia were lower for IMPT than for IMXT in the 15 patients. After completing IMPT, 13 patients completed the evaluation, and 12 of these patients had a complete response. The proportions of patients who experienced grade 2 or worse acute toxicities in the IMPT and IMXT cohorts were 21.4 and 56.5% for dysphagia (P < 0.05), 46.7 and 76.3% for dysgeusia (P < 0.05), 73.3 and 62.8% for xerostomia (P = 0.43), 73.3 and 90.6% for mucositis (P = 0.08) and 66.7 and 76.4% for dermatitis (P = 0.42), respectively. Multivariate analysis revealed that IMPT was independently associated with a lower rate of grade 2 or worse dysphagia and dysgeusia. After propensity score matching, 12 pairs of IMPT and IMXT patients were selected. Dysphagia was also statistically lower in IMPT than in IMXT (P < 0.05). IMPT using a model-based approach may have clinical benefits for acute dysphagia.
• Are simple verbal instructions sufficient to ensure that bladder volume does not deteriorate prostate position reproducibility during spot scanning proton therapy?

  Kentaro Nishioka, Kento Gotoh, Takayuki Hashimoto, Takashige Abe, Takahiro Osawa, Ryuji Matsumoto, Isao Yokota, Norio Katoh, Rumiko Kinoshita, Koichi Yasuda, Toshiaki Yakabe, Takaaki Yoshimura, Seishin Takao, Nobuo Shinohara, Hidefumi Aoyama, Shinichi Shimizu, Hiroki Shirato

  BJR|Open 3 (1) 2021/01 [Refereed]
   

  The purpose of this study is to investigate whether verbal instructions are sufficient for bladder volume (BV) control not to deteriorate prostate position reproducibility in image-guided spot scanning proton therapy (SSPT) for localized prostate cancer. A total of 268 treatment sessions in 12 consecutive prostate cancer patients who were treated with image-guided SSPT with fiducial markers were retrospectively analyzed. In addition to strict rectal volume control procedures, simple verbal instructions to void urine one hour before the treatment were used here. The BV was measured by a Bladder Scan just before the treatment, and the prostate motion was measured by intraprostatic fiducial markers and two sets of X-ray fluoroscopy images. The correlation between the BV change and prostate motion was assessed by linear mixed-effects models and systematic and random errors according to the reproducibility of the BV. The mean absolute BV change during treatment was from −98.7 to 86.3 ml (median 7.1 ml). The mean absolute prostate motion of the patients in the left-right direction was −1.46 to 1.85 mm; in the cranial-caudal direction it was −6.10 to 3.65 mm, and in the anteroposterior direction −1.90 to 5.23 mm. There was no significant relationship between the BV change and prostate motion during SSPT. The early and late genitourinary and gastrointestinal toxicity was minimal with a minimum follow up of 4.57 years. Simple verbal instructions about urination was suggested to be sufficient to control the BV not to impact on the prostate motion and clinical outcomes in image-guided SSPT. Careful attention to BV change is still needed when the seminal vesicle is to be treated. Our data demonstrated that there was no apparent relationship between BV changes and prostate position reproducibility and simple verbal instruction about urination could be sufficient for image-guided SSPT.
• Quantitative analysis of treatments using real-time image gated spot-scanning with synchrotron-based proton beam therapy system log data.

  Takaaki Yoshimura, Shinichi Shimizu, Takayuki Hashimoto, Kentaro Nishioka, Norio Katoh, Hiroshi Taguchi, Koichi Yasuda, Taeko Matsuura, Seishin Takao, Masaya Tamura, Sodai Tanaka, Yoichi M Ito, Yuto Matsuo, Hiroshi Tamura, Kenji Horita, Kikuo Umegaki, Hiroki Shirato

  Journal of applied clinical medical physics 21 (12) 10 - 19 2020/12 [Refereed]
   

  A synchrotron-based real-time image gated spot-scanning proton beam therapy (RGPT) system with inserted fiducial markers can irradiate a moving tumor with high accuracy. As gated treatments increase the beam delivery time, this study aimed to investigate the frequency of intra-field adjustments corresponding to the baseline shift or drift and the beam delivery efficiency of a synchrotron-based RGPT system. Data from 118 patients corresponding to 127 treatment plans and 2810 sessions between October 2016 and March 2019 were collected. We quantitatively analyzed the proton beam delivery time, the difference between the ideal beam delivery time based on a simulated synchrotron magnetic excitation pattern and the actual treatment beam delivery time, frequency corresponding to the baseline shift or drift, and the gating efficiency of the synchrotron-based RGPT system according to the proton beam delivery machine log data. The mean actual beam delivery time was 7.1 min, and the simulated beam delivery time in an ideal environment with the same treatment plan was 2.9 min. The average difference between the actual and simulated beam delivery time per session was 4.3 min. The average frequency of intra-field adjustments corresponding to baseline shift or drift and beam delivery efficiency were 21.7% and 61.8%, respectively. Based on our clinical experience with a synchrotron-based RGPT system, we determined the frequency corresponding to baseline shift or drift and the beam delivery efficiency using the beam delivery machine log data. To maintain treatment accuracy within ± 2.0 mm, intra-field adjustments corresponding to baseline shift or drift were required in approximately 20% of cases. Further improvements in beam delivery efficiency may be realized by shortening the beam delivery time.
• Analysis of treatment process time for real-time-image gated-spot-scanning proton-beam therapy (RGPT) system.

  Takaaki Yoshimura, Shinichi Shimizu, Takayuki Hashimoto, Kentaro Nishioka, Norio Katoh, Tetsuya Inoue, Hiroshi Taguchi, Koichi Yasuda, Taeko Matsuura, Seishin Takao, Masaya Tamura, Yoichi M Ito, Yuto Matsuo, Hiroshi Tamura, Kenji Horita, Kikuo Umegaki, Hiroki Shirato

  Journal of applied clinical medical physics 21 (2) 38 - 49 2020/02 [Refereed][Not invited]
   

  We developed a synchrotron-based real-time-image gated-spot-scanning proton-beam therapy (RGPT) system and utilized it to clinically operate on moving tumors in the liver, pancreas, lung, and prostate. When the spot-scanning technique is linked to gating, the beam delivery time with gating can increase, compared to that without gating. We aim to clarify whether the total treatment process can be performed within approximately 30 min (the general time per session in several proton therapy facilities), even for gated-spot-scanning proton-beam delivery with implanted fiducial markers. Data from 152 patients, corresponding to 201 treatment plans and 3577 sessions executed from October 2016 to June 2018, were included in this study. To estimate the treatment process time, we utilized data from proton beam delivery logs during the treatment for each patient. We retrieved data, such as the disease site, total target volume, field size at the isocenter, and the number of layers and spots for each field, from the treatment plans. We quantitatively analyzed the treatment process, which includes the patient load (or setup), bone matching, marker matching, beam delivery, patient unload, and equipment setup, using the data obtained from the log data. Among all the cases, 90 patients used the RGPT system (liver: n = 34; pancreas: n = 5; lung: n = 4; and prostate: n = 47). The mean and standard deviation (SD) of the total treatment process time for the RGPT system was 30.3 ± 7.4 min, while it was 25.9 ± 7.5 min for those without gating treatment, excluding craniospinal irradiation (CSI; head and neck: n = 16, pediatric: n = 31, others: n = 15); for CSI (n = 11) with two or three isocenters, the process time was 59.9 ± 13.9 min. Our results demonstrate that spot-scanning proton therapy with a gating function can be achieved in approximately 30-min time slots.
• Combination of FDG-PET and FMISO-PET as a treatment strategy for patients undergoing early-stage NSCLC stereotactic radiotherapy.

  Shiro Watanabe, Tetsuya Inoue, Shozo Okamoto, Keiichi Magota, Ayumi Takayanagi, Jun Sakakibara-Konishi, Norio Katoh, Kenji Hirata, Osamu Manabe, Takuya Toyonaga, Yuji Kuge, Hiroki Shirato, Nagara Tamaki, Tohru Shiga

  EJNMMI research 9 (1) 104 - 104 2019/12/04 [Refereed][Not invited]
   

  BACKGROUND: We investigated the prognostic predictive value of the combination of fluorodeoxyglucose (FDG)- and fluoromisonidazole (FMISO)-PET in patients with non-small cell lung carcinoma (NSCLC) treated with stereotactic body radiation therapy (SBRT). PATIENTS AND METHODS: We prospectively examined patients with pathologically proven NSCLC; all underwent FDG and FMISO PET/CT scans before SBRT. PET images were acquired using a whole-body time-of-flight PET-CT scanner with respiratory gating. We classified them into recurrent and non-recurrent groups based on their clinical follow-ups and compared the groups' tumor diameters and PET parameters (i.e., maximum of the standardized uptake value (SUVmax), metabolic tumor volume, tumor-to-muscle ratio, and tumor-to-blood ratio). We performed univariate analysis to evaluate the impact of the PET variables on the patients' progression-free survival (PFS). We divided the patients by thresholds of FDG SUVmax and FMISO SUVmax obtained from receiver operating characteristic analysis for assessment of recurrence rate and PFS. RESULTS: Thirty-two NSCLC patients (19 male and 13 females; median age, 83 years) were enrolled. All received SBRT. At the study endpoint, 23 patients (71.9%) were non-recurrent and nine patients (28.1%) had recurrent disease. Significant between-group differences were observed in tumor diameter and all the PET parameters, demonstrating that those were significant predictors of the recurrence in all patients. In the 22 patients with tumors > 2 cm, tumor diameter and FDG SUVmax were not significant predictors. Thirty-two patients were divided into three patterns from the thresholds of FDG SUVmax (6.81) and FMISO SUVmax (1.89); A, low FDG and low FMISO (n = 14); B, high FDG and low FMISO (n = 8); C, high FDG and high FMISO (n = 10). No pattern A patient experienced tumor recurrence, whereas two pattern B patients (25%) and seven pattern C patients (70%) exhibited recurrence. A Kaplan-Meier analysis of all patients revealed a significant difference in PFS between patterns A and B (p = 0.013) and between patterns A and C (p < 0.001). In the tumors > 2 cm patients, significant differences in PFS were demonstrated between pattern A and C patients (p = 0.002). CONCLUSION: The combination of FDG- and FMISO-PET can identify patients with a baseline risk of recurrence and indicate whether additional therapy might be performed to improve survival.
• Phase 2 Study of Neoadjuvant Treatment of Sequential S-1-Based Concurrent Chemoradiation Therapy Followed by Systemic Chemotherapy with Gemcitabine for Borderline Resectable Pancreatic Adenocarcinoma (HOPS-BR 01).

  Hayashi T, Nakamura T, Kimura Y, Yoshida M, Someya M, Kawakami H, Sakuhara Y, Katoh N, Takahashi K, Ambo Y, Miura K, Motoya M, Tanaka E, Murakawa K, Yamabuki T, Yamazaki H, Katanuma A, Hirano S, Hokkaido Pancreatic, Study Group

  International journal of radiation oncology, biology, physics 105 (3) 606 - 617 0360-3016 2019/11 [Refereed][Not invited]
   

  PURPOSE: Preoperative treatment is recommended for borderline resectable pancreatic ductal adenocarcinoma. However, the standard treatment has not yet been determined. We conducted a multicenter phase 2 study to investigate the efficacy of neoadjuvant treatment of sequential chemoradiation followed by chemotherapy. METHODS AND MATERIALS: All enrolled patients were treated by preoperative chemoradiation (a total dose of 50.4 Gy in 28 fractions and orally administered S-1 at 80 mg/m2 on the day of irradiation) followed by chemotherapy (administration of gemcitabine at 1000 mg/m2/dose on days 1, 8, and 15 in 3 cycles of 4 weeks) and attempted curative resection. The primary outcome was an R0 resection rate among patients who completed preoperative treatment and pancreatectomy. The threshold of the R0 resection rate was defined as 74% based on a previous study of up-front surgery. RESULTS: Forty-five patients were included. Twenty-one patients could not undergo pancreatectomy because of progressive diseases (n = 14), adverse events (n = 5), or consent withdrawal (n = 2), and 4 patients underwent additional resection after dropping out. The resection rates were 53.3% and 62.2% in the per-protocol set (PPS) and full analysis set (FAS) populations, respectively. The R0 resection rates were 95.8% (95% confidence interval, 78.9%-99.9%) and 96.4% (81.7%-99.9%) in the PPS and FAS populations, respectively. The median overall survival and progression-free survival of all the included patients were 17.3 and 10.5 months, respectively. The median survival time of the patients with pancreatectomy was significantly longer than that of the patients without pancreatectomy in the PPS (27.9 vs 12.3 months; P = .001) and FAS populations (32.2 vs 11.8 months; P < .001). CONCLUSIONS: This study revealed that a long duration of preoperative treatment of sequential chemoradiation followed by systemic chemotherapy provides a high rate of R0 resection and sufficient survival time in patients undergoing pancreatectomy.
• Percutaneous insertion of hepatic fiducial true-spherical markers for real-time adaptive radiotherapy.

  Ryo Morita, Daisuke Abo, Yusuke Sakuhara, Takeshi Soyama, Norio Katoh, Naoki Miyamoto, Yuusuke Uchinami, Shinichi Shimizu, Hiroki Shirato, Kohsuke Kudo

  Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy 29 (6) 1 - 10 1364-5706 2019/09/13 [Refereed][Not invited]
   

  Purpose: This study evaluated the success rate and complications of percutaneous implantation of hepatic fiducial true-spherical gold markers for real-time adaptive radiotherapy (RAR), which constitutes real-time image-guided radiotherapy with gating. Material and methods: We retrospectively evaluated 100 patients who underwent 116 percutaneous intrahepatic implantations of 2-mm-diameter, spherical, gold fiducial markers before RAR from 1999 to 2016, with Seldinger's method. We defined technical success as marker placement at the intended liver parenchyma, without mispositioning, and clinical success as successful tracking of the gold marker and completion of planned RAR. Complications related to marker placement were assessed. Results: The technical success rate for true-spherical gold marker implantation was 92.2% (107/116). Nine of 116 markers migrated (intra-procedurally in seven patients, delayed in two patients). Migration out of the liver (n = 4) or intrahepatic vessels (n = 5) occurred without complications; these markers were not retrieved. The clinical success rate was 100.0% (115/115). Abdominal pain occurred in 16 patients, fever and hemorrhage in seven patients each, and pneumothorax and nausea in one patient each. No major complications were encountered. Conclusions: Percutaneous transhepatic implantation of true-spherical gold markers for RAR is feasible and can be conducted with a high success rate and low complication rate.
• Quantitative evaluation of image recognition performance of fiducial markers in real-time tumor-tracking radiation therapy.

  Miyamoto N, Maeda K, Abo D, Morita R, Takao S, Matsuura T, Katoh N, Umegaki K, Shimizu S, Shirato H

  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) 65 33 - 39 1120-1797 2019/09 [Refereed][Not invited]
   

  PURPOSE: To quantitatively evaluate and compare the image recognition performance of multiple fiducial markers available in real-time tumor-tracking radiation therapy (RTRT). METHODS: Clinically available markers including sphere shape, coil shape, cylinder shape, line shape, and ball shape (folded line shape) were evaluated in liver and lung models of RTRT. Maximum thickness of the polymethyl metacrylate (PMMA) phantom that could automatically recognize the marker was determined by template-pattern matching. Image registration accuracy of the fiducial marker was determined using liver RTRT model. Lung RTRT was mimicked with an anthropomorphic chest phantom and a one-dimensional motion stage in order to simulate marker motion in heterogeneous fluoroscopic images. The success or failure of marker tracking and image registration accuracy for the lung model were evaluated in the same manner as that for the liver model. RESULTS: All fiducial markers except for line shape and coil shape of thinner diameter were recognized by the PMMA phantom, which is assumed to have the typical thickness of an abdomen, with two-dimensional image registration accuracy of <2 pixels. Three-dimensional calculation error with the use of real-time stereoscopic fluoroscopy in RTRT was thought to be within 1 mm. In the evaluation using the lung model, the fiducial markers were recognized stably with sufficient accuracy for clinical application. The same was true for the evaluation using the liver model. CONCLUSIONS: The image recognition performance of fiducial markers was quantified and compared. The results presented here may be useful for the selection of fiducial markers.
• Impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with intensity-modulated radiotherapy.

  Uchinami Y, Suzuki R, Katoh N, Taguchi H, Yasuda K, Miyamoto N, Ito YM, Shimizu S, Shirato H

  Journal of applied clinical medical physics 20 (8) 78 - 86 2019/08 [Refereed][Not invited]
   

  PURPOSE: Interplay effects may influence dose distributions to a moving target when using dynamic delivery techniques such as intensity-modulated radiotherapy (IMRT). The aim of this study was to evaluate the impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with IMRT. METHODS: Ten patients who had been treated with IMRT for stomach lymphomas were enrolled. The clinical target volume (CTV) was contoured as the whole stomach. Considering interfractional uncertainty, the internal target volume (ITV) margin was uniformly 1.5 cm to the CTV and then modified based on the 4DCT images in case of the large respiratory motion. The planning target volume (PTV) was created by adding 5 mm to the ITV. The impact of organ motion on the volumetric and dosimetric parameters was evaluated retrospectively (4D simulation). The organ motion was reproduced by shifting the isocenter on the radiation treatment planning system. Several simulation plans were created to test the influence of the beam-on timing in the respiration cycle on the dose distribution. The homogeneity index (HI), volume percentage of stomach covered by the prescribed dose (Vp ), and D99 of the CTV were evaluated. RESULTS: The organ motion was the largest in the superior-inferior direction (10.1 ± 4.5 mm [average ± SD]). Stomach volume in each respiratory phase compared to the mean volume varied approximately within a ± 5% range in most of the patients. The PTV margin was sufficiently large to cover the CTV during the IMRT. There was a significant reduction in Vp and D99 but not in HI in the 4D simulation in free-breathing and multiple fractions compared to the clinically-used plan (P < 0.05) suggesting that interplay effects deteriorate the dose distribution. The absolute difference of D99 was less than 1% of the prescribed dose. CONCLUSIONS: There were significant interplay effects affecting the dose distribution in stomach IMRT. The magnitude of the dose reduction was small when patients were treated on free-breathing and multiple fractions.
• The normal tissue complication probability model-based approach considering uncertainties for the selective use of radiation modality in primary liver cancer patients.

  Prayongrat A, Kobashi K, Ito YM, Katoh N, Tamura M, Dekura Y, Toramatsu C, Khorprasert C, Amornwichet N, Alisanant P, Shirato H, Shimizu S

  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology 135 100 - 106 0167-8140 2019/06 [Refereed][Not invited]
   

  PURPOSE: To predict the probability of radiation-induced liver toxicity (RILT) and implement the normal tissue complication probability (NTCP) model-based approach considering confidence intervals (CIs) to select patients for new treatment techniques, such as proton beam therapy, based on a certain NTCP reduction (ΔNTCP) threshold for primary liver cancer patients. METHODS AND MATERIALS: Common Toxicity Criteria for Adverse Events (CTCAE) grade ≥2 RILT was scored. The Lyman NTCP models predicting the probability of CTCAE grade ≥2 RILT as a function of the fraction-size adjusted mean liver dose (MLD), using reference fraction size = 2 Gy/fraction and α/β ratio = 2 Gy, were fitted using the maximum likelihood method. At certain combinations of MLDs, ΔNTCP with a CI was evaluated by the delta method. RESULTS: Of the 239 patients, the incidence of CTCAE grade ≥2 RILT was 55% (46% in the Child-Pugh (CP)-A vs. 81% in the CP-B/C, p < 0.001). Among 180 CP-A patients, 40% who had viral hepatitis infections experienced toxicity vs. 32% in the nonhepatitis subgroup. The MLD was 18 Gy in the toxicity group vs. 16.1 Gy in the nontoxicity group (p = 0.002). The estimated NTCP model parameters specific to the patient subgroups and the ΔNTCP with CI assuming a particular CP classification and viral hepatitis infection status were considerably different which possible changed treatment decision. CONCLUSIONS: Patients with CP-A and viral hepatitis infection or CP-B/C cirrhosis had greater susceptibility to CTCAE grade ≥2 RILT. The estimated NTCP and ΔNTCP for individual patients along with a consideration of uncertainties improve the reliability of the NTCP model-based approach.
• Real-Time Tumor-Tracking Radiotherapy and General Stereotactic Body Radiotherapy for Adrenal Metastasis in Patients With Oligometastasis.

  Katoh N, Onishi H, Uchinami Y, Inoue T, Kuriyama K, Nishioka K, Shimizu S, Komiyama T, Miyamoto N, Shirato H

  Technology in cancer research & treatment 17 1533033818809983 - 1533033818809983 1533-0346 2018/10 [Refereed][Not invited]
   

  BACKGROUND: Precise local radiotherapy for adrenal metastasis can prolong the useful life of patients with oligometastasis. The aim of this retrospective, 2-center study was to establish the safety and effectiveness of real-time tumor-tracking radiotherapy and general stereotactic body radiotherapy in treating patients with adrenal metastatic tumors. MATERIALS AND METHODS: Thirteen lesions in 12 patients were treated with real-time tumor-tracking radiotherapy (48 Gy in 8 fractions over 2 weeks) and 8 lesions in 8 patients were treated with general stereotactic body radiotherapy (40-50 Gy in 5-8 fractions over 2 weeks or 60-70 Gy in 10 fractions over 2 weeks). Overall survival rates, local control rates, and adverse effects were analyzed. RESULTS: The actuarial overall survival rates for all patients at 1 and 2 years were 78.5% and 45.8%, respectively, with a median follow-up of 17.5 months, and the actuarial local control rates for all tumors at 1 and 2 years were 91.7% and 53.0%, respectively, with a median follow-up of 9 months. A complete local tumor response was obtained in 3 tumors treated by real-time tumor-tracking radiotherapy (lung adenocarcinomas with diameters of 35, 40, and 60 mm). There was a statistically significant difference in the local control between the groups treated by real-time tumor-tracking radiotherapy (100% at 1 year) and general stereotactic body radiotherapy (50% at 1 year; P < .001). No late adverse reactions at Grade 2 or higher were reported for either treatment group. CONCLUSIONS: This study showed that although both treatments are safe and effective, the real-time tumor-tracking radiotherapy is more effective than general stereotactic body radiotherapy in local control for adrenal metastasis.
• R0 Resection for Locally Advanced Pancreatic Cancer with Low-dose Gemcitabine with Wide Irradiation Area as Neoadjuvant Chemoradiotherapy.

  Kamachi H, Tsuruga Y, Orimo T, Wakayama K, Shimada S, Nagatsu A, Yokoo H, Kamiyama T, Katoh N, Taketomi A

  In vivo (Athens, Greece) 32 (5) 1183 - 1191 0258-851X 2018/09 [Refereed][Not invited]
   

  BACKGROUND: Local antitumor efficacy and the outcome of neoadjuvant chemoradiotherapy (NACRT) with low-dose gemcitabine and wide irradiation area for borderline resectable and unresectable pancreatic cancer were evaluated. PATIENTS AND METHODS: Thirty-four cases of borderline resectable and unresectable pancreatic cancer were recruited. Three-dimensional conformal radiotherapy to the pancreatic bed and the region scheduled for lymph node dissection was performed to a total dose of 50.4 Gy28 fractions with gemcitabine at a dose of 150 mg/m2 weekly. Clinical and pathological results were examined. RESULTS: Twenty-seven patients (79.4%) completed the protocol. Grade 3/4 leucopenia (n=10), and grade 3 anorexia (n=1) occurred. Seven cases were excluded (two refused treatment; five had progressive disease), 20 underwent laparotomy, and 16 resected (47.1%) cases achieved R0 resection. Median survival time, and 3-year and 5-year survival rates were 39.0 months, and 56.3% and 28.1% in resected cases, respectively. CONCLUSION: NACRT with low-dose gemcitabine and wide irradiation area achieved 100% R0 resection and acceptable prognosis.
• Stereotactic body radiotherapy to treat small lung lesions clinically diagnosed as primary lung cancer by radiological examination: A prospective observational study

  Tetsuya Inoue, Norio Katoh, Yoichi M Ito, Tomoki Kimura, Yasushi Nagata, Kengo Kuriyama, Hiroshi Onishi, Tadamasa Yoshitake, Yoshiyuki Shioyama, Yusuke Iizuka, Koji Inaba, Koji Konishi, Masaki Kokubo, Katsuyuki Karasawa, Takuyo Kozuka, Kensuke Tanaka, Jun Sakakibara-Konishi, Ichiro Kinoshita, Hiroki Shirato

  Lung Cancer 122 107 - 112 1872-8332 2018/08/01 [Refereed][Not invited]
   

  Objectives: Even with advanced image guidance, biopsies occasionally fail to diagnose small lung lesions, which are highly suggestive of primary lung cancer by radiological examination. The aim of this study was to evaluate the outcome of stereotactic body radiotherapy (SBRT) to treat small lung lesions clinically diagnosed as primary lung cancer. Materials and methods: This is a prospective, multi-institutional observation study. Strict inclusion and exclusion criteria were determined in a nation-wide consensus meeting and used to include patients who were clinically diagnosed with primary lung cancer using precise imaging modalities, for whom further surgical intervention was not feasible, who refused watchful waiting, and who were highly tolerable of SBRT with informed consent. SBRT was performed with 48 Gy in 4 fractions at the tumor isocenter. Results: From August 2009 to August 2014, 62 patients from 11 institutions were enrolled. Their median age was 80 years. The tumors ranged in size from 9 to 30 mm in diameter (median, 18 mm). The median follow-up interval was 55 months. The 3-year overall survival rate was 83.3% (95% confidence interval (CI) 71.1–90.7%) for all the patients and 94.7% (95% CI 68.1–99.2%) for the patients younger than 75 years. Local failure, regional lymph node metastases and distant metastases occurred in 4 (6.4%), 3 (4.8%) and 11 (17.7%) patients, respectively. Grades 3 and 4 toxicities were observed in 8 (12.9%) patients and 1 (1.6%) patient, respectively. No grade 5 toxicities were observed. Conclusions: SBRT is safe and effective for patients with small lung lesions clinically diagnosed as primary lung cancer that satisfied the proposed strict indication criteria as previously reported. A prospective interventional study is required to ascertain if SBRT is an alternative strategy for these patients.
• Optimal resection area for superior mesenteric artery nerve plexuses after neoadjuvant chemoradiotherapy for locally advanced pancreatic carcinoma.

  Takahiro Einama, Hirofumi Kamachi, Yosuke Tsuruga, Toshihiro Sakata, Kazuaki Shibuya, Yuzuru Sakamoto, Shingo Shimada, Kenji Wakayama, Tatsuya Orimo, Hideki Yokoo, Toshiya Kamiyama, Norio Katoh, Yusuke Uchinami, Tomoko Mitsuhashi, Akinobu Taketomi

  Medicine 97 (31) e11309  0025-7974 2018/08 [Refereed][Not invited]
   

  Recently, several reports demonstrated the efficacy of neoadjuvant chemotherapy (NAC) or chemoradiotherapy (NACRT) for patients with borderline resectable (BRPC) and locally advanced unresectable pancreatic carcinoma (LAPC). The aim of this study was to evaluate the treatment response after NACRT, especially for nerve plexuses, and the optimal resection area for superior mesenteric artery nerve plexuses in BRPC and LAPC patients after NACRT.A total of 17 patients with BRPC and LAPC received preoperative gemcitabine-based NACRT. The numbers of BRPC and LAPC patients were 13 and 4, respectively. We evaluated nerve plexus invasion by CT before and after NACRT, decided on the resection area of plexus invasion in SMA before NACRT, and compared the preoperative evaluation and clinicopathological findings.In the plexus of the supra-mesenteric artery (pl-SMA), arterial nerve plexus invasion, in cases <90°, all patients showed the absence of residual cancer in the resected specimen after NACRT. In cases between 90° and 180°, 1 of 2 patients (50%) showed nerve plexus invasion. In cases over 180°, all patients showed nerve plexus invasion. We could perform R0 resection in all 10 cases, and pl-SMA invasion disappeared in 6 of 7 BRPC patients.We demonstrated the relationship between the angle of nerve plexus tumor invasion and treatment effect after NACRT. We could perform R0 resection in all pl-SMA invasion cases, deciding on the resection area of pl-SMA based on CT before NACRT.
• Assessing the uncertainty in a normal tissue complication probability difference ('NTCP): Radiation-induced liver disease (RILD) in liver tumour patients treated with proton vs X-ray therapy

  Keiji Kobashi, Anussara Prayongrat, Takuya Kimoto, Chie Toramatsu, Yasuhiro Dekura, Norio Katoh, Shinichi Shimizu, Yoichi M Ito, Hiroki Shirato

  Journal of Radiation Research 59 (suppl_1) i50 - i57 1349-9157 2018/03/01 [Refereed][Not invited]
   

  Modern radiotherapy technologies such as proton beam therapy (PBT) permit dose escalation to the tumour and minimize unnecessary doses to normal tissues. To achieve appropriate patient selection for PBT, a normal tissue complication probability (NTCP) model can be applied to estimate the risk of treatment-related toxicity relative to X-ray therapy (XRT). A methodology for estimating the difference in NTCP ('NTCP), including its uncertainty as a function of dose to normal tissue, is described in this study using the Delta method, a statistical method for evaluating the variance of functions, considering the variance-covariance matrix. We used a virtual individual patient dataset of radiation-induced liver disease (RILD) in liver tumour patients who were treated with XRT as a study model. As an alternative option for individual patient data, dose-bin data, which consists of the number of patients who developed toxicity in each dose level/bin and the total number of patients in that dose level/bin, are useful for multi-institutional data sharing. It provides comparable accuracy with individual patient data when using the Delta method. With reliable NTCP models, the 'NTCP with uncertainty might potentially guide the use of PBT however, clinical validation and a cost-effectiveness study are needed to determine the appropriate 'NTCP threshold.
• Prospective study to evaluate the safety of the world-first spot-scanning dedicated, small 360-degree gantry, synchrotron-based proton beam therapy system

  Kentaro Nishioka, Anussara Prayongrat, Kota Ono, Shunsuke Onodera, Takayuki Hashimoto, Norio Katoh, Tetsuya Inoue, Rumiko Kinoshita, Koichi Yasuda, Takashi Mori, Rikiya Onimaru, Hiroki Shirato, Shinichi Shimizu

  Journal of Radiation Research 59 (suppl_1) i63 - i71 0449-3060 2018/03/01 [Refereed][Not invited]
   

  © The Author(s) 2017. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology. This is a report of a single-institution prospective study evaluating the safety of a spot-scanning dedicated, small 360-degree gantry, synchrotron-based proton beam therapy (PBT) system. Data collection was performed for 56 patients with 59 treatment sites who received proton beam therapy at Hokkaido University Hospital between March 2014 and July 2015. Forty-one patients were male and 15 were female. The median age was 66 years. The primary lesion sites were prostate (n = 17), bone/soft tissue (n = 10), liver (n = 7), lung (n = 6), central nervous system (n = 5), colon (n = 2), pancreas (n = 2), kidney (n = 2) and others (n = 5). Chemotherapy was administered in 11 patients. The prescribed total dose was from 20 to 76 GyE (Radiobiological equivalent dose, RBE = 1.1), with the median dose of 65 GyE in 4 to 35 fractions. No PBT-related Common Terminology Criteria for Adverse Events Grade 4 or 5 toxicities were observed; the incidence of early PBT-related Grade 4 adverse events was 0% (95% confidence interval 0 to 6.38%). The most common Grade 3 toxicities were hematologic toxicity (12.5%) unlikely to be related to the PBT. One patient developed a left femoral neck fracture (Grade 3) at 14.5 months after PBT for chondrosarcoma of the left pelvis. The pathological findings showed no other malignancies, suggesting that it was possibly related to the PBT. In conclusion, the spot-scanning dedicated, synchrotron-based PBT system is feasible, but further studies on its long-term safety and efficacy are warranted.
• Analysis of inter- and intra fractional partial bladder wall movement using implanted fiducial markers

  Kentaro Nishioka, Shinichi Shimizu, Nobuo Shinohara, Yoichi M. Ito, Takashige Abe, Satoru Maruyama, Norio Katoh, Rumiko Kinoshita, Takayuki Hashimoto, Naoki Miyamoto, Rikiya Onimaru, Hiroki Shirato

  RADIATION ONCOLOGY 12 (1) 44  1748-717X 2017/03 [Refereed][Not invited]
   

  Background: Current adaptive and dose escalating radiotherapy for muscle invasive bladder cancer requires knowledge of both inter-fractional and intra-fractional motion of the bladder wall involved. The purpose of this study is to characterize inter-and intra-fractional movement of the partial bladder wall using implanted fiducial markers and a real-time tumor-tracking radiotherapy system. Methods: Two hundred fifty one sessions with 29 patients were analysed. After maximal transurethral bladder tumor resection and 40 Gy of whole bladder irradiation, up to six gold markers were implanted transurethrally into the bladder wall around the tumor bed and used for positional registration. We compared the systematic and random uncertainty of positions between cranial vs. caudal, left vs. right, and anterior vs. posterior tumor groups. The variance in intrafractional movement and the percentage of sessions where 3 mm and 5 mm or more of intrafractional wall movement occurring at 2, 4, 6, 8, 10, and at more than 10 min until the end of a session were determined. Results: The cranial and anterior tumor group showed larger interfractional uncertainties in the position than the opposite side tumor group in the CC and AP directions respectively, but these differences did not reach significance. Among the intrafractional uncertainty of position, the cranial and anterior tumor group showed significantly larger systematic uncertainty of position than the groups on the opposite side in the CC direction. The variance of intrafractional movement increased over time; the percentage of sessions where intrafractional wall movement was larger than 3 mm within 2 min of the start of a radiation session or larger than 5 mm within 10 min was less than 5%, but this percentage was increasing further during the session, especially in the cranial and anterior tumor group. Conclusions: More attention for intrafractional uncertainty of position is required in the treatment of cranial and anterior bladder tumors especially in the CC direction. The optimal internal margins in each direction should be chosen or a precise intrafractional target localization system is required depending on the tumor location and treatment delivery time in the setting of partial bladder radiotherapy.
• Impact of Real-Time Image Gating on Spot Scanning Proton Therapy for Lung Tumors: A Simulation Study

  Takahiro Kanehira, Taeko Matsuura, Seishin Takao, Yuka Matsuzaki, Yusuke Fujii, Takaaki Fujii, Yoichi M. Ito, Naoki Miyamoto, Tetsuya Inoue, Norio Katoh, Shinichi Shimizu, Kikuo Umegaki, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 97 (1) 173 - 181 0360-3016 2017/01 [Refereed][Not invited]
   

  Purpose: To investigate the effectiveness of real-time-image gated proton beam therapy for lung tumors and to establish a suitable size for the gating window (GW). Methods and Materials: A proton beam gated by a fiducial marker entering a preassigned GW (as monitored by 2 fluoroscopy units) was used with 7 lung cancer patients. Seven treatment plans were generated: real-time-image gated proton beam therapy with GW sizes of +/- 1, 2, 3, 4, 5, and 8 mm and free-breathing proton therapy. The prescribed dose was 70 Gy (relative biological effectiveness)/10 fractions to 99% of the target. Each of the 3-dimensional marker positions in the time series was associated with the appropriate 4-dimensional computed tomography phase. The 4-dimensional dose calculations were performed. The dose distribution in each respiratory phase was deformed into the end-exhale computed tomography image. The D99 and D5 to D95 of the clinical target volume scaled by the prescribed dose with criteria of D99 > 95% and D5 to D95 < 5%, V20 for the normal lung, and treatment times were evaluated. Results: Gating windows <= +/- 2 mm fulfilled the CTV criteria for all patients (whereas the criteria were not always met for GWs >= +/- 3 mm) and gave an average reduction in V20 of more than 17.2% relative to free-breathing proton therapy (whereas GWs >= +/- 4 mm resulted in similar or increased V20). The average (maximum) irradiation times were 384 seconds (818 seconds) for the +/- 1-mm GW, but less than 226 seconds (292 seconds) for the +/- 2-mm GW. The maximum increased considerably at +/- 1-mm GW. Conclusion: Real-time-image gated proton beam therapy with a GW of +/- 2 mm was demonstrated to be suitable, providing good dose distribution without greatly extending treatment time. (C) 2016 Elsevier Inc. All rights reserved.
• Clinical outcomes of stage I and IIA non-small cell lung cancer patients treated with stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy system

  Norio Katoh, Itaru Soda, Hiroyasu Tamamura, Shotaro Takahashi, Yusuke Uchinami, Hiromichi Ishiyama, Kiyotaka Ota, Tetsuya Inoue, Rikiya Onimaru, Keiko Shibuya, Kazushige Hayakawa, Hiroki Shirato

  RADIATION ONCOLOGY 12 (1) 3  1748-717X 2017/01 [Refereed][Not invited]
   

  Purpose: To investigate the clinical outcomes of stage I and IIA non-small cell lung cancer (NSCLC) patients treated with stereotactic body radiotherapy (SBRT) using a real-time tumor-tracking radiotherapy (RTRT) system. Materials and methods: Patterns-of-care in SBRT using RTRT for histologically proven, peripherally located, stage I and IIA NSCLC was retrospectively investigated in four institutions by an identical clinical report format. Patterns-of-outcomes was also investigated in the same manner. Results: From September 2000 to April 2012, 283 patients with 286 tumors were identified. The median age was 78 years (52-90) and the maximum tumor diameters were 9 to 65 mm with a median of 24 mm. The calculated biologically effective dose (10) at the isocenter using the linear-quadratic model was from 66 Gy to 126 Gy with a median of 106 Gy. With a median follow-up period of 28 months (range 0-127), the overall survival rate for the entire group, for stage IA, and for stage IB + IIA was 75%, 79%, and 65% at 2 years, and 64%, 70%, and 50% at 3 years, respectively. In the multivariate analysis, the favorable predictive factor was female for overall survival. There were no differences between the clinical outcomes at the four institutions. Grade 2, 3, 4, and 5 radiation pneumonitis was experienced by 29 (10.2%), 9 (3.2%), 0, and 0 patients. The subgroup analyses revealed that compared to margins from gross tumor volume (GTV) to planning target volume (PTV) >= 10 mm, margins < 10 mm did not worsen the overall survival and local control rates, while reducing the risk of radiation pneumonitis. Conclusions: This multi-institutional retrospective study showed that the results were consistent with the recent patterns-of-care and patterns-of-outcome analysis of SBRT. A prospective study will be required to evaluate SBRT using a RTRT system with margins from GTV to PTV < 10mm.
• Evaluation of the motion of lung tumors during stereotactic body radiation therapy (SBRT) with four-dimensional computed tomography (4DCT) using real-time tumor-tracking radiotherapy system (RTRT)

  Keiichi Harada, Norio Katoh, Ryusuke Suzuki, Yoichi M. Ito, Shinichi Shimizu, Rikiya Onimaru, Tetsuya Inoue, Naoki Miyamoto, Hiroki Shirato

  PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS 32 (2) 305 - 311 1120-1797 2016/02 [Refereed][Not invited]
   

  Purpose: We investigated the usefulness of four-dimensional computed tomography (4DCT) performed before stereotactic body radiation therapy (SBRT) in determining the internal margins for peripheral lung tumors. Methods and Materials: The amplitude of the movement of a fiducial marker near a lung tumor measured using the maximum intensity projection (MIP) method in 4DCT imaging was acquired before the SBRT (Amp(CT)) and compared with the mean amplitude of the marker movement during SBRT (Amp(mean)) and with the maximum amplitude of the marker movement during SBRT (Amp(max)) using a real-time tumortracking radiotherapy (RTRT) system with 22 patients. Results: There were no significant differences between the means of the Amp(mean) and the means of the Amp(CT) in all directions (LR, P = 0.45; CC, P = 0.80; AP, P = 0.65). The means of the Amp(max) were significantly larger than the means of the Amp(CT) in all directions (LR, P < 0.01; CC, P = 0.03; AP, P < 0.01). In the lower lobe, the mean difference of the Amp(CT) from the mean of the Amp(max) was 5.7 +/- 8.0 mm, 12.5 +/- 16.7 mm, and 6.8 +/- 8.5 mm in the LR, CC, and AP directions, respectively. Conclusions: Acquiring 4DCT MIP images before the SBRT treatment is useful to establish the mean amplitude for a patient during SBRT but it underestimates the maximum amplitude during actual SBRT. Caution must be paid to determine the margin with the 4DCT especially for tumors at the lower lobe where it is of the potentially greatest benefit. (C) 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd.
• Intrafractional Baseline Shift or Drift of Lung Tumor Motion During Gated Radiation Therapy With a Real-Time Tumor-Tracking System

  Seishin Takao, Naoki Miyamoto, Taeko Matsuura, Rikiya Onimaru, Norio Katoh, Tetsuya Inoue, Kenneth Lee Sutherland, Ryusuke Suzuki, Hiroki Shirato, Shinichi Shimizu

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 94 (1) 172 - 180 0360-3016 2016/01 [Refereed][Not invited]
   

  Purpose: To investigate the frequency and amplitude of baseline shift or drift (shift/drift) of lung tumors in stereotactic body radiation therapy (SBRT), using a real-time tumor-tracking radiation therapy (RTRT) system. Methods and Materials: Sixty-eight patients with peripheral lung tumors were treated with SBRT using the RTRT system. One of the fiducial markers implanted near the tumor was used for the real-time monitoring of the intrafractional tumor motion every 0.033 seconds by the RTRT system. When baseline shift/drift is determined by the system, the position of the treatment couch is adjusted to compensate for the shift/drift. Therefore, the changes in the couch position correspond to the baseline shift/drift in the tumor motion. The frequency and amount of adjustment to the couch positions in the left-right (LR), cranio-caudal (CC), and antero-posterior (AP) directions have been analyzed for 335 fractions administered to 68 patients. Results: The average change in position of the treatment couch during the treatment time was 0.45 +/- 2.23 mm (mean +/- standard deviation), -1.65 +/- 5.95 mm, and 1.50 +/- 2.54 mm in the LR, CC, and AP directions, respectively. Overall the baseline shift/drift occurs toward the cranial and posterior directions. The incidence of baseline shift/drift exceeding 3 mm was 6.0%, 15.5%, 14.0%, and 42.1% for the LR, CC, AP, and for the square-root of sum of 3 directions, respectively, within 10 minutes of the start of treatment, and 23.0%, 37.6%, 32.5%, and 71.6% within 30 minutes. Conclusions: Real-time monitoring and frequent adjustments of the couch position and/or adding appropriate margins are suggested to be essential to compensate for possible underdosages due to baseline shift/drift in SBRT for lung cancers. (C) 2016 Elsevier Inc. All rights reserved.
• Stereotactic Radiosurgery With or Without Whole-Brain Radiotherapy for Brain Metastases Secondary Analysis of the JROSG 99-1 Randomized Clinical Trial

  Hidefumi Aoyama, Masao Tago, Hiroki Shirato

  JAMA ONCOLOGY 1 (4) 457 - 464 2374-2437 2015/07 [Refereed][Not invited]
   

  IMPORTANCE It remains uncertain whether treatment with stereotactic radiosurgery (SRS) alone can be safely applied to all patient populations with 1 to 4 brain metastases (BMs) exhibiting heterogeneous prognoses. OBJECTIVE To investigate the feasibility of SRS alone for patients with different prognoses determined by the diagnosis-specific Graded Prognostic Assessment (DS-GPA). DESIGN, SETTING, AND PARTICIPANTS A secondary analysis (performed in September 2014) of the Japanese Radiation Oncology Study Group (JROSG) 99-1, a phase 3 randomized trial, comparing SRS alone and whole-brain radiotherapy (WBRT) + SRS conducted in 1999 to 2003. Among a total of 132 patients, 88 with non-small-cell lung cancer (NSCLC) and 1 to 4 BMs were included and poststratified by DS-GPA scores to avoid potential bias from BMs from different primary cancer types. The median follow-up time was 8.05 months. INTERVENTIONS The WBRT schedule was 30 Gy in 10 fractions over 2 to 2.5 weeks. The mean SRS dose was 21.9 Gy in SRS alone and 16.6 Gy in WBRT + SRS. MAIN OUTCOMES AND MEASURES The primary end point was overall survival (OS), and the secondary end points included brain tumor recurrence (BTR), salvage treatment, and radiation toxic effects. RESULTS Forty-seven patients had a favorable prognosis, with DS-GPA scores of 2.5 to 4.0 (26 SRS-alone and 21 WBRT + SRS [DS-GPA 2.5-4.0 group]), and 41 had an unfavorable prognosis, with DS-GPA scores of 0.5 to 2.0 (19 SRS-alone and 22 WBRT + SRS [DS-GPA 0.5-2.0 group]). Significantly better OS was observed in the DS-GPA 2.5-4.0 group in WBRT + SRS vs the SRS alone, with a median survival time of 16.7 (95% CI, 7.5-72.9) months vs 10.6 (95% CI, 7.7-15.5) months (P = .04) (hazard ratio [HR], 1.92; 95% CI, 1.01-3.78). However, no such difference was observed in the DS-GPA 0.5-2.0 group (HR, 1.05; 95% CI, 0.55-1.99) (P =.86). This benefit could be explained by the differing BTR rates, in that the prevention against BTR by WBRT had a more significant impact in the DS-GPA 2.5-4.0 group (HR, 8.31; 95% CI, 3.05-29.13) (P < .001) vs the DS-GPA 0.5-2.0 group (HR, 3.57; 95% CI, 1.02-16.49) (P = .04). CONCLUSIONS AND RELEVANCE Despite the current trend of using SRS alone, the important role of WBRT for patients with BMs from NSCLC with a favorable prognosis should be considered. Our findings should be validated through appropriately designed prospective studies.
• Influence of respiration on dose calculation in stereotactic body radiotherapy of the lung

  Rie Yamazaki, Rikiya Onimaru, Norio Katoh, Tetsuya Inoue, Takeshi Nishioka, Hiroki Shirato, Hiroyuki Date

  Radiological Physics and Technology 7 (2) 284 - 289 1865-0333 2014/07 [Refereed][Not invited]
   

  Our purpose in this study was to evaluate the variation in calculated doses caused by respiration in stereotactic body radiotherapy (SBRT) of the lung. The study targeted ten patients who underwent SBRT for lung tumors. CT images were acquired during free breathing and in the inhalation and exhalation phases. We compared the CT image at inhalation with the image at exhalation so as to measure the change in lung volume, variation in the CT value, and displacement of the chest wall. The lung volume change was shown to be correlated with the maximum of the chest wall motion and with the variation in the CT value. A statistically significant difference was observed in the CT values between inhalation and exhalation (p < 0.05). The total dose variation at the isocenter was confined within ±2 %. However, the dose from individual beams can vary significantly when the chest wall moves more than 10 mm in natural breathing. © 2014 Japanese Society of Radiological Technology and Japan Society of Medical Physics.
• Early results of urethral dose reduction and small safety margin in intensity-modulated radiation therapy (IMRT) for localized prostate cancer using a real-time tumor-tracking radiotherapy (RTRT) system

  Shinichi Shimizu, Kentaro Nishioka, Ryusuke Suzuki, Nobuo Shinohara, Satoru Maruyama, Takashige Abe, Rumiko Kinoshita, Norio Katoh, Rikiya Onimaru, Hiroki Shirato

  RADIATION ONCOLOGY 9 118  1748-717X 2014/05 [Refereed][Not invited]
   

  Background: We prospectively assessed the utility of intensity-modulated radiation therapy (IMRT) with urethral dose reduction and a small margin between the clinical target volume (CTV) and the planning target volume (PTV) for patients with localized prostate cancer. Methods: The study population was 110 patients in low- (14.5%), intermediate- (41.8%), and high-risk (43.6%) categories. Three gold fiducial markers were inserted into the prostate. A soft guide-wire was used to identify the urethra when computed tomography (CT) scan for treatment planning was performed. A dose constraint of V70 < 10% was applied to the urethral region. Margins between the CTV-PTV were set at 3 mm in all directions. Patients were treated with 70 Gy IMRT in 30 fractions (D95 of PTV) over 7.5 weeks. The patient couch was adjusted to keep the gold markers within 2.0 mm from their planned positions with the use of frequent on-line verification. Results: The median follow-up period was 31.3 (3.2 to 82.1) months. The biochemical relapse-free survival (bRFS) rates at 3 years were 100%, 93.8% and 89.5% for the low-, intermediate-, and high-risk patients, respectively. The incidences of acute adverse events (AEs) were 45.5% and 0.9% for grades 1 and 2, respectively. The late AEs were grade 1 cystitis in 10.0% of the patients, rectal bleeding in 7.3%, and urinary urgency in 6.4%. Only three patients (2.7%) developed grade 2 late AEs. Conclusions: On-line image guidance with precise correction of the table position during radiotherapy achieved one of the lowest AEs rates with a bRFS equal to the highest in the literature.
• Stereotactic body radiotherapy using gated radiotherapy with real-time tumor-tracking for stage I non-small cell lung cancer

  Tetsuya Inoue, Norio Katoh, Rikiya Onimaru, Shinichi Shimizu, Kazuhiko Tsuchiya, Ryusuke Suzuki, Jun Sakakibara-Konishi, Naofumi Shinagawa, Satoshi Oizumi, Hiroki Shirato

  Radiation Oncology 8 (1) 69  2013/03/21 [Refereed][Not invited]
   

  Background: To clarify the clinical outcomes of two dose schedule of stereotactic body radiotherapy (SBRT) for stage I non-small cell lung cancer (NSCLC) using a real-time tumor-tracking radiation therapy (RTRT) system in single institution.Methods: Using a superposition algorithm, we administered 48 Gy in 4 fractions at the isocenter in 2005-2006 and 40 Gy in 4 fractions to the 95% volume of PTV in 2007-2010 with a treatment period of 4 to 7 days. Target volume margins were fixed irrespective of the tumor amplitude.Results: In total, 109 patients (79 T1N0M0 and 30 T2N0M0). With a median follow-up period of 25 months (range, 4 to 72 months), the 5-year local control rate (LC) was 78% and the 5-year overall survival rate (OS) was 64%. Grade 2, 3, 4, and 5 radiation pneumonitis (RP) was experienced by 15 (13.8%), 3 (2.8%), 0, and 0 patients, respectively. The mean lung dose (MLD) and the volume of lung receiving 20 Gy (V20) were significantly higher in patients with RP Grade 2/3 than in those with RP Grade 0/1 (MLD p = 0.002, V20 p = 0.003). There was no correlation between larger maximum amplitude of marker movement and larger PTV (r = 0.137), MLD (r = 0.046), or V20 (r = 0.158).Conclusions: SBRT using the RTRT system achieved LC and OS comparable to other SBRT studies with very low incidence of RP, which was consistent with the small MLD and V20 irrespective of tumor amplitude. For stage I NSCLC, SBRT using RTRT was suggested to be reliable and effective, especially for patients with large amplitude of tumor movement. © 2013 Inoue et al.; licensee BioMed Central Ltd.
• What is the appropriate size criterion for proton radiotherapy for hepatocellular carcinoma? A dosimetric comparison of spot-scanning proton therapy versus intensity-modulated radiation therapy

  Chie Toramatsu, Norio Katoh, Shinichi Shimizu, Hideaki Nihongi, Taeko Matsuura, Seishin Takao, Naoki Miyamoto, Ryusuke Suzuki, Kenneth Sutherland, Rumiko Kinoshita, Rikiya Onimaru, Masayori Ishikawa, Kikuo Umegaki, Hiroki Shirato

  RADIATION ONCOLOGY 8 48  1748-717X 2013/03 [Refereed][Not invited]
   

  Background: We performed a dosimetric comparison of spot-scanning proton therapy (SSPT) and intensity-modulated radiation therapy (IMRT) for hepatocellular carcinoma (HCC) to investigate the impact of tumor size on the risk of radiation induced liver disease (RILD). Methods: A number of alternative plans were generated for 10 patients with HCC. The gross tumor volumes (GTV) varied from 20.1 to 2194.5 cm(3). Assuming all GTVs were spherical, the nominal diameter was calculated and ranged from 3.4 to 16.1 cm. The prescription dose was 60 Gy for IMRT or 60 cobalt Gy-equivalents for SSPT with 95% planning target volume (PTV) coverage. Using IMRT and SSPT techniques, extensive comparative planning was conducted. All plans were evaluated by the risk of RILD estimated using the Lyman-normal-tissue complication probability model. Results: For IMRT the risk of RILD increased drastically between 6.3-7.8 cm nominal diameter of GTV. When the nominal diameter of GTV was more than 6.3 cm, the average risk of RILD was 94.5% for IMRT and 6.2% for SSPT. Conclusions: Regarding the risk of RILD, HCC can be more safely treated with SSPT, especially if its nominal diameter is more than 6.3 cm.
• [F-18]fluoromisonidazole and a New PET System With Semiconductor Detectors and a Depth of Interaction System for Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer

  Koichi Yasuda, Rikiya Onimaru, Shozo Okamoto, Tohru Shiga, Norio Katoh, Kazuhiko Tsuchiya, Ryusuke Suzuki, Wataru Takeuchi, Yuji Kuge, Nagara Tamaki, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 85 (1) 142 - 147 0360-3016 2013/01 [Refereed][Not invited]
   

  Purpose: The impact of a new type of positron emission tomography (New PET) with semiconductor detectors using F-18-labeled fluoromisonidazole (FMISO)-guided intensity modulated radiation therapy (IMRT) was compared with a state-of-the-art PET/computed tomography (PET/CT) system in nasopharyngeal cancer (NPC) patients. Methods and Materials: Twenty-four patients with non-NPC malignant tumors (control group) and 16 patients with NPC were subjected to FMISO-PET. The threshold of the tumor-to-muscle (T/M) ratio in each PET scan was calculated. The hypoxic volume within the gross tumor volume (GTVh) was determined using each PET ((NewPET)GTVh and (PET/CT)GTVh, respectively). Dose escalation IMRT plans prescribing 84 Gy to each GTVh were carried out. Results: The threshold of the T/M ratio was 1.35 for New PET and 1.23 for PET/CT. The mean volume of NewPETGTVh was significantly smaller than that of PET/CTGTVh (1.5 +/- 1.6 cc vs 4.7 +/- 4.6 cc, respectively; P = .0020). The dose escalation IMRT plans using New PET were superior in dose distribution to those using PET/CT. Dose escalation was possible in all 10 New PET-guided plans but not in 1 PET/CT-guided plan, because the threshold dose to the brainstem was exceeded. Conclusions: New PET was found to be useful for accurate dose escalation in FMISO-guided IMRT for patients with NPC. (c) 2013 Elsevier Inc.
• A New Brain Positron Emission Tomography Scanner With Semiconductor Detectors for Target Volume Delineation and Radiotherapy Treatment Planning in Patients With Nasopharyngeal Carcinoma

  Norio Katoh, Koichi Yasuda, Tohru Shiga, Masakazu Hasegawa, Rikiya Onimaru, Shinichi Shimizu, Gerard Bengua, Masayori Ishikawa, Nagara Tamaki, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 82 (4) E671 - E676 0360-3016 2012/03 [Refereed][Not invited]
   

  Purpose: We compared two treatment planning methods for stereotactic boost for treating nasopharyngeal carcinoma (NPC): the use of conventional whole-body bismuth germanate (BGO) scintillator positron emission tomography (PETCONVWB) versus the new brain (BR) PET system using semiconductor detectors (PETNEWBR). Methods and Materials: Twelve patients with NPC were enrolled in this study. [F-18]Fluorodeoxyglucose-PET images were acquired using both the PETNEWBR and the PETCONVWB system on the same day. Computed tomography (CT) and two PET data sets were transferred to a treatment planning system, and the PETCONVWB and PETNEWBR images were coregistered with the same set of CT images. Window width and level values for all PET images were fixed at 3000 and 300, respectively. The gross tumor volume (GTV) was visually delineated on PET images by using either PETCONVWB (GTV(CONV)) images or PETNEWBR (GTV(NEW)) images. Assuming a stereotactic radiotherapy boost of 7 ports, the prescribed dose delivered to 95% of the planning target volume (PTV) was set to 2000 cGy in 4 fractions. Results: The average absolute volume (+/- standard deviation [SD]) of GTV(NEW) was 15.7 ml (+/- 9.9) ml, and that of GTV(CONV) was 34.0 (+/- 20.5) ml. The average GTV(NEW) was significantly smaller than that of GTV(CONV) (p = 0.0006). There was no statistically significant difference between the maximum dose (p = 0.0585) and the mean dose (p = 0.2748) of PTV. The radiotherapy treatment plan based on the new gross tumor volume (PLAN(NEW)) significantly reduced maximum doses to the cerebrum and cerebellum (p = 0.0418) and to brain stem (p = 0.0041). Conclusion: Results of the present study suggest that the new brain PET system using semiconductor detectors can provide more accurate tumor delineation than the conventional whole-body BGO PET system and may be an important tool for functional and molecular radiotherapy treatment planning. (C) 2012 Elsevier Inc.
• Clinical outcomes of stereotactic body radiotherapy for patients with lung tumors in the state of oligo-recurrence

  Tetsuya Inoue, Norio Katoh, Rikiya Onimaru, Hiroki Shirato

  Pulmonary Medicine 2012 369820  2090-1836 2012 [Refereed][Not invited]
   

  We retrospectively evaluated the clinical outcomes of patients with oligometastatic lung tumors who underwent stereotactic body radiotherapy (SBRT). Twenty-two patients with one or two oligometastatic lung tumors were treated with SBRT at our institution between 1999 and 2009. With a median follow-up period of 25 months from the date of SBRT to the detection of oligometastatic lung tumors, the patients' 3- and 5-year overall survival (OS) and progression-free survival (PFS) rates were 72 and 54, respectively. The median disease-free interval (DFI) between the treatment of the primary site and SBRT to oligometastatic lung tumors was 41 months. The OS of patients with a DFI ≥36 months was significantly longer than that of the patients with a DFI < 36 months by the log-rank test (P = 0.02). For patients with a DFI ≥36 months, the 3- and 5-year OS rates were both 88, compared to 50 for the patients with a DFI <36 months. The primary tumor of all patients was locally controlled when SBRT to oligometastatic lung tumors was performed, and thus they were in the state of oligo-recurrence. Patients with oligometastatic lung lesions treated by SBRT had good prognoses. This was especially true of the patients with a long DFI and in the state of oligo-recurrence. Copyright © 2012 Tetsuya Inoue et al.
• Phase I study of concurrent real-time tumor-tracking thoracic radiation therapy with paclitaxel and carboplatin in locally advanced non-small cell lung cancer

  Jun Sakakibara-Konishi, Satoshi Oizumi, Ichiro Kinoshita, Naofumi Shinagawa, Junko Kikuchi, Mototsugu Kato, Tetsuya Inoue, Norio Katoh, Rikiya Onimaru, Hiroki Shirato, Hirotoshi Dosaka-Akita, Masaharu Nishimura

  LUNG CANCER 74 (2) 248 - 252 0169-5002 2011/11 [Refereed][Not invited]
   

  Introduction: Although paclitaxel with carboplatin and thoracic radiotherapy has improved survival for patients with locally advanced unresectable non-small cell lung cancer (NSCLC), the optimal dose of paclitaxel has not been well defined in Japan. This study was conducted to determine the maximum tolerated dose (MTD) and recommended dose (RD) of paclitaxel in combination with carboplatin and concurrent real-time tumor-tracking thoracic radiation therapy (thoracic RTRT). Patients and methods: Previously untreated patients with histologically confirmed, locally advanced unresectable NSCLC were eligible. Before treatment, gold markers were inserted into the lung and the mediastinum of all patients. RTRT comprised a total of 66 Gy at 2 Gy/fraction, 5 days/week, for 7 weeks. Patients received paclitaxel at a starting dose of 40 mg/m(2) followed by carboplatin at a fixed area under the curve (AUC) of 2, as a weekly regimen with RTRT. The dose of paclitaxel was escalated by 5 mg/m(2) per level. Results: Eight patients with locally advanced unresectable NSCLC were enrolled and treated with two dose levels of paclitaxel (40 mg/m(2) and 45 mg/m(2)), carboplatin (AUC = 2) and RTRT. No dose limiting toxicities (DLTs) were observed at Level 1 (paclitaxel, 40 mg/m(2) and carboplatin, AUC = 2). At Level 2 (paclitaxel, 45 mg/m(2) and carboplatin, AUC = 2), two of five patients experienced DLTs, in the form of esophagitis and discontinuation of chemotherapy more than twice. The MTD and RD of paclitaxel were thus defined as 45 mg/m(2) and 40 mg/m(2), respectively. Conclusions: This phase I study was well tolerated and the RD of paclitaxel and carboplatin with RTRT is 40 mg/m(2) at AUC = 2, respectively. Further studies are warranted to evaluate the efficacy of this regimen. (C) 2011 Elsevier Ireland Ltd. All rights reserved.
• Long-term Outcomes of Fractionated Stereotactic Radiotherapy for Intracranial Skull Base Benign Meningiomas in Single Institution

  Shunsuke Onodera, Hidefumi Aoyama, Norio Katoh, Hiroshi Taguchi, Kouichi Yasuda, Daisuke Yoshida, Ken Surtherland, Ryusuke Suzuki, Masayori Ishikawa, Bengua Gerard, Shunsuke Terasaka, Hiroki Shirato

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 41 (4) 462 - 468 0368-2811 2011/04 [Refereed][Not invited]
   

  Objective: To investigate the outcome of linac-based fractionated stereotactic radiotherapy over the last 10 years for intracranial skull base benign meningiomas in patients who were inoperable, who had residual tumors with some components of high mitotic index after surgery and who experienced relapse of the tumor. Methods: Twenty-seven patients with intracranial skull base benign meningiomas treated with fractionated stereotactic radiotherapy were retrospectively reviewed. Twenty-seven cases were diagnosed as benign meningiomas on pathological (17 cases) or radiological (10 cases) examination. The median follow-up time was 90 months after initial treatment and 63 months after fractionated stereotactic radiotherapy. The median biological equivalent dose calculated using an alpha/beta ratio of 2.0 Gy was 82.0 Gy (range, 60-106 Gy). Results: The 5-year overall survival was 95.7 (95% confidence interval: 87.3-100)% after initial treatment and 96.2 (88.8-100)% after fractionated stereotactic radiotherapy. The 5-year overall survival and local control rate of patients who received fractionated stereotactic radiotherapy alone were both 100%. The 5-year progression-free survival and local control rate after fractionated stereotactic radiotherapy were all 100% with a tumor volume of <9.1 cc and 68.2 (37.2-99.2) and 75.8 (45.2-100)% for the tumors 9.1 cc, respectively. The difference was significant in progression-free survival (P=0.022) and local control rate (P=0.044). The local control rate was significantly worse in patients who received fractionated stereotactic radiotherapy for relapsed tumors (P=0.01). No late radiation damage was observed in the follow-up period. Conclusions: The long-term outcome suggests that fractionated stereotactic radiotherapy is a safe and effective treatment for intracranial skull base benign meningioma, especially for those who have tumors <9.1 cc or would receive fractionated stereotactic radiotherapy with or without surgery as the initial treatment.
• Semiquantitative analysis of C-11 methionine PET may distinguish brain tumor recurrence from radiation necrosis even in small lesions

  Shozo Okamoto, Tohru Shiga, Naoya Hattori, Naoki Kubo, Toshiki Takei, Norio Katoh, Yutaka Sawamura, Kenichi Nishijima, Yuji Kuge, Nagara Tamaki

  ANNALS OF NUCLEAR MEDICINE 25 (3) 213 - 220 0914-7187 2011/04 [Refereed][Not invited]
   

  (11)C-Methionine positron emission tomography (MET-PET) has been used to distinguish brain tumor recurrence from radiation necrosis. Because the spatial resolution of conventional PET scanners is low, partial volume effect (PVE) may decrease the detectability of small tumor recurrence. The aim of this study is to investigate the diagnostic value of MET-PET upon semiquantitative analyses in particular PVE-affected small lesions. First, we performed a phantom experiment to investigate what size lesion is affected by PVE. This study included 29 patients (33 lesions) suspected of recurrent brain tumors by magnetic resonance imaging (MRI) after radiation therapy. All of them received MET-PET. Semiquantitative analysis was performed using maximum standardized uptake value (SUVmax) and lesion-versus-normal ratio (L/N ratio). ROC analysis was also assessed about the diagnostic value of MET-PET. From the result of the phantom experiment, lesions smaller than 20 mm in brain mode or smaller than 30 mm in whole-body mode were defined as PVE-affected lesions. Histological analysis or clinical follow-up confirmed the diagnosis of tumor recurrence in 22 lesions, and radiation necrosis in 11 lesions. L/N ratios of recurrence and necrosis for overall lesions were 1.98 +/- A 0.62 and 1.27 +/- A 0.28, respectively (p < 0.01). In the PVE-affected lesions, L/N ratio for recurrence (1.72 +/- A 0.44) was also significantly higher than that for necrosis (1.20 +/- A 0.11) (p < 0.01). On the ROC analysis for the PVE-affected lesions, the area under the curve for L/N ratio (0.897) was significantly higher than that for SUVmax (0.718) (p < 0.05). These areas under the curve were almost equal to that of overall lesions for L/N ratio (0.886) and for SUVmax (0.738). Semiquantitative analysis of MET provided high diagnostic value even for PVE-affected small lesions. MET-PET enables early diagnosis of recurrence of brain tumor in the follow-up after the radiation therapy.
• EVALUATION OF THE EFFECTIVENESS OF THE STEREOTACTIC BODY FRAME IN REDUCING RESPIRATORY INTRAFRACTIONAL ORGAN MOTION USING THE REAL-TIME TUMOR-TRACKING RADIOTHERAPY SYSTEM

  Gerard Bengua, Masayori Ishikawa, Kenneth Sutherland, Kenji Horita, Rie Yamazaki, Katsuhisa Fujita, Rikiya Onimaru, Noriwo Katoh, Tetsuya Inoue, Shunsuke Onodera, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 77 (2) 630 - 636 0360-3016 2010/06 [Refereed][Not invited]
   

  Purpose: To evaluate the effectiveness of the stereotactic body frame (SBF), with or without a diaphragm press or a breathing cycle monitoring device (Abches), in controlling the range of lung tumor motion, by tracking the real-time position of fiducial markers. Methods and Materials: The trajectories of gold markers in the lung were tracked with the real-time tumor-tracking radiotherapy system. The SBF was used for patient immobilization and the diaphragm press and Abches were used to actively control breathing and for self-controlled respiration, respectively. Tracking was performed in five setups, with and without immobilization and respiration control. The results were evaluated using the effective range, which was defined as the range that includes 95% of all the recorded marker positions in each setup. Results: The SBF, with or without a diaphragm press or Abches, did not yield effective ranges of marker motion which were significantly different from setups that did not use these materials. The differences in the effective marker ranges in the upper lobes for all the patient setups were less than 1mm. Larger effective ranges were obtained for the markers in the middle or lower lobes. Conclusion: The effectiveness of controlling respiratory-induced organ motion by using the SBF+diaphragm press or SBF + Abches patient setups were highly dependent on the individual patient reaction to the use of these materials and the location of the markers. They may be considered for lung tumors in the lower lobes, but are not necessary for tumors in the upper lobes. (C) 2010 Elsevier Inc.
• Clinical outcomes of stereotactic brain and/or body radiotherapy for patients with oligometastatic lesions

  Tetsuya Inoue, Norio Katoh, Hidefumi Aoyama, Rikiya Onimaru, Hiroshi Taguchi, Shunsuke Onodera, Satoshi Yamaguchi, Hiroki Shirato

  Japanese Journal of Clinical Oncology 40 (8) 788 - 794 0368-2811 2010/04 [Refereed][Not invited]
   

  Objective: Several recent studies have shown that oligometastatic disease has curative potential, although it was previously considered to signal a patient's last stage of life. Stereotactic body radiotherapy has been available for extra-cranial metastases in addition to stereotactic cranial radiotherapy for brain metastases. The aim of the present study was to retrospectively evaluate the clinical outcomes of stereotactic radiotherapy for patients with oligometastatic lesions. Methods: Between 1999 and 2008, 41 patients with five or fewer detectable metastases were treated with stereotactic radiotherapy at our institution. The treated oligometastatic lesions were in the brain, lung and adrenal glands. Results: With a median follow-up period of 20 months, the 3-year overall survival, progression-free survival, local control and distant control rates were 39%, 20%, 80% and 35%, respectively, and the respective 5-year rates were 28%, 20%, 80% and 35%. The median survival time was 24 months. According to interval to recurrence, the 3-and 5-year overall survival rates were 19% and 10%, respectively, for patients with,12 months (n = 18), compared with 53% and 40% for those with AdvP4C4E74.-1.C2112 months (n = 23) (P = 0.006). Conclusions: Precise stereotactic radiotherapy was effective in controlling oligometastatic lesions for patients with a median survival time of 24 months. Interval to recurrence may impact the overall survival rate and should be included in the stratification criteria in a prospective randomized trial to investigate the benefits of stereotactic radiotherapy for patients with oligometastases. © The Author (2010). Published by Oxford University Press. All rights reserved.
• High Dose Three-Dimensional Conformal Boost Using the Real-Time Tumor Tracking Radiotherapy System in Cervical Cancer Patients Unable to Receive Intracavitary Brachytherapy

  Hee Chul Park, Shinichi Shimizu, Akio Yonesaka, Kazuhiko Tsuchiya, Yasuhiko Ebina, Hiroshi Taguchi, Norio Katoh, Rumiko Kinoshita, Masayori Ishikawa, Noriaki Sakuragi, Hiroki Shirato

  YONSEI MEDICAL JOURNAL 51 (1) 93 - 99 0513-5796 2010/01 [Refereed][Not invited]
   

  Purpose: The purpose of this study is to evaluate the clinical results of treatment with a high dose of 3-dimensional conformal boost (3DCB) using a real-time tracking radiation therapy (RTRT) system in cervical cancer patients. Materials and Methods: Between January 2001 and December 2004, 10 patients with cervical cancer were treated with a high dose 3DCB using RTRT system. Nine patients received whole pelvis radiation therapy (RT) with a median dose of 50 Gy (range, 40-50 Gy) before the 3DCB. The median dose of the 3DCB was 30 Gy (range, 25-30 Gy). Eight patients received the 3DCB twice a week with a daily fraction of 5 Gy. The determined endpoints were tumor response, overall survival, local failure free survival, and distant metastasis free survival. The duration of survival was calculated from the time of the start of radiotherapy. Results: All patients were alive at the time of analysis and the median follow-up was 17.6 months (range, 4.9-27.3 months). Complete response was achieved in nine patients and one patient had a partial response. The 1- and 2-year local failure free survival was 78.8% and 54%, respectively. The 1- and 2-year distant metastasis free survival was 90% and 72%, respectively. Late toxicity of a grade 2 rectal hemorrhage was seen in one patient. A subcutaneous abscess was encountered in one patient. Conclusion: the use of the high dose 3DCB in the treatment of cervical cancer is safe and feasible where intracavitary brachytherapy (ICBT) is unable to be performed. The escalation of the 3DCB dose is currently under evaluation.
• Clinical outcomes of stereotactic brain and/or body radiotherapy for patients with oligometastatic lesions.

  Inoue T, Katoh N, Aoyama H, Onimaru R, Taguchi H, Onodera S, Yamaguchi S, Shirato H

  Jpn J Clin Oncol 40 (8) 788 - 94 1465-3621 2010 [Refereed][Not invited]
  
• A feasibility study of novel plastic scintillation dosimetry with pulse-counting mode

  M. Ishikawa, G. Bengua, K. L. Sutherland, J. Hiratsuka, N. Katoh, S. Shimizu, H. Aoyama, K. Fujita, R. Yamazaki, K. Horita, H. Shirato

  PHYSICS IN MEDICINE AND BIOLOGY 54 (7) 2079 - 2092 0031-9155 2009/04 [Refereed][Not invited]
   

  The purpose of this study was to develop a novel scintillation dosimeter for in vivo dosimetry in Ir-192 brachytherapy via the pulse-counting mode. The new dosimeter was made from a plastic scintillator shaped into a hemisphere of diameter 1 mm and connected to the tip of a plastic optical fiber. The relationship between pulse counts and absorbed dose was derived based on the assumption that scintillation photons from the incident gamma ray are proportional to the absorbed dose. An equation for the conversion of pulse counts to water-equivalent dose was deduced wherein the pulse height spectrum from scintillation photons was assumed to be exponential. To confirm its accuracy, the dose rate distribution in a water phantom was measured by the present dosimeter and this was compared with Monte Carlo simulations, resulting in a discrepancy of less than 1.97%. It was found that the dosimeter has a wide dynamic range of linearity up to an order of magnitude of almost 10(3), including corrections for loss of counts due to pile-up.
• A New PET Scanner with Semiconductor Detectors Enables Better Identification of Intratumoral Inhomogeneity

  Tohru Shiga, Yuichi Morimoto, Naoki Kubo, Norio Katoh, Chietsugu Katoh, Wataru Takeuchi, Reiko Usui, Kenji Hirata, Shinichi Kojima, Kikuo Umegaki, Hiroki Shirato, Nagara Tamaki

  JOURNAL OF NUCLEAR MEDICINE 50 (1) 148 - 155 0161-5505 2009/01 [Refereed][Not invited]
   

  An autoradiography method revealed intratumoral inhomogeneity in various solid tumors. It is becoming increasingly important to estimate intratumoral inhomogeneity. However, with low spatial resolution and high scatter noise, it is difficult to detect intratumoral inhomogeneity in clinical settings. We developed a new PET system with CdTe semiconductor detectors to provide images with high spatial resolution and low scatter noise. Both phantom images and patients' images were analyzed to evaluate intratumoral inhomogeneity. Methods: This study was performed with a cold spot phantom that had 6-mm-diameter cold sphenoid defects, a dual-cylinder phantom with an adjusted concentration of 1:2, and an "H"-shaped hot phantom. These were surrounded with water. Phantom images and (18)F-FDG PET images of patients with nasopharyngeal cancer were compared with conventional bismuth germanate PET images. Profile curves for the phantoms were measured as peak-to-valley ratios to define contrast. Intratumoral inhomogeneity and tumor edge sharpness were evaluated on the images of the patients. Results: The contrast obtained with the semiconductor PET scanner (1.53) was 28% higher than that obtained with the conventional scanner (1.20) for the 6-mm-diameter cold sphenoid phantom. The contrast obtained with the semiconductor PET scanner (1.43) was 27% higher than that obtained with the conventional scanner (1.13) for the dual-cylinder phantom. Similarly, the 2-mm cold region between 1-mm hot rods was identified only by the new PET scanner and not by the conventional scanner. The new PET scanner identified intratumoral inhomogeneity in more detail than the conventional scanner in 6 of 10 patients. The tumor edge was sharper on the images obtained with the new PET scanner than on those obtained with the conventional scanner. Conclusion: These phantom and clinical studies suggested that this new PET scanner has the potential for better identification of intratumoral inhomogeneity, probably because of its high spatial resolution and low scatter noise.
• A new PET scanner with semiconductor detector reveals intratumoral inhomogeneous cell activity with high spatial and energy resolution

  Shiga T, Kubo N, Morimoto Y, Katoh N, Katoh C, Ueno Y, Hirata K, Usui R, Kobayashi K, Takeuchi W, Shirato H, Tamaki N

  Molecular Imaging for Integrated Medical Therapy and Drug Development 42 - 51 2009 [Not refereed][Not invited]
  
• Real-time tumor-tracking radiotherapy for adrenal tumors

  Norio Katoh, Rikiya Onimaru, Yusuke Sakuhara, Daisuke Abo, Shinichi Shimizu, Hiroshi Taguchi, Yoshiaki Watanabe, Nobuo Shinohara, Masayori Ishikawa, Hiroki Shirato

  RADIOTHERAPY AND ONCOLOGY 87 (3) 418 - 424 0167-8140 2008/06 [Refereed][Not invited]
   

  Purpose: To investigate the three-dimensional movement of internal fiducial markers near the adrenal tumors using a real-time tumor-tracking radiotherapy (RTRT) system and to examine the feasibility of high-dose hypofractionated radiotherapy for the adrenal tumors. Materials and methods: The subjects considered in this study were 10 markers of the 9 patients treated with RTRT. A total of 72 days in the prone position and 61 treatment days in the supine position for nine of the 10 markers were analyzed. All but one patient were prescribed 48 Gy in eight fractions at the isocenter. Results: The average absolute amplitude of the marker movement in the prone position was 6.1 +/- 4.4 mm (range 2.3-14.4), 11.1 +/- 7.1 mm (3.5-25.2), and 7.0 +/- 3.5 mm (3.9-12.5) in the left-right (LR), craniocaudal (CC), and anterior-posterior (AP) directions, respectively. The average absolute amplitude in the supine position was 3.4 +/- 2.9 mm (0.6-9.1), 9.9 +/- 9.8 mm (1.1-27.1), and 5.4 +/- 5.2 mm (1.7-26.6) in the LR, CC, and AP directions, respectively. Of the eight markers, which were examined in both the prone and supine positions, there was no significant difference in the average absolute amplitude between the two positions. No symptomatic adverse effects were observed within the median follow-up period of 16 months (range 5-21 months). The actuarial freedom-from-local-progression rate was 100% at 12 months. Conclusions: Three-dimensional motion of a fiducial marker near the adrenal tumors was detected. Hypofractionated RTRT for adrenal tumors was feasible for patients with metastatic tumors. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
• Three-dimensional intrafractional motion of breast during tangential breast irradiation monitored with high-sampling frequency using a real-time tumor-tracking radiotherapy system

  Rumiko Kinoshita, Shinichi Shimizu, Hiroshi Taguchi, Norio Katoh, Masaharu Fujino, Rikiya Onimaru, Hidefumi Aoyama, Fumi Katoh, Tokuhiko Omatsu, Masayori Ishikawa, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 70 (3) 931 - 934 0360-3016 2008/03 [Refereed][Not invited]
   

  Purpose: To evaluate the three-dimensional intrafraction motion of the breast during tangential breast irradiation using a real-time tracking radiotherapy (RT) system with a high-sampling frequency. Methods and Materials: A total of 17 patients with breast cancer who had received breast conservation RT were included in this study. A 2.0-mm gold marker was placed on the skin near the nipple of the breast for RT. A fluoroscopic real-time tumor-tracking RT system was used to monitor the marker. The range of motion of each patient was calculated in three directions. Results: The mean standard deviation of the range of respiratory motion was 1.0 +/- 0.6 mm (median, 0.9; 95% confidence interval [CI] of the marker position, 0.4-2.6), 1.3 +/- 0.5 mm (median, 1.1; 95 % CI, 0.5-2.5), and 2.6 +/- 1.4 (median, 2.3; 95 % CI, 1.0-6.9) for the right-left, craniocaudal, and anteroposterior direction, respectively. No correlation was found between the range of motion and the body mass index or respiratory function. The mean +/- standard deviation of the absolute value of the baseline shift in the right-left, craniocaudal, and anteroposterior direction was 0.2 +/- 0.2 mm (range, 0.0-0.8 mm), 0.3 +/- 0.2 mm (range, 0.0-0.7 mm), and 0.8 +/- 0.7 mm (range, 0.1-1.8 mm), respectively. Conclusion: Both the range of motion and the baseline shift were within a few millimeters in each direction. As long as the conventional wedge-pair technique and the proper immobilization are used, the intrafraction three-dimensional change in the breast surface did not much influence the dose distribution. (C) 2008 Elsevier Inc.
• Steep dose-response relationship for stage I non-small-cell lung cancer using hypofractionated high-dose irradiation by real-time tumor-tracking radiotherapy

  Rikiya Onimaru, Masaharu Fujino, Koichi Yamazaki, Yuya Onodera, Hiroshi Taguchi, Norio Katoh, Fumihiro Hommura, Satoshi Oizumi, Masaharu Nishimura, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 70 (2) 374 - 381 0360-3016 2008/02 [Refereed][Not invited]
   

  Purpose: To investigate the clinical outcomes of patients with pathologically proven, peripherally located, Stage I non-small-cell lung cancer who had undergone stereotactic body radiotherapy using real-time tumor tracking radiotherapy during the developmental period. Methods and Materials: A total of 41 patients (25 with Stage T1 and 16 with Stage T2) were admitted to the study between February 2000 and June 2005. A 5-mm planning target volume margin was added to the clinical target volume determined with computed tomography at the end of the expiratory phase. The gating window ranged from 2 to 3 rum. The dose fractionation schedule was 40 or 48 Gy in four fractions within 1 week. The dose was prescribed at the center of the planning target volume, giving more than an 80% dose at the planning target volume periphery. Results: For 28 patients treated with 48 Gy in four fractions, the overall actuarial survival rate at 3 years was 82% for those with Stage IA and 32% for those with Stage IB. For patients treated with 40 Gy in four fractions within 1 week, the overall actuarial survival rate at 3 years was 50% for those with Stage IA and 0% for those with Stage IB. A significant difference was found in local control between those with Stage IB who received 40 Gy vs. 48 Gy (p = 0.0015) but not in those with Stage IA (p = 0.5811). No serious radiation morbidity was observed with either dose schedule. Conclusion: The results of our study have shown that 48 Gy in four fractions within 1 week is a safe and effective treatment for peripherally located, Stage IA non-small-cell lung cancer. A steep dose-response curve between 40 and 48 Gy using a daily dose of 12 Gy delivered within 1 week was identified for Stage IB non-small-cell lung cancer in stereotactic body radiotherapy using real-time tumor tracking radiotherapy. (C) 2008 Elsevier Inc.
• Neurocognitive function of patients with brain metastasis who received either whole brain radiotherapy plus stereotactic radiosurgery or radiosurgery alone

  Hidefumi Aoyama, Masao Tago, Norio Kato, Tatsuya Toyoda, Masahiro Kenjyo, Saeko Hirota, Hiroki Shioura, Taisuke Inomata, Etsuo Kunieda, Kazushige Hayakawa, Keiichi Nakagawa, Gen Kobashi, Hiroki Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 68 (5) 1388 - 1395 0360-3016 2007/08 [Refereed][Not invited]
   

  Purpose: To determine how the omission of whole brain radiotherapy (WBRT) affects the neurocognitive function of patients with one to four brain metastases who have been treated with stereotactic radiosurgery (SRS). Methods and Materials: In a prospective randomized trial between WBRT+SRS and SRS alone for patients with one to four brain metastases, we assessed the neurocognitive function using the Mini-Mental State Examination (MMSE). Of the 132 enrolled patients, MMSE scores were available for 110. Results: In the baseline MMSE analyses, statistically significant differences were observed for total tumor volume, extent of tumor edema, age, and Karnofsky performance status. Of the 92 patients who underwent the follow-up MMSE, 39 had a baseline MMSE score of <= 27 (17 in the WBRT+SRS group and 22 in the SRS-alone group). Improvements of <= 3 points in the MMSEs of 9 WBRT+SRS patients and 11 SRS-alone patients (p = 0.85) were observed. Of the 82 patients with a baseline MMSE score of >= 27 or whose baseline MMSE score was >= 26 but had improved to = 27 after the initial brain treatment, the 12-,24-, and 36-month actuarial free rate of the 3-point drop in the MMSE was 76.1%, 68.5 %, and 14.7 % in the WBRT+SRS group and 59.3 %, 51.9 %, and 51.9 % in the SRS-alone group, respectively. The average duration until deterioration was 16.5 months in the WBRT+SRS group and 7.6 months in the SRS-alone group (p = 0.05). Conclusion: The results of the present study have revealed that, for most brain metastatic patients, control of the brain tumor is the most important factor for stabilizing neurocognitive function. However, the long-term adverse effects of WBRT on neurocognitive function might not be negligible. (C) 2007 Elsevier Inc.
• Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases - A randomized controlled trial

  H Aoyama, H Shirato, M Tago, K Nakagawa, T Toyoda, K Hatano, M Kenjyo, N Oya, S Hirota, H Shioura, E Kunieda, T Inomata, K Hayakawa, N Katoh, G Kobashi

  JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION 295 (21) 2483 - 2491 0098-7484 2006/06 [Refereed][Not invited]
   

  Context In patients with brain metastases, it is unclear whether adding up-front whole-brain radiation therapy (WBRT) to stereotactic radiosurgery (SRS) has beneficial effects on mortality or neurologic function compared with SRS alone. Objective To determine if WBRT combined with SRS results in improvements in survival, brain tumor control, functional preservation rate, and frequency of neurologic death. Design, Setting, and Patients Randomized controlled trial of 132 patients with 1 to 4 brain metastases, each less than 3 cm in diameter, enrolled at 11 hospitals in Japan between October 1999 and December 2003. Interventions Patients were randomly assigned to receive WBRT plus SRS ( 65 patients) or SRS alone ( 67 patients). Main Outcome Measures The primary end point was overall survival; secondary end points were brain tumor recurrence, salvage brain treatment, functional preservation, toxic effects of radiation, and cause of death. Results The median survival time and the 1-year actuarial survival rate were 7.5 months and 38.5% (95% confidence interval, 26.7%-50.3%) in the WBRT + SRS group and 8.0 months and 28.4% (95% confidence interval, 17.6%-39.2%) for SRS alone (P=. 42). The 12-month brain tumor recurrence rate was 46.8% in the WBRT + SRS group and 76.4% for SRS alone group ( P <. 001). Salvage brain treatment was less frequently required in the WBRT + SRS group (n = 10) than with SRS alone ( n = 29) ( P <. 001). Death was attributed to neurologic causes in 22.8% of patients in the WBRT + SRS group and in 19.3% of those treated with SRS alone ( P=. 64). There were no significant differences in systemic and neurologic functional preservation and toxic effects of radiation. Conclusions Compared with SRS alone, the use of WBRT plus SRS did not improve survival for patients with 1 to 4 brain metastases, but intracranial relapse occurred considerably more frequently in those who did not receive WBRT. Consequently, salvage treatment is frequently required when up-front WBRT is not used.
• Hypofractionated radiotherapy boost for dose escalation as a treatment option for high-grade spinal cord astrocytic tumor

  N Katoh, H Shirato, H Aoyama, R Onimaru, K Suzuki, K Hida, K Miyasaka, Y Iwasaki

  JOURNAL OF NEURO-ONCOLOGY 78 (1) 63 - 69 0167-594X 2006/05 [Refereed][Not invited]
   

  Purpose: To retrospectively analyze the outcome of post-operative radiotherapy for spinal cord glioma with the emphasis on the hypofractionated radiotherapy boost for dose escalation as a treatment option for high-grade spinal cord astrocytic tumors. Materials & methods: Forty-one patients with spinal cord glioma received post-operative radiotherapy between 1979 and 2003. The median age was 34 years (range, 10-66 years). Median follow-up was 49 months (range, 5-291 months). There were 12 low-grade astrocytic tumors, 11 high-grade astrocytic tumors, 16 low-grade ependymal tumors and 2 high-grade ependymal tumors. Among 11 patients with high-grade astrocytic tumors, 5 with anaplastic astrocytoma and 1 with glioblastoma received hypofractionated radiotherapy boost for dose escalation. The median total dose of the conventional radiotherapy was 45.5 Gy in 19 fractions (range, 30.0-60.0 Gy). The median normalized total dose (using daily dose of 2.0 Gy and an alpha/beta ratio of 2.0) of the hypofractionated radiotherapy boost was 131 Gy(2) (range, 85-249). Results: The Kaplan-Meier survival rates at 10 years from the date of the first surgery were 64% for the entire group, 47% for the astrocytic tumors and 84% for the ependymal tumors, respectively (P=0.009). Among 11 patients with high-grade astrocytic tumors, the actuarial survival rate at 10 years was 35%. The actuarial survival rates at 10 years were 67% for those who received hypofractionated radiotherapy boost for dose escalation, and 20% for those who did not (P=0.47). Discussion: The results for ependymal tumors and low-grade astrocytic tumors were comparable to those reported in the literature. Hypofractionated radiotherapy boost for dose escalation may help to prolong the survival of patients with high-grade astrocytic tumors.
• Speed and amplitude of lung tumor motion precisely detected in four-dimensional setup and in real-time tumor-tracking radiotherapy

  H Shirato, K Suzuki, GC Sharp, K Fujita, R Onimaru, M Fujino, N Kato, Y Osaka, R Kinoshita, H Taguchi, S Onodera, K Miyasaka

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 64 (4) 1229 - 1236 0360-3016 2006/03 [Refereed][Not invited]
   

  Background: To reduce the uncertainty of registration for lung tumors, we have developed a four-dimensional (4D) setup system using a real-time tumor-tracking radiotherapy system. Methods and Materials: During treatment planning and daily setup in the treatment room, the trajectory of the internal fiducial marker was recorded for 1 to 2 min at the rate of 30 times per second by the real-time tumor-tracking radiotherapy system. To maximize gating efficiency, the patient's position on the treatment couch was adjusted using the 4D setup system with fine on-line remote control of the treatment couch. Results: The trajectory of the marker detected in the 4D setup system was well visualized and used for daily setup. Various degrees of interfractional and intrafractional changes in the absolute amplitude and speed of the internal marker were detected. Readjustments were necessary during each treatment session, prompted by baseline shifting of the tumor position. Conclusion: The 4D setup system was shown to be useful for reducing the uncertainty of tumor motion and for increasing the efficiency of gated irradiation. Considering the interfractional and intrafractional changes in speed and amplitude detected in this study, intercepting radiotherapy is the safe and cost-effective method for 4D radiotherapy using real-time tracking technology. (C) 2006 Elsevier Inc.
• 放射線治療効果の向上を目指した新手法開発とその臨床応用 動体追跡照射装置を用いた放射線治療

  鬼丸 力也, 白土 博樹, 藤野 賢治, 田口 大志, 加藤 徳雄, 大坂 康博, 清水 伸一, 青山 英史, 鈴木 恵士郎

  日本放射線影響学会大会講演要旨集 (一社)日本放射線影響学会 48回 75 - 75 1347-8680 2005/11 [Not refereed][Not invited]
  
• Comparison of imaging modalities for the accurate delineation of arteriovenous malformation, with reference to stereotactic radiosurgery

  H Aoyama, H Shirato, N Katoh, K Kudo, T Asano, S Kuroda, T Ishikawa, K Miyasaka

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 62 (4) 1232 - 1238 0360-3016 2005/07 [Refereed][Not invited]
   

  Purpose: To investigate the discrepancy between the arteriovenous malformations seen on magnetic resonance angiography (MRA) and on stereotactic digital subtracted angiography (DSA). Methods and Materials: The target volume on stereotactic DSA (V-DSA) and the target volume on MRA (V,(MRA) rA) were separately delineated in 28 intracranial arteriovenous malformations. The coordinates of the center and the outer edges of V-DSA and V-MRA,A were calculated and used for the analyses. Results: The standard deviations (mean value) of the displacement of centers of V-MRA from V-DSA were 2.67 mm (-1.82 mm) in the left-right direction, 3.23 mm (-0.08 mm) in the anterior-posterior direction, and 2.16 mm (0.91 mm) in the craniocaudal direction. V-MRA covered less than 80% of V-DSA, in any dimensions in 9 cases (32%), although no significant difference was seen in the target volume between each method, with a mean value of 11.9 cc for V-DSA and 12.3 cc for V-MRA (p = 0.948). Conclusion: The shift of centers between each modality is not negligible. Considering no significant difference between V-DSA and V-MRA, but inadequate coverage of the V-DSA by V (MRA), it is reasonable to consider that the target on MRA might include the feeding artery and draining vein and possibly miss a portion of the nidus. (c) 2005 Elsevier Inc.
• Stereotactic irradiation for intracranial arteriovenous malformation using stereotactic radiosurgery or hypofractionated stereotactic radiotherapy

  TC Chang, H Shirato, H Aoyama, S Ushikoshi, N Kato, S Kuroda, T Ishikawa, K Houkin, Y Iwasaki, K Miyasaka

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 60 (3) 861 - 870 0360-3016 2004/11 [Refereed][Not invited]
   

  Purpose: To investigate the appropriateness of the treatment policy of stereotactic irradiation using both hypofractionated stereotactic radiotherapy (HSRT) and stereotactic radiosurgery (SRS) for arteriovenous malformations (AVMs) located in an eloquent region or for large AVMs and using SRS alone for the other AVMs. Methods and Materials: Included in this study were 75 AVMs in 72 patients, with a mean follow-up of 52 months. Of the 75 AVMs, 33 were located in eloquent regions or were >2.5 cm in maximal diameter and were given 25-35 Gy (mean, 32.4 Gy) in four daily fractions at a single isocenter if the patient agreed to prolonged wearing of the stereotactic frame for 5 days. The other 42 AVMs were treated with SRS at a dose of 15-25 Gy (mean, 24.1 Gy) at the isocenter. The 75 AVMs were classified according to the Spetzler-Martin grading system; 21, 23, 28, 2, and 1 AVM were Grade I, II, III, IV, V, and VI, respectively. Results: The overall actuarial rate of obliteration was 43% (95% confidence interval [CI], 30-56%) at 3 years, 72% (95% CI, 58-86%) at 5 years, and 78% (95% CI, 63-93%) at 6 years. The actuarial obliteration rate at 5 years was 79% for the 42 AVMs <2.0 cm and 66% for the 33 AVMs >2 cm. The 5- and 6-year actuarial obliteration rate was 61% (95% Cl, 39-83%) and 71% (95% CI, 47-95%), respectively, after HSRT and 81% (95% CI, 66-96%) and 81% (95% CI, 66-96%), respectively, after SRS; the difference was not statistically significant. Radiation-induced necrosis was observed in 4 subjects in the SRS group and 1 subject in the HSRT group. Cyst formation occurred in 3 patients in the SRS group and no patient in the HSRT group. A permanent symptomatic complication was observed in 3 cases (4.2%), and 1 of the 3 was fatal. All 3 patients were in the SRS group. The annual intracranial hemorrhage rate was 5.5-5.6% for all patients. Conclusion: Our treatment policy using SRS and HSRT was as effective as the policy involving SRS alone. The HSRT schedule was suggested to have a lower frequency of radiation necrosis and cyst formation than the high-dose SRS schedule. The benefit of HSRT compared with lower dose SRS has not yet been determined. (C) 2004 Elsevier Inc.
• Three-dimensional conformal setup (3D-CSU) of patients using the coordinate system provided by three internal fiducial markers and two orthogonal diagnostic X-ray systems in the treatment room

  H Shirato, M Oita, K Fujita, S Shimizu, R Onimaru, S Uegaki, Y Watanabe, N Kato, K Miyasaka

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 60 (2) 607 - 612 0360-3016 2004/10 [Refereed][Not invited]
   

  Purpose: To test the accuracy of a system for correcting for the rotational error of the clinical target volume (CTV) without having to reposition the patient using three fiducial markers and two orthogonal fluoroscopic images. We call this system "three-dimensional conformal setup" (3D-CSU). Methods and Materials: Three 2.0-mm gold markers are inserted into or adjacent to the CTV. On the treatment couch, the actual positions of the three markers are calculated based on two orthogonal fluoroscopies crossing at the isocenter of the linear accelerator. Discrepancy of the actual coordinates of gravity center of three markers from its planned coordinates is calculated. Translational setup error is corrected by adjustment of the treatment couch. The rotation angles (alpha, beta, gamma) of the coordinates of the actual CTV relative to the planned CTV are calculated around the lateral (x), craniocaudal (y), and anteroposterior (z) axes of the planned CTV. The angles of the gantry head, collimator, and treatment couch of the linear accelerator are adjusted according to the rotation of the actual coordinates of the tumor in relation to the planned coordinates. We have measured the accuracy of 3D-CSU using a static cubic phantom. Results: The gravity center of the phantom was corrected within 0.9 +/- 0.3 mm (mean +/- SD), 0.4 +/- 0.2 mm, and 0.6 +/- 0.2 mm for the rotation of the phantom from 0-30 degrees around the x, y, and z axes, respectively, every 5 degrees. Dose distribution was shown to be consistent with the planned dose distribution every 10 degrees of the rotation from 0-30 degrees. The mean rotational error after 3D-CSU was -0.4 +/- 0.4 (mean +/- SD), -0.2 +/- 0.4, and 0.0 +/- 0.5 degrees around the x, y, and z axis, respectively, for the rotation from 0-90 degrees. Conclusions: Phantom studies showed that 3D-CSU is useful for performing rotational correction of the target volume without correcting the position of the patient on the treatment couch. The 3D-CSU will be clinically useful for tumors in structures such as paraspinal diseases and prostate cancers not subject to large internal organ motion. (C) 2004 Elsevier Inc.
• Impact of margin for target volume in low-dose involved field radiotherapy after induction chemotherapy for intracranial germinoma

  H Shirato, H Aoyama, J Ikeda, K Fujieda, N Kato, N Ishi, K Miyasaka, Y Iwasaki, Y Sawamura

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 60 (1) 214 - 217 0360-3016 2004/09 [Refereed][Not invited]
   

  Purpose: We previously published a report stating that germinomas with elevated serum beta human chorionic gonadotropin (HCG-beta) had a poor relapse rate, but these findings have not been supported by a multi-institutional trial. The margin for initial gross tumor volume (GTV) before surgery and chemotherapy of the same materials was investigated by retrospective review. Methods and Material: The 27 patients reported on in the previous paper were analyzed. The two-dimensional margin from the initial GTV to 90% of the prescribed dose of 24 Gy was 2.0 cm for a solitary lesion in the protocol. This margin was measured retrospectively without knowledge of the serum HCG-beta level. The whole ventricle field was used for patients with multifocal disease and whole central nervous system field was used for disseminated disease, respectively. Results: Six relapses were seen in 18 patients with solitary tumors, and were treated with the minimum margin of 1.5 cm or less to the initial GTV. Five of the 6 had initially elevated serum HCG-beta at the median of 7.4 mIU/mL, ranging from 0.7-233 mIU/mL. No relapses were seen in the 9 patients who were treated with whole ventricle or whole central nervous system field. Conclusions: An inadequate margin and elevated serum HCG-beta were equally determined to be candidates that caused the poor local control. The whole ventricle is recommended as the smallest target volume for germinoma with or without elevated HCG-beta after induction chemotherapy. (C) 2004 Elsevier Inc.
• A case of intravascular lymphoma with increased regional cerebral blood flow in I-123 IMP single-photon emission CT

  C Miyazaki, M Mukai, Y Kawaai, M Takeda, N Katoh, S Nagano, K Kubo, M Kohno

  AMERICAN JOURNAL OF NEURORADIOLOGY 25 (4) 565 - 570 0195-6108 2004/04 [Refereed][Not invited]
   

  This report documents a case of intravascular lymphoma (IVL) with increased regional cerebral blood flow (rCBF) disclosed at I-123 IMP single-photon emission CT (IMP-SPECT). A 73-year-old woman with IVL had high rCBF disclosed by IMP-SPECT before chemotherapy; rCBF was normal after one course of CHOP (cyclophophamide, vincristine, doxorubicin, and prednisone) chemotherapy. During her clinical course, she had an episode in which she showed increased rCBF in the left cerebral hemisphere at IMP-SPECT performed immediately after the recovery from the right hemiparesis.

MISC

• 膵癌に対する動体追跡放射線治療用の経皮的あるいは経動脈的マーカー留置術の検討

  加藤 大祐, 阿保 大介, 森田 亮, 打浪 雄介, 加藤 徳雄, 山田 亮太, 木野田 直也, 藤井 宝顕, 山崎 康之, 高柳 歩, 青山 英史, 工藤 與亮  日本インターベンショナルラジオロジー学会雑誌  39-  (Suppl.)  191  -191  2024/04
• 体幹部定位放射線治療時の呼気止め分割CBCTにおける呼吸再現性と輪郭の評価

  山田 亮太, 吉村 高明, 一宇 佑太, 若林 倭, 松尾 勇斗, 孫田 惠一, 加藤 徳雄  日本放射線技術学会総会学術大会予稿集  79回-  190  -190  2023/03
• 内科・外科による消化器病共同診療の現況と展望 当科における切除可能境界膵癌に対する術前治療の現状

  原田 一顕, 中村 赳晶, 渡辺 亮介, 山村 貴洋, 川本 泰之, 結城 敏志, 桑谷 将城, 田口 大志, 加藤 徳雄, 浅野 賢道, 中村 透, 平野 聡, 小松 嘉人, 坂本 直哉  日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集  131回・125回-  28  -28  2022/09
• 汎用リニアックを用いた膵定位放射線治療における呼気止め分割CBCT

  一宇 佑太, 山田 亮太, 安渡 大輔, 田村 弘詞, 若林 倭, 加藤 徳雄, 青山 英史  日本放射線技術学会雑誌  78-  (9)  1057  -1057  2022/09
• 免疫チェックポイント阻害薬と放射線治療—Clinical evidences for the combination of immune checkpoint inhibitor and radiation therapy—特集 がん免疫療法の展望 : 免疫チェックポイント阻害薬の併用療法に中心に ; 免疫チェックポイント阻害薬の併用療法のエビデンス

  安田 耕一, 志藤 元泰, 小泉 富基, 高橋 周平, 藤田 祥博, 大塚 愛美, 宮﨑 智彦, 西川 昇, 打浪 雄介, 森 崇, 西岡 健太郎, 木下 留美子, 田口 大志, 加藤 徳雄, 橋本 孝之, 青山 英史  腫瘍内科 = Clinical oncology / 腫瘍内科編集委員会 編  30-  (1)  23  -28  2022/07
• 再照射 小児がんに対する陽子線再照射

  橋本 孝之, 森 崇, 西岡 健太郎, 打浪 雄介, 安田 耕一, 木下 留美子, 田口 大志, 加藤 徳雄, 清水 伸一, 青山 英史  日本小児血液・がん学会雑誌  58-  (2)  89  -93  2021/08  

  陽子線治療は通常のX線による放射線治療に比べて線量集中性に優れ,標的への線量を保ったまま周囲の正常組織線量を低減することで,小児がん患者の急性期並びに晩期有害事象の軽減が可能である.2016年4月からは20歳未満の限局性固形悪性腫瘍に対する根治的な陽子線照射が保険適応となり,各施設で小児がんの陽子線治療実施件数が増加傾向にある.局所領域再発に対する再照射は,腫瘍進行抑制・症状緩和と,時に治癒や長期の腫瘍制御による健康状態・QOLの維持をもたらす可能性がある.小児患者に対する再照射における重要臓器・器官の累積耐容線量や安全性は確立していないが,中枢神経腫瘍に対する陽子線再照射により,有害事象の発生を抑えた良好な治療成績が報告されている.今後,小児がん再発の治療選択肢における陽子線再照射の有用性については,前向き臨床試験での評価が必要と考える.(著者抄録)
• Propensity scoreを用いた解析によるvp3、4肝細胞癌の門脈腫瘍栓に対する術前放射線治療の有効性の検討

  柿坂 達彦, 神山 俊哉, 折茂 達也, 長津 明久, 旭 よう, 坂本 譲, 蒲池 浩文, 加藤 徳雄, 畑中 佳奈子, 武冨 紹信  日本外科学会定期学術集会抄録集  121回-  SF  -3  2021/04
• 尿量の経日変化および前立腺体積が放射線治療時の前立腺の位置に与える影響(The Impact of Daily Urinary Volume Variations and Prostate Volume on Prostate Position During Radiotherapy)

  Nishioka Kentaro, Hashimoto Takayuki, Yokota Isao, Katoh Norio, Kinoshita Rumiko, Yasuda Koichi, Takao Seishin, Yoshimura Takaaki, Aoyama Hidefumi, Shimizu Shinichi  日本医学放射線学会学術集会抄録集  80回-  S193  -S194  2021/03
• SMARCB1欠損篩骨洞癌に対する強度変調陽子線治療 症例報告と文献レビュー

  宮崎 智彦, 安田 耕一, 志藤 元泰, 小泉 富基, 藤田 祥博, 高橋 周平, 湊川 英樹, 大塚 愛美, 加藤 徳雄, 清水 伸一, 青山 英史  北海道放射線医学雑誌  1-  1  -6  2021/03  

  近年、腫瘍抑制遺伝子の一つであるSMARCB1を欠損した腫瘍の存在が頭頸部領域でも知られるようになったが、希少な亜型であるため臨床上の特徴についてはまだ不明な点が多い。今回、SMARCB1欠損を伴う篩骨洞癌に対して強度変調陽子線治療(IMPT)を施行した1例を報告する。患者は40代女性で、左眼の視力低下をきっかけに副鼻腔腫瘍を指摘され当院に紹介となった。各種画像検査にて前頭蓋底と左視神経への浸潤が疑われた。腫瘍生検でSMARCB1欠損を認め、SMARCB1欠損篩骨洞癌、cT4bN0M0、stageIVB(UICC 8th)の診断となった。治療はIMPT単独の方針となり、65Gy(RBE)/26frの治療が実施された。治療効果は良好で、治療後3年6ヵ月経過した時点において完全寛解を維持している。過去の文献からは2年生存率は58%と推定された。SMARCB1欠損副鼻腔癌に対する放射線治療の報告は限られており、陽子線治療症例については我々の調べる限りでは今回が最初の報告となる。(著者抄録)
• Proton beam therapy for reirradiation in pediatric cancer

  橋本孝之, 森崇, 西岡健太郎, 打浪雄介, 安田耕一, 木下留美子, 田口大志, 加藤徳雄, 清水伸一, 青山英史  日本小児血液・がん学会雑誌(Web)  58-  (2)  2021
• 肝細胞癌陽子線治療前MRIにおけるばらつきの小さいADC値指標の検討:治療効果予測に向けた前段階の研究

  藤田祥博, 加藤徳雄, 田口大志, 打浪雄介, 西岡健太郎, 森崇, 湊川英樹, 安田耕一, 清水伸一, 青山英史  日本放射線腫瘍学会高精度放射線外部照射部会学術大会プログラム・抄録集  34th-  2021
• Conversion surgery for locally advanced unresectable pancreatic cancer treated with proton beam therapy combined with S-1 chemotherapy: a case report and literature review

  小泉富基, 加藤徳雄, 中村透, 川本泰之, 高尾聖心, 阿保大介, 清水伸一, 清水伸一, 青山英史  臨床放射線  66-  (8)  2021  [Refereed][Not invited]
  
• 動体追跡陽子線照射における気管支内視鏡的放射線治療用マーカー留置術の検討

  伊藤 祥太郎, 品川 尚文, 高島 雄太, 國崎 守, 古田 恵, 水柿 秀紀, 朝比奈 肇, 菊地 英毅, 菊地 順子, 榊原 純, 加藤 徳雄, 田口 大志, 青山 英史, 今野 哲  気管支学  42-  (6)  576  -576  2020/11
• 膵癌に対するS-1併用術前化学放射線療法(S-1併用NACRT)の治療成績

  小泉 富基, 加藤 徳雄, 中村 透, 川本 泰之, 田口 大志, 打浪 雄介, 清水 伸一, 青山 英史  日本医学放射線学会秋季臨床大会抄録集  56回-  S103  -S103  2020/10
• 画像誘導治療の今後について 画像誘導陽子線治療の将来展望

  田口 大志, 橋本 孝之, 加藤 徳雄, 木下 留美子, 安田 耕一, 西岡 健太郎, 森 崇, 打浪 雄介, 宮本 直樹, 高尾 聖心, 清水 伸一, 青山 英史  日本癌治療学会学術集会抄録集  58回-  SY14  -3  2020/10
• 動体追跡陽子線照射における気管支内視鏡的放射線治療用マーカー留置術の検討

  伊藤 祥太郎, 品川 尚文, 高島 雄太, 國崎 守, 古田 恵, 水柿 秀紀, 朝比奈 肇, 菊地 英毅, 菊地 順子, 榊原 純, 加藤 徳雄, 田口 大志, 青山 英史, 今野 哲  気管支学  42-  (Suppl.)  S277  -S277  2020/06
• 画像誘導陽子線治療の将来展望

  田口大志, 橋本孝之, 橋本孝之, 加藤徳雄, 木下留美子, 安田耕一, 西岡健太郎, 西岡健太郎, 森崇, 打浪雄介, 宮本直樹, 高尾聖心, 清水伸一, 清水伸一, 青山英史  日本癌治療学会学術集会(Web)  58th-  2020
• 局所進行食道癌に対してspot scanning法による根治的化学陽子線療法を施行した一例

  宮崎 智彦, 打浪 雄介, 田口 大志, 加藤 徳雄, 清水 伸一, 白土 博樹, 中積 宏之, 中野 真太郎, 坂本 直哉, 高尾 聖心, 田村 昌也, 松浦 妙子  日本医学放射線学会秋季臨床大会抄録集  55回-  S520  -S520  2019/09
• Initial Clinical Outcomes of Real-Time-Image Gated Spot-Scanning Proton Beam Therapy for Hepatocellular Carcinomas

  N. Katoh, Y. Uchinami, D. Abo, S. Takao, T. Inoue, H. Taguchi, R. Morita, T. Soyama, T. Hashimoto, R. Onimaru, A. Prayongrat, M. Tamura, T. Matsuura, S. Shimizu, H. Shirato  International Journal of Radiation Oncology*Biology*Physics  105-  (1)  E222  -E223  2019/09
• 局所進行食道癌に対してspot scanning法による根治的化学陽子線療法を施行した一例

  宮崎 智彦, 打浪 雄介, 田口 大志, 加藤 徳雄, 清水 伸一, 白土 博樹, 中積 宏之, 中野 真太郎, 坂本 直哉, 高尾 聖心, 田村 昌也, 松浦 妙子  日本医学放射線学会秋季臨床大会抄録集  55回-  S520  -S520  2019/09  [Not refereed][Not invited]
  
• Big Data Analysis of Treatment Process Time for the Real-Time-Image Gated-Spot-Scanning Proton-Beam Therapy (RGPT) System

  T. Yoshimura, S. Shimizu, T. Hashimoto, N. Katoh, T. Inoue, K. Nishioka, T. Matsuura, S. Takao, M. Tamura, H. Tamura, K. Horita, K. Umegaki, H. Shirato  International Journal of Radiation Oncology*Biology*Physics  102-  (3)  e501  -e502  2018/11
• Uncertainties of Normal Tissue Complication Probability (NTCP) and NTCP Difference between Radiation Treatment Modalities for Radiation-Induced Liver Toxicity in Child-Pugh A Primary Liver Cancer Patients

  A. Prayongrat, K. Kobashi, Y. Ito, N. Katoh, Y. Dekura, N. Amornwichet, S. Shimizu, H. Shirato  International Journal of Radiation Oncology*Biology*Physics  102-  (3)  e65  -e66  2018/11
• Analysis of Beam Delivery Times and Dose Rates for the Treatment of Mobile Tumors Using Real Time Image Gated Spot-Scanning Proton Beam Therapy

  S. Shimizu, T. Yoshimura, N. Katoh, T. Inoue, T. Hashimoto, K. Nishioka, S. Takao, T. Matsuura, N. Miyamoto, Y.M. Ito, K. Umegaki, H. Shirato  International Journal of Radiation Oncology*Biology*Physics  102-  (3)  S182  -S183  2018/11
• 乳癌眼窩尖部転移により視力低下をきたし,放射線治療により著明な改善を認めた1例

  湊川英樹, 安田耕一, 打浪雄介, 白土博樹, 土屋和彦, 加藤徳雄, 木下留美子, 石田直子, 山下啓子, 石嶋漢  Japanese Journal of Radiology  36-  (Supplement)  11  -11  2018/02/25  [Not refereed][Not invited]
  
• 乳癌眼窩尖部転移により視力低下をきたし、放射線治療により著明な改善を認めた1例

  湊川 英樹, 安田 耕一, 打浪 雄介, 白土 博樹, 土屋 和彦, 加藤 徳雄, 木下 留美子, 石田 直子, 山下 啓子, 石嶋 漢  Japanese Journal of Radiology  36-  (Suppl.)  11  -11  2018/02  [Not refereed][Not invited]
  
• 放射線治療における数値指標の医学物理的利用

  清水伸一, 小橋啓司, 伊藤陽一, PRAYONGRAT Anussara, 加藤徳雄, 安田耕一, 出倉康裕, 木元拓也, 白土博樹  日本放射線腫瘍学会高精度放射線外部照射部会学術大会プログラム・抄録集  31st (CD-ROM)-  39  2018  [Not refereed][Not invited]
  
• An Organ Motion and Acute Toxicity Study of Image-Guided Spot-Scanning Proton Beam Therapy With An Internal Fiducial Marker for Pancreatic Cancers.

  Y. Uchinami, N. Katoh, D. Abo, K. Harada, Y. Nishikawa, T. Inoue, T. Hashimoto, R. Onimaru, N. Miyamoto, Y. Sakuhara, S. Shimizu, H. Shirato  International Journal of Radiation Oncology*Biology*Physics  99-  (2)  E194  -E194  2017/10  [Refereed][Not invited]
  
• Analysis of Threshold Doses for Radiation Induced Liver Parenchymal Changes on MRI after Real Time–Image Gated Spot-Scanning Proton Beam Therapy of Hepatocellular Carcinomas

  N. Katoh, Y. Uchinami, S. Takao, K. Yasuda, K. Harada, T. Inoue, T. Matsuura, T. Hashimoto, S. Shimizu, H. Shirato  International Journal of Radiation Oncology*Biology*Physics  99-  (2)  E159  -E160  2017/10  [Refereed][Not invited]
  
• Can F-18-fluoromisonidazole PET/CT Predict the Clinical Outcome for Stage I Non-small Cell Lung Cancer Treated By Stereotactic Body Radiation Therapy?

  T. Inoue, S. Watanabe, K. Harada, K. Yasuda, N. Katoh, S. Okamoto, T. Shiga, Y. Kuge, N. Tamaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  99-  (2)  E466  -E466  2017/10  [Not refereed][Not invited]
  
• 肝腫瘍に対する動態追跡照射のための経皮的マーカ留置

  森田亮, 曽山武士, 阿保大介, 作原祐介, 工藤與亮, 加藤徳雄, 白土博樹  IVR  32-  (2)  161  -161  2017/07/10  [Not refereed][Not invited]
  
• 【悪性脊椎脊髄腫瘍に対する治療】 原発性悪性脊椎脊髄腫瘍に対する放射線治療

  鬼丸 力也, 森 崇, 加藤 徳雄, 関 俊隆, 白土 博樹  脊椎脊髄ジャーナル  30-  (7)  673  -676  2017/07  [Not refereed][Not invited]
  
• 肝腫瘍に対する動態追跡照射のための経皮的マーカ留置

  森田 亮, 曽山 武士, 阿保 大介, 作原 祐介, 工藤 與亮, 加藤 徳雄, 白土 博樹  IVR: Interventional Radiology  32-  (2)  161  -161  2017/07  [Not refereed][Not invited]
  
• 肝細胞癌の陽子線治療

  加藤徳雄  月刊メディカル・サイエンス・ダイジェスト  43-  (7)  324‐327  2017/06/30  [Not refereed][Not invited]
  
• 甲状腺癌分化癌の骨転移に対するIMRTを含めた外照射の治療成績

  安田 耕一, 加藤 徳雄, 岡本 祥三, 木下 留美子, 志賀 哲, 水町 貴諭, 畠山 博充, 本間 明宏, 田口 純, 清水 康, 森 崇, 土屋 和彦, 白土 博樹  頭頸部癌  43-  (2)  221  -221  2017/05  [Not refereed][Not invited]
  
• Stereotactic body radiation therapy (SBRT) and proton beam therapy (PBT) for hepatocellular carcinoma (HCC)

  加藤 徳雄  臨床放射線  62-  (4)  521  -528  2017/04  [Not refereed][Not invited]
  
• 肝腫瘍に対する動態追跡照射のための経皮的マーカ留置(Percutaneous hepatic fiducial marker implantation for Real-time Tumor-tracking Radiotherapy(RTRT))

  森田 亮, 作原 祐介, 曽山 武士, 阿保 大介, 加藤 徳雄, 工藤 與亮, 白土 博樹  IVR: Interventional Radiology  32-  (Suppl.)  173  -173  2017/04  [Not refereed][Not invited]
  
• Analysis of Durations and Dose Rates for Treatment of Moving Liver Tumors Using Real-Time Image Gated Spot Scanning Proton Beam Therapy

  S. Shimizu, N. Katoh, T. Hashimoto, K. Nishioka, T. Yoshimura, S. Takao, T. Matsuura, N. Miyamoto, K. Umegaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  96-  (2)  S211  -S212  2016/10  [Not refereed][Not invited]
  
• Stereotactic Body Radiation Therapy Using a Real-time Tumor-Tracking Radiation Therapy System for Hepatocellular Carcinomas

  Y. Uchinami, N. Katoh, D. Abo, K. Harada, T. Inoue, H. Taguchi, R. Onimaru, S. Shimizu, Y. Sakuhara, K. Ogawa, T. Kamiyama, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  96-  (2)  E155  -E155  2016/10  [Not refereed][Not invited]
  
• Simulation Study of Real-Time-Image Gating On Spot Scanning Proton Therapy for Lung Tumors

  T. Kanehira, T. Matsuura, S. Takao, Y. Matsuzaki, Y. Fujii, T. Fujii, N. Miyamoto, T. Inoue, N. Katoh, S. Shimizu, K. Umegaki, H. Shirato  MEDICAL PHYSICS  43-  (6)  2016/06  [Not refereed][Not invited]
  
• Dosimetric Comparison of Spot-Scanning Proton Therapy Techniques for Liver Tumors Close to the Skin Surface

  S. Takao, T. Matsuura, Y. Matsuzaki, Y. Fujii, T. Fujii, N. Katoh, S. Shimizu, K. Umegaki, H. Shirato  MEDICAL PHYSICS  43-  (6)  3505  -3505  2016/06  [Not refereed][Not invited]
  
• Clinical application for molecular imaging(Therapy) 分子イメージングを用いた放射線治療

  安田 耕一, 岡本 祥三, 西川 由記子, 伊藤 陽一, 志賀 哲, 井上 哲也, 森 崇, 豊永 拓哉, 鬼丸 力也, 渡邊 史郎, 土屋 和彦, 竹内 渉, 加藤 徳雄, 久下 裕司, 玉木 長良, 白土 博樹  JSMI Report  9-  (2)  83  -83  2016/04  [Not refereed][Not invited]
  
• Treatment Time and Dose Rate Analysis for Respiratory Moving Liver Tumor Using Real-time-image Gated Spot Scanning Proton Beam Therapy System

  SHIMIZU Shinichi, KATOH Norio, TAKAO Seishin, MATSUURA Taeko, MIYAMOTO Naoki, HASHIMOTO Takayuki, NISHIOKA Kentaro, YOSHIMURA Takaaki, UMEGAKI Kikuo, SHIRATO Hiroki  日本医学放射線学会総会抄録集  75th-  S225  -S225  2016/02/29  [Not refereed][Not invited]
  
• 照射中と4DCT撮像時の肺内マーカー移動の比較

  原田慶一, 加藤徳雄, 井上哲也, 鬼丸力也, 清水伸一, 白土博樹, 鈴木隆介, 宮本直樹, 石川正純  Japanese Journal of Radiology  34-  (Supplement)  10  -10  2016/02/25  [Not refereed][Not invited]
  
• 【呼吸性移動対策の今後-光子線治療から粒子線治療まで-】 次世代型動体追跡放射線治療システムの臨床応用と今後の展望

  宮本 直樹, 石川 正純, 井上 哲也, 加藤 徳雄, 清水 伸一, 鬼丸 力也, 白土 博樹  臨床放射線  61-  (2)  293  -302  2016/02  [Not refereed][Not invited]
  
• 呼吸性移動の複雑さと対策:最新の動体追跡放射線治療

  宮本直樹, 高尾聖心, 原田慶一, 石川正純, 鈴木隆介, 松浦妙子, 牧永彩乃, 井上哲也, 加藤徳雄, 清水伸一, 鬼丸力也, 白土博樹  日本放射線腫瘍学会高精度放射線外部照射部会学術大会プログラム・抄録集  29th-  46  2016  [Not refereed][Not invited]
  
• 食道癌術後/化学放射線療法後再発に対する化学放射線療法の成績

  井上哲也, 原田慶一, 加藤徳雄, 清水伸一, 白土博樹, 中積宏之, 福島拓, 小松嘉人, 海老原裕磨, 七戸俊明  北海道医学雑誌  90-  (2)  153‐154  -154  2015/11/01  [Not refereed][Not invited]
  
• The Voxel-based Analysis of FMISO-PET Image in Patients With Local Recurrence of Nasopharyngeal Carcinoma

  Y. Nishikawa, K. Yasuda, S. Okamoto, Y. M. Ito, T. Mori, R. Onimaru, T. Shiga, K. Tsuchiya, S. Watanabe, W. Takeuchi, N. Katoh, Y. Kuge, N. Tamaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  93-  (3)  E337  -E337  2015/11  [Not refereed][Not invited]
  
• Respiration-gated F-18-fluoromisonidazole PET/CT for Stage I Non-Small Cell Lung Cancer Treated by Stereotactic Body Radiation Therapy

  T. Inoue, S. Okamoto, S. Watanabe, K. Yasuda, N. Katoh, K. Harada, R. Onimaru, T. Shiga, N. Tamaki, Y. Kuge, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  93-  (3)  E390  -E391  2015/11  [Not refereed][Not invited]
  
• Target Residual Motion During Beam Delivery in Gated Irradiation Using Real Time Tumor Tracking Radiation Therapy System: Analysis of Simultaneous Motion of Multiple Internal Fiducial Markers

  N. Miyamoto, M. Ishikawa, R. Suzuki, A. Makinaga, T. Matsuura, S. Takao, Y. Matsuzaki, T. Inoue, N. Katoh, S. Shimizu, R. Onimaru, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  93-  (3)  E554  -E554  2015/11  [Not refereed][Not invited]
  
• Development of a Real-Time Image Gated Proton Beam Therapy (RGPT) System and Its Initial Clinical Application to Respiratory Moving Liver Tumors

  S. Shimizu, N. Katoh, S. Takao, T. Matsuura, N. Miyamoto, T. Hashimoto, K. Nishioka, T. Yoshimura, Y. Matsuzaki, R. Kinoshita, Y. Nishikawa, R. Onimaru, K. Umegaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  93-  (3)  S42  -S42  2015/11  [Not refereed][Not invited]
  
• Clinical analysis of 27 patients with malignant pleural mesothelioma treated at our institution

  Hajime Kikuchi, Hajime Asahina, Jun Sakakibara-Konishi, Naofumi Shinagawa, Satoshi Oizumi, Yasuhiro Hida, Kichizo Kaga, Tetsuya Inoue, Norio Katoh, Masaharu Nishimura  Japanese Journal of Lung Cancer  55-  (1)  2  -8  2015/02/20  [Not refereed][Not invited]
   

  © 2015 The Japan Lung Cancer Society. Objective. We reviewed the clinical outcomes of patients with malignant pleural mesothelioma (MPM) treated at our institution. Methods. We conducted a retrospective analysis of 27 patients with MPM treated at our institution in the period from April 2005 to April 2013. Results. The patient characteristics were as follows: male/female = 26/1; age = 35-76 years (median, 62); histology: epithelioid/biphasic/sarcomatoid = 23/2/2; location, right/left = 14/13; clinical stage (IMIG) IA/IB/II/III/IV = 3/5/4/9/6. The initial treatment was surgery/ chemotherapy/best supportive care in 15/11/1 cases, including 14 patients treated with extrapleural pneumonectomy (EPP) and one patient treated with tumor resection. After EPP, three patients received adjuvant chemotherapy, five received hemithoracic radiotherapy (H-RT) and two received both. The median survival time (MST) of all patients was 21.8 months overall, compared to 30.7 months in the patients who received EPP. The patients who received H-RT after EPP demonstrated a significantly longer MST than those who did not (37.3 months vs. 12.0 months; p = 0.04). Conclusions. The use of H-RT after EPP is associated with a better prognosis.
• 4DCTを用いた肺内マーカー移動の解析

  加藤 徳雄, 原田 慶一, 鈴木 隆介, 井上 哲也, 鬼丸 力也, 清水 伸一, 宮本 直樹, 白土 博樹  Japanese Journal of Radiology  33-  (Suppl.)  5  -5  2015/02  [Not refereed][Not invited]
  
• 放射線治療のいま : 各がん腫におけるエビデンスと標準治療(5)体幹部定位放射線治療

  加藤 徳雄  臨床腫瘍プラクティス  11-  (3)  251  -254  2015  [Not refereed][Not invited]
  
• 局所進行食道癌に対する強度変調放射線治療を用いた放射線化学療法の経験

  井上哲也, 加藤徳雄, 清水伸一, 白土博樹, 鈴木隆介, 佐々木尚英, 福島拓, 小松嘉人  北海道外科雑誌  59-  (2)  206  -206  2014/12/20  [Not refereed][Not invited]
  
• 【放射線治療活用BOOK 2014】 (DIVISION-3)これからの放射線治療の展望 最新の動体追跡放射線治療装置

  宮本 直樹, 石川 正純, 松浦 妙子, 井上 哲也, 加藤 徳雄, 清水 伸一, 鬼丸 力也, 梅垣 菊男, 白土 博樹  Rad Fan  12-  (15)  75  -77  2014/12  [Not refereed][Not invited]
   

  動体追跡法は、日本が世界に先駆けて実現してきた治療法であり、多くの実績を有する。本稿では、最新の迎撃照射型動体追跡装置として、島津製作所からリリースされたX線治療用動体追跡装置「SyncTraX」、日立製作所からリリースされた動体追跡陽子線スポットスキャニングシステム「PROBEAT-RT」について、その特徴と利点を紹介する。(著者抄録)
• Japanese Multi-institutional Study of Stereotactic Body Radiation Therapy For Renal and Adrenal Tumors

  N. Katoh, H. Onishi, H. Matsushita, T. Nomiya, K. Nakata, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  90-  S467  -S467  2014/09  [Not refereed][Not invited]
  
• Naming rule for radiation therapy

  安田耕一, 土屋和彦, 井上哲也, 西岡健太郎, 原田慶一, 西川由記子, 鬼丸力也, 清水伸一, 加藤徳雄, 木下留美子, 小野寺俊介, 白土博樹, 鈴木隆介, 藤田勝久, 辻真太郎, 山崎理衣  Jpn J Radiol  32-  (Supplement)  7  -7  2014/02/25  [Not refereed][Not invited]
  
• 【高精度放射線治療における呼吸性移動対策のコツとピットフォール】 RTRTによる呼吸性移動対策 有用性と今後の展望

  宮本 直樹, 石川 正純, 井上 哲也, 加藤 徳雄, 清水 伸一, 鬼丸 力也, 白土 博樹  Rad Fan  12-  (3)  70  -73  2014/02  [Not refereed][Not invited]
   

  RTRTは、X線透視装置と治療装置を組み合わせた治療システムにより、体内マーカーを利用した待ち伏せ照射をすることで、呼吸性移動対策を実現している。これまでの長きにわたり、臨床的な成績はもちろん、呼吸性移動に関する様々な知見が得られた。また、昨春に次世代型のRTRTシステムがリリースされ、今後のさらなる発展と普及が期待される。(著者抄録)
• 局所進行食道癌に対する通常照射と強度変調放射線治療を組み合わせた放射線化学療法

  井上哲也, 加藤徳雄, 清水伸一, 白土博樹, 鈴木隆介, 佐々木尚英, 福島拓, 小松嘉人  北海道外科雑誌  58-  (2)  112  -216  2013/12/20  [Not refereed][Not invited]
  
• 当院における悪性胸膜中皮腫27例の検討

  菊池 創, 朝比奈 肇, 北井 秀典, 池澤 靖元, 高階 太一, 品川 尚文, 榊原 純, 大泉 聡史, 西村 正治, 樋田 泰浩, 加賀 基知三, 井上 哲也, 加藤 徳雄  肺癌  53-  (7)  918  -918  2013/12  [Not refereed][Not invited]
  
• 当院における悪性胸膜中皮腫27例の検討

  菊池創, 朝比奈肇, 北井秀典, 池澤靖元, 高階太一, 品川尚文, 榊原純, 大泉聡史, 西村正治, 樋田泰浩, 加賀基知三, 井上哲也, 加藤徳雄  肺癌(Web)  53-  (7)  918(J-STAGE)  -918  2013/12  [Not refereed][Not invited]
  
• A Retrospective Multicenter Study of Stereotactic Body Radiation Therapy Using a Real-Time Tumor-Tracking Radiation Therapy System for Stage I Non-Small Cell Lung Cancer

  N. Katoh, I. Soda, H. Tamamura, S. Takahashi, T. Inoue, R. Onimaru, K. Shibuya, K. Hayakawa, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  87-  (2)  S507  -S507  2013/10  [Not refereed][Not invited]
  
• 当院における悪性胸膜中皮腫27例の検討

  菊池創, 朝比奈肇, 北井秀典, 池澤靖元, 高階太一, 品川尚文, 榊原純, 大泉聡史, 樋田泰浩, 加賀基知三, 井上哲也, 加藤徳雄, 西村正治  日本肺癌学会総会号  53-  (5)  382  -382  2013/10  [Not refereed][Not invited]
  
• Safety, Stability, and Location of Implantation of Multiple Gold Markers Into the Soft Bladder Wall by Rigid Cystoscopy

  K. Nishioka, S. Shimizu, R. Onimaru, R. Kinoshita, N. Kato, K. Harada, T. Abe, S. Maruyama, N. Shinohara, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  87-  (2)  S397  -S397  2013/10  [Refereed][Not invited]
  
• SU‐E‐J‐57: A Feasibility Study On Molecular‐Imaging‐Based Real‐Time Tumor Tracking for Gated Radiotherapy

  M. Ishikawa, S. Tanabe, S. Yamaguchi, N. Ukon, T. Yamanaka, K. Sutherland, N. Miyamoto, R. Suzuki, N. Katoh, K. Yasuda, H. Shirato  Medical Physics  40-  (6)  162  2013/06  [Not refereed][Not invited]
   

  Purpose: Molecular imaging is one of the important modalities in delineating tumors particularly in radiotherapy treatment planning. If the real‐time tumor position can be detected using molecular imaging during radiotherapy, it may be helpful for gated irradiation. A feasibility study on a beam gating system for radiotherapy using real‐time molecular imaging was conducted by the prototype and simulating a parallel plane PET system. Methods: Assuming that the motion of the positron source is constrained to the central plane, the source position can be calculated from a cross point of the Line of Response (LOR) and the central plane between detector surfaces. If a positron source is located at the ISO center, distribution of the cross points might be blurred due to random/scattered coincidence. Center Located Ratio (CLR) was defined as a ratio of LORs passing through the ISO center divided by the entire LORs. When dislocation for perpendicular direction is occurred, a distribution of cross points will be spread out and associated decrease of CLR value will be expected. Results: The behavior between real measurement and simulation was similar on proto‐type experiments, however, the Result from simulation for demonstrator might be different from actual measurement. RTRT system recognizes the position of a gold marker in the rate of 30 fps using two X‐ray television systems. It is shown that 15,000 events per second will be needed for an appropriate gating irradiation to recognize discrepancy over 2mm of time resolution in the parallel plane PET system demonstrator. Conclusion: A feasibility study was carried out to verify the potential for gating irradiation of tumors with real‐time molecular imaging using a parallel plane PET system. For an parallel plane PET system demonstrator, the possibility of detecting the tumor position with an accuracy of 2 mm from the ISO center with 500 events. This research was a part of the “Innovation COE Program for Future Drug Discovery and Medical Care” project and partially supported by the Grant‐in‐Aid for Project for Developing Innovation Systems of the Japanese Ministry of Education, Culture, Sports, Science and Technology. © 2013, American Association of Physicists in Medicine. All rights reserved.
• 北海道大学病院における上咽頭癌の治療 10年間(2000〜2010)のまとめ

  土屋 和彦, 安田 耕一, 西川 由記子, 木下 留美子, 鬼丸 力也, 原田 慶一, 井上 哲也, 加藤 徳雄, 清水 伸一, 白土 博樹, 西岡 健, 鈴木 恵士郎, 田口 大志, 長谷川 雅一, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 福田 諭, 竹内 啓, 田口 純  耳鼻咽喉科展望  56-  (補冊2)  174  -175  2013/05  [Not refereed][Not invited]
  
• 原発性肺癌に対する動体追跡照射を用いた体幹部定位放射線治療

  井上哲也, 加藤徳雄, 鬼丸力也, 榊原純, 品川尚文, 大泉聡史, 鈴木隆介, 白土博樹  日本医学放射線学会総会抄録集  72nd-  S271  -S271  2013/02/28  [Not refereed][Not invited]
  
• 照射前FMISO‐PETの集積部位と照射後再発の位置関係

  YASUDA KOICHI, TSUCHIYA KAZUHIKO, OKAMOTO SHOZO, ONIMARU RIKIYA, SHIGA SATORU, KATO NORIO, HARADA KEIICHI, KUGE YUJI, TAMAKI NAGARA, SHIRATO HIROKI  日本医学放射線学会総会抄録集  72nd-  S381-S382  -S382  2013/02/28  [Not refereed][Not invited]
  
• 肝臓への放射線治療用病変識別マーカー留置

  作原 祐介, 阿保 大介, 加藤 徳雄, 田口 大志, 曽山 武士, 白土 博樹  日本医学放射線学会学術集会抄録集  72回-  S310  -S310  2013/02  [Not refereed][Not invited]
  
• Stereotactic Body Radiation Therapy Using Gated Radiation Therapy With Real-time Tumor-tracking for Stage I Non-small Cell Lung Cancer

  T. Inoue, N. Katoh, R. Onimaru, R. Suzuki, J. Sakakibara-Konishi, N. Shinagawa, S. Oizumi, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  84-  (3)  S559  -S559  2012/11  [Not refereed][Not invited]
  
• 低酸素イメージングと放射線治療(Hypoxia imaging and Radiation therapy)

  安田 耕一, 鬼丸 力也, 岡本 祥三, 志賀 哲, 加藤 徳雄, 玉木 長良, 白土 博樹  日本癌学会総会記事  71回-  84  -85  2012/08  [Not refereed][Not invited]
  
• リンフォーマの画像診断と新規治療のプラクティス 皮膚悪性リンパ腫に対する放射線治療

  鬼丸 力也, 清水 伸一, 土屋 和彦, 加藤 徳雄, 木下 留美子, 井上 哲也, 小野寺 俊輔, 安田 耕一, 西岡 健太郎, 白土 博樹  日本皮膚悪性腫瘍学会学術大会プログラム・抄録集  28回-  82  -82  2012/06  [Not refereed][Not invited]
  
• 末梢肺におけるディスポーザブルゴールドマーカーによる金球留置の成績

  小倉粋, 品川尚文, 池澤靖元, 高階太一, 水柿秀紀, 山田範幸, 朝比奈肇, 榊原純, 井上哲也, 加藤徳雄, 鬼丸力也, 白戸博樹, 大泉聡史, 大泉聡史, 西村正治  気管支学  34-  S199  2012/05/20  [Not refereed][Not invited]
  
• 先進的放射線治療におけるPETの役割

  加藤徳雄, 鬼丸力也, 安田耕一, 志賀哲, 土屋和彦, 岡本祥三, 玉木長良, 白土博樹  日本薬学会年会要旨集  132nd-  (1)  118  -118  2012/03/05  [Not refereed][Not invited]
  
• 胃MALTリンパ腫に対する動体追跡照射の経験

  米山理奈, 安田耕一, 加藤徳雄, 鬼丸力也, 白土博樹  Jpn J Radiol  30-  (Supplement 1)  5  -5  2012/02/25  [Not refereed][Not invited]
  
• 当院における緩和的放射線治療の適応と効果

  照井健, 小池和彦, 平山泰生, 日下部俊朗, 中島信久, 鬼丸力也, 井上哲也, 加藤徳雄, 石谷邦彦  日本臨床腫瘍学会学術集会プログラム・抄録集  10th-  312-313  2012  [Not refereed][Not invited]
  
• Pattern of ipsilateral breast tumor recurrence after breast conservation therapy

  KINOSHITA RUMIKO, SHIMIZU SHIN'ICHI, TSUCHIYA KAZUHIKO, KATO NORIO, TAGUCHI HIROSHI, TAKAHASHI MASATO, TAKAHASHI HIROMASA, SHIRATO HIROKI  臨床放射線  56-  (13)  1813-1818  -1818  2011/12/10  [Not refereed][Not invited]
  
• Development of a 3D Brain PET Scanner Using CdTe Semiconductor Detectors and Its First Clinical Application

  Y. Morimoto, Y. Ueno, W. Takeuchi, S. Kojima, K. Matsuzaki, T. Ishitsu, K. Umegaki, Y. Kiyanagi, N. Kubo, C. Katoh, T. Shiga, H. Shirato, N. Tamaki  IEEE TRANSACTIONS ON NUCLEAR SCIENCE  58-  (5)  2181  -2189  2011/10  [Not refereed][Not invited]
   

  Targeting improved spatial resolution, a three-dimensional positron-emission-tomography (PET) scanner employing CdTe semiconductor detectors and using depth-of-interaction (DOI) information was developed, and its physical performance was evaluated. This PET scanner is the first to use semiconductor detectors dedicated to the human brain and head-and-neck region. Imaging performance of the scanner used for (18)F-fluorodeoxy glucose (FDG) scans of phantoms and human brains was evaluated. The gantry of the scanner has a 35.0-cm-diameter patient port, the trans-axial field of view (FOV) is 31.0 cm, and the axial FOV is 24.6 cm. The energy resolution averaged over all detector channels and timing resolution were 4.1% and 6.8 ns (each in FWHM), respectively. Spatial resolution measured at the center of FOV was 2.3-mm FWHM-which is one of the best resolutions achieved by human PET scanners. Noise-equivalent count ratio (NEC2R) has a maximum in the energy window of 390 to 540 keV and is 36 kcps/Bq/cm(3) at 3.7 kBq/cm(3). The sensitivity of the system according to NEMA 1994 was 25.9 cps/Bq/cm(3). Scatter fraction of the scanner is 37% for the energy window of 390 to 540 keV and 23% for 450 to 540 keV. Images of a hot-rod phantom and images of brain glucose metabolism show that the structural accuracy of the images obtained with the semiconductor PET scanner is higher than that possible with a conventional Bismuth Germanium Oxide (BGO) PET scanner. In addition, the developed scanner permits better delineation of the head-and-neck cancer. These results show that the semiconductor PET scanner will play a major role in the upcoming era of personalized medicine.
• 当院における緩和的放射線治療の実際

  照井健, 平山泰生, 小池和彦, 日下部俊朗, 中島信久, 鬼丸力也, 井上哲也, 加藤徳雄, 石谷邦彦  日本癌治療学会誌  46-  (2)  738  2011/09/13  [Not refereed][Not invited]
  
• EBUS‐GS併用経気管支鏡下生検にて診断し動体追跡放射線照射にて治療した末梢小型肺癌の検討

  竹内裕, 品川尚文, 池澤靖元, 高階太一, 小倉粋, 水柿秀紀, 山田範幸, 朝比奈肇, 榊原純, 加藤徳雄, 鬼丸力也, 白土博樹, 大泉聡史, 西村正治  気管支学  33-  S174  2011/05/20  [Not refereed][Not invited]
  
• Prospective Study on the Effect of High Resolution Semiconductor PET in Fluoromisonidazole (FMISO)-Guided Intensity Modulated Radiation Therapy (IMRT) Dose-escalation Simulation Planning in Patients with Nasopharyngeal Carcinoma (NPC)

  K. Yasuda, S. Okamoto, R. Onimaru, T. Shiga, M. Hasegawa, N. Katoh, Y. Kuge, K. Umegaki, N. Tamaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  81-  (2)  S506  -S507  2011  [Not refereed][Not invited]
  
• Utilization of positron emission tomography (PET) for radiotherapy

  Rikiya Onimaru, Koichi Yasuda, Norio Katoh, Hiroki Shirato, Tohru Shiga, Shozo Okamoto, Nagara Tamaki, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda  Japanese Journal of Head and Neck Cancer  37-  (3)  376  -380  2011  [Not refereed][Not invited]
   

  Positron emission tomography (PET) can obtain functional information about tumors. There are some reports that intensity modulated radiation therapy (IMRT) planning was made using hypoxic imaging information obtained by PET. We used a semiconductor PET which was developed by the Department of Nuclear Medicine in Hokkaido University, where hypoxic imaging by [18F] fluoromisonidazole (FMISO) PET is available. We are investigating a dose escalation planning study of IMRT using FMISO PET imaging, and report on the usage of PET for radiotherapy in Hokkaido University.
• 乳房温存療法後局所再発症例の検討

  木下 留美子, 清水 伸一, 土屋 和彦, 加藤 徳雄, 田口 大志, 高橋 将人, 高橋 弘昌, 白土 博樹  日本医学放射線学会秋季臨床大会抄録集  46回-  S506  -S506  2010/08  [Not refereed][Not invited]
  
• 口唇癌の放射線治療のretrospective study

  香泉和寿, 安田耕一, 長谷川雅一, 鬼丸力也, 清水伸一, 木下留美子, 井上哲也, 加藤徳雄, 小野寺俊輔, 田口大志, 溝口史樹, 青山英史, 白土博樹, 西岡健, 武島嗣英  Jpn J Radiol  28-  (Supplement 1)  7  -7  2010/07/25  [Not refereed][Not invited]
  
• The impact of 18F-fluoromisonidazole PET for H&N cancer and the applying for IMRT

  YASUDA KOICHI, HASEGAWA MASAICHI, ONIMARU RIKIYA, KINOSHITA RUMIKO, KATO NORIO, TAGUCHI HIROSHI, SHIMIZU SHIN'ICHI, INOUE TETSUYA, ONODERA SHUNSUKE, MIZOGUCHI FUMIKI, AOYAMA HIDEFUMI, SHIRATO HIROKI, SHIGA SATORU, OKAMOTO SHOZO, TAMAKI NAGARA, ISHIKAWA MASAZUMI, SUTHERLAND KENNETH, BENGUA GERARD, MIYAMOTO NAOKI, SUZUKI TAKASUKE  Jpn J Radiol  28-  (Supplement 1)  14  -14  2010/07/25  [Not refereed][Not invited]
  
• 鼻腔・副鼻腔癌に対する超選択的動注を併用した根治的化学放射線療法

  長谷川雅一, 安田耕一, 吉田大介, 加藤徳雄, 鬼丸力也, 浅野剛, 白土博樹, 本間明宏, 折舘伸彦, 福田諭, 石川正純, BENGUA Gerard, SUTHERLAND Kenneth, 宮本直樹, 鈴木隆介  Jpn J Radiol  28-  (Supplement 1)  7  -7  2010/07/25  [Not refereed][Not invited]
  
• Oligometastases症例に対する定位放射線治療の有用性についての検討

  井上哲也, 加藤徳雄, 青山英史, 鬼丸力也, 石川正純, 田口大志, 白土博樹  日本医学放射線学会総会抄録集  69th-  S193-S194  -S194  2010/02/28  [Not refereed][Not invited]
  
• 動体追跡放射線照射(RTRT)における金球標識(金マーカー)留置キットの使用経験

  竹内裕, 品川尚文, 小倉粋, 河井康孝, 伊藤健一郎, 水柿秀紀, 山田範幸, 菊地英毅, 菊地順子, 小西純, 大泉聡史, 西村正治, 井上哲也, 加藤徳雄, 鬼丸力也, 白土博樹  気管支学  32-  (1)  80  -80  2010/01/25  [Not refereed][Not invited]
  
• Conceptual Design of PET-linac System for Molecular-guided Radiotherapy

  M. Ishikawa, S. Yamaguchi, S. Tanabe, G. Bengua, K. Sutherland, R. Suzuki, N. Miyamoto, K. Nishijima, N. Katoh, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  78-  (3)  S674  -S674  2010  [Not refereed][Not invited]
  
• Feasibility Study on Molecular-imaging Based Tracking System for Lung Cancer Treatment

  S. Tanabe, M. Ishikawa, S. Yamaguchi, G. Bengua, K. Sutherland, R. Suzuki, N. Miyamoto, N. Katoh, R. Onimaru, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  78-  (3)  S749  -S749  2010  [Not refereed][Not invited]
  
• 臨床 動体追跡放射線治療10年の経験 (特集 放射線治療の現在)

  加藤 徳雄, 鬼丸 力也, 田口 大志  映像情報medical  41-  (12)  1222  -1227,1207  2009/11  [Not refereed][Not invited]
  
• Oligometastases症例に対する定位放射線治療の有用性についての検討

  井上哲也, 加藤徳雄, 青山英史, 鬼丸力也, 石川正純, 田口大志, 白土博樹  日本放射線腫よう学会誌  21-  (Supplement 1)  159  2009/08/19  [Not refereed][Not invited]
  
• 動体追跡放射線照射(RTRT)における金球標識(金マーカー)留置キットの使用経験

  竹内裕, 品川尚文, 小倉粋, 河井康孝, 伊藤健一郎, 水柿秀紀, 山田範幸, 菊地英毅, 菊地順子, 小西純, 井上哲也, 加藤徳雄, 鬼丸力也, 白土博樹, 大泉聡史, 西村正治  気管支学  31-  (0)  S118  2009/05/20  [Not refereed][Not invited]
  
• 放射線治療におけるFDG‐PETでのSUVと正確な標的体積設定への影響因子

  藤野賢治, 田口大志, 加藤徳雄, 木下留美子, 鬼丸力也, 長谷川雅一, 溝口史樹, 青山英史, 白土博樹, 志賀哲, 玉木長良, 加藤千恵次, 梶智人  Radiat Med  27-  (Supplement 1)  6  2009/04/25  [Not refereed][Not invited]
  
• 放射線治療におけるFDG-PETでのSUVと正確な標的体積設定への影響因子

  藤野 賢治, 田口 大志, 加藤 徳雄, 木下 留美子, 鬼丸 力也, 長谷川 雅一, 溝口 史樹, 青山 英史, 白土 博樹, 志賀 哲, 玉木 長良, 加藤 千恵次, 梶 智人  Japanese Journal of Radiology  27-  (Suppl.)  6  -6  2009/04  [Not refereed][Not invited]
  
• 上咽頭癌における半導体PET画像を用いた放射線治療計画

  加藤徳雄, 志賀哲, 長谷川雅一, 鬼丸力也, 安田耕一, 清水伸一, ベングア ジェラード, 石川正純, 玉木長良, 白土博樹  日本医学放射線学会総会抄録集  68th-  S307-S308  -S308  2009/02/28  [Not refereed][Not invited]
  
• ¹⁸F‐FMISO PETを用いたIMRT dose painting planの試み

  安田耕一, 白土博樹, 岡本祥三, 志賀哲, SUTHERLAND Ken, 加藤徳雄, 長谷川雅一, 鬼丸力也, BENGUA Gerard, 石川正純  日本医学放射線学会総会抄録集  68th-  S267  -S267  2009/02/28  [Not refereed][Not invited]
  
• Can the Real-time Tumor-tracking Radiotherapy Give the Planned Dose to the Tumor? DVH Analysis Based on Measured Real-time Tracking Data

  M. Ishikawa, K. L. Sutherland, G. Bengua, R. Suzuki, N. Miyamoto, N. Katoh, S. Shimizu, R. Onimaru, H. Aoyama, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  75-  (3)  S590  -S591  2009  [Not refereed][Not invited]
  
• Skull base MeningiomaにおけるIMRTの利用—当院治療成績を踏まえて—

  小野寺俊輔, 白土博樹, 青山英史, 田口大志, 加藤徳雄, 木下留美子, 鬼丸力也, 清水伸一, 井上哲也, 安田耕一  日本医学放射線学会秋季臨床大会抄録集  44th-  S521  -S521  2008/09/24  [Not refereed][Not invited]
  
• 鼻腔/副鼻腔癌に対する超選択的動注を併用した根治的化学放射線療法の治療成績

  長谷川雅一, 安田耕一, 吉田大介, 加藤徳雄, 鬼丸力也, 浅野剛, 白土博樹, 本間明宏, 折館伸彦, 福田諭  日本放射線腫よう学会誌  20-  (Supplement 1)  223  2008/09/22  [Not refereed][Not invited]
  
• 当院における遠隔放射線治療の現状について

  鈴木恵士郎, 木下留美子, 鬼丸力也, 安田耕一, 小野寺俊介, 加藤徳雄, 田口大志, 藤野賢治, 青山英史, 白上博樹, 宮坂和男  Radiat Med  26-  (Suppl.I)  3  -3  2008/04/25  [Not refereed][Not invited]
  
• [非小細胞肺癌]画像誘導放射線治療と強度変調放射線治療

  白土博樹, 鬼丸力也, 石川正純, 田口大志, 加藤徳雄, 清水伸一  MOOK肺癌の臨床  2008-2009-  319-326  2008/03/31  [Not refereed][Not invited]
  
• A new positron emission tomography with semiconductor detectors for target volume delineation and radiotherapy treatment planning in patients with nasopharyngeal carcinoma

  N. Katoh, T. Shiga, M. Hasegawa, R. Onimaru, K. Yasuda, S. Shimizu, G. Bengua, M. Ishikawa, N. Tamaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  72-  (1)  S589  -S590  2008  [Not refereed][Not invited]
  
• 定位放射線治療による予後改善に関する研究 T2N0M0非小細胞肺癌の体幹部放射線治療の線量増加試験に関する研究

  白土博樹, 鬼丸力也, 田口大志, 加藤徳雄, 石川正純  定位放射線治療による予後改善に関する研究 平成19年度 総括研究報告書  9-10  2008  [Not refereed][Not invited]
  
• 当院におけるMU値検証システムについて

  鈴木恵士郎, 白土博樹, 青山英史, 鬼丸力也, 加藤徳雄, 田口大志, 藤野賢治, 吉田有里, 宮坂和男, 熊谷まなみ, 藤田勝久  Radiat Med  25-  (Suppl.I)  8  -8  2007/04/25  [Not refereed][Not invited]
  
• 腎・副腎腫瘍に対する動体追跡照射 技術的検討について

  加藤 徳雄, 芹澤 慈子, 白土 博樹, 鬼丸 力也, 大坂 康博, 鈴木 恵士郎, 渡辺 佳明, 阿保 大介, 清水 匡, 宮坂 和男, 清水 伸一  Radiation Medicine  25-  (Suppl.I)  17  -17  2007/04
• 動体追跡装置を用いた前立腺癌の放射線治療のPSA再発及び副作用発生率

  大坂康博, 青山英史, 田口大志, 加藤徳雄, 木下留美子, 藤野賢治, 鬼丸力也, 鈴木恵士郎, 白土博樹  日本医学放射線学会学術集会抄録集  66th-  S247  -S247  2007/02/28  [Not refereed][Not invited]
  
• 多発肺腫瘍に対する3ケ月以内の連続した定位照射の安全性と有効性の検討

  鬼丸力也, 藤野賢治, 田口大志, 加藤徳雄, 木下留美子, 安田耕一, 鈴木恵士郎, 白土博樹, 宮坂和男  日本医学放射線学会学術集会抄録集  66th-  S233  -S233  2007/02/28  [Not refereed][Not invited]
  
• 脳動静脈奇形定位照射におけるMR‐perfusionを用いた治療前後の血流動態の検討

  芹澤慈子, THA Khin K, 青山英史, 工藤與亮, 加藤徳雄, 寺江聡, 白土博樹  日本医学放射線学会学術集会抄録集  66th-  S225  -S225  2007/02/28  [Not refereed][Not invited]
  
• Feasibility study of real-time tumor-tracking radiotherapy for adrenal tumors: Three-dimensional movement of internal fiducial gold markers measured in supine and prone patient positions

  N. Katoh, R. Onimaru, S. Shimizu, D. Abo, Y. Sakuhara, H. Taguchi, Y. Osaka, B. Gerard, M. Ishikawa, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  69-  (3)  S675  -S675  2007  [Not refereed][Not invited]
  
• Utilization the fusion image of CT and FDG-PET for radiation therapy planning in lung cancer

  Masaharu Fujino, T. Taguchi, T. Kato, H. Aoyama, K. Suzuki, R. Onimaru, R. Kinoshita, K. Yasuda, H. Shirato, C. Kato, S. Shiga, N. Tamaki, S. Onodera  Japanese Journal of Clinical Radiology  52-  (1)  137  -144  2007  [Not refereed][Not invited]
   

  We have investigated the feasibility of the integration of breath-holding FDG-PET image (BH-PET) into radiation treatment planning for non-small cell lung (NSCLC) cancer patients. BH-PET has its advantage in the prevention from the decrease of SUV due to the movement of tumor, especially in the case of small tumors, both in phantom experiments and in actual NSCLC cases. This might result in the reduction of the interobserver deviation of the contoured target volume among NSCLC patients, and would lead to the accurate stereotactic radiotherapy for tumors in the moving organs including lung, liver, and so on.
• Image Guided Radiotherapy (IGRT) and Intensity Modulated Radiotherapy (IMRT)

  Rikiya Onimaru, M. Fujino, N. Kato, H. Taguchi, R. Kinoshita, I. Serizawa, T. Inoue, M. Hasegavva, H. Aoyama, Y. Osaka, H. Shirato  Japanese Journal of Clinical Radiology  52-  (8)  961  -966  2007  [Not refereed][Not invited]
   

  Both Image Guided Radiotherapy (IGRT) and Intensity Modulated Radiotherapy (IMRT) becomes widely used. IMRT can reduce dose of normal tissue without reduction of target volume dose. IMRT seems to be closest to the ideal radiotherapy using photon at present. Although there is no direct relationship between IGRT and IMRT, combination of IGRT and IMRT seems to solve some problems in radiotherapy. In this article, we reviewed usage of medical imaging in radiotherapy and discuss combination of IGRT and IMRT.
• 手術不能Stage I非小細胞肺癌に対する動体追跡照射のマージンと効果の探索的検討

  鬼丸力也, 白土博樹, 藤野賢治, 田口大志, 加藤徳雄, 木下留美子, 鈴木恵士郎, 青山英史, 宮坂和男  日本放射線腫よう学会誌  18-  (Supplement 1)  217  2006/10/25  [Not refereed][Not invited]
  
• プラスチックシンチレーションファイバー検出器の応答特性に関する基礎的検討

  笈田将皇, 石川正純, 藤野賢治, 加藤徳雄, 田口大志, 白土博樹, 渡辺良晴  日本放射線腫よう学会誌  18-  (Supplement 1)  199  2006/10/25  [Not refereed][Not invited]
  
• 極微小プラスチックシンチレータを用いた水吸収線量測定法の開発

  石川正純, 笈田将皇, 加藤徳雄, 藤野賢治, 大坂康博, 白土博樹  日本放射線腫よう学会誌  18-  (Supplement 1)  199  2006/10/25  [Not refereed][Not invited]
  
• 膵癌に対する4次元強度変調放射線治療(4D‐IMRT)に向けての基礎的研究

  安田耕一, 加藤徳雄, 青山英史, 田口大志, 藤野賢治, 木下留美子, 鬼丸力也, 鈴木恵士朗, 白土博樹, 宮坂和男  日本放射線腫よう学会誌  18-  (Supplement 1)  170  2006/10/25  [Not refereed][Not invited]
  
• 【体幹部定位放射線治療】 動体追跡照射装置を用いた腹部臓器への迎撃照射

  鬼丸 力也, 田口 大志, 加藤 徳雄, 作原 祐介, 阿保 大介, 白土 博樹, 宮坂 和男  臨床放射線  51-  (10)  1165  -1170  2006/10  [Not refereed][Not invited]
  
• 前立腺癌における動体追跡装置を用いた尿道線量低減強度変調放射線治療の検討

  大坂康博, 青山英史, 田口大志, 加藤徳雄, 木下留美子, 藤野賢治, 鬼丸力也, 鈴木恵士郎, 白土博樹, 宮坂和男  日本医学放射線学会学術集会抄録集  65th-  S211  -S211  2006/02/25  [Not refereed][Not invited]
  
• Prediction of four-dimensional (4D) tumor response using finite element method (FEM) and radiobiological model for adaptive radiotherapy

  H. Taguchi, S. Takao, Y. Kogure, H. Shirato, S. Tadano, K. Suzuki, R. Onimaru, N. Katoh, R. Kinoshita  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  66-  (3)  S596  -S596  2006  [Not refereed][Not invited]
  
• Challenges in the use of breath-hold (18)F-fluorodeoxyglucose positron emission tomography in real-time tumor-tracking radiotherapy in patients with lung cancer without atelectasis

  M. Fujino, C. Katoh, T. Kaji, N. Kubo, N. Kato, S. Onodera, T. Shiga, H. Aoyama, H. Shirato, N. Tamaki  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  66-  (3)  S617  -S618  2006  [Not refereed][Not invited]
  
• Intercepting irradiation for abdominal organ tumor using real time tracking radiation therapy (RTRT) system

  Rikiya Onimaru, H. Taguchi, N. Katoh, Y. Sakuhara, D. Abo, H. Shirato, K. Miyasaka  Japanese Journal of Clinical Radiology  51-  (10)  1165  -1170  2006  [Not refereed][Not invited]
   

  We have developed real time tracking radiation therapy (RTRT) system and treated hepatocellular carcinoma (HCC) and metastatic adrenal gland tumor using RTRT system. We reported our initial experience. Although results seem to be promising, clinical trial is needed to confirm our results.
• 放射線治療計画用分子イメージングシステムの肺癌放射線治療計画への初期利用経験

  小野寺俊輔, 藤野賢治, 加藤徳雄, 青山英史, 西岡健, 白土博樹, 宮坂和男, 加藤千恵次, 志賀哲, 玉木長良  日本放射線腫よう学会誌  17-  (Supplement 1)  164  -164  2005/10/25  [Not refereed][Not invited]
  
• 動体追跡照射装置を用いた迎撃照射

  鬼丸力也, 藤野賢治, 田口大志, 加藤徳雄, 木下留美子, 鈴木恵士郎, 青山英史, 白土博樹  日本放射線腫よう学会誌  17-  (Supplement 1)  61  -61  2005/10/25  [Not refereed][Not invited]
  
• 放射線治療計画用分子イメージングシステムの開発

  藤野賢治, 加藤徳雄, 青山英史, 西岡健, 白土博樹, 加藤千恵次, 志賀哲, 玉木長良, 田口太志, 鬼丸力也  日本放射線腫よう学会誌  17-  (Supplement 1)  102  -102  2005/10/25  [Not refereed][Not invited]
  
• Estimation of dose distribution from the fluoroscopy in real-time tumor tracking radiotherapy (RTRT) for stereotactic body radiotherapy (SBRT)

  M Oita, R Onimaru, K Suzuki, H Aoyama, M Fujino, N Kato, R Kinoshita, K Fujita, H Shirato, K Miyasaka  RADIOTHERAPY AND ONCOLOGY  76-  S147  -S147  2005/09  [Not refereed][Not invited]
  
• 聴神経腫瘍に対する定位分割照射の治療成績

  坂本 徹, 白土 博樹, 澤村 豊, 鈴木 恵士郎, 青山 英史, 加藤 徳雄  定位的放射線治療  9-  37  -44  2005/08  

  定位分割照射を行った聴神経腫瘍165例(男62例・女103例,中央値54歳)の成績を報告した.平均腫瘍径は照射前17.0mm,平均観察期間42ヵ月後13.9mmであった.2〜7年の累積腫瘍制御率は91.8%で,腫瘍増大を9例に認め,うち3例に手術,2例に追加照射を行った.累積腫瘍縮小率は3年で54%,7年で61.6%であった.腫瘍径25mm以上の31例では7年の累積腫瘍制御率90.5%,縮小率78.1%であった.腫瘍の性状別にみると,cystic typeは腫瘍制御率100%,縮小率88.6%で,solid typeは各々86.8%,56.6%と,縮小率に有意差を認めた.聴力検査の結果は,照射前が平均48.7dBで,照射1年後に10dB,5年で20.1dBの低下を認め,7年の累積聴力温存率は71.5%,保存率は56.3%であった.腫瘍縮小群は非縮小群に比較して聴力温存率が高い傾向であった.合併障害は三叉神経障害,めまいが9%,顔面神経麻痺が3%にみられたがいずれも一過性で,照射後にシャント手術を必要としたのは18例であった
• Stereotactic Irradiation and Four-dimensional Radiotherapy

  SHIRATO HIROKI, KATO NORIO, FUJINO MASAHARU, ONIMARU RIKIYA, MIYASAKA KAZUO  画像診断  25-  (5)  640-646  2005/04/25  [Not refereed][Not invited]
  
• 肺腫ようの胸部単純写真での存在部位から推定する通常の放射線治療でのinternal margin

  鬼丸力也, 藤野賢治, 白土博樹, 鈴木恵士郎, 田口大志, 加藤徳雄, 木下留美子, 宮坂和男  日本医学放射線学会学術集会抄録集  64th-  S344  2005/02/25  [Not refereed][Not invited]
  
• Long-term outcome of fractionated small-field irradiation (FSR) for vestibular schwannoma in patients followed for more than five years

  N Katoh, T Sakamoto, H Aoyama, W Sakai, H Taguchi, K Suzuki, K Tsuchiya, S Fukuda, H Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  63-  (2)  S264  -S265  2005  [Not refereed][Not invited]
  
• Estimation of fluoroscopic dose in real-time tumor tracking radiotherapy (RTRT) using a commercial based radiotherapy planning system

  M.Oita, R Onimaru, K Suzuki, H Aoyama, M Fujino, N Kato, R Kinoshita, K Fujita, H Shirato, K Miyasaka  Radiotherapy and Oncology  76-  (S2)  147  -147  2005  [Not refereed][Not invited]
  
• 前立腺癌の動体追跡装置を用いた尿道線量低減強度変調放射線治療

  大坂康博, 青山英史, 鬼丸力也, 田口大志, 木下留美子, 加藤徳雄, 鈴木恵士郎, 白土博樹, 宮坂和男  日本放射線腫よう学会誌  16-  (Supplement 1)  91  2004/11  [Not refereed][Not invited]
  
• 脊髄原発gliomaに対する放射線治療

  加藤徳雄, 白土博樹, 青山英史, 鬼丸力也, 飛騨一利, 岩崎喜信, 宮坂和男  日本放射線腫よう学会誌  16-  (Supplement 1)  106  2004/11  [Not refereed][Not invited]
  
• Methionine PET in differentiating recurrent brain tumor from radiation necrosis following cranial radiation

  N Katoh, K Nakada, T Takei, H Aoyama, H Shirato, C Katoh, Y Kuge, E Tsukamoto, N Tamaki  PET AND MOLECULAR IMAGING: STATE OF THE ART AND FUTURE PERSPECTIVES  1264-  217  -221  2004  [Not refereed][Not invited]
   

  Objectives: The purpose of the present study was to determine whether PET with C-11-methionine (MET) is valuable in distinguishing recurrent tumor from radiation necrosis. Methods: Twenty-one patients (27 lesions) with previously treated 10 primary or 11 metastatic brain tumor who presented focally enhanced mass lesion on postcontrast magnetic resonance imaging (MRI) images were studied with MET-PET. Uptake of MET was visually interpreted by three independent nuclear medicine physicians in a blind manner. In addition, semiquantitative evaluation was performed in forms of tumor-to-contralateral (TCR) tissue ratio of standardized uptake value (SUV). Final confirmation was established based on pathological diagnosis in 13 lesions and clinical follow-up for more than 6 months in the remaining 14. Results: Final diagnosis was radiation necrosis in nine lesions and recurrent tumor in 18. Every recurrent tumor showed intense MET uptake while none of the radiation necrosis showed significant MET uptake. Sensitivity as well as specificity of visual interpretation of MET-PET images were 100%. The difference in the mean value of TCR was statistically significant between radiation necrosis and recurrent tumor (1.05 +/- 0.11 vs. 1.79 +/- 0.32, p < 0.0001). Conclusions: MET-PET accurately distinguishes recurrent brain tumor from radiation necrosis. (C) 2004 Published by Elsevier B.V.
• Methionine PET in differentiating recurrent brain tumor from radiation necrosis following cranial radiation therapy.

  K Nakada, N Katoh, N Takei, H Aoyama, H Shirato, C Katoh, Y Kuge, F Yamamoto, E Tsukamoto, N Tamaki  JOURNAL OF NUCLEAR MEDICINE  44-  (5)  244P  -245P  2003/05  [Not refereed][Not invited]
  
• 肺非小細胞癌における肺腫瘍・脳転移に対する定位放射線照射(第46回肺癌学会北海道支部会 北海道支部 支部活動)

  加藤 徳雄, 青山 英史, 鬼丸 力也, 白土 博樹, 宮坂 和男, 原田 敏之, 木下 一郎, 山崎 浩一, 西村 正治, 秋田 弘俊  肺癌  43-  (1)  72  -73  2003/02/20  [Not refereed][Not invited]
  
• 心肺停止に陥った冠攣縮性狭心症症例の蘇生後I-123 metaiodobenzylguanidine(MIBG)心筋シンチグラフィーの検討

  大山 徳子, 大山 尚貢, 尾崎 威文, 高木 千佳, 岡田 斉, 佐藤 勝彦, 加藤 法喜, 林 俊之, 加藤 徳雄, 阿保 大介, 久保 公三, 宮崎 知保子  市立札幌病院医誌  60-  (2)  165  -168  2000/12  [Not refereed][Not invited]
   

  心肺停止後蘇生され,心肺停止の原因が心原性と考えられ,かつ急性冠症候群と診断した11例を,急性心筋梗塞群(5例)と冠攣縮性狭心症群(6例)に分類し,MIBG心筋シンチグラフィー所見を比較検討した.MIBGは15分後(初期)像において左心部(H)と上縦隔(M)に関心領域を設定し,H/M比をMIBG取り込みの指標とした.冠攣縮性狭心症群の平均H/M比は2.217±0.306,急性心筋梗塞群の平均H/M比は1.590±0.299で冠攣縮性狭心症群で有意に取り込みが多かった

Books etc

• Stereotactic Body Radiation Therapy

  Editor Yasushi Nagata (ContributorChapter 17 Real-Time Tumor-Tracking Radiotherapy (RTRT), SyncTraX)
  Springer Singapore 2023/10 (ISBN: 9789819939787)

Presentations

• 膵癌に対する動体追跡放射線治療用の経皮的あるいは経動脈的マーカー留置術の検討

  加藤 大祐, 阿保 大介, 森田 亮, 打浪 雄介, 加藤 徳雄, 山田 亮太, 木野田 直也, 藤井 宝顕, 山崎 康之, 高柳 歩, 青山 英史, 工藤 與亮

  日本インターベンショナルラジオロジー学会雑誌  2024/04  (一社)日本インターベンショナルラジオロジー学会
  
• 胸部食道がん化学放射線療法における重症放射線食道炎に関する後方視的研究

  原田 一顕, 中村 赳晶, 渡辺 亮介, 山村 貴洋, 結城 敏志, 坂本 直哉, 川本 泰之, 小松 嘉人, 打浪 雄介, 田口 大志, 加藤 徳雄, 青山 英史

  北海道医学雑誌  2023/11  北海道医学会
  
• 体幹部定位放射線治療時の呼気止め分割CBCTにおける呼吸再現性と輪郭の評価

  山田 亮太, 吉村 高明, 一宇 佑太, 若林 倭, 松尾 勇斗, 孫田 惠一, 加藤 徳雄

  日本放射線技術学会総会学術大会予稿集  2023/03  (公社)日本放射線技術学会
  
• 肝細胞癌陽子線治療効果予測におけるADC値指標の検討

  藤田 祥博, 加藤 徳雄, 打浪 雄介, 田口 大志, 西岡 健太郎, 森 崇, 安田 耕一, 小泉 富基, 大塚 愛美, 高尾 聖心, 田村 昌也, Sutherland Kenneth, Khin Khin Tha, 伊藤 陽一, 青山 英史

  Japanese Journal of Radiology  2023/02  (公社)日本医学放射線学会
  
• 内科・外科による消化器病共同診療の現況と展望 当科における切除可能境界膵癌に対する術前治療の現状

  原田 一顕, 中村 赳晶, 渡辺 亮介, 山村 貴洋, 川本 泰之, 結城 敏志, 桑谷 将城, 田口 大志, 加藤 徳雄, 浅野 賢道, 中村 透, 平野 聡, 小松 嘉人, 坂本 直哉

  日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集  2022/09  日本消化器病学会-北海道支部
  
• 尿量の経日変化および前立腺体積が放射線治療時の前立腺の位置に与える影響(The Impact of Daily Urinary Volume Variations and Prostate Volume on Prostate Position During Radiotherapy)

  Nishioka Kentaro, Hashimoto Takayuki, Yokota Isao, Katoh Norio, Kinoshita Rumiko, Yasuda Koichi, Takao Seishin, Yoshimura Takaaki, Aoyama Hidefumi, Shimizu Shinichi

  日本医学放射線学会学術集会抄録集  2021/03  (公社)日本医学放射線学会
  
• The Impact of Daily Urinary Volume Variations and Prostate Volume on Prostate Position During Radiotherapy(和訳中)

  Nishioka Kentaro, Hashimoto Takayuki, Yokota Isao, Katoh Norio, Kinoshita Rumiko, Yasuda Koichi, Takao Seishin, Yoshimura Takaaki, Aoyama Hidefumi, Shimizu Shinichi

  日本医学放射線学会学術集会抄録集  2021/03  (公社)日本医学放射線学会
  
• 動体追跡陽子線照射における気管支内視鏡的放射線治療用マーカー留置術の検討

  伊藤 祥太郎, 品川 尚文, 高島 雄太, 國崎 守, 古田 恵, 水柿 秀紀, 朝比奈 肇, 菊地 英毅, 菊地 順子, 榊原 純, 加藤 徳雄, 田口 大志, 青山 英史, 今野 哲

  気管支学  2020/11  (NPO)日本呼吸器内視鏡学会
  
• Automatic Bladder Delineation on MR Images Using a Convolution Neural Network for Online Image-Guided Radiotherapy

  K. Nishioka, Y. Nomura, T. Hashimoto, R. Kinoshita, N. Katoh, H. Taguchi, K. Yasuda, T. Mori, Y. Uchinami, M. Otsuka, T. Matsuura, S. Takao, R. Suzuki, S. Tanaka, T. Yoshimura, H. Aoyama, S. Shimizu

  International Journal of Radiation Oncology*Biology*Physics  2020/11  Elsevier BV
  
• 局所進行食道癌に対してspot scanning法による根治的化学陽子線療法を施行した一例

  宮崎 智彦, 打浪 雄介, 田口 大志, 加藤 徳雄, 清水 伸一, 白土 博樹, 中積 宏之, 中野 真太郎, 坂本 直哉, 高尾 聖心, 田村 昌也, 松浦 妙子

  日本医学放射線学会秋季臨床大会抄録集  2019/09  (公社)日本医学放射線学会
  
• Prognosis after Local Recurrence or Metastases in Medically Operable Stage I Non-Small Cell Lung Cancer Patients Treated By Stereotactic Body Radiotherapy  [Not invited]

  H. Onishi, Y. Shioyama, Y. Matsuo, K. Takayama, A. Miyakawa, H. Yamashita, T. Nomiya, Y. Matsumo, H. Matsushita, T. Kimura, N. Murakami, H. Ishiyama, T. Uno, T. Takanaka, N. Katoh, A. Takeda, K. Nakata, K. Ogawa, K. Nihei, M. Aoki, K. Kuriyama, T. Komiyama, K. Marino, M. Araya, S. Aoki, R. Saito, Y. Maehata, R. Tominaga, H. Nonaka, M. Oguri, M. Matsuda, T. Yamada, T. Akita, M. Hiraoka

  International Journal of Radiation Oncology*Biology*Physics  2019/09  Elsevier BV
  
• Multicenter Prospective Study of Stereotactic Body Radiotherapy for Untreated Solitary Primary Hepatocellular Carcinoma: The STRSPH Study  [Not invited]

  T. Kimura, A. Takeda, S. Ishikura, K. Ariyoshi, T. Yamaguchi, T. Imagumbai, N. Katoh, T. Eriguchi, Y. Oku, S. Ozawa, Y. Tsurugai, M. Kokubo, S. Shimizu

  International Journal of Radiation Oncology*Biology*Physics  2019/09  Elsevier BV
  
• Initial Clinical Outcomes of Real-Time-Image Gated Spot-Scanning Proton Beam Therapy for Hepatocellular Carcinomas  [Not invited]

  N. Katoh, Y. Uchinami, D. Abo, S. Takao, T. Inoue, H. Taguchi, R. Morita, T. Soyama, T. Hashimoto, R. Onimaru, A. Prayongrat, M. Tamura, T. Matsuura, S. Shimizu, H. Shirato

  International Journal of Radiation Oncology*Biology*Physics  2019/09  Elsevier BV
  
• Big Data Analysis of Treatment Process Time for the Real-Time-Image Gated-Spot-Scanning Proton-Beam Therapy (RGPT) System  [Not invited]

  T. Yoshimura, S. Shimizu, T. Hashimoto, N. Katoh, T. Inoue, K. Nishioka, T. Matsuura, S. Takao, M. Tamura, H. Tamura, K. Horita, K. Umegaki, H. Shirato

  International Journal of Radiation Oncology*Biology*Physics  2018/11  Elsevier BV
  
• Uncertainties of Normal Tissue Complication Probability (NTCP) and NTCP Difference between Radiation Treatment Modalities for Radiation-Induced Liver Toxicity in Child-Pugh A Primary Liver Cancer Patients  [Not invited]

  A. Prayongrat, K. Kobashi, Y. Ito, N. Katoh, Y. Dekura, N. Amornwichet, S. Shimizu, H. Shirato

  International Journal of Radiation Oncology*Biology*Physics  2018/11  Elsevier BV
  
• Analysis of Beam Delivery Times and Dose Rates for the Treatment of Mobile Tumors Using Real Time Image Gated Spot-Scanning Proton Beam Therapy  [Not invited]

  S. Shimizu, T. Yoshimura, N. Katoh, T. Inoue, T. Hashimoto, K. Nishioka, S. Takao, T. Matsuura, N. Miyamoto, Y.M. Ito, K. Umegaki, H. Shirato

  International Journal of Radiation Oncology*Biology*Physics  2018/11  Elsevier BV
  
• 肝腫瘍に対する動態追跡照射のための経皮的マーカ留置  [Not invited]

  森田 亮, 曽山 武士, 阿保 大介, 作原 祐介, 工藤 與亮, 加藤 徳雄, 白土 博樹

  IVR: Interventional Radiology  2017/07
• 甲状腺癌分化癌の骨転移に対するIMRTを含めた外照射の治療成績  [Not invited]

  安田 耕一, 加藤 徳雄, 岡本 祥三, 木下 留美子, 志賀 哲, 水町 貴諭, 畠山 博充, 本間 明宏, 田口 純, 清水 康, 森 崇, 土屋 和彦, 白土 博樹

  頭頸部癌  2017/05
• 肝腫瘍に対する動態追跡照射のための経皮的マーカ留置(Percutaneous hepatic fiducial marker implantation for Real-time Tumor-tracking Radiotherapy(RTRT))  [Not invited]

  森田 亮, 作原 祐介, 曽山 武士, 阿保 大介, 加藤 徳雄, 工藤 與亮, 白土 博樹

  IVR: Interventional Radiology  2017/04
• Clinical application for molecular imaging(Therapy) 分子イメージングを用いた放射線治療  [Not invited]

  安田 耕一, 岡本 祥三, 西川 由記子, 伊藤 陽一, 志賀 哲, 井上 哲也, 森 崇, 豊永 拓哉, 鬼丸 力也, 渡邊 史郎, 土屋 和彦, 竹内 渉, 加藤 徳雄, 久下 裕司, 玉木 長良, 白土 博樹

  JSMI Report  2016/04
• Treatment Time and Dose Rate Analysis for Respiratory Moving Liver Tumor Using Real-time-image Gated Spot Scanning Proton Beam Therapy System  [Not invited]

  SHIMIZU Shinichi, KATOH Norio, TAKAO Seishin, MATSUURA Taeko, MIYAMOTO Naoki, HASHIMOTO Takayuki, NISHIOKA Kentaro, YOSHIMURA Takaaki, UMEGAKI Kikuo, SHIRATO Hiroki

  日本医学放射線学会総会抄録集  2016/02
• 18F-fluoromisonidazole PET/CT for Stage I Non-Small Cell Lung Cancer Treated by Stereotactic Body Radiotherapy  [Not invited]

  INOUE Tetsuya, OKAMOTO Shozo, WATANABE Shiro, YASUDA Koichi, KATOH Norio, HARADA Keiichi, SHIGA Toru, TAMAKI Nagara, KUGE Yuji, SHIRATO Hiroki

  日本医学放射線学会総会抄録集  2016/02
• Spot-scanning proton beam therapy (SSPT) with or without the use of a real-time tumor-tracking function: Clinical Experience  [Not invited]

  KATOH Norio, SHIMIZU Shinichi, NISHIOKA Kentaro, HASHIMOTO Takayuki, INOUE Tetsuya, MATSUURA Taeko, SEISHIN Takao, ONIMARU Rikiya, UMEGAKI Kikuo, SHIRATO Hiroki

  日本医学放射線学会総会抄録集  2016/02
• Stereotactic Body Radiation Therapy and Proton Beam Therapy for Hepatocellular Carcinoma  [Not invited]

  KATOH Norio

  日本医学放射線学会総会抄録集  2016/02
• 照射中と4DCT撮像時の肺内マーカー移動の比較  [Not invited]

  原田 慶一, 加藤 徳雄, 井上 哲也, 鬼丸 力也, 清水 伸一, 白土 博樹, 鈴木 隆介, 宮本 直樹, 石川 正純

  Japanese Journal of Radiology  2016/02
• 椎体IMRTとその精度に関する研究  [Not invited]

  安田 耕一, 清水 伸一, 橋本 孝之, Sutherland Ken, 白土 博樹, 土屋 和彦, 加藤 徳雄, 鬼丸 力也, 木下 留美子, 井上 哲也, 西岡 健太郎, 西川 由記子, 森 崇, 原田 慶一, 原田 八重, 鈴木 隆介, 寅松 千枝, 松浦 妙子, 高尾 聖心, 宮本 直樹, 伊藤 陽一

  Japanese Journal of Radiology  2016/02
• Real-time-image gated proton beam therapy (RGPT) for cancer  [Not invited]

  SHIRATO Hiroki, SHIRATO Hiroki, SHIRATO Hiroki, SHIMIZU Shinichi, SHIMIZU Shinichi, SHIMIZU Shinichi, ONIMARU Rikiya, ONIMARU Rikiya, HASHIMOTO Takayuki, HASHIMOTO Takayuki, TSUCHIYA Kazuhiko, KATOH Norio, KATOH Norio, INOUE Tetsuya, INOUE Tetsuya

  日本癌治療学会学術集会(Web)  2016
• 食道癌術後/化学放射線療法後再発に対する化学放射線療法の成績  [Not invited]

  井上 哲也, 原田 慶一, 加藤 徳雄, 清水 伸一, 白土 博樹, 中積 宏之, 福島 拓, 小松 嘉人, 海老原 裕磨, 七戸 俊明

  北海道医学雑誌  2015/11
• Clinical analysis of 27 patients with malignant pleural mesothelioma treated at our institution  [Not invited]

  Hajime Kikuchi, Hajime Asahina, Jun Sakakibara-Konishi, Naofumi Shinagawa, Satoshi Oizumi, Yasuhiro Hida, Kichizo Kaga, Tetsuya Inoue, Norio Katoh, Masaharu Nishimura

  Japanese Journal of Lung Cancer  2015/02  The Japan Lung Cancer Society
   

  © 2015 The Japan Lung Cancer Society. Objective. We reviewed the clinical outcomes of patients with malignant pleural mesothelioma (MPM) treated at our institution. Methods. We conducted a retrospective analysis of 27 patients with MPM treated at our institution in the period from April 2005 to April 2013. Results. The patient characteristics were as follows: male/female = 26/1; age = 35-76 years (median, 62); histology: epithelioid/biphasic/sarcomatoid = 23/2/2; location, right/left = 14/13; clinical stage (IMIG) IA/IB/II/III/IV = 3/5/4/9/6. The initial treatment was surgery/ chemotherapy/best supportive care in 15/11/1 cases, including 14 patients treated with extrapleural pneumonectomy (EPP) and one patient treated with tumor resection. After EPP, three patients received adjuvant chemotherapy, five received hemithoracic radiotherapy (H-RT) and two received both. The median survival time (MST) of all patients was 21.8 months overall, compared to 30.7 months in the patients who received EPP. The patients who received H-RT after EPP demonstrated a significantly longer MST than those who did not (37.3 months vs. 12.0 months; p = 0.04). Conclusions. The use of H-RT after EPP is associated with a better prognosis.
• 4DCTを用いた肺内マーカー移動の解析  [Not invited]

  加藤 徳雄, 原田 慶一, 鈴木 隆介, 井上 哲也, 鬼丸 力也, 清水 伸一, 宮本 直樹, 白土 博樹

  Japanese Journal of Radiology  2015/02
• 局所進行食道癌に対する強度変調放射線治療を用いた放射線化学療法の経験  [Not invited]

  井上 哲也, 加藤 徳雄, 清水 伸一, 白土 博樹, 鈴木 隆介, 佐々木 尚英, 福島 拓, 小松 嘉人

  北海道外科雑誌  2014/12
• 肝臓への放射線治療用病変識別マーカー留置  [Not invited]

  作原 祐介, 阿保 大介, 曽山 武士, 安井 太一, 寺江 聡, 加藤 徳雄, 白土 博樹

  IVR: Interventional Radiology  2014/12
• Chemoradiation therapy using intensity-modulated radiation therapy for locally advanced esophageal carcinoma  [Not invited]

  INOUE Tetsuya, KATOH Norio, SHIMIZU Shinichi, SUZUKI Ryusuke, SASAKI Takahide, FUKUSHIMA Hiraku, KOMATSU Yoshito, SHIRATO Hiroki

  日本医学放射線学会総会抄録集  2014/02
• Naming rule for radiation therapy  [Not invited]

  安田耕一, 土屋和彦, 井上哲也, 西岡健太郎, 原田慶一, 西川由記子, 鬼丸力也, 清水伸一, 加藤徳雄, 木下留美子, 小野寺俊介, 白土博樹, 鈴木隆介, 藤田勝久, 辻真太郎, 山崎理衣

  Jpn J Radiol  2014/02  (公社)日本医学放射線学会
  
• 放射線療法に関する名付けルール(Naming rule for radiation therapy)  [Not invited]

  安田 耕一, 土屋 和彦, 井上 哲也, 西岡 健太郎, 原田 慶一, 西川 由記子, 鬼丸 力也, 清水 伸一, 加藤 徳雄, 木下 留美子, 小野寺 俊介, 白土 博樹, 鈴木 隆介, 藤田 勝久, 辻 真太郎, 山崎 理衣

  Japanese Journal of Radiology  2014/02
• 北海道大学病院における髄膜腫に対する強度変調放射線治療(IMRT)の初期成績  [Not invited]

  西川 由記子, 原田 慶一, 西岡 健太郎, 安田 耕一, 井上 哲也, 土屋 和彦, 小野寺 俊輔, 木下 留美子, 加藤 徳雄, 清水 伸一, 鬼丸 力也, 白土 博樹, 鈴木 隆介, 石川 正純

  Japanese Journal of Radiology  2014/02
• 当院における悪性胸膜中皮腫27例の検討  [Not invited]

  菊池 創, 朝比奈 肇, 北井 秀典, 池澤 靖元, 高階 太一, 品川 尚文, 榊原 純, 大泉 聡史, 西村 正治, 樋田 泰浩, 加賀 基知三, 井上 哲也, 加藤 徳雄

  肺癌  2013/12  (NPO)日本肺癌学会
  
• 局所進行食道癌に対する通常照射と強度変調放射線治療を組み合わせた放射線化学療法  [Not invited]

  井上 哲也, 加藤 徳雄, 清水 伸一, 白土 博樹, 鈴木 隆介, 佐々木 尚英, 福島 拓, 小松 嘉人

  北海道外科雑誌  2013/12
• 悪性胸膜中皮腫に対する病理診断と治療戦略 当院における悪性胸膜中皮腫27例の検討  [Not invited]

  菊池 創, 朝比奈 肇, 北井 秀典, 池澤 靖元, 高階 太一, 品川 尚文, 榊原 純, 大泉 聡史, 樋田 泰浩, 加賀 基知三, 井上 哲也, 加藤 徳雄, 西村 正治

  肺癌  2013/10
• 照射前FMISO-PETの集積部位と照射後再発の位置関係  [Not invited]

  安田 耕一, 土屋 和彦, 岡本 祥三, 鬼丸 力也, 志賀 哲, 加藤 徳雄, 原田 慶一, 久下 裕司, 玉木 長良, 白土 博樹

  日本医学放射線学会学術集会抄録集  2013/02
• 肝臓への放射線治療用病変識別マーカー留置  [Not invited]

  作原 祐介, 阿保 大介, 加藤 徳雄, 田口 大志, 曽山 武士, 白土 博樹

  日本医学放射線学会学術集会抄録集  2013/02
• 原発性肺癌に対する動体追跡照射を用いた体幹部定位放射線治療  [Not invited]

  井上 哲也, 加藤 徳雄, 鬼丸 力也, 榊原 純, 品川 尚文, 大泉 聡史, 鈴木 隆介, 白土 博樹

  日本医学放射線学会学術集会抄録集  2013/02
• 北海道大学病院における上咽頭癌の治療:―10年間 (2000～2010) のまとめ―  [Not invited]

  土屋 和彦, 安田 耕一, 西川 由記子, 木下 留美子, 鬼丸 力也, 原田 慶一, 井上 哲也, 加藤 徳雄, 清水 伸一, 白土 博樹, 西岡 健, 鈴木 恵士郎, 田口 大志, 長谷川 雅一, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 福田 諭, 竹内 啓, 田口 純

  耳鼻咽喉科展望  2013
• Real-time Tumor-tracking Radiation Therapy for Lymphoma of the Stomach  [Not invited]

  N. Katoh, R. Suzuki, S. Shimizu, T. Inoue, K. Yasuda, R. Onimaru, R. Kimura, M. Kato, M. Ishikawa, H. Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  2012/11  ELSEVIER SCIENCE INC
  
• 低酸素イメージングと放射線治療(Hypoxia imaging and Radiation therapy)  [Not invited]

  安田 耕一, 鬼丸 力也, 岡本 祥三, 志賀 哲, 加藤 徳雄, 玉木 長良, 白土 博樹

  日本癌学会総会記事  2012/08
• リンフォーマの画像診断と新規治療のプラクティス 皮膚悪性リンパ腫に対する放射線治療  [Not invited]

  鬼丸 力也, 清水 伸一, 土屋 和彦, 加藤 徳雄, 木下 留美子, 井上 哲也, 小野寺 俊輔, 安田 耕一, 西岡 健太郎, 白土 博樹

  日本皮膚悪性腫瘍学会学術大会プログラム・抄録集  2012/06
• 末梢肺におけるディスポーザブルゴールドマーカーによる金球留置の成績  [Not invited]

  小倉 粋, 品川 尚文, 池澤 靖元, 高階 太一, 水柿 秀紀, 山田 範幸, 朝比奈 肇, 榊原 純, 井上 哲也, 加藤 徳雄, 鬼丸 力也, 白戸 博樹, 大泉 聡史, 西村 正治

  気管支学  2012/05
• 放射線を利用した画像診断・治療の最前線 先進的放射線治療におけるPETの役割  [Not invited]

  加藤 徳雄, 鬼丸 力也, 安田 耕一, 志賀 哲, 土屋 和彦, 岡本 祥三, 玉木 長良, 白土 博樹

  日本薬学会年会要旨集  2012/03
• 胃MALTリンパ腫に対する動体追跡照射の経験  [Not invited]

  米山 理奈, 安田 耕一, 加藤 徳雄, 鬼丸 力也, 白土 博樹

  Japanese Journal of Radiology  2012/02
• 北海道大学病院における乳房外Paget病の放射線治療経験  [Not invited]

  原田 慶一, 木下 留美子, 加藤 徳雄, 西岡 健太郎, 清水 伸一, 鬼丸 力也, 白土 博樹

  日本医学放射線学会学術集会抄録集  2012/02
• 胃悪性リンパ腫に対する迎撃照射とマーカー移動の解析  [Not invited]

  加藤 徳雄, 鈴木 隆介, 井上 哲也, 安田 耕一, 鬼丸 力也, 清水 伸一, 木村 理奈, 石川 正純, 白土 博樹

  日本医学放射線学会学術集会抄録集  2012/02
• A new brain positron emission tomography scanner with semiconductor detectors for target volume delineation and radiotherapy treatment planning in patients with nasopharyngeal carcinoma  [Not invited]

  KATOH Norio, YASUDA Koichi, HASEGAWA Masakazu, ONIMARU Rikiya, SHIMIZU Shinichi, SHIRATO Hiroki, SHIGA Tohru, TAMAKI Nagara, BENGUA Gerard, ISHIKAWA Masayori

  Int J Radiat Oncol Biol Phys  2012
• 食道癌IMRT(強度変調放射線治療)の初期経験  [Not invited]

  原田 慶一, 井上 哲也, 安田 耕一, 加藤 徳雄, 清水 伸一, 白土 博樹, Bengua Gerard, 石川 正純, 中積 宏之, 結城 敏志, 小松 嘉人

  北海道外科雑誌  2011/12
• 当院における緩和的放射線治療の実際  [Not invited]

  照井 健, 平山 泰生, 小池 和彦, 日下部 俊朗, 中島 信久, 鬼丸 力也, 井上 哲也, 加藤 徳雄, 石谷 邦彦

  日本癌治療学会誌  2011/09
• O3-4 EBUS-GS併用経気管支鏡下生検にて診断し動体追跡放射線照射にて治療した末梢小型肺癌の検討(インターベンション/動体追跡照射,一般口演3,第34回日本呼吸器内視鏡学会学術集会)  [Not invited]

  竹内 裕, 品川 尚文, 池澤 靖元, 高階 太一, 小倉 粋, 水柿 秀紀, 山田 範幸, 朝比奈 肇, 榊原 純, 加藤 徳雄, 鬼丸 力也, 白土 博樹, 大泉 聡史, 西村 正治

  気管支学 : 日本気管支研究会雑誌  2011/05
• EBUS-GS併用経気管支鏡下生検にて診断し動体追跡放射線照射にて治療した末梢小型肺癌の検討  [Not invited]

  竹内 裕, 品川 尚文, 池澤 靖元, 高階 太一, 小倉 粋, 水柿 秀紀, 山田 範幸, 朝比奈 肇, 榊原 純, 加藤 徳雄, 鬼丸 力也, 白土 博樹, 大泉 聡史, 西村 正治

  気管支学  2011/05
• 乳房温存療法後局所再発症例の検討  [Not invited]

  木下 留美子, 清水 伸一, 土屋 和彦, 加藤 徳雄, 田口 大志, 高橋 将人, 高橋 弘昌, 白土 博樹

  日本医学放射線学会秋季臨床大会抄録集  2010/08
• 口唇癌の放射線治療のretrospective study  [Not invited]

  香泉和寿, 安田耕一, 長谷川雅一, 鬼丸力也, 清水伸一, 木下留美子, 井上哲也, 加藤徳雄, 小野寺俊輔, 田口大志, 溝口史樹, 青山英史, 白土博樹, 西岡健, 武島嗣英

  Jpn J Radiol  2010/07  (公社)日本医学放射線学会
  
• The impact of 18F-fluoromisonidazole PET for H&N cancer and the applying for IMRT  [Not invited]

  YASUDA KOICHI, HASEGAWA MASAICHI, ONIMARU RIKIYA, KINOSHITA RUMIKO, KATO NORIO, TAGUCHI HIROSHI, SHIMIZU SHIN'ICHI, INOUE TETSUYA, ONODERA SHUNSUKE, MIZOGUCHI FUMIKI, AOYAMA HIDEFUMI, SHIRATO HIROKI, SHIGA SATORU, OKAMOTO SHOZO, TAMAKI NAGARA, ISHIKAWA MASAZUMI, SUTHERLAND KENNETH, BENGUA GERARD, MIYAMOTO NAOKI, SUZUKI TAKASUKE

  Jpn J Radiol  2010/07  (公社)日本医学放射線学会
  
• 2.動体追跡放射線照射(RTRT)における金球標識(金マーカー)留置キットの使用経験(第31回 日本呼吸器内視鏡学会北海道支部会)  [Not invited]

  竹内 裕, 品川 尚文, 小倉 粋, 河井 康孝, 伊藤 健一郎, 水柿 秀紀, 山田 範幸, 菊地 英毅, 菊地 順子, 小西 純, 大泉 聡史, 西村 正治, 井上 哲也, 加藤 徳雄, 鬼丸 力也, 白土 博樹

  気管支学 : 日本気管支研究会雑誌  2010/01
• 動体追跡装置を用いた肺定位照射時の投与線量解析—動体追跡データに基づくDVH解析—  [Not invited]

  石川正純, サザランド ケネス, ベングア ジェラード, 鈴木隆介, 宮本直樹, 加藤徳雄, 清水伸一, 鬼丸力也, 青山英史, 白土博樹

  日本放射線腫よう学会誌  2009/08
• OR16-6 動体追跡放射線照射(RTRT)における金球標識(金マーカー)留置キットの使用経験(診断・他,一般口演16,第32回日本呼吸器内視鏡学会学術集会)  [Not invited]

  竹内 裕, 品川 尚文, 小倉 粋, 河井 康孝, 伊藤 健一郎, 水柿 秀紀, 山田 範幸, 菊地 英毅, 菊地 順子, 小西 純, 井上 哲也, 加藤 徳雄, 鬼丸 力也, 白土 博樹, 大泉 聡史, 西村 正治

  気管支学 : 日本気管支研究会雑誌  2009/05
• 転移性脳腫瘍への放射線治療後の認知機能の推移

  青山 英史, 加藤 徳雄, 白土 博樹

  Japanese Journal of Radiology  2009/04  (公社)日本医学放射線学会
  
• 対向型PET装置を用いた分子イメージング動体追跡装置の開発〜¹⁸F点線源を用いた追跡精度の検証〜  [Not invited]

  棚邊哲史, 石川正純, 山口哲, 武島嗣英, 鈴木隆介, 宮本直樹, 加藤徳雄, 清水伸一, 鬼丸力也, 白土博樹

  医学物理 Supplement  2009/04
• 上咽頭癌における半導体PET画像を用いた放射線治療計画  [Not invited]

  加藤徳雄, 志賀哲, 長谷川雅一, 鬼丸力也, 安田耕一, 清水伸一, ベングア ジェラード, 石川正純, 玉木長良, 白土博樹

  日本医学放射線学会総会抄録集  2009/02  (公社)日本医学放射線学会
  
• Can the Real-time Tumor-tracking Radiotherapy Give the Planned Dose to the Tumor? DVH Analysis Based on Measured Real-time Tracking Data  [Not invited]

  M. Ishikawa, K. L. Sutherland, G. Bengua, R. Suzuki, N. Miyamoto, N. Katoh, S. Shimizu, R. Onimaru, H. Aoyama, H. Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  2009  ELSEVIER SCIENCE INC
  
• Skull base MeningiomaにおけるIMRTの利用—当院治療成績を踏まえて—  [Not invited]

  小野寺俊輔, 白土博樹, 青山英史, 田口大志, 加藤徳雄, 木下留美子, 鬼丸力也, 清水伸一, 井上哲也, 安田耕一

  日本医学放射線学会秋季臨床大会抄録集  2008/09  (公社)日本医学放射線学会
  
• 北海道大学における非小細胞肺癌に対する体幹部定位放射線治療の治療成績  [Not invited]

  鬼丸力也, 加藤徳雄, 井上哲也, 田口大志, 清水伸一, 長谷川雅一, 安田耕一, 小野寺俊輔, 木下留美子, 青山英史, 白土博樹

  日本放射線腫よう学会誌  2008/09
• 動体追跡装置を用い安全域3mmで行ったホルモン非併用の前立腺癌放射線治療  [Not invited]

  清水伸一, 大坂康博, 鬼丸力也, 長谷川雅一, 田口大志, 加藤徳雄, 木下留美子, 青山英史, 白土博樹

  日本放射線腫よう学会誌  2008/09
• SOF線量計によるIr‐192高線量率密封小線源治療時のin‐vivoリアルタイム線量測定  [Not invited]

  石川正純, 平塚純一, 長瀬尚巳, GERARD Bengua, KENNETH Sutherland, 加藤徳雄, 清水伸一, 鬼丸力也, 青山英史, 白土博樹

  日本放射線腫よう学会誌  2008/09
• 分子イメージングを利用した患者位置確認のための対向型Open‐PET装置の製作と基礎検討  [Not invited]

  棚邊哲史, 石川正純, 山口哲, 武島嗣英, GERARD Bengua, KENNETH Sutherland, 加藤徳雄, 清水伸一, 鬼丸力也, 白土博樹

  日本放射線腫よう学会誌  2008/09
• 75歳以上の高齢者に対する子宮頚癌の放射線治療  [Not invited]

  木下留美子, 田口大志, 加藤徳雄, 清水伸一, 溝口史樹, 米坂祥朗, 北原利博, 白土博樹

  日本放射線腫よう学会誌  2008/09
• A new positron emission tomography with semiconductor detectors for target volume delineation and radiotherapy treatment planning in patients with nasopharyngeal carcinoma  [Not invited]

  N. Katoh, T. Shiga, M. Hasegawa, R. Onimaru, K. Yasuda, S. Shimizu, G. Bengua, M. Ishikawa, N. Tamaki, H. Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  2008  ELSEVIER SCIENCE INC
  
• 腎・副腎腫瘍に対する動体追跡照射;臨床的検討について  [Not invited]

  芹澤慈子, 加藤徳雄, 白土博樹, 鬼丸力也, 大坂康博, 鈴木恵士郎, 渡辺明, 澤田明徳, 清水匡, 宮坂和男, 清水伸一

  Radiat Med  2007/04
• 腎・副腎腫瘍に対する動体追跡照射;技術的検討について  [Not invited]

  加藤徳雄, 芹澤慈子, 白土博樹, 鬼丸力也, 大坂康博, 鈴木恵士郎, 渡辺佳明, 阿保大介, 清水匡, 宮坂和男, 清水伸一

  Radiat Med  2007/04  (公社)日本医学放射線学会
  
• 頭頚部癌のDOC併用放射線療法;副作用軽減を目的としたステロイド使用について  [Not invited]

  小野寺俊輔, 木下留美子, 藤野賢治, 加藤徳雄, 田口大志, 鬼丸力也, 大阪康博, 清水伸一, 鈴木恵士郎, 西岡健, 白土博樹

  Radiat Med  2007/04
• 動体追跡装置を用いた照射中の乳腺表面の動きの検討  [Not invited]

  木下留美子, 清水伸一, 加藤徳雄, 藤野賢治, 鬼丸力也, 白土博樹

  日本医学放射線学会学術集会抄録集  2007/02
• Feasibility study of real-time tumor-tracking radiotherapy for adrenal tumors: Three-dimensional movement of internal fiducial gold markers measured in supine and prone patient positions  [Not invited]

  N. Katoh, R. Onimaru, S. Shimizu, D. Abo, Y. Sakuhara, H. Taguchi, Y. Osaka, B. Gerard, M. Ishikawa, H. Shirato

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  2007  ELSEVIER SCIENCE INC
  
• 副腎領域における腹臥位と仰臥位でのマーカー移動と迎撃照射の有効性の検討  [Not invited]

  加藤徳雄, 白土博樹, 鬼丸力也, 大坂康博, 清水伸一, 阿保大介, 作原祐介, 宮坂和男

  日本放射線腫よう学会誌  2006/10
• Real-time and precise monitoring of the breast motion during irradiation using real-time tumor-tracking radiotherapy (RTRT) system  [Not invited]

  R. Kinoshita, S. Shimizu, N. Katoh, R. Onimaru, H. Shirato, K. Miyasaka

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  2006  ELSEVIER SCIENCE INC
  
• 放射線治療効果の向上を目指した新手法開発とその臨床応用 動体追跡照射装置を用いた放射線治療  [Not invited]

  鬼丸 力也, 白土 博樹, 藤野 賢治, 田口 大志, 加藤 徳雄, 大坂 康博, 清水 伸一, 青山 英史, 鈴木 恵士郎

  日本放射線影響学会大会講演要旨集  2005/11  (一社)日本放射線影響学会
  
• 画像診断技術の進歩と放射線治療 脳動静脈奇形の定位照射を例として

  青山 英史, 加藤 徳雄, 土屋 和彦, 藤野 賢治, 白土 博樹, 宮坂 和男

  日本医学放射線学会雑誌  2004/11  (公社)日本医学放射線学会
  
• 画像診断の進歩と放射線治療 治療計画と効果判定にどのように役立っているか 放射線脳壊死と腫瘍再発の鑑別におけるL-[methyl-11C]-methionine PET(Met-PET)

  加藤 徳雄, 中駄 邦博, 青山 英史, 竹井 俊樹, 白土 博樹, 玉木 長良, 宮坂 和男

  断層映像研究会雑誌  2003/09  断層映像研究会
  
• Could stereotactic irradiation (STI) for both lung tumor and metastatic brain tumors improve survival and functional status of patients with non-small cell lung cancer (NSCLC)?  [Not invited]

  Katoh N, Aoyama H, Onimaru R, Shirato H, Miyasaka K

  6th Internatinal Stereotactic Radisorugery Society Congress  2003/06
• 肺非小細胞癌における肺腫瘍・脳転移に対する定位放射線照射(第46回肺癌学会北海道支部会 北海道支部 支部活動)  [Not invited]

  加藤 徳雄, 青山 英史, 鬼丸 力也, 白土 博樹, 宮坂 和男, 原田 敏之, 木下 一郎, 山崎 浩一, 西村 正治, 秋田 弘俊

  肺癌  2003/02
• 放射線脳壊死と脳腫瘍の鑑別におけるL-[methyl-11C]-methionine PET(MET)

  加藤 徳雄, 中駄 邦博, 青山 英史, 竹井 俊樹, 白土 博樹, 玉木 長良, 宮坂 和男

  日本医学放射線学会雑誌  2003/02  (公社)日本医学放射線学会
  
• 肝損傷のIVR

  船窪 正勝, 久保 公三, 阿保 大介, 大山 徳子, 加藤 徳雄, 宮崎 知保子, 佐藤 朝之

  IVR: Interventional Radiology  2001/07  (一社)日本インターベンショナルラジオロジー学会
  
• 腎損傷のIVR

  久保 公三, 阿保 大介, 船窪 正勝, 大山 徳子, 加藤 徳雄, 宮崎 知保子, 佐藤 朝之

  IVR: Interventional Radiology  2001/07  (一社)日本インターベンショナルラジオロジー学会
  
• 脾損傷のIVR

  阿保 大介, 久保 公三, 船窪 正勝, 大山 徳子, 加藤 徳雄, 宮崎 知保子, 佐藤 朝之

  IVR: Interventional Radiology  2001/07  (一社)日本インターベンショナルラジオロジー学会
  
• 中枢神経サルコイドーシスの2例

  阿保 大介, 宮崎 知保子, 加藤 徳雄, 大山 徳子, 羽田 健一, 久保 公三

  日本医学放射線学会雑誌  2001/05  (公社)日本医学放射線学会
  
• 脳ノカルジア症の2例

  加藤 徳雄, 阿保 大介, 大山 徳子, 羽田 健一, 久保 公三, 宮崎 知保子, 寺江 聡

  日本医学放射線学会雑誌  2001/05  (公社)日本医学放射線学会
  
• 抗リン脂質抗体症候群を背景にして発症した腎梗塞の1例

  阿保 大介, 久保 公三, 大山 徳子, 松下 和裕, 加藤 徳雄, 宮崎 知保子

  IVR: Interventional Radiology  2001/01  (一社)日本インターベンショナルラジオロジー学会
  
• 十二指腸閉塞で発症した多発膵十二指腸動脈瘤の1例

  大山 徳子, 久保 公三, 阿保 大介, 松下 和裕, 加藤 徳雄, 宮崎 知保子

  IVR: Interventional Radiology  2001/01  (一社)日本インターベンショナルラジオロジー学会
  

Association Memberships

• 欧州放射線腫瘍学会   米国放射線腫瘍学会   日本肝癌研究会   日本膵臓学会   日本放射線腫瘍学会   日本医学放射線学会   

Research Projects

• MR画像誘導陽子線治療システムおよび磁場下の治療計画・検証技法に関する基盤開発

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2024/04 -2028/03 

  Author : 松浦 妙子, 宮本 直樹, 打浪 雄介, 高尾 聖心, 陳 叶, 橋本 孝之, 栗山 靖敏, 加藤 徳雄
• Research on standard methods and data for evaluating the cost-effectiveness of particle therapy

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2017/04 -2022/03 

  Author : Moriwaki Kensuke

   

  Standard methods for evaluating the cost-effectiveness of proton beam therapy (PBT) were organized and analyzed in liver cancer. A model was constructed based on the Advanced B trial, and the incremental cost-effectiveness ratio (ICER) of PBT compared to transarterial embolization (TACE) was estimated from the public payer's perspective: $18,102 in additional costs were incurred in the PBT group compared to the TACE group, with an incremental benefit of 0.307 QALYs, and an ICER was $59,006/QALY, below the threshold for cancer treatment of $75,000/QALY. While the sensitivity analysis estimated a 70.8% probability that PBT would be cost-effective, scenarios were identified in which PBT would be cost-effective poorly, mainly in the survival function setting.
• Development of minimum invasive real-time markerless image guided radiotherapy technique using minimum space information.

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B)

  Date (from‐to) : 2018/04 -2021/03 

  Author : Shimizu Shinichi

   

  In the real-time tumor tracking radiotherapy, feature point information, that is used for gating, is obtained by fluoroscopic X-ray images. There still problems exist:1.X-ray exposure from diagnostic X ray that used for gating 2.insertion of a gold marker etc. as a feature pointReduce or eliminate X-ray exposure by making the observing area through diagnostic X-rays as small as possible to acquire target movement information or establishing the method of processing gating information obtained using MRI technology without using fluoroscopy were considered to be the goal of this study. X-rays are still optimal for acquiring organ motion information within human body necessary for gating treatment in real time, but a method for limiting the range was achieved in this study. In addition, we succeeded in trying to visualize the position of organs with MRI image data without using X-rays when preparing for treatment, and there were expectations for the promotion of future research.
• Personalized Proton Beam Thearpy for Liver Cancers

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2016/04 -2021/03 

  Author : Norio Katoh

   

  The purpose of this study is to develop a method to identify radioresistance of liver cancers from imaging information before proton beam therapy and to establish personalized proton beam therapy for each patient. Analysis of clinical outcomes of radiotherapy for liver cancer has shown that tumors smaller than 2 cm rarely recur even when treated with high doses. Analysis of the association between ADC images of MRI before proton beam therapy and local recurrence of tumors larger than 2 cm suggests that tumors with low ADC values are more likely to recur and that ADC values are effective in predicting treatment efficacy before proton beam therapy. Considering that the selection of treatment with X-ray or proton beam therapy is necessary for personalized proton beam therapy for tumors smaller than 5 cm, we created a selection model and found three factors related to the tumors (size, location, and number of tumors) that are necessary to consider for the selection criteria.
• Effect and safety of stereotactic radiotherapy for cancers in various organs except for lung and liver

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B)

  Date (from‐to) : 2016/04 -2021/03 

  Author : ONISHI Hiroshi

   

  We started this study in order to expand the indications of re-imbursement and roles of SRT for various cancers and disease status. By the multi-institutional studies of the SRT for cancers in that it was difficult to complete the research because one sole institution can hardly collect treated cases, we got a lot of new findings for them. According to presentations and publications of the study results, we have accomplished the initial purpose of this study that included the expansion of national medical insurance for SRT in some cancers (renal cancer, spinal metastases, oligometastases and pancreas cancer), deep discussion of a proper indication of SRT in the cancer board, and increase of SRT cases. Further studies and public awareness campaigns are mandatory for a more suitable indication and utilization of SRT.
• Attempt of 4D-IGRT by Volume Matching Method of 4D-CBCT and Therapy Planning CT

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B)

  Date (from‐to) : 2015/04 -2018/03 

  Author : Shimizu Shinichi

   

  We conduct research using 2 axis of diagnostic X-ray fluoroscope that consist real-time tumour-tracking (RTRT) system installed in a proton beam treatment gantry. With the use of the system, we conduct a research aimed constructing a 4D-IGRT radiotherapy system that can treat cancer in consideration of spatial and temporal fluctuations and also respiratory movement of tumors. Four-dimensional cone beam CT (4D-CBCT) image is obtained from the fluoroscopic image of the RTRT system. From the 4D-CBCT image group composed of a plurality of respiratory phases, a CT image that represent the same respiratory phase as the CT image used for the treatment plan is selected. We develop an advanced real time image guidance system aiming marker-less 4D-RT using selected CBCT image and its source image.
• A study for single nucleotide polymorphism as a risk factor correlating to radiation pneumonitis after stereotactic body radiotherapy for non-small celllung cancer.

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)

  Date (from‐to) : 2012/04 -2016/03 

  Author : ONISHI Hiroshi, SHIOYAMA Yoshiyuki, YOSHITAKE Tadamasa, ITO Yoichi, SHIRATO Hiroki, IMAI Takashi, ONIMARU Rikiya, KOKUBO Masaki, KURIYAMA Kengo, KOMIYAMA Takafumi, TOMINAGA Rihito, OGURI Mitsuhiko, NONAKA Hotaka, AOKI Shinichi, MATSUMOTO Yasuo, MATSUSHITA Haruo, TAKAYAMA Kenji, INOUE Tetsuya, KATO Norio, YAMASHITA Hideomi, KARASAWA Katsuyuki, EBARA Takeshi, UEKI Nami, MATSUO Yukinori

   

  Stereotactic body radiotherapy (SBRT) has been expected to be highly effective and safe treatment for early stage non-small cell lung cancer, however serious radiation pneumonitis is occasionally reported. One of the risk factors may include pulmonary fibrosis, but the details have not been clarified. Therefore, in this study, we examined a single nucleotide polymorphism (SNPs) in TGFb1 gene, para- TGFb1, or inflammation-related gene observed in the white and the black group in that a correlation with an onset risk of radiation pneumonitis after SBRT. As a result, it was revealed that a history of steroid administratoin, mean dose of normal lung）, and SNIPs of rs1801270 or rs1800470 were correlated to outbreak of CTCAE grade 2 or more radiation pneumonitis, and that history of steroid administratoin and SNIP of rs1800470 were correlated to outbreak of infiltrative shadow on extra-irradiated volume in CT images.
• Development of a new method for gated radiotherapy using multiple gating points with a real time tumor tracking system.

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Young Scientists (B)

  Date (from‐to) : 2012/04 -2015/03 

  Author : KATOH Norio

   

  The efficacy of four-dimensional computed tomography (4DCT) before stereotactic body radiotherapy (SBRT) for peripheral lung tumors was evaluated. The amplitude of a fiducial marker implanted near a lung tumor was measured using the maximum intensity projection (MIP) method in 4DCT imaging acquired before SBRT and compared with that measured during SBRT using real-time tumor-tracking radiotherapy (RTRT) system. In the lower lobe, the mean discrepancy from the amplitude measured with 4DCT to the mean of maximum amplitude of the patient during SBRT was 5.7 ± 8.0 mm, 12.5 ± 16.7 mm, 6.8 ± 8.5 mm in the LR, CC, and AP direction, respectively. 4DCT MIP before SBRT underestimates the maximum amplitude during actual SBRT. Caution must be paid to determine the margin with 4DCT especially for tumors in the lower lobe. More research is needed to establish a new method for gated radiotherapy using multiple gating points.
• Research for Real-time Tracking Medical Science

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (A)

  Date (from‐to) : 2009 -2012 

  Author : SHIRATO Hiroki, HONMA Sato, TAMAKI Nagara, KUGE Yuji, MIZUTA Masahiro, DATE Hiroyuki, TANAKA Masaki, HAGA Hisashi, NISHIOKA Takeshi, KATO Motothugu, CHAMOTO Kenji, OIZUMI Satoshi, MATSUNAGA Naofumi, OKIMOTO Tomoaki, HAYAKAWA Kazushige, NISHIO Teiji, TADANO Shigeru, ISHIKAWA Masayori, ONODERA Yasuhito, SHIBUYA Keiko, HAMADA Toshiyuki, ONIMARU Rikiya, SHIMIZU Shinichi, TSUCHIYA Kazuhiko, KATOH Norio, KINOSHITA Rumiko, INOUE Tetsuya, ONODERA Syunsuke, TAKAO Seishin, KAGA Kichizo, TERAE Satoshi, ONODERA Yuya, SAKUHARA Yusuke, MANABE Noriko, ABO Daisuke, KATO Fumi, KHIN KHIN Tha, NAM Jin-min, SABE Hisataka, INUBUSHI Masayuki, SHINAGAWA Naofumi, KENNETH Sutherland

   

  Up to now, in the field of basic medicine from micro-level to animal level, to track and quantify the three-dimensional spatial information along the time axis in real-time has not caught up with the accuracy in the field of clinical medicine. By handing big data of “motion in life, a new idea of real-time radiotherapy and a new precise four-dimensional computed tomography has been developed based on the data of actual tumor motion in the human body.

Industrial Property Rights

• 特開2020-156562:動体追跡装置とそれを備えた放射線治療システム、プログラム、および動体の追跡方法  2020/10/01

  梅川 徹, 宮崎 康一, 藤井 孝, 清水 伸一, ▲高▼尾 聖心, 梅垣 菊男, 宮本 直樹, 加藤 徳雄  株式会社日立製作所, 国立大学法人北海道大学  202003018251233772
• 特開2016-131737:放射線治療システムおよび放射線治療プログラム  2016/07/25

  宮本 直樹, 清水 伸一, 松浦 妙子, 高▼尾 聖心, 平田 雄一, 梅垣 菊男, 加藤 徳雄  国立大学法人北海道大学  201603011303099827

Social Contribution

• Japanese Journal of Radiology Associate Editor

  Date (from-to) : 2024/06/01-Today

  Role : Editor

  Sponser, Organizer, Publisher  : 日本医学放射線学会