Researcher Profile and Settings

Affiliation

• Hokkaido University Hospital　Radiology

Job Title

• Assistant Professor

Research funding number

• 00431362

J-Global ID

• 201301064167069273

Research Interests

• Intensity-modulated proton therapy   Proton therapy   semiconductor PET   FMISO   Intensity Modulated Radiation Therapy   Head and Neck Cancer   Hypoxia   Positron Emission Tomography   radiation therapy   

Research Areas

• Life sciences / Radiology / radiation therapy

Educational Organization

•  Master's degree program　Graduate School of Medicine
•  Doctoral (PhD) degree program　Graduate School of Medicine

Academic & Professional Experience

• 2017/04 - Today Hokkaido University Hospital Department of Radiation Oncology Assistant Professor
• 2012/09 - 2017/03 Research Center for Cooperative Projects, Graduate School of Medicine, Hokkaido University Assistant Professor
• 2015/04 - 2015/09 Stanford University School of Medicine Department of Radiation Oncology visiting scholar

Education

• 2008/04 - 2012/06  Graduate School of Medicine, Hokkaido University

Association Memberships

• JAPAN SOCIETY FOR HEAD AND NECK CANCER   American Society for Radiation Oncology   JAPAN RADIOLOGICAL SOCIETY   JAPANESE SOCIETY FOR THERAPEUTIC RADIOLOGY AND ONCOLOGY   

Research Activities

Published Papers

• 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.
• 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.
• Correction: Treatment outcomes of radiotherapy with concurrent weekly cisplatin in older patients with locally advanced head and neck squamous cell carcinoma.

  Yusuke Uchinami, Koichi Yasuda, Satoshi Kano, Manami Otsuka, Seijiro Hamada, Takayoshi Suzuki, Nayuta Tsushima, Shuhei Takahashi, Yoshihiro Fujita, Tomohiko Miyazaki, Hajime Higaki, Jun Taguchi, Yasushi Shimizu, Tomohiro Sakashita, Akihiro Homma, Hidefumi Aoyama

  Discover. Oncology 15 (1) 18 - 18 2024/01/25 [Refereed]
  
• Radiotherapy with or without chemotherapy for locally advanced head and neck cancer in elderly patients: analysis of the Head and Neck Cancer Registry of Japan.

  Koichi Yasuda, Yusuke Uchinami, Satoshi Kano, Jun Taguchi, Daisuke Kawakita, Megumi Kitayama, Kentaro Nishioka, Takashi Mori, Fuki Koizumi, Yuri Fujii, Yasushi Shimizu, Keiji Kobashi, Seiichi Yoshimoto, Ken-Ichi Nibu, Akihiro Homma, Hidefumi Aoyama

  International journal of clinical oncology 2023/12/29 [Refereed]
   

  BACKGROUND: Whether concurrent chemotherapy with radiotherapy (CRT) is effective for elderly patients with head and neck cancer is a controversial topic. This study aimed to analyze the effectiveness of CRT vs. radiation therapy (RT) among elderly patients in Japan. METHODS: Data from the Head and Neck Cancer Registry of Japan were extracted and analyzed. Patients with locally advanced squamous cell carcinoma of the oropharynx, hypopharynx, or larynx who received definitive CRT or RT between 2011 and 2014 were included. RESULTS: CRT was administered to 78% of the 1057 patients aged ≥ 70 years and 67% of the 555 patients aged ≥ 75 years. For the patients aged ≥ 75 years, the overall survival (OS) rate was significantly better in the CRT group than in the RT group (P < 0.05), while the progression-free survival (PFS) rate was not significantly different (P > 0.05). The add-on effect of CRT was significantly poor in elderly patients (P < 0.05), and it was not a significant factor in the multivariate analysis for patients aged ≥ 75 years. After propensity score matching, there were no significant differences in the OS and PFS rates between the patients aged ≥ 70 years and those aged ≥ 75 years (all, P > 0.05). CONCLUSION: Although aggressive CRT is administered to elderly patients in Japan, its effectiveness is uncertain. Further prospective randomized trials are needed to verify whether CRT is superior to RT alone for elderly patients.
• Treatment outcomes of radiotherapy with concurrent weekly cisplatin in older patients with locally advanced head and neck squamous cell carcinoma.

  Yusuke Uchinami, Koichi Yasuda, Satoshi Kano, Manami Otsuka, Seijiro Hamada, Takayoshi Suzuki, Nayuta Tsushima, Shuhei Takahashi, Yoshihiro Fujita, Tomohiko Miyazaki, Hajime Higaki, Jun Taguchi, Yasushi Shimizu, Tomohiro Sakashita, Akihiro Homma, Hidefumi Aoyama

  Discover. Oncology 14 (1) 226 - 226 2023/12/08 [Refereed]
   

  BACKGROUND: Tri-weekly cisplatin and radiotherapy (CDDP + RT) is a standard of care for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) but is sometimes challenging to complete in older patients. Weekly CDDP + RT has shown mild toxicity compared to tri-weekly CDDP + RT for LA-HNSCC and is a promising option for older adults. We aimed to report the treatment outcomes and prognostic factors in patients with LA-HNSCC treated with weekly CDDP + RT. METHODS: We analyzed patients aged ≥ 70 years who started weekly CDDP + RT for LA-HNSCC between July 2006 and October 2022. LA-HNSCC includes cancer in the oropharynx, hypopharynx, or larynx with a clinical stage of 3 or 4 without distant metastases based on the Union for International Cancer Control staging system 8th edition. The radiation dose of 70 Gy was delivered in 35 fractions by 3-dimensional conformal radiotherapy, intensity-modulated radiotherapy, or proton beam therapy. The primary endpoint was the 3-year overall survival (OS), and the secondary endpoints were the 3-year progression-free survival (PFS) and 3-year cause-specific survival (CSS). The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to evaluate statistical significance. A Cox proportional hazards model was used for the multivariate analysis of prognostic factors. RESULTS: The median age of the 49 patients was 72 (range: 70-78) years. The median CDDP dose was 200 (40-280) mg/ m2, and 47 patients completed scheduled radiotherapy. Forty-eight patients (98.0%) had a performance status of ≥ 1 at the initial visit. The 3-year OS, PFS, and CSS were 80.9% (95% confidence interval [CI]: 64.8-90.7), 68.3% (95% CI 51.8-81.2), and 85.0% (95% CI 68.7-93.4), respectively. In the multivariate analysis, the cumulative CDDP dose (< 200 or ≥ 200 mg/m2) was a significant factor for OS (hazard ratio: 0.29 [95% CI 0.08-0.97], p = 0.044). There was one case of early mortality. Grade 3 or higher late adverse events were observed in four patients (8.2%). CONCLUSIONS: Weekly CDDP + RT in older patients led to good survival outcomes with an acceptable rate of adverse events. CDDP should be administered at a dose of at least 200 mg/m2 in older patients. Trial registration Retrospectively registered.
• 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]
   

  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.
• Comparative study of physiological FDG uptake in small structures between silicon photomultiplier-based PET and conventional PET.

  Shiro Watanabe, Kenji Hirata, Keiichi Magota, Junki Takenaka, Naoto Wakabayashi, Daiki Shinyama, Koichi Yasuda, Akihiro Homma, Kohsuke Kudo

  Annals of nuclear medicine 2023/11/09 [Refereed]
   

  OBJECTIVE: Silicon photomultiplier-based positron emission tomography/computed tomography (SiPM-PET/CT) has the superior spatial resolution to conventional PET/CT (cPET/CT). This head-to-head comparison study compared the images of physiological 18F-fluorodeoxyglucose (FDG) accumulation in small-volume structures between SiPM-PET/CT and cPET/CT in patients scanned with both modalities, and we investigated whether the thresholds that are reported to be useful for differentiating physiological accumulations from malignant lesions can also be applied to SiPM-PET/CT. METHODS: We enrolled 21 consecutive patients with head and neck malignancies who underwent whole-body FDG-PET/CT for initial staging or a follow-up evaluation (October 2020 to March 2022). After being injected with FDG, all patients underwent PET acquisition on both Vereos PET-CT and Gemini TF64 PET-CT systems (both Philips Healthcare) in random order. For each patient, the maximum standardized uptake value (SUVmax) was measured in the pituitary gland, esophagogastric junction (EGJ), adrenal glands, lumbar enlargement of the spinal cord, and epididymis. We measured the liver SUVmean and the blood pool SUVmean to calculate the target-to-liver ratio (TLR) and the target-to-blood ratio (TBR), respectively. Between-groups differences in each variable were examined by a paired t-test. We also investigated whether there were cases of target uptake greater than the reported threshold for distinguishing pathological from physiological accumulations. RESULTS: Data were available for 19 patients. Ten patients were in Group 1, i.e., the patients who underwent SiPM-PET first, and the remaining nine patients who underwent cPET first were in Group 2. In the SiPM-PET results, the SUVmax of all targets was significantly higher than that obtained by cPET in all patients, and this tendency was also observed when the patients were divided into Groups 1/2. The TLRs of all targets were significantly higher in SiPM-PET than in cPET in all patients, and SiPM-PET also showed significantly higher TBRs for all targets except the EGJ (p = 0.052). CONCLUSIONS: The physiological uptake in the small structures studied herein showed high accumulation on SiPM-PET. Our results also suggest that the thresholds reported for cPET to distinguish pathological accumulations likely lead to false-positive findings in SIPM-PET evaluations.
• Adjuvant treatments for locally advanced differentiated thyroid cancer: a nationwide survey in Japan.

  Terufumi Kawamoto, Koichi Yasuda, Yoshinori Ito, Sadamoto Zenda, Katsuyuki Sakanaka, Naoto Shikama, Naoki Nakamura, Takashi Mizowaki

  Endocrine journal 2023/09/30 [Refereed]
   

  The role of adjuvant external-beam radiotherapy (EBRT) for locally advanced differentiated thyroid cancer (DTC) is controversial because of the lack of prospective data. To prepare for a clinical trial, this study investigated the current clinical practice of adjuvant treatments for locally advanced DTC. A survey on treatment selection criteria for hypothetical locally advanced DTC was administered to representative thyroid surgeons of facilities participating in the Japan Clinical Oncology Group Radiation Therapy Study Group. Of the 43 invited facilities, surgeons from 39 (91%) completed the survey. For R1 resection or suspected residual disease, 26 (67%) facilities administered high-dose (100-200 mCi) radioactive iodine (RAI), but none performed EBRT. For R2 resection or unresectable primary disease, 26 (67%) facilities administered high-dose RAI and 7 (18%) performed adjuvant treatments, including EBRT. For complete resection with nodal extra-capsular extension, 13 (34%) facilities administered high-dose RAI and 1 (3%) performed EBRT. For unresectable mediastinal lymph node metastasis, 31 (79%) facilities administered high-dose RAI and 5 (13%) performed adjuvant treatments, including EBRT. Adjuvant EBRT was not routinely performed mainly because of the lack of evidence for efficacy (74%). Approximately 15% of the facilities routinely considered adjuvant EBRT for DTC with R2 resection or unresectable primary or lymph node metastasis disease. Future clinical trials will need to optimize EBRT for these patients.
• 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]
   

  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.
• Summary of Japanese clinical practice guidelines for head and neck cancer - 2022 update edited by the Japan society for head and neck cancer.

  Akihiro Homma, Mizuo Ando, Nobuhiro Hanai, Hiroyuki Harada, Yoshitaka Honma, Tomonori Kanda, Satoshi Kano, Daisuke Kawakita, Naomi Kiyota, Yoshiyuki Kizawa, Masahiro Nakagawa, Takenori Ogawa, Hirotaka Shinomiya, Takeshi Shinozaki, Motoyuki Suzuki, Tetsuya Tsuji, Koichi Yasuda, Sadamoto Zenda, Takeshi Kodaira, Tadaaki Kirita, Ken-Ichi Nibu

  Auris, nasus, larynx 2023/07/21 [Refereed]
   

  The aim of the "Japanese Clinical Practice Guidelines for Head and Neck Cancer - 2022 Update" is to review the latest evidence regarding head and neck cancer and to present the current standard approaches for diagnosis and treatment. These evidence-based recommendations were created with the consensus of the Guideline Committee, which is composed of otorhinolaryngologists and head and neck surgeons, together with radiologists, radiation oncologists, medical oncologists, plastic surgeons, dentists, palliative care physicians, and rehabilitation physicians. These guidelines were created by the Clinical Practice Guideline Committee of the Japan Society for Head and Neck Cancer based on the "Head and Neck Cancer Treatment Guidelines 2018 Edition," and the revised draft was compiled after evaluation by the Assessment Committee and public comments. The 'Clinical questions and recommendations' section consists of 13 categories, and 59 clinical questions are described in total. Here we describe 6 clinical questions specific to other sets of guidelines with recommendations and comments.
• Treatment outcomes of the patient with sinonasal mucosal melanoma: the role of endoscopic resection and postoperative radiotherapy.

  Nayuta Tsushima, Satoshi Kano, Koichi Yasuda, Takayoshi Suzuki, Seijiro Hamada, Yuji Nakamaru, Masanobu Suzuki, Yusuke Uchinami, Hidefumi Aoyama, Akihiro Homma

  International journal of clinical oncology 28 (9) 1218 - 1226 2023/06/17 [Refereed]
   

  BACKGROUND: The standard of care for sinonasal mucosal melanoma is surgery and postoperative radiotherapy (PORT). Our treatment strategy comprises endoscopic resection and PORT. We performed combined endoscopic and open resection or applied an external approach alone when sufficient resection was difficult to achieve endoscopically. The objective of this study was to evaluate the validity of our treatment strategy. METHODS: We assessed 30 patients with sinonasal mucosal melanoma who underwent definitive therapy between January 2002 and April 2021, and conducted a retrospective analysis. The median follow-up period was 2.2 years. The primary endpoint was overall survival. The Kaplan-Meier method was used for the calculation of survival rates, the cumulative incidence of distant metastasis, and local recurrence. RESULTS: Twenty-eight patients underwent surgery. The other two patients were treated by definitive proton beam therapy. Twenty-one of 28 (75%) patients underwent resection by endoscopic approach alone. Postoperative radiotherapy was performed for all 28 patients who underwent surgery. Twenty-one patients (70%) experienced recurrence during the observation period. Overall, distant metastasis was observed in 19 patients. Twelve patients died during the observation period, with 10 of the 12 patients (83%) dying of distant metastasis. The overall survival rate at 2 and 5 years was 70% and 46%, respectively. The cumulative incidence rate of distant metastasis at 2 years was 63%, while the 2-year cumulative incidence rate of local recurrence was 6.7%. CONCLUSION: The local disease was controlled by our treatment strategy. To improve treatment outcomes, control of the distant metastasis is needed.
• The superselective intra-arterial infusion of cisplatin and concomitant radiotherapy (RADPLAT) is effective for metastatic lymph nodes in head and neck squamous cell carcinoma.

  Satoshi Kano, Takayoshi Suzuki, Daisuke Yoshida, Nayuta Tsushima, Seijiro Hamada, Koichi Yasuda, Yusuke Uchinami, Hidefumi Aoyama, Akihiro Homma

  International journal of clinical oncology 28 (9) 1121 - 1128 2023/06/08 [Refereed]
   

  BACKGROUND: Superselective intra-arterial infusion of cisplatin and concomitant radiotherapy (RADPLAT) is a very promising treatment modality for locally advanced head and neck squamous cell carcinoma. However, there are some concerns regarding its potential for the control of neck lymph node metastasis. The objective of this study was to investigate whether RADPLAT provided inferior regional control compared to intravenous chemoradiotherapy (IV-CRT). METHODS: A total of 172 patients with neck lymph node metastases, 66 of whom underwent RADPLAT and 106 IV-CRT, were enrolled in this study. We retrospectively compared regional control rates between RADPLAT and IV-CRT. Furthermore, to adjust for differences in factors related to patient background between the groups, we conducted inverse probability weighting (IPW) analysis using the propensity score. RESULTS: A comparison between the two groups revealed that the regional control rates were almost equal under unadjusted conditions; however, after adjustment by IPW analysis, the RADPLAT group had a relatively better regional control rate than did the IV-CRT group (1 year regional control rate: 86.6% vs. 79.4%). In addition, the analysis of relative risk factors for regional control in the RADPLAT group showed that the absence of intra-arterial cisplatin infusion into metastatic lymph nodes was the only independent risk factor (Hazard ratio: 4.23, p = 0.04). CONCLUSION: This study showed that the regional control rate in patients treated with RADPLAT was noninferior to that for IV-CRT. Locally advanced head and neck cancers is a good indication for RADPLAT, even if the patients have neck lymph node metastases.
• Proton beam therapy for gliomas: a multicenter prospective registry study from all proton beam facilities in Japan

  Takashi Mori, Masashi Mizumoto, Katsuya Maebayashi, Kentaro Nishioka, Yoshiki Arakawa, Kazuhiko Kurozumi, Koichi Yasuda, Taisuke Sumiya, Hiroyasu Tamamura, Yoshitaka Sato, Takahiro Waki, Masaru Takagi, Yu Takada, Tomoaki Okimoto, Masao Murakami, Yasuhiro Kikuchi, Kazufumi Okada, Yoichi M Ito, Tetsuo Akimoto, Hidefumi Aoyama

  Journal of Radiation Research 0449-3060 2023/04/07 [Refereed]
   

  Abstract We reviewed the outcomes of glioma patients enrolled in a prospective observational registry study of proton beam therapy (PBT) in Japan. The inclusion criteria were glioma patients registered in the Electronic Data Capture system, the Proton-net, between May 2016 and July 2019. Data on patient characteristics, treatments, late adverse events, survival status, recurrence and secondary tumors were extracted and statistically analyzed. The primary endpoint was the overall survival (OS) rate, and the secondary endpoints were the progression-free survival (PFS) rate and cumulative local recurrence rate (cLRR). Of the 65 primary brain tumor patients registered, 29 glioma patients from eight of 19 PBT facilities met the inclusion criteria. There were 19 glioblastoma patients, eight of other malignant gliomas, and two of low-grade gliomas. For glioblastomas, with a median follow-up period of 16 months, the median survival time was 21.2 months and the OS at 1, 2, 3 and 4 years were 77.4%, 44.9%, 23.9% and 23.9%, respectively. The median PFS period was 10.1 months, the 1, 2, 3 and 4-year PFS were 32.4%, 19.4%, 9.7% and 9.7%, respectively. The 1, 2, 3 and 4-year cLRR were 56.1%, 68.8%, 78.4 and 78.4%, respectively. Grade 3 brain necrosis was observed in two patients. No secondary tumor was observed. This is the first report on the current status of PBT for gliomas in Japan. For glioblastomas, the outcomes of PBT are estimated to be equivalent to historical data of photon therapy. The results of a prospective comparative evaluation of PBT and photon therapy are awaited.
• 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.
• Deformed dose restoration to account for tumor deformation and position changes for adaptive proton therapy.

  Koichi Miyazaki, Yusuke Fujii, Takahiro Yamada, Takahiro Kanehira, Naoki Miyamoto, Taeko Matsuura, Koichi Yasuda, Yusuke Uchinami, Manami Otsuka, Hidefumi Aoyama, Seishin Takao

  Medical physics 50 (2) 675 - 687 2022/12/11 [Refereed]
   

  BACKGROUND: Online adaptation during intensity-modulated proton therapy (IMPT) can minimize the effect of inter-fractional anatomical changes, but remains challenging because of the complex workflow. One approach for fast and automated online IMPT adaptation is dose restoration, which restores the initial dose distribution on the updated anatomy. However, this method may fail in cases where tumor deformation or position changes occur. PURPOSE: To develop a fast and robust IMPT online adaptation method named "deformed dose restoration (DDR)" that can adjust for inter-fractional tumor deformation and position changes. METHODS: THE DDR METHOD COMPRISES TWO STEPS: : (1) calculation of the deformed dose distribution, and (2) restoration of the deformed dose distribution. First, the deformable image registration (DIR) between the initial clinical target volume (CTV) and the new CTV were performed to calculate the vector field. To ensure robustness for setup and range uncertainty and the ability to restore the deformed dose distribution, an expanded CTV-based registration to maintain the dose gradient outside the CTV was developed. The deformed dose distribution was obtained by applying the vector field to the initial dose distribution. Then, the voxel-by-voxel dose difference optimization was performed to calculate beam parameters that restore the deformed dose distribution on the updated anatomy. The optimization function was the sum of total dose differences and dose differences of each field to restore the initial dose overlap of each field. This method only requires target contouring, which eliminates the need for organs at risk (OARs) contouring. Six clinical cases wherein the tumor deformation and/or position changed on repeated CTs were selected. DDR feasibility was evaluated by comparing the results with those from three other strategies, namely, not adapted (continuing the initial plan), adapted by previous dose restoration, and fully optimized. RESULTS: In all cases, continuing the initial plan was largely distorted on the repeated CTs and the dose-volume histogram (DVH) metrics for the target were reduced due to the tumor deformation or position changes. On the other hand, DDR improved DVH metrics for the target to the same level as the initial dose distribution. Dose increase was seen for some OARs because tumor growth had reduced the relative distance between CTVs and OARs. Robustness evaluation for setup and range uncertainty (3 mm/3.5%) showed that deviation in DVH-bandwidth for CTV D95% from the initial plan was 0.4 ± 0.5% (Mean ± S.D.) for DDR. The calculation time was 8.1 ± 6.4 min. CONCLUSIONS: An online adaptation algorithm was developed that improved the treatment quality for inter-fractional anatomical changes and retained robustness for intra-fractional setup and range uncertainty. The main advantage of this method is that it only requires target contouring alone and saves the time for OARs contouring. The fast and robust adaptation method for tumor deformation and position changes described here can reduce the need for offline adaptation and improve treatment efficiency. This article is protected by copyright. All rights reserved.
• 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.
• Hyperfractionated intensity-modulated proton therapy for pharyngeal cancer with variable relative biological effectiveness: A simulation study.

  Koki Kasamatsu, Taeko Matsuura, Koichi Yasuda, Koichi Miyazaki, Seishin Takao, Masaya Tamura, Manami Otsuka, Yusuke Uchinami, Hidefumi Aoyama

  Medical physics 49 (12) 7815 - 7825 2022/10/27 [Refereed]
   

  BACKGROUND: The relative biological effectiveness (RBE) of proton is considered to be dependent on biological parameters and fractional dose. While hyperfractionated photon therapy was effective in the treatment of patients with head and neck cancers, its effect in intensity-modulated proton therapy (IMPT) under the variable RBE has not been investigated in detail. PURPOSE: To study the effect of variable RBE on hyperfractionated IMPT for the treatment of pharyngeal cancer. We investigated the biologically effective dose (BED) to determine the theoretical effective hyperfractionated schedule. METHODS: The treatment plans of three pharyngeal cancer patients were used to define the ΔBED for the clinical target volume (CTV) and soft tissue (acute and late reaction) as the difference between the BED for the altered schedule with variable RBE and conventional schedule with constant RBE. The ΔBED with several combinations of parameters (treatment days, number of fractions, and prescribed dose) was comprehensively calculated. Of the candidate schedules, the one that commonly gave a higher ΔBED for CTV was selected as the resultant schedule. The BED volume histogram was used to compare the influence of variable RBE and fractionation. RESULTS: In the conventional schedule, compared with the constant RBE, the variable RBE resulted in a mean 2.6 and 2.7 Gy reduction of BEDmean for the CTV and soft tissue (acute reaction) of the three plans, respectively. Moreover, the BEDmean for soft tissue (late reaction) increased by 7.4 Gy, indicating a potential risk of increased RBE. Comprehensive calculation of the ΔBED resulted in the hyperfractionated schedule of 80.52 Gy (RBE = 1.1)/66 fractions in 6.5 weeks. When variable RBE was used, compared with the conventional schedule, the hyperfractionated schedule increased the BEDmean for CTV by 7.6 Gy; however, this was associated with a 7.8 Gy increase for soft tissue (acute reaction). The BEDmean for soft tissue (late reaction) decreased by 2.4 Gy. CONCLUSION: The results indicated a potential effect of the variable RBE on IMPT for pharyngeal cancer but with the possibility that hyperfractionation could outweigh this effect. Although biological uncertainties require conservative use of the resultant schedule, hyperfractionation is expected to be an effective strategy in IMPT for pharyngeal cancer.
• 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 2022/07 [Refereed]
   

  Background: For small primary liver tumors, favorable outcomes have been reported with both of proton beam therapy (PBT) and X-ray therapy (XRT). However, no clear criteria have been proposed in the cases for which and when of PBT or XRT has to be used. The aim of this study is to investigate cases that would benefit from PBT based on the predicted rate of hepatic toxicity. Materials and methods: Eligible patients were those who underwent PBT for primary liver tumors with a maximum diameter of ≤ 5 cm and Child-Pugh grade A (n = 40). To compare the PBT-plan, the treatment plan using volumetric modulated arc therapy was generated as the XRT-plan. The rate of predicted hepatic toxicity was estimated using five normal tissue complication probability (NTCP) models with three different endpoints. The differences in NTCP values (ΔNTCP) were calculated to determine the relative advantage of PBT. Factors predicting benefits of PBT were analyzed by logistic regression analysis. Results: From the dose-volume histogram comparisons, an advantage of PBT was found in sparing of the normal liver receiving low doses. The factors predicting the benefit of PBT differed depending on the selected NTCP model. From the five models, the total tumor diameter (sum of the target tumors), location (hepatic hilum vs other), and number of tumors (1 vs 2) were significant factors. Conclusions: From the radiation-related hepatic toxicity, factors were identified to predict benefits of PBT in primary liver tumors with Child-Pugh grade A, with the maximum tumor diameter of ≤ 5 cm.
• Systemic therapy for salivary gland malignancy: current status and future perspectives.

  Yoshinori Imamura, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Ichiro Ota, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Tomoya Yokota, Susumu Okano, Kaoru Tanaka, Takuma Onoe, Yosuke Ariizumi, Akihiro Homma

  Japanese journal of clinical oncology 52 (4) 293 - 302 2022/04/06 [Refereed]
   

  Salivary gland malignancies are rare neoplasms that have a broad histological spectrum and a variety of biologic behaviors. Salivary gland malignancies are known as chemo-resistant tumors, which render optimal treatment challenging. This review summarizes the role of systemic therapy for salivary gland malignancies. To date, the advantage of adding concurrent chemotherapy has remained undefined for both postoperative and inoperable locally advanced salivary gland malignancy patients undergoing radiotherapy. For recurrent/metastatic disease, local and/or systemic treatment options should be discussed in a multidisciplinary setting with consideration to both patient needs and tumor factors. For symptomatic patients or those who may compromise organ function, palliative systemic therapy can be a reasonable option based on the results of phase II studies. Platinum combination regimens as first-line therapy have been widely accepted. Personalized therapies have become established options, particularly for androgen receptor-positive, HER2-positive and NTRK fusion-positive salivary gland malignancies (i.e. androgen receptor and HER2 in salivary duct carcinoma and NTRK3 in secretory carcinoma). For patients with adenoid cystic carcinoma, multi-targeted tyrosine kinase inhibitors have also been developed. Anti-PD1 checkpoint inhibitors have shown limited activity to date. Investigation of active systemic treatments for salivary gland malignancy remains a significant unmet need. Future directions might include a more comprehensive genomic screening approach (usually next-generation sequencing-based) and combination strategies using immune checkpoint inhibitors. These are rare malignancies that require ongoing effort in the conduct of high-quality clinical trials.
• Human papillomavirus-related oropharyngeal carcinoma.

  Yuki Saito, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Ichiro Ota, Tomoya Yokota, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Susumu Okano, Yoshinori Imamura, Yosuke Ariizumi, Ryuichi Hayashi

  Japanese journal of clinical oncology 52 (7) 692 - 698 2022/04/05 [Refereed]
   

  It was not until around 2000 that human papillomavirus-related oropharyngeal carcinoma was recognized as carcinoma with clinical presentations different from nonrelated head and neck carcinoma. Twenty years after and with the revision of the tumor-node-metastasis classification in 2017, various clinical trials focused on human papillomavirus-related oropharyngeal carcinoma to improve the prognosis and quality of life of patients with this disease. However, the incidence of human papillomavirus-related cancers is increasing, which is expected to be particularly prominent in Japan, where human papillomavirus vaccination is not widely available. In this review, we describe the current status of clinical trials (mainly focused on initial surgery and radiation dose reduction) for, primary and secondary prevention of, and the present status of human papillomavirus-related oropharyngeal carcinoma in Japan.
• Management of elderly patients with head and neck cancer.

  Ryo Ishii, Akira Ohkoshi, Naomi Kiyota, Kazuto Matsuura, Koichi Yasuda, Yoshinori Imamura, Yuki Saito, Akihiro Homma

  Japanese journal of clinical oncology 52 (4) 313 - 321 2022/02/15 [Refereed]
   

  There are no established guidelines for managing older patients with head and neck cancer. Most clinical trials that define current standard therapy included few elderly patients. On the other hand, there is great variability in patients' comorbidities, physical functions, cognitive function, familial and financial background and values. The key point appears to be appropriate geriatric assessment, clarifying the patients' outcomes and a multidisciplinary team approach, including the treatment decision-making policy. Although these processes should be scientific in nature, the evidence for the treatment of elderly head and neck patients is very limited. This review summarizes the evidence available regarding the management of geriatric assessment, each treatment modality and the multidisciplinary team approach for older patients with head and neck cancers.
• Prediction of the local treatment outcome in patients with oropharyngeal squamous cell carcinoma using deep learning analysis of pretreatment FDG-PET images.

  Noriyuki Fujima, V Carlota Andreu-Arasa, Sara K Meibom, Gustavo A Mercier, Minh Tam Truong, Kenji Hirata, Koichi Yasuda, Satoshi Kano, Akihiro Homma, Kohsuke Kudo, Osamu Sakai

  BMC cancer 21 (1) 900 - 900 2021/08/06 [Refereed]
   

  BACKGROUND: This study aimed to assess the utility of deep learning analysis using pretreatment FDG-PET images to predict local treatment outcome in oropharyngeal squamous cell carcinoma (OPSCC) patients. METHODS: One hundred fifty-four OPSCC patients who received pretreatment FDG-PET were included and divided into training (n = 102) and test (n = 52) sets. The diagnosis of local failure and local progression-free survival (PFS) rates were obtained from patient medical records. In deep learning analyses, axial and coronal images were assessed by three different architectures (AlexNet, GoogLeNET, and ResNet). In the training set, FDG-PET images were analyzed after the data augmentation process for the diagnostic model creation. A multivariate clinical model was also created using a binomial logistic regression model from a patient's clinical characteristics. The test data set was subsequently analyzed for confirmation of diagnostic accuracy. Assessment of local PFS rates was also performed. RESULTS: Training sessions were successfully performed with an accuracy of 74-89%. ROC curve analyses revealed an AUC of 0.61-0.85 by the deep learning model in the test set, whereas it was 0.62 by T-stage, 0.59 by clinical stage, and 0.74 by a multivariate clinical model. The highest AUC (0.85) was obtained with deep learning analysis of ResNet architecture. Cox proportional hazards regression analysis revealed deep learning-based classification by a multivariate clinical model (P < .05), and ResNet (P < .001) was a significant predictor of the treatment outcome. In the Kaplan-Meier analysis, the deep learning-based classification divided the patient's local PFS rate better than the T-stage, clinical stage, and a multivariate clinical model. CONCLUSIONS: Deep learning-based diagnostic model with FDG-PET images indicated its possibility to predict local treatment outcomes in OPSCCs.
• Treatment outcomes of stereotactic body radiation therapy using a 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 2021/08 [Refereed]
   

  AIM: To report the outcomes of stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy system for hepatocellular carcinoma patients. METHODS: From January 2005 to July 2018, 63 patients with 74 lesions with a maximum diameter ≤52 mm were treated by stereotactic body radiotherapy using a real-time tumor-tracking radiotherapy 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 an α/β ratio of 10 (BED10 ), the median dose in BED10 at the reference point was 76.8 Gy (range 60-122.5 Gy). Overall survival (OS) and local control rates were assessed using the Kaplan-Meier method. RESULTS: With a median follow-up period of 24.6 months (range 0.9-118.4 months), 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 local control rates were 100% (100-100%) and 92.0% (77.5-97.5%). The local control rates were significantly higher in the BED10 ≥100 Gy group than in the BED10 <100 Gy group (2-year 100% vs. 86.5%, p = 0.049) at the reference point. CONCLUSION: This retrospective study of stereotactic body radiotherapy using real-time tumor-tracking radiotherapy for hepatocellular carcinoma showed favorable outcomes with lower incidence of toxicities, especially in patients treated with BED10 ≥100 Gy to the reference point.
• Predictors of the need for prophylactic percutaneous endoscopic gastrostomy in head and neck cancer patients treated with concurrent chemoradiotherapy.

  Satoshi Kano, Nayuta Tsushima, Takayoshi Suzuki, Seijiro Hamada, Taizo Yokokawa, Hiroshi Idogawa, Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Hidefumi Aoyama, Akihiro Homma

  International journal of clinical oncology 26 (7) 1179 - 1187 2021/07 [Refereed]
   

  BACKGROUND: We investigated whether prophylactic percutaneous endoscopic gastrostomy (PEG) is used effectively for patients treated with definitive concurrent chemoradiotherapy (CCRT) and the predictors of the need for PEG. METHODS: 326 patients with laryngeal, oropharyngeal or hypopharyngeal cancers were retrospectively reviewed. RESULTS: The PEG tube use group had more favorable results than the total parenteral nutrition and nasogastric tube groups in terms of rate of serum albumin loss, incidence of severe fever and aspiration pneumonia, CCRT completion rate and hospitalization period. However, it was inferior to oral intake. Analysis of the relative risk of requiring enteral or parenteral nutrition revealed that performance status (PS) 2, primary site (supraglottis, oropharynx, or hypopharynx), N3 disease, and cisplatin were predictors of the need for nutritional support. CONCLUSIONS: Prophylactic PEG is effective for patients treated with definitive CCRT and is especially required for patients with PS2 or oropharyngeal cancer.
• Salvage surgery improves the treatment outcome of patients with residual/recurrent maxillary sinus cancer after superselective intra-arterial cisplatin infusion with concomitant radiation therapy.

  Nayuta Tsushima, Satoshi Kano, Takayoshi Suzuki, Hiroshi Idogawa, Daisuke Yoshida, Koichi Yasuda, Manami Otsuka, Hidefumi Aoyama, Akihiro Homma

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 279 (2) 899 - 905 2021/04/18 [Refereed]
   

  PURPOSE: We have performed superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) for patients with maxillary sinus cancer. The promising treatment outcomes of this non-surgical treatment were reported in past studies. However, few clinical studies have been conducted to evaluate the outcome of salvage surgery following RADPLAT. The purpose of this study was to analyze the treatment outcomes of salvage surgery for patients with recurrent maxillary sinus cancer after RADPLAT. METHODS: We assessed 45 patients who had recurrence following RADPLAT between 1999 and 2017, and conducted a retrospective analysis. We excluded patients who did not complete RADPLAT. Patients were not considered to have completed RADPLAT if they underwent intra-arterial cisplatin less than three times or received a total radiation dose of less than 60 Gy. The primary endpoint was overall survival. The median follow-up period for surviving patients after recurrence was 5.1 years. RESULTS: Twenty-five of the 45 (56%) patients underwent salvage surgery. The 5-year overall survival rate was 68% in patients who underwent salvage surgery, while all patients who did not undergo salvage surgery died during the observation period. Fifteen of 24 (63%) patients with local recurrence underwent salvage surgery. Eight patients did not undergo salvage surgery because of unresectable disease; five of the eight patients had unresectable posterior extension. All nine patients with nodal recurrence underwent neck dissection. CONCLUSION: Treatment outcomes of salvage surgery following RADPLAT were favorable enough for it to be generally recommended. To reduce unresectable recurrence, the posterior section should be eradicated by RADPLAT.
• 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.
• Induction chemotherapy in locally advanced squamous cell carcinoma of the head and neck.

  Susumu Okano, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Takenori Ogawa, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Tomoya Yokota, Yoshinori Imamura, Yosuke Ariizumi, Tetsuo Akimoto, Ryuichi Hayashi

  Japanese journal of clinical oncology 51 (2) 173 - 179 2021/02/08 [Refereed]
   

  In order to maximize the benefit of induction chemotherapy, practice based on a comprehensive interpretation of a large number of clinical trials, as in this review, is essential. The standard treatment for locally advanced squamous cell carcinoma of the head and neck is surgery or chemoradiation. However, induction chemotherapy followed by (chemo) radiotherapy may be used in some circumstances. Although many clinical trials of induction chemotherapy have been conducted, a rationale other than to preserve the larynx is still controversial. Selection of this modality should therefore be made with care. The current standard regimen for induction chemotherapy is docetaxel, cisplatin and 5-FU, but concerns remain about toxicity, cost and the duration of treatment. Regarding treatment after induction chemotherapy, it is also unclear whether radiation alone or chemoradiation is the better option. Furthermore, there is no answer as to what drugs should be used in combination with radiation therapy after induction chemotherapy. Several new induction chemotherapy treatment developments are currently underway, and future developments are expected. This review article summarizes the current position of induction chemotherapy for head and neck squamous cell carcinoma, based on the evidence produced to date, and discusses the future prospects for this treatment.
• The role of endoscopic resection for selected patients with sinonasal squamous cell carcinoma.

  Yuji Nakamaru, Masanobu Suzuki, Satoshi Kano, Takatsugu Mizumachi, Nayuta Tsushima, Takayoshi Suzuki, Aya Honma, Akira Nakazono, Shogo Kimura, Rikiya Onimaru, Koichi Yasuda, Hiroki Shirato, Akihiro Homma

  Auris, nasus, larynx 48 (1) 131 - 137 2021/02 [Refereed]
   

  OBJECTIVE: Despite of rapid advances in endoscopic surgery, the gold standard for sinonasal squamous cell carcinoma (SNSCC) surgery has remained the open approach with en-block resection due to the aggressive nature of SNSCC, including frequent recurrence and high mortality rate. For that reason, few studies have focused on SNSCC treated by endoscopic surgery alone. The objective of this study was to evaluate the usefulness of endoscopic surgery for patients with SNSCC. METHODS: A retrospective analysis was performed for 15 consecutive SNSCC patients who underwent endoscopic surgery without an open approach. We carefully selected patients whose tumor attachment sites could be fully visualized and completely resected through an endonasal approach. RESULTS: Of the fifteen patients, 4 patients (27%) were diagnosed with T1, 7 (47%) with T2, 4 (27%) with T3, and no patients with T4a or T4b disease. Four of the 15 (27%) patients showed positive surgical margins. The 5-yr overall survival, disease-specific survival, and local control rate was 72.4%, 79.6%, and 92.9%, respectively. The 5-yr disease-specific survival for T1, T2, and T3 disease was 100% and 75% and 75%, respectively. Patients with negative surgical margins had a better disease-specific survival rate than did those with positive surgical margins (p = 0.0253). CONCLUSION: Endoscopic surgery for patients with SNSCC appears to afford an effective method in selected cases. The achievement of negative surgical margins with a good view of the tumor attachment site was considered to be critical to the management of SNSCC.
• Multiparametric Analysis of Tumor Morphological and Functional MR Parameters Potentially Predicts Local Failure in Pharynx Squamous Cell Carcinoma Patients.

  Noriyuki Fujima, Yukie Shimizu, Daisuke Yoshida, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma, Koichi Yasuda, Rikiya Onimaru, Osamu Sakai, Kohsuke Kudo, Hiroki Shirato

  The journal of medical investigation : JMI 68 (3.4) 354 - 361 2021 [Refereed]
   

  Purpose : To predict local control / failure by a multiparametric approach using magnetic resonance (MR)-derived tumor morphological and functional parameters in pharynx squamous cell carcinoma (SCC) patients. Materials and Methods : Twenty-eight patients with oropharyngeal and hypopharyngeal SCCs were included in this study. Quantitative morphological parameters and intratumoral characteristics on T2-weighted images, tumor blood flow from pseudo-continuous arterial spin labeling, and tumor diffusion parameters of three diffusion models from multi-b-value diffusion-weighted imaging as well as patients' characteristics were analyzed. The patients were divided into local control / failure groups. Univariate and multiparametric analysis were performed for the patient group division. Results : The value of morphological parameter of 'sphericity' and intratumoral characteristic of 'homogeneity' was revealed respectively significant for the prediction of the local control status in univariate analysis. Higher diagnostic performance was obtained with the sensitivity of 0.8, specificity of 0.75, positive predictive value of 0.89, negative predictive value of 0.6 and accuracy of 0.79 by multiparametric diagnostic model compared to results in the univariate analysis. Conclusion : A multiparametric analysis with MR-derived quantitative parameters may be useful to predict local control in pharynx SCC patients. J. Med. Invest. 68 : 354-361, August, 2021.
• 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) 20210064 - 20210064 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.
• Potential benefits of adaptive intensity-modulated proton therapy in nasopharyngeal carcinomas.

  Hideki Minatogawa, Koichi Yasuda, Yasuhiro Dekura, Seishin Takao, Taeko Matsuura, Takaaki Yoshimura, Ryusuke Suzuki, Isao Yokota, Noriyuki Fujima, Rikiya Onimaru, Shinichi Shimizu, Hidefumi Aoyama, Hiroki Shirato

  Journal of applied clinical medical physics 22 (1) 174 - 183 2021/01 [Refereed]
   

  PURPOSE: To investigate potential advantages of adaptive intensity-modulated proton beam therapy (A-IMPT) by comparing it to adaptive intensity-modulated X-ray therapy (A-IMXT) for nasopharyngeal carcinomas (NPC). METHODS: Ten patients with NPC treated with A-IMXT (step and shoot approach) and concomitant chemotherapy between 2014 and 2016 were selected. In the actual treatment, 46 Gy in 23 fractions (46Gy/23Fx.) was prescribed using the initial plan and 24Gy/12Fx was prescribed using an adapted plan thereafter. New treatment planning of A-IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A-IMXT with A-IMPT. RESULTS: The means of the Dmean of the right parotid gland (P < 0.001), right TM joint (P < 0.001), left TM joint (P < 0.001), oral cavity (P < 0.001), supraglottic larynx (P = 0.001), glottic larynx (P < 0.001), , middle PCM (P = 0.0371), interior PCM (P < 0.001), cricopharyngeal muscle (P = 0.03643), and thyroid gland (P = 0.00216), in A-IMPT are lower than those of A-IMXT, with statistical significance. The means of, D0.03cc , and Dmean of each sub portion of auditory apparatus and D30% for Eustachian tube and D0.5cc for mastoid volume in A-IMPT are significantly lower than those of A-IMXT. The mean doses to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 Gy (RBE = 1.1). CONCLUSIONS: An adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.
• Construction of a detachable artificial trachea model for three age groups for use in an endotracheal suctioning training environment simulator.

  Takaaki Yoshimura, Noriyo Colley, Shunsuke Komizunai, Shinji Ninomiya, Satoshi Kanai, Atsushi Konno, Koichi Yasuda, Hiroshi Taguchi, Takayuki Hashimoto, Shinichi Shimizu

  PloS one 16 (3) e0249010  2021 [Refereed]
   

  Tracheal suctioning is an important procedure to maintain airway patency by removing secretions. Today, suctioning operators include not only medical staff, but also family caregivers. The use of a simulation system has been noted to be the most effective way to learn the tracheal suctioning technique for operators. While the size of the trachea varies across different age groups, the artificial trachea model in the simulation system has only one fixed model. Thus, this study aimed to construct multiple removable trachea models according to different age groups. We enrolled 20 patients who had previously received proton beam therapy in our institution and acquired the treatment planning computed tomography (CT) image data. To construct the artificial trachea model for three age groups (children, adolescents and young adults, and adults), we analyzed the three-dimensional coordinates of the entire trachea, tracheal carina, and the end of the main bronchus. We also analyzed the diameter of the trachea and main bronchus. Finally, we evaluated the accuracy of the model by analyzing the difference between the constructed model and actual measurements. The trachea model was 8 cm long for children and 12 cm for adolescents and young adults, and for adults. The angle between the trachea and bed was about 20 degrees, regardless of age. The mean model accuracy was less than 0.4 cm. We constructed detachable artificial trachea models for three age groups for implementation in the endotracheal suctioning training environment simulator (ESTE-SIM) based on the treatment planning CT image. Our constructed artificial trachea models will be able to provide a simulation environment for various age groups in the ESTE-SIM.
• 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.
• 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 108 (3) e288 - e289 0360-3016 2020/11 [Refereed]
  
• Immunotherapy for squamous cell carcinoma of the head and neck.

  Tomoya Yokota, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Takenori Ogawa, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Susumu Okano, Yoshinori Imamura, Yosuke Ariizumi, Ryuichi Hayashi

  Japanese journal of clinical oncology 50 (10) 1089 - 1096 2020/09/28 [Refereed]
   

  Squamous cell carcinoma of the head and neck is characterized by an immunosuppressive environment and evades immune responses through multiple resistance mechanisms. A breakthrough in cancer immunotherapy employing immune checkpoint inhibitors has evolved into a number of clinical trials with antibodies against programmed cell death 1 (PD-1), its ligand PD-L1 and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) for patients with squamous cell carcinoma of the head and neck. CheckMate141 and KEYNOTE-048 were practice-changing randomized phase 3 trials for patients with platinum-refractory and platinum-sensitive recurrent or metastatic squamous cell carcinoma of the head and neck, respectively. Furthermore, many combination therapies using anti-CTLA-4 inhibitors, tyrosine kinase inhibitors and immune accelerators are currently under investigation. Thus, the treatment strategy of recurrent or metastatic squamous cell carcinoma of the head and neck is becoming more heterogeneous and complicated in the new era of individualized medicine. Ongoing trials are investigating immunotherapeutic approaches in the curative setting for locoregionally advanced disease. This review article summarizes knowledge of the role of the immune system in the development and progression of squamous cell carcinoma of the head and neck, and provides a comprehensive overview on the development of immunotherapeutic approaches in both recurrent/metastatic and locoregionally advanced diseases.
• [Ⅱ.Radiation Therapy for Recurrent Head and Neck Cancer].

  Koichi Yasuda

  Gan to kagaku ryoho. Cancer & chemotherapy (株)癌と化学療法社 47 (7) 1042 - 1045 0385-0684 2020/07 [Not refereed]
  
• Difference in LET-based biological doses between IMPT optimization techniques: Robust and PTV-based optimizations.

  Shusuke Hirayama, Taeko Matsuura, Koichi Yasuda, Seishin Takao, Takaaki Fujii, Naoki Miyamoto, Kikuo Umegaki, Shinichi Shimizu

  Journal of applied clinical medical physics 21 (4) 42 - 50 2020/04 [Refereed]
   

  PURPOSE: While a large amount of experimental data suggest that the proton relative biological effectiveness (RBE) varies with both physical and biological parameters, current commercial treatment planning systems (TPS) use the constant RBE instead of variable RBE models, neglecting the dependence of RBE on the linear energy transfer (LET). To conduct as accurate a clinical evaluation as possible in this circumstance, it is desirable that the dosimetric parameters derived by TPS ( D RBE = 1.1 ) are close to the "true" values derived with the variable RBE models ( D v RBE ). As such, in this study, the closeness of D RBE = 1.1 to D v RBE was compared between planning target volume (PTV)-based and robust plans. METHODS: Intensity-modulated proton therapy (IMPT) treatment plans for two Radiation Therapy Oncology Group (RTOG) phantom cases and four nasopharyngeal cases were created using the PTV-based and robust optimizations, under the assumption of a constant RBE of 1.1. First, the physical dose and dose-averaged LET (LETd ) distributions were obtained using the analytical calculation method, based on the pencil beam algorithm. Next, D v RBE was calculated using three different RBE models. The deviation of D v RBE from D RBE = 1.1 was evaluated with D99 and Dmax , which have been used as the evaluation indices for clinical target volume (CTV) and organs at risk (OARs), respectively. The influence of the distance between the OAR and CTV on the results was also investigated. As a measure of distance, the closest distance and the overlapped volume histogram were used for the RTOG phantom and nasopharyngeal cases, respectively. RESULTS: As for the OAR, the deviations of D max v RBE from D max RBE = 1.1 were always smaller in robust plans than in PTV-based plans in all RBE models. The deviation would tend to increase as the OAR was located closer to the CTV in both optimization techniques. As for the CTV, the deviations of D 99 v RBE from D 99 RBE = 1.1 were comparable between the two optimization techniques, regardless of the distance between the CTV and the OAR. CONCLUSION: Robust optimization was found to be more favorable than PTV-based optimization in that the results presented by TPS were closer to the "true" values and that the clinical evaluation based on TPS was more reliable.
• 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.
• The Potential Benefit of Adaptive Intensity Modulated Proton Therapy in Nasopharyngeal Carcinoma: Planning Comparison Study

  H. Minatogawa, K. Yasuda, T. Matsuura, R. Onimaru, T. Yoshimura, S. Takao, Y. Matsuo, Y. Dekura, R. Suzuki, M. Tamura, N. Miyamoto, S. Shimizu, H. Shirato

  International Journal of Radiation Oncology*Biology*Physics 105 (1) E394 - E394 0360-3016 2019/09 [Not refereed]
  
• Impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with intensity-modulated radiotherapy.

  Yusuke Uchinami, Ryusuke Suzuki, Norio Katoh, Hiroshi Taguchi, Koichi Yasuda, Naoki Miyamoto, Yoichi M Ito, Shinichi Shimizu, Hiroki Shirato

  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.
• Machine-Learning-Based Prediction of Treatment Outcomes Using MR Imaging-Derived Quantitative Tumor Information in Patients with Sinonasal Squamous Cell Carcinomas: A Preliminary Study.

  Noriyuki Fujima, Yukie Shimizu, Daisuke Yoshida, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma, Koichi Yasuda, Rikiya Onimaru, Osamu Sakai, Kohsuke Kudo, Hiroki Shirato

  Cancers 11 (6) 2019/06/10 [Refereed][Not invited]
   

  The purpose of this study was to determine the predictive power for treatment outcome of a machine-learning algorithm combining magnetic resonance imaging (MRI)-derived data in patients with sinonasal squamous cell carcinomas (SCCs). Thirty-six primary lesions in 36 patients were evaluated. Quantitative morphological parameters and intratumoral characteristics from T2-weighted images, tumor perfusion parameters from arterial spin labeling (ASL) and tumor diffusion parameters of five diffusion models from multi-b-value diffusion-weighted imaging (DWI) were obtained. Machine learning by a non-linear support vector machine (SVM) was used to construct the best diagnostic algorithm for the prediction of local control and failure. The diagnostic accuracy was evaluated using a 9-fold cross-validation scheme, dividing patients into training and validation sets. Classification criteria for the division of local control and failure in nine training sets could be constructed with a mean sensitivity of 0.98, specificity of 0.91, positive predictive value (PPV) of 0.94, negative predictive value (NPV) of 0.97, and accuracy of 0.96. The nine validation data sets showed a mean sensitivity of 1.0, specificity of 0.82, PPV of 0.86, NPV of 1.0, and accuracy of 0.92. In conclusion, a machine-learning algorithm using various MR imaging-derived data can be helpful for the prediction of treatment outcomes in patients with sinonasal SCCs.
• [A Nutritional Supplement with a High Blend Ratio of ω-3 Fatty Acids(Prosure®) Reduces Severe Oral Mucositis and Body Weight Loss for Head and Neck Cancer Patients Treated with Chemoradiotherapy].

  Takatsugu Mizumachi, Satoshi Kano, Akihiro Homma, Mikiko Akazawa, Chiharu Hasegawa, Yoko Shiroishi, Chiaki Okamoto, Satomi Kumagai, Masaharu Nishimura, Hiroyo Takasaki, Hiroshi Takeda, Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Rikiya Onimaru, Hiroki Shirato, Satoshi Fukuda

  Gan to kagaku ryoho. Cancer & chemotherapy 46 (4) 685 - 689 0385-0684 2019/04 [Not refereed][Not invited]
   

  BACKGROUND: Oral mucositis and body weight loss are the most critical conditions known to lead to the discontinuation of chemoradiotherapy for head and neck cancer. We investigated the effect of a nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)on body weight loss, oral mucositis, and the completion rate of chemoradiotherapy in patients with oropharyngeal and hypopharyngeal cancer. PATIENTS AND METHODS: The study group comprised patients with oropharyngeal and hypopharyngeal cancer who were treated with concomitant cisplatin and 70 Gy of radiotherapy. These patients received 2 packs of Prosure®per day during chemoradiotherapy. RESULTS: A total of 17 patients were included in this study. The reduction in body weight was significantly improved compared with that in the historical control group that did not receive Prosure®(7.3% vs 10.3%, p<0.01), and the rate of Grade 3-4 oral mucositis was significantly reduced for the patient groups that received Prosure®(CTCAE v3.0 GradeB3; 24% vs 58%, p<0.05). The completion rate of chemoradiotherapy was not significantly different between both groups(77% vs 60%, NS). CONCLUSIONS: A nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)had effects on oral mucositis and body weight loss in head and neck cancer patients treated with chemoradiotherapy.
• Treatment outcomes of local advanced external auditory canal squamous cell carcinomas

  Satoshi Kano, Shinya Morita, Yuji Nakamaru, Takatsugu Mizumachi, Nayuta Tsushima, Takayoshi Suzuki, Akira Nakazono, Atsushi Fukuda, Koichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Akihiro Homma

  Japanese Journal of Head and Neck Cancer 45 (3) 300 - 304 1349-5747 2019 [Refereed][Not invited]
   

  © 2019, Japan Society for Head and Neck Cancer. All rights reserved. We analyzed the treatment outcomes and safety of concomitant chemoradiotherapy (CCRT), especially with a combination of docetaxel, cisplatin and 5FU (TPF), for local advanced external auditory canal squamous cell carcinomas. In addition, we analyzed the correlation between tumor invasion site and prognosis. The study comprised 21 patients with the following criteria: (1) external auditory canal squamous cell carcinomas which were subject to radical treatment at Hokkaido University Hospital between 2007 and 2017, and (2) T3–4 classified according to the University of Pittsburg system. As a result, tumor invasion into the dura or temporomandibular joint was associated with neck lymph node metastasis, and tumor invasion into the temporomandibular joint was associated with local recurrence. The 2-year overall survival rate (OS) and 2-year local control rate (LC) were 61.1％ and 52.1％ in all patients, respectively. In patients treated with CCRT, the 2-year OS was 85.7％ in CCRT with TPF and 25.0％ in CCRT with others, and the 2-year LC was 57.1％ in CCRT with TPF and 25.0％ in CCRT with others. Grade 3︲4 leucopenia and neutropenia occurred in 55％ and 45％ of patients treated with CCRT with TPF, respectively. CCRT with TPF shows high efficacy and safety for local advanced external auditory canal squamous cell carcinomas.
• Automatic metastatic bone tumor classification with DCNN-based features using treatment-planning CT

  Haruna Watanabe, Ren Togo, Takahiro Ogawa, Miki Haseyama, Koichi Yasuda, Khin Khin Tha, Kohsuke Kudo, Hiroki Shirato

  Proceedings of SPIE - The International Society for Optical Engineering 11050 0277-786X 2019/01/01 [Not refereed][Not invited]
   

  © 2019 SPIE. In this paper, we propose a method to classify metastatic bone tumors using treatment-planning computed tomography images. The proposed method utilizes pre-trained deep convolutional neural network (DCNN) models as feature extractors and enables the metastatic bone tumor classification by using the obtained features. Performance of several state-of-the-art DCNN-based features was compared and evaluated in our experiment.
• Integrating quantitative morphological and intratumoural textural characteristics in FDG-PET for the prediction of prognosis in pharynx squamous cell carcinoma patients.

  N Fujima, K Hirata, T Shiga, R Li, K Yasuda, R Onimaru, K Tsuchiya, S Kano, T Mizumachi, A Homma, K Kudo, H Shirato

  Clinical radiology 73 (12) 1059.e1-1059.e8  2018/12 [Refereed][Not invited]
   

  AIM: To assess potential prognostic factors in pharynx squamous cell carcinoma (SCC) patients by quantitative morphological and intratumoural characteristics obtained by 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (FDG-PET/CT). MATERIALS AND METHODS: The cases of 54 patients with pharynx SCC who underwent chemoradiation therapy were analysed retrospectively. Using their FDG-PET data, the quantitative morphological and intratumoural characteristics of 14 parameters were calculated. The progression-free survival (PFS) and overall survival (OS) information was obtained from patient medical records. Univariate and multivariate analyses were performed to assess the 14 quantitative parameters as well as the T-stage, N-stage, and tumour location data for their relation to PFS and OS. When an independent predictor was suggested in the multivariate analysis, the parameter was further assessed using the Kaplan-Meier method. RESULTS: In the assessment of PFS, the univariate and multivariate analyses indicated the following as independent predictors: the texture parameter of homogeneity and the morphological parameter of sphericity. In the Kaplan-Meier analysis, the PFS rate was significantly improved in the patients who had both a higher value of homogeneity (p=0.01) and a higher value of sphericity (p=0.002). With the combined use of homogeneity and sphericity, the patients with different PFS rates could be divided more clearly. CONCLUSION: The quantitative parameters of homogeneity and sphericity obtained by FDG-PET can be useful for the prediction of the PFS of pharynx SCC patients, especially when used in combination.
• Intensity-Modulated Proton Therapy with Dose Painting based on Hypoxia Imaging for Nasopharyngeal Cancer

  K. Yasuda, S. Takao, Y. Matsuo, T. Yoshimura, M. Tamura, H. Minatogawa, Y. Dekura, T. Matsuura, R. Onimaru, T. Shiga, S. Shimizu, K. Umegaki, H. Shirato

  International Journal of Radiation Oncology*Biology*Physics 102 (3) e378 - e378 0360-3016 2018/11
• Semi-quantitative analysis of pre-treatment morphological and intratumoral characteristics using 18F-fluorodeoxyglucose positron-emission tomography as predictors of treatment outcome in nasal and paranasal squamous cell carcinoma.

  Noriyuki Fujima, Kenji Hirata, Tohru Shiga, Koichi Yasuda, Rikiya Onimaru, Kazuhiko Tsuchiya, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma, Kohsuke Kudo, Hiroki Shirato

  Quantitative imaging in medicine and surgery 8 (8) 788 - 795 2223-4292 2018/09 [Refereed][Not invited]
   

  Background: To investigate the utility of quantitative morphological and intratumoral characteristics obtained by 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) for the prediction of treatment outcome in patients with nasal or paranasal cavity squamous cell carcinoma (SCC). Methods: Twenty-four patients with nasal or paranasal cavity SCC who received curative non-surgical therapy (a combination of super-selective arterial cisplatin infusion and radiotherapy) were retrospectively analyzed. From pre-treatment FDG-PET data, a total of 13 parameters of quantitative morphological characteristics (tumor volume, surface area and sphericity), intratumoral characteristics (the maximum and mean standard uptake value, three intratumoral histogram and four textural parameters) and total lesion glycolysis (TLG) were respectively calculated. Information regarding the treatment outcome was determined from the histological diagnosis or clinical follow-up. Each of the 13 quantitative parameters as well as T- and N-stage was assessed for its relation to treatment outcome of local control or failure. Results: In univariate analysis, significant differences in surface area and sphericity between the local control and failure groups were observed. The receiver operating characteristic (ROC) curve analysis showed that sphericity had the highest accuracy of 0.88. In the multivariate analysis, sphericity was revealed as an independent predictor of the local control or failure. Conclusions: The quantitative parameters of sphericity are useful to predict the treatment outcome in patients with nasal or paranasal SCC.
• 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 - i71 0449-3060 2018/03/01 [Refereed][Not invited]
   

  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.
• Regional dental cooperation and oral supportive care for head and neck cancer patients

  Hironobu Hata, Kazuhito Yoshikawa, Kenji Imamachi, Chika Murai, Michihiro Ueda, Tatsumi Nagahashi, Noriaki Nishiyama, Kouichi Yasuda, Akihiro Honma, Yoshimasa Kitagawa

  Japanese Journal of Head and Neck Cancer 44 (4) 380 - 386 1349-5747 2018 

  Due to various functional disorders and adverse events with head and neck cancer treatment, the QOL of cancer survivors markedly decreases. In many cases, there is a gradual improvement in QOL, though patients experience various discomforts daily. A critical issue is how long long-term survivors can continue to manage their oral condition. Since 2012, cooperating cancer dentists have been registered and presently there are more than 14,000 such dentists in Japan, creating a framework for referring such cancer patients to dentists in general practice. In 2011, for patients who were treated from 2007 to 2010, we performed a survey of continued oral management after discharge from Hokkaido University Hospital. After discharge, 34.3% of cases continued oral management, but when limited to patients in the care of general practice dentists, the rate was only 7.5%. In this study of patients from 2011 to 2016, the patients who continued oral management after discharge and the patients in the care of general practice dentists were higher, at 70.5% and 40.4%. It is essential that appropriate oral management in cooperation with local dental clinics is continued to improve the QOL of head and neck cancer patients.
• Local relapse of nasopharyngeal cancer and Voxel-based analysis of FMISO uptake using PET with semiconductor detectors.

  Yukiko Nishikawa, Koichi Yasuda, Shozo Okamoto, Yoichi M Ito, Rikiya Onimaru, Tohru Shiga, Kazuhiko Tsuchiya, Shiro Watanabe, Wataru Takeuchi, Yuji Kuge, Hao Peng, Nagara Tamaki, Hiroki Shirato

  Radiation oncology (London, England) 12 (1) 148 - 148 1748-717X 2017/09/06 [Refereed][Not invited]
   

  BACKGROUND: Hypoxic cancer cells are thought to be radioresistant and could impact local recurrence after radiotherapy (RT). One of the major hypoxic imaging modalities is [18F]fluoromisonidazole positron emission tomography (FMISO-PET). High FMISO uptake before RT could indicate radioresistant sites and might be associated with future local recurrence. The predictive value of FMISO-PET for intra-tumoral recurrence regions was evaluated using high-resolution semiconductor detectors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy (IMRT). METHODS: Nine patients with local recurrence and 12 patients without local recurrence for more than 3 years were included in this study. These patients received homogeneous and standard doses of radiation to the primary tumor irrespective of FMISO uptake. The FMISO-PET image before RT was examined via a voxel-based analysis, which focused on the relationship between the degree of FMISO uptake and recurrence region. RESULTS: In the pretreatment FMISO-PET images, the tumor-to-muscle ratio (TMR) of FMISO in the voxels of the tumor recurrence region was significantly higher than that of the non-recurrence region (p < 0.0001). In the recurrent patient group, a TMR value of 1.37 (95% CI: 1.36-1.39) corresponded to a recurrence rate of 30%, the odds ratio was 5.18 (4.87-5.51), and the area under the curve (AUC) of the receiver operating characteristic curve was 0.613. In all 21 patients, a TMR value of 2.42 (2.36-2.49) corresponded to an estimated recurrence rate of 30%, and the AUC was only 0.591. CONCLUSIONS: The uptake of FMISO in the recurrent region was significantly higher than that in the non-recurrent region. However, the predictive value of FMISO-PET before IMRT is not sufficient for up-front dose escalation for the intra-tumoral high-uptake region of FMISO. Because of the higher mean TMR of the recurrence region, a new hypoxic imaging method is needed to improve the sensitivity and specificity for hypoxia.
• The reoxygenation of hypoxia and the reduction of glucose metabolism in head and neck cancer by fractionated radiotherapy with intensity-modulated radiation therapy.

  Shozo Okamoto, Tohru Shiga, Koichi Yasuda, Shiro Watanabe, Kenji Hirata, Ken-Ichi Nishijima, Keiichi Magota, Katsuhiko Kasai, Rikiya Onimaru, Kazuhiko Tuchiya, Yuji Kuge, Hiroki Shirato, Nagara Tamaki

  European journal of nuclear medicine and molecular imaging 43 (12) 2147 - 2154 1619-7070 2016/11 [Refereed][Not invited]
   

  PURPOSE: The purpose of this study was to prospectively investigate reoxygenation in the early phase of fractionated radiotherapy and serial changes of tumoricidal effects associated with intensity-modulated radiation therapy (IMRT) in patients with head and neck cancer (HNC) using F-18 fluoromisonidazole (FMISO) PET and F-18 fluorodeoxyglucose (FDG) PET. METHODS: Patients with untreated HNC underwent FMISO-PET and FDG-PET studies prospectively. A PET evaluation was conducted before each IMRT (Pre-IMRT), during IMRT (at 30 Gy/15 fr) (Inter-IMRT), and after completion of IMRT (70 Gy/35 fr) (Post-IMRT). FMISO-PET images were scanned by a PET/CT scanner at 4 h after the FMISO injection. We quantitatively analyzed the FMISO-PET images of the primary lesion using the maximum standardized uptake (SUVmax) and tumor-to-muscle ratio (TMR). The hypoxic volume (HV) was calculated as an index of tumor hypoxia, and was defined as the volume when the TMR was ≥ 1.25. Each FDG-PET scan was started 1 h after injection. The SUVmax and metabolic tumor volume (MTV) values obtained by FDG-PET were analyzed. RESULTS: Twenty patients finished the complete PET study protocol. At Pre-IMRT, 19 patients had tumor hypoxia in the primary tumor. In ten patients, the tumor hypoxia disappeared at Inter-IMRT. Another seven patients showed the disappearance of tumor hypoxia at Post-IMRT. Two patients showed tumor hypoxia at Post-IMRT. The FMISO-PET results showed that the reduction rates of both SUVmax and TMR from Pre-IMRT to Inter-IMRT were significantly higher than the corresponding reductions from Inter-IMRT to Post-IMRT (SUVmax: 27 % vs. 10 %, p = 0.025; TMR: 26 % vs. 12 %, p = 0.048). The reduction rate of SUVmax in FDG-PET from Pre-IMRT to Inter-IMRT was similar to that from Inter-IMRT to Post-IMRT (47 % vs. 48 %, p = 0.778). The reduction rate of the HV in FMISO-PET from Pre-IMRT to Inter-IMRT tended to be larger than that from Inter-IMRT to Post-IMRT (63 % vs. 40 %, p = 0.490). Conversely, the reduction rate of the MTV in FDG-PET from Pre-IMRT to Inter-IMRT was lower than that from Inter-IMRT to Post-IMRT (47 % vs. 74 %, p = 0.003). CONCLUSIONS: Both the intensity and the volume of tumor hypoxia rapidly decreased in the early phase of radiotherapy, indicating reoxygenation of the tumor hypoxia. In contrast, the FDG uptake declined gradually with the course of radiotherapy, indicating that the tumoricidal effect continues over the entire course of radiation treatment.
• Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis.

  Takayoshi Suzuki, Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Fumiyuki Suzuki, Satoshi Fukuda

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 273 (10) 3331 - 6 0937-4477 2016/10 [Refereed][Not invited]
   

  We sought to evaluate the efficacy and feasibility of superselective intra-arterial infusion of high-dose cisplatin with concomitant radiotherapy (hereafter RADPLAT) for head and neck squamous cell cancer (hereafter HNSCC) patients with retropharyngeal lymph node (hereafter RPLN) metastasis. A retrospective case series review was conducted at University medical center in Japan. Ten HNSCC patients with RPLN metastasis treated by RADPLAT were analyzed. The ascending pharyngeal artery was targeted for the treatment of RPLN metastasis in 9 patients. The median total dose of cisplatin was 26.6 mg/m(2) (mean 31.5 mg/m(2), range 11.7-87.9 mg/m(2)). In the remaining patient, the RPLN was supplied by the ascending palatine artery. As grade 3 and 4 adverse effects, leukopenia was observed in three, mucositis in four and nausea in one patient. No neurological complications were observed in any patients. Metastatic RPLNs were evaluated as a complete response in all patients. There was no recurrence of RPLN metastasis in any patients. Four patients remain alive without any evidence of disease and six patients died of disease. The 5-year overall survival rate was 50 %. We have shown that superselective intra-arterial cisplatin infusion for RPLNs was a feasible and effective approach for HNSCC patients with RPLN metastasis.
• A Retrospective Study of G-Tube Use in Japanese Patients Treated with Concurrent Chemoradiotherapy for Hypopharyngeal Cancer.

  Akihiro Homma, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Rinnosuke Kuramoto, Yuji Nakamaru, Rikiya Onimaru, Kazuhiko Tsuchiya, Daisuke Yoshida, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  PloS one 11 (8) e0161734  1932-6203 2016 [Refereed][Not invited]
   

  OBJECTIVE: Late toxicity after concurrent chemoradiotherapy (CCRT), such as dysphagia, in patients with squamous cell carcinoma of the head and neck has received a good deal of attention recently. The gastrostomy tube (G-tube) dependence rate 1 year after CCRT was reported to be 16.7-42.9% in Western countries. We evaluated swallowing outcomes after CCRT in patients with hypopharyngeal cancer (HPC) treated in our hospital and compared them with previous reports. METHODS: We reviewed 96 consecutive patients with a HPC treated by radiotherapy with intravenous or intra-arterial chemotherapy between 2006 and 2013 at Hokkaido University Hospital, Sapporo, Japan. RESULTS: At 1 month after CCRT, 13 patients (13.7%) used a G-tube, whereas 5/91 (5.5%) and 4/81 (4.9%) used a G-tube at 3 and 6 months, respectively. Two patients used a G-tube at 12 and 24 months after CCRT (G-tube use rate: 2.8% at 12 months, and 3.2% at 24 months). The variables female, posterior wall primary, stage IV, ECOG performance status of 2, and smoking status were significantly associated with G-tube use at 12 months after CCRT, whereas the route of cisplatin administration was not related to G-tube use (p = 0.303). CONCLUSIONS: The G-tube use rate up to 1year could be lower in Japanese patients than in Western patients according to previous reports. In particular, Japanese patients resume oral intake sooner than Western patients. Further study of the incidence of dysphagia after CCRT by ethnicity is required to clarify the differences in dysphagia after CCRT.
• Clinical outcomes of weekly cisplatin chemoradiotherapy for patients with pyriform sinus cancer.

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Jun Furusawa, Satoshi Kano, Takatsugu Mizumachi, Satoshi Iizuka, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  International journal of clinical oncology 20 (6) 1081 - 5 1341-9625 2015/12 [Refereed][Not invited]
   

  BACKGROUND: Pyriform sinus squamous cell carcinoma (SCC) has one of the worst prognoses of all upper aerodigestive tract cancers. Improving clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists. METHODS: We investigated 30 patients with pyriform sinus SCC to verify the effectiveness of weekly cisplatin chemotherapy with concurrent radiotherapy. Cisplatin was administered at a dose of 40 mg/m(2) on weeks 1, 2, 3, 5, 6, and 7 during definitive radiotherapy with the aim of preserving the larynx. RESULTS: All 30 patients achieved definitive radiotherapy at a median dose of 70 Gy (range 64-70 Gy). Cisplatin was administrated concomitantly a median of five times (range 2-6 times). Persistent or recurrent primary disease was observed in four patients (13 %). Persistent or recurrent nodal metastasis was observed in five patients (17 %). Nine salvage surgeries were performed for eight patients, of whom seven survived without any evidence of disease. Post-operative complications were observed in two patients (22 %). The 5-year overall survival and locoregional control rates were 87 and 96 %, respectively. The 5-year laryngeal preservation rate was 74 %. CONCLUSIONS: The regimen of weekly cisplatin CRT may be effective for pyriform sinus SCC; however, there were problems with strong selection bias in the current study due to the large number of T2 patients. Salvage surgery was safe and was able to improve the survival rate. This chemoradiation regimen was considered successful in preserving laryngeal function.
• Indications for superselective intra-arterial cisplatin infusion and concomitant radiotherapy in cases of hypopharyngeal cancer.

  Jun Furusawa, Akihiro Homma, Rikiya Onimaru, Tomohiro Sakashita, Daisuke Yoshida, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  Auris, nasus, larynx 42 (6) 443 - 8 0385-8146 2015/12 [Refereed][Not invited]
   

  OBJECTIVE: We retrospectively assessed the indications for superselective intra-arterial infusion of cisplatin with concomitant radiotherapy (RADPLAT) in patients with hypopharyngeal cancer (HPC). METHODS: Between April 2000 and March 2013, 41 previously untreated patients received superselective intra-arterial infusion of cisplatin (100-120mg/m(2) per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional radiotherapy (65-70Gy). RESULTS: During the median follow-up period of 5.5 years, a statistically significant difference in the 5-year overall survival was noted between patients with N0-1 (n=14) and N2b-3 disease (n=27). One-half of deaths were observed to be the result of distant metastasis. The 5-year local control and overall survival were significantly better in patients with unilateral than in those with bilateral primary tumors. All the patients with T4b disease (n=3) died of disease within 2 years. CONCLUSION: Indications for RADPLAT in patients with HPC were defined as patients with unilateral tumors staged as T3-4a and N0-1.
• Management for squamous cell carcinoma of the nasal cavity and ethmoid sinus: A single institution experience.

  Akihiro Homma, Yuji Nakamaru, Tomohiro Sakashita, Rikiya Onimaru, Shunsuke Terasaka, Kazuhiko Tsuchiya, Daisuke Yoshida, Koichi Yasuda, Hiromitsu Hatakeyama, Jun Furusawa, Takatsugu Mizumachi, Satoshi Kano, Hiroki Shirato, Satoshi Fukuda

  Auris, nasus, larynx 42 (5) 377 - 81 0385-8146 2015/10 [Refereed][Not invited]
   

  OBJECTIVE: Here we report our experience of patients with squamous cell carcinoma (SCC) of the nasal cavity and ethmoid sinus (NC&ES) together with an analysis of treatment outcomes. METHODS: A retrospective analysis was performed using data from 25 consecutive patients treated between 2000 and 2012. Four patients were diagnosed with T1, 3 with T2, 4 with T3, 7 with T4a, and 7 with T4b disease. No patient had lymph node metastasis. RESULTS: Twelve patients were treated with surgery with/without radiotherapy and with/without chemotherapy. Of these, 4 underwent endoscopic surgery without an open approach and 3 required an anterior skull base approach. Thirteen were treated with radiotherapy; 1 with radiotherapy alone, and 4 and 8 with intravenous and intra-arterial chemotherapy, respectively. The 5-yr overall survival for T1-3, T4a, and T4b disease was 53.9%, 71.4%, and 29.0%, respectively. The 5-yr disease-specific survival for T1-3, T4a, and T4b disease was 74.1%, 71.4%, and 29.0%, respectively. CONCLUSION: Our treatment policy for patients with SCC of NC&ES, which basically follows the NCCN guideline, was considered to be appropriate. However, several points in terms of surgery and non-surgical approach remain to be solved through further research.
• The efficacy of superselective intra-arterial infusion with concomitant radiotherapy for adenoid cystic carcinoma of the head and neck.

  Akihiro Homma, Tomohiro Sakashita, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Yuji Nakamaru, Daisuke Yoshida, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  Acta oto-laryngologica 135 (9) 950 - 4 0001-6489 2015/09 [Refereed][Not invited]
   

  CONCLUSIONS: Superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) is considered to be one of the treatments of choice for patients with adenoid cystic carcinoma (ACC) who prefer not to undergo radical surgery. OBJECTIVE: To evaluate the efficacy of RADPLAT for patients with ACC of the head and neck. PATIENTS AND METHODS: Between 2001-2010, nine patients with untreated ACC were given superselective intra-arterial infusion of cisplatin (100-120 mg/m(2)/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and radiotherapy (65-70 Gy). RESULTS: Five patients had tumors arising in the base of the tongue, two in the maxillary sinus, and the remaining two in the nasopharynx. The median follow-up period was 9 years 7 months (9;7) (range = 4;6-12;5), and the 5-year local control (LC), overall survival (OS), and disease-free survival rates were 88.9%, 88.9%, and 55.6%, respectively. The 10-year OS rate was 57.1%, but all patients who remained alive for over 10 years are still alive with disease. Primary tumor recurrence was observed in five of the nine patients, with the median time to recurrence being 6 years (range = 4-9 years). Five of the nine patients had distant metastasis, and of these three patients also had primary recurrence.
• Comparison of acute toxicities associated with cetuximab-based bioradiotherapy and platinum-based chemoradiotherapy for head and neck squamous cell carcinomas: A single-institution retrospective study in Japan.

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Jun Furusawa, Satoshi Kano, Takatsugu Mizumachi, Satoshi Iizuka, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  Acta oto-laryngologica 135 (8) 853 - 8 0001-6489 2015/08 [Refereed][Not invited]
   

  CONCLUSION: Grade ≥ 3 mucositis/stomatitis and inability to feed orally were problematic for patients undergoing cetuximab-based bioradiotherapy (BRT) as well as platinum-based chemoradiotherapy (CRT). Severe mucositis/stomatitis and radiation dermatitis should be addressed carefully in patients undergoing cetuximab-based BRT as well. OBJECTIVES: The efficacy of cetuximab-based BRT in locally advanced head and neck squamous cell carcinomas has been established. However, the safety of cetuximab-based BRT in comparison with platinum-based CRT is currently under investigation. METHOD: This study retrospectively analyzed 14 patients undergoing cetuximab-based BRT and 29 patients undergoing platinum-based CRT to compare the incidence of acute toxicities. In the BRT group, an initial cetuximab loading dose of 400 mg/m(2) was delivered 1 week before the start of radiotherapy. Seven weekly infusions of 250 mg/m(2) of cetuximab followed during the definitive radiotherapy. In the CRT group, cisplatin was administered at a dose of 40 mg/m(2) weekly during the definitive radiotherapy. RESULTS: The BRT group had a higher incidence of Grade ≥ 3 radiation dermatitis than did the CRT group (43% vs 3%, respectively, p < 0.01). The incidence rate of Grade ≥ 3 mucositis/stomatitis was 64.3% and 41.4% in the BRT and CRT group, respectively (p = 0.1484), while the incidence rate of the inability to feed orally was 38.5% and 55.2%, respectively (p = 0.2053).
• Feasibility and efficacy of induction docetaxel, cisplatin, and 5-fluorouracil chemotherapy combined with concurrent weekly cisplatin chemoradiotherapy for locally advanced head and neck squamous cell carcinoma.

  Takatsugu Mizumachi, Akihiro Homma, Tomohiko Kakizaki, Tomohiro Sakashita, Satoshi Kano, Hiromitsu Hatakeyama, Kazuhiko Tsuchiya, Koichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Jun Taguchi, Yasushi Shimizu, Ichiro Kinoshita, Hirotoshi Akita, Satoshi Fukuda

  International journal of clinical oncology 20 (3) 431 - 7 1341-9625 2015/06 [Refereed][Not invited]
   

  BACKGROUND: The aim of this study was to evaluate the feasibility of induction docetaxel, cisplatin, and 5-fluorouracil chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: Between 2010 and 2013, 30 patients with Stage IV HNSCC were treated in Hokkaido University Hospital with three cycles of induction chemotherapy (docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2), day 1; and 5-fluorouracil 750 mg/m(2)/day 120 h continuous infusion, every 3 weeks) followed by concurrent weekly cisplatin (40 mg/m(2), on weeks 1, 2, 3, 5, 6 and 7) chemoradiotherapy. RESULTS: Three courses of induction chemotherapy were performed in 25 patients (83%) with grade 3-4 toxicities during induction chemotherapy observed in 22 patients (73%). The major toxicities were hematologic, with 22 cases (73%) showing grade 3-4 neutropenia. Radiotherapy was completed (70 Gy) in 29 patients (97%), while a total of 19 patients (63%) completed five (13 patients) or six (6 patients) courses of chemotherapy. During concurrent chemoradiotherapy, no grade 4 hematological toxicities were observed. Grade 4 dermatitis was observed in one patient, and grade 3 mucositis was observed in 12 patients. There were no treatment-related deaths during the induction chemotherapy or concurrent chemoradiotherapy. The 1- and 2-year progression-free survival rates and the 1- and 2-year overall survival rates were 86%, 72%, and 89%, 81%, respectively. CONCLUSION: Sequential therapy composed of induction chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy is feasible, showing encouraging results in patients with locally advanced HNSCC. Concurrent weekly cisplatin chemoradiotherapy following induction chemotherapy appears to be a suitable alternative to three-weekly high-dose cisplatin therapy.
• Olfactory neuroblastoma: the long-term outcome and late toxicity of multimodal therapy including radiotherapy based on treatment planning using computed tomography.

  Takashi Mori, Rikiya Onimaru, Shunsuke Onodera, Kazuhiko Tsuchiya, Koichi Yasuda, Hiromitsu Hatakeyama, Hiroyuki Kobayashi, Shunsuke Terasaka, Akihiro Homma, Hiroki Shirato

  Radiation oncology (London, England) 10 (1) 88 - 88 1748-717X 2015/04/15 [Refereed][Not invited]
   

  BACKGROUND: Olfactory neuroblastoma (ONB) is a rare tumor originating from olfactory epithelium. Here we retrospectively analyzed the long-term treatment outcomes and toxicity of radiotherapy for ONB patients for whom computed tomography (CT) and three-dimensional treatment planning was conducted to reappraise the role of radiotherapy in the light of recent advanced technology and chemotherapy. METHODS: Seventeen patients with ONB treated between July 1992 and June 2013 were included. Three patients were Kadish stage B and 14 were stage C. All patients were treated with radiotherapy with or without surgery or chemotherapy. The radiation dose was distributed from 50 Gy to 66 Gy except for one patient who received 40 Gy preoperatively. RESULTS: The median follow-up time was 95 months (range 8-173 months). The 5-year overall survival (OS) and relapse-free survival (RFS) rates were estimated at 88% and 74%, respectively. Five patients with stage C disease had recurrence with the median time to recurrence of 59 months (range 7-115 months). Late adverse events equal to or above Grade 2 in CTCAE v4.03 were observed in three patients. CONCLUSION: Multimodal therapy including radiotherapy with precise treatment planning based on CT simulation achieved an excellent local control rate with acceptable toxicity and reasonable overall survival for patients with ONB.
• The incidence of late neck recurrence in N0 maxillary sinus squamous cell carcinomas after superselective intra-arterial chemoradiotherapy without prophylactic neck irradiation.

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Jun Furusawa, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 271 (10) 2767 - 70 0937-4477 2014/10 [Refereed][Not invited]
   

  The efficacy of elective neck irradiation (ENI) for patients with N0 carcinoma of the maxillary sinus has been controversial. The purpose of our study was to investigate the incidence of late neck recurrence and the mortality rate from regional disease in patients with N0 maxillary sinus cancer after superselective cisplatin infusion and concomitant radiotherapy (RADPLAT) without ENI. We retrospectively analyzed 48 patients with N0 maxillary sinus cancer who underwent RADPLAT. Chemotherapy consisted of 100-120 mg/m(2) superselective intra-arterial cisplatin administered at a median rate of four times weekly. Concurrent radiation therapy was administered at a median dose of 65 Gy without ENI. Late neck recurrence was observed in 8.3% (4/48). Three patients underwent salvage neck dissection and survived without any evidence of disease. The remaining patient did not undergo neck dissection due to coexistence with distant metastasis, and he died of regional disease. The mortality rate from regional disease was calculated to be 2% (1/48). The incidence of late neck recurrence was not frequent, and the mortality rate from regional disease was low. Salvage neck dissection was considered to be feasible for patients with late neck recurrence. When definitive radiotherapy and concomitant chemotherapy are applied, it is considered that ENI is not required for cases of N0 maxillary sinus cancer.
• Dual tracer evaluation of dynamic changes in intratumoral hypoxic and proliferative states after radiotherapy of human head and neck cancer xenografts using radiolabeled FMISO and FLT.

  Chowdhury Nusrat Fatema, Songji Zhao, Yan Zhao, Wenwen Yu, Ken-ichi Nishijima, Koichi Yasuda, Yoshimasa Kitagawa, Nagara Tamaki, Yuji Kuge

  BMC cancer 14 692 - 692 1471-2407 2014/09/22 [Refereed][Not invited]
   

  BACKGROUND: Radiotherapy is an important treatment strategy for head and neck cancers. Tumor hypoxia and repopulation adversely affect the radiotherapy outcome. Accordingly, fractionated radiotherapy with dose escalation or altered fractionation schedule is used to prevent hypoxia and repopulation. 18F-fluoromisonidazole (FMISO) and 18F-fluorothymidine (FLT) are noninvasive markers for assessing tumor hypoxia and proliferation, respectively. Thus, we evaluated the dynamic changes in intratumoral hypoxic and proliferative states following radiotherapy using the dual tracers of 18F-FMISO and 3H-FLT, and further verified the results by immunohistochemical staining of pimonidazole (a hypoxia marker) and Ki-67 (a proliferation marker) in human head and neck cancer xenografts (FaDu). METHODS: FaDu xenografts were established in nude mice and assigned to the non-radiation-treated control and two radiation-treated groups (10- and 20-Gy). Tumor volume was measured daily. Mice were sacrificed 6, 24, and 48 hrs and 7 days after radiotherapy. 18F-FMISO, and 3H-FLT and pimonidazole were injected intravenously 4 and 2 hrs before sacrifice, respectively. Intratumoral 18F-FMISO and 3H-FLT levels were assessed by autoradiography. Pimonidazole and Ki-67 immunohistochemistries were performed. RESULTS: In radiation-treated mice, tumor growth was significantly suppressed compared with the control group, but the tumor volume in these mice gradually increased with time. Visual inspection showed that intratumoral 18F-FMISO and 3H-FLT distribution patterns were markedly different. Intratumoral 18F-FMISO level did not show significant changes after radiotherapy among the non-radiation-treated control and radiation-treated groups, whereas 3H-FLT level markedly decreased to 59 and 45% of the non-radiation-treated control at 6 hrs (p<0.0001) and then gradually increased with time in the 10- and 20-Gy-radiation-treated groups. The pimonidazole-positive hypoxic areas were visually similar in both the non-radiation-treated control and radiation-treated groups. No significant differences were observed in the percentage of pimonidazole-positive cells and Ki-67 index. CONCLUSION: Intratumoral 18F-FMISO level did not change until 7 days, whereas 3H-FLT level markedly decreased at 6 hrs and then gradually increased with time after a single dose of radiotherapy. The concomitant monitoring of dynamic changes in tumor hypoxia and proliferation may provide important information for a better understanding of tumor biology after radiotherapy and for radiotherapy planning, including dose escalation and altered fractionation schedules.
• Salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy.

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Jun Furusawa, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Fumiyuki Suzuki, Satoshi Fukuda

  The British journal of oral & maxillofacial surgery 52 (4) 323 - 8 0266-4356 2014/04 [Refereed][Not invited]
   

  Our aim was to evaluate the feasibility of salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy. We retrospectively analysed the records of 61 patients with cancer of the maxillary sinus who were treated in this way. Chemotherapy comprised 100-120 mg/m(2) superselective intra-arterial infusions of cisplatin given a median of 4 times weekly (range 2-5). Concurrent radiotherapy was given in a median dose of 65 Gy (range 24-70 Gy). Persistent or recurrent cancer of the maxillary sinus was found in 17 patients, of whom 11 had salvage surgery. The disease was controlled in 8 of the 11, and 7 of the 11 survived with no evidence of disease. Their 5-year overall survival was 61%. Two of the 11 developed serious operative complications. Salvage surgery for patients with persistent or recurrent cancer of the maxillary sinus treated by superselective chemoradiotherapy is both safe and successful. Salvage surgery is a good option when this sort of persistent or recurrent cancer is followed up after the regimen of chemoradiotherapy described.
• Superselective intra-arterial cisplatin infusion and concomitant radiotherapy for maxillary sinus cancer

  A. Homma, T. Sakashita, D. Yoshida, R. Onimaru, K. Tsuchiya, F. Suzuki, K. Yasuda, H. Hatakeyama, J. Furusawa, T. Mizumachi, S. Kano, N. Inamura, S. Taki, H. Shirato, S. Fukuda

  BRITISH JOURNAL OF CANCER 109 (12) 2980 - 2986 0007-0920 2013/12 [Refereed][Not invited]
   

  Background: The purpose of this study was to evaluate the efficacy of superselective cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with the squamous cell carcinoma of maxillary sinus (SCC-MS). Methods: Between 1999 and 2010, 54 patients were given superselective intra-arterial infusions of cisplatin (100-120mgm(-2) per week) with simultaneous intra-venous infusions of thiosulfate to neutralise cisplatin toxicity and conventional radiotherapy (65-70 Gy). Results: One patient (1.9%) was diagnosed with T2, 14 (25.9%) with T3, 27 (50%) with T4a, and 12 (22.2%) with T4b disease. Lymph-node involvement was present in 12 patients (22.2%). During the median follow-up period of 6.4 years, the 5-year local progression-free and overall survival rates were 65.8 and 67.9% for all patients, respectively. No patient died as a result of treatment toxicity or experienced a cerebrovascular accident. Osteonecrosis (n-5), brain necrosis (n-1), and ocular/ visual problems (n = 14) were observed as late adverse reactions. Conclusion: We have shown excellent overall survival and local progression-free rate in SCC-MS patients treated by RADPLAT with acceptable rates of acute and late toxicity. A multi-institutional trial is needed to prove that this strategy is a feasible and effective approach for the treatment of SCC-MS.
• Evaluation of inter-observer variability of bladder boundary delineation on cone-beam CT.

  Kentaro Nishioka, Shinichi Shimizu, Rumiko Kinoshita, Tetsuya Inoue, Shunsuke Onodera, Koichi Yasuda, Keiichi Harada, Yukiko Nishikawa, Rikiya Onimaru, Hiroki Shirato

  Radiation oncology (London, England) 8 185 - 185 1748-717X 2013/07/23 [Refereed][Not invited]
   

  BACKGROUND: In-room cone-beam computerized tomography (CBCT) imaging is a promising method to reduce setup errors, especially in organs such as the bladder that often have large intrafractional variations due to organ movement. CBCT image quality is limited by low contrast and imaging artifacts, but few data have been reported about inter-observer variability of bladder boundary delineation on CBCT. The aim of this work was to analyze and evaluate the inter-observer contouring uncertainties of bladder boundary delineation on CBCT images in a prospective fashion. METHODS: Five radiation oncologists contoured 10 bladders using the CBCT datasets of consecutive 10 patients (including 4 females) who were irradiated to the pelvic region. Prostates were also contoured in male patients. Patients who had had prostatectomy were excluded. The coefficient of variation (COV), conformity index (CI(gen)), and coordinates of center-of-mass (COM) of the bladder and prostate were calculated for each patient. RESULTS: The mean COV for the bladder and prostate was 0.08 and 0.20, respectively. The mean CI(gen) of the bladder and prostate was 0.81 and 0.66, respectively. The root mean square (RMS) of the inter-observer standard deviation (σ) of the COM displacement in the left-right (LR) and anterior-posterior (AP) direction was 0.79, 0.87 and 0.54 for the bladder and 0.63, 0.99 and 1.72 for the prostate. Regarding the mean COV and CI(gen) for the bladder, the differences between males and females were not significant. CONCLUSIONS: Inter-observer variability for bladder delineation on CBCT images was substantially small regardless of gender. We believe that our results support the applicability of CBCT in adaptive radiotherapy for bladder cancer.
• Regional control after concomitant chemoradiotherapy without planned neck dissection in node-positive head and neck squamous cell carcinomas.

  Tomohiro Sakashita, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  Auris, nasus, larynx 40 (2) 211 - 5 0385-8146 2013/04 [Refereed][Not invited]
   

  OBJECTIVES: Although three-weekly high-dose (100mg/m(2)) cisplatin (three cycles) chemoradiotherapy has been considered a standard regimen for patients with advanced head and neck squamous cell carcinomas (HNSCC), this protocol is associated with significant acute and late toxicities. Therefore, weekly cisplatin at a dose of 40mg/m(2) has been used at our institution since 2006. This retrospective study was aimed at assessing the oncologic efficacy of weekly cisplatin chemoradiotherapy for the control of nodal metastasis. METHODS: We analyzed 28 patients with node-positive HNSCC treated with weekly cisplatin and concurrent radiotherapy. Computed tomography was performed 4-8 weeks after the completion of chemoradiotherapy to evaluate nodal response. If residual neck disease was apparent or suspected, we performed early salvage neck dissection (ND). In cases with a complete response (CR), we took a "wait and see" approach. When no viable tumor cells were observed in the surgical specimens obtained by ND, nodal metastasis was defined as controlled by weekly cisplatin chemoradiotherapy alone. RESULTS: Nodal metastasis was evaluated as having a CR in 20 patients (71%). Eight patients (29%) underwent early salvage ND. Recurrent primary tumors were observed in the other four patients (14%). Salvage primary resection and associated ND were performed for these four patients. In 7 of 12 patients undergoing ND, no viable tumor cells were observed. In 23of 28 patients, neck diseases were controlled by chemoradiotherapy alone (not including salvage by ND). In 27 of 28 patients, neck diseases were controlled by the overall treatment (including salvage by ND). The rate of nodal control by chemoradiotherapy alone and by the overall treatment was found to be 82.0% and 96.3%, respectively, using the Kaplan-Meier method. The three-year overall and disease free survival rates were 86.8% and 80.8%, respectively. CONCLUSION: Concomitant weekly cisplatin at a dose of 40mg/m(2) chemoradiotherapy showed a good control rate of not only primary lesions but also neck diseases.
• High reproducibility of tumor hypoxia evaluated by 18F-fluoromisonidazole PET for head and neck cancer.

  Shozo Okamoto, Tohru Shiga, Koichi Yasuda, Yoichi M Ito, Keiichi Magota, Katsuhiko Kasai, Yuji Kuge, Hiroki Shirato, Nagara Tamaki

  Journal of nuclear medicine : official publication, Society of Nuclear Medicine 54 (2) 201 - 7 0161-5505 2013/02 [Refereed][Not invited]
   

  UNLABELLED: Tumor hypoxia is well known to be radiation resistant. (18)F-fluoromisonidazole ((18)F-FMISO) PET has been used for noninvasive evaluation of hypoxia. Quantitative evaluation of (18)F-FMISO uptake is thus expected to play an important role in the planning of dose escalation radiotherapy. However, the reproducibility of (18)F-FMISO uptake has remained unclarified. We therefore investigated the reproducibility of tumor hypoxia by using quantitative analysis of (18)F-FMISO uptake. METHODS: Eleven patients with untreated head and neck cancer underwent 2 (18)F-FMISO PET/CT scans ((18)F-FMISO(1) and (18)F-FMISO(2)) with a 48-h interval prospectively. All images were acquired at 4 h after (18)F-FMISO injection for 10 min. The maximum standardized uptake (SUVmax), tumor-to-blood ratio (TBR), and tumor-to-muscle ratio (TMR) of (18)F-FMISO uptake were statistically compared between the 2 (18)F-FMISO scans by use of intraclass correlation coefficients (ICCs). The hypoxic volume was calculated as the area with a TBR of greater than or equal to 1.5 or the area with a TMR of greater than or equal to 1.25 to assess differences in hypoxic volume between the 2 (18)F-FMISO scans. The distances from the maximum uptake locations of the (18)F-FMISO(1) images to those of the (18)F-FMISO(2) images were measured to evaluate the locations of (18)F-FMISO uptake. RESULTS: The SUVmax (mean ± SD) for (18)F-FMISO(1) and (18)F-FMISO(2) was 3.16 ± 1.29 and 3.02 ± 1.12, respectively, with the difference between the 2 scans being 7.0% ± 4.6%. The TBRs for (18)F-FMISO(1) and (18)F-FMISO(2) were 2.98 ± 0.83 and 2.97 ± 0.64, respectively, with a difference of 9.9% ± 3.3%. The TMRs for (18)F-FMISO(1) and (18)F-FMISO(2) were 2.25 ± 0.71 and 2.19 ± 0.67, respectively, with a difference of 7.1% ± 5.3%. The ICCs for SUVmax, TBR, and TMR were 0.959, 0.913, and 0.965, respectively. The difference in hypoxic volume based on TBR was 1.8 ± 1.8 mL, and the difference in hypoxic volume based on TMR was 0.9 ± 1.3 mL, with ICCs of 0.986 and 0.996, respectively. The maximum uptake locations of the (18)F-FMISO(1) images were different from those of the (18)F-FMISO(2) images and were within the full width at half maximum of the PET/CT scanner, except in 1 case. CONCLUSION: The values for (18)F-FMISO PET uptake and hypoxic volume in head and neck tumors between the 2 (18)F-FMISO scans were highly reproducible. Such high reproducibility of tumor hypoxia is promising for accurate radiation planning.
• [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.
• [18F]fluoromisonidazole and a new PET system with semiconductor detectors and a depth of interaction system for intensity modulated radiation therapy for nasopharyngeal cancer

  Yasuda K, Onimaru R, Okamoto S, Shiga T, Katoh N, Tsuchiya K, Suzuki R, Takeuchi W, Kuge Y, Tamaki N, Shirato H

  Int J Radiat Oncol Biol Phys 85 (1) 142 - 7 1879-355X 2013 [Refereed][Not invited]
  
• 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) e671-6 - E676 0360-3016 2012/03/15 [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 (PET(CONV)WB) versus the new brain (BR) PET system using semiconductor detectors (PET(NEW)BR). METHODS AND MATERIALS: Twelve patients with NPC were enrolled in this study. [(18)F]Fluorodeoxyglucose-PET images were acquired using both the PET(NEW)BR and the PET(CONV)WB system on the same day. Computed tomography (CT) and two PET data sets were transferred to a treatment planning system, and the PET(CONV)WB and PET(NEW)BR 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 PET(CONV)WB (GTV(CONV)) images or PET(NEW)BR (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.
• Multi-institutional analysis of solitary extramedullary plasmacytoma of the head and neck treated with curative radiotherapy.

  Ryohei Sasaki, Koichi Yasuda, Eisuke Abe, Nobue Uchida, Mitsuhiko Kawashima, Takashi Uno, Masayuki Fujiwara, Yoshiyuki Shioyama, Yoshikazu Kagami, Yuta Shibamoto, Kensei Nakata, Yoshie Takada, Tetsuya Kawabe, Kazuyuki Uehara, Kenichi Nibu, Syogo Yamada

  International journal of radiation oncology, biology, physics 82 (2) 626 - 34 0360-3016 2012/02/01 [Refereed][Not invited]
   

  PURPOSE: The purpose of this study was to elucidate the efficacy and optimal method of radiotherapy in the management of solitary extramedullary plasmacytoma occurring in the head and neck regions (EMPHN). METHODS AND MATERIALS: Sixty-seven patients (43 male and 24 female) diagnosed with EMPHN between 1983 and 2008 at 23 Japanese institutions were reviewed. The median patient age was 64 years (range, 12-83). The median dose administered was 50 Gy (range, 30-64 Gy). Survival data were calculated by the Kaplan-Meier method. RESULTS: The median follow-up duration was 63 months. Major tumor sites were nasal or paranasal cavities in 36 (54%) patients, oropharynx or nasopharynx in 16 (23%) patients, orbita in 6 (9%) patients, and larynx in 3 (5%) patients. The 5- and 10-year local control rates were 95% and 87%, whereas the 5- and 10-year disease-free survival rates were 56% and 54%, respectively. There were 5 (7.5%), 12 (18%), and 8 (12%) patients who experienced local failure, distant metastasis, and progression to multiple myeloma, respectively. In total, 18 patients died, including 10 (15%) patients who died due to complications from EMPHN. The 5- and 10-year overall survival (OS) rates were 73% and 56%, respectively. Radiotherapy combined with surgery was identified as the lone significant prognostic factor for OS (p = 0.04), whereas age, gender, radiation dose, tumor size, and chemotherapy were not predictive. No patient experienced any severe acute morbidity. CONCLUSIONS: Radiotherapy was quite effective and safe for patients with EMPHN. Radiotherapy combined with surgery produced a better outcome according to survival rates. These findings require confirmation by further studies with larger numbers of patients with EMPHN.
• Accurate analysis of the change in volume, location, and shape of metastatic cervical lymph nodes during radiotherapy.

  Seishin Takao, Shigeru Tadano, Hiroshi Taguchi, Koichi Yasuda, Rikiya Onimaru, Masayori Ishikawa, Gerard Bengua, Ryusuke Suzuki, Hiroki Shirato

  International journal of radiation oncology, biology, physics 81 (3) 871 - 9 0360-3016 2011/11/01 [Refereed][Not invited]
   

  PURPOSE: To establish a method for the accurate acquisition and analysis of the variations in tumor volume, location, and three-dimensional (3D) shape of tumors during radiotherapy in the era of image-guided radiotherapy. METHODS AND MATERIALS: Finite element models of lymph nodes were developed based on computed tomography (CT) images taken before the start of treatment and every week during the treatment period. A surface geometry map with a volumetric scale was adopted and used for the analysis. Six metastatic cervical lymph nodes, 3.5 to 55.1 cm(3) before treatment, in 6 patients with head and neck carcinomas were analyzed in this study. Three fiducial markers implanted in mouthpieces were used for the fusion of CT images. Changes in the location of the lymph nodes were measured on the basis of these fiducial markers. RESULTS: The surface geometry maps showed convex regions in red and concave regions in blue to ensure that the characteristics of the 3D tumor geometries are simply understood visually. After the irradiation of 66 to 70 Gy in 2 Gy daily doses, the patterns of the colors had not changed significantly, and the maps before and during treatment were strongly correlated (average correlation coefficient was 0.808), suggesting that the tumors shrank uniformly, maintaining the original characteristics of the shapes in all 6 patients. The movement of the gravitational center of the lymph nodes during the treatment period was everywhere less than ±5 mm except in 1 patient, in whom the change reached nearly 10 mm. CONCLUSIONS: The surface geometry map was useful for an accurate evaluation of the changes in volume and 3D shapes of metastatic lymph nodes. The fusion of the initial and follow-up CT images based on fiducial markers enabled an analysis of changes in the location of the targets. Metastatic cervical lymph nodes in patients were suggested to decrease in size without significant changes in the 3D shape during radiotherapy. The movements of the gravitational center of the lymph nodes were almost all less than ±5 mm.
• Concomitant weekly cisplatin and radiotherapy for head and neck cancer.

  Akihiro Homma, Naoya Inamura, Nobuhiko Oridate, Seigo Suzuki, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Rikiya Onimaru, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  Japanese journal of clinical oncology 41 (8) 980 - 6 0368-2811 2011/08 [Refereed][Not invited]
   

  OBJECTIVE: The most common chemoradiotherapy regimen is high-dose (100 mg/m(2)) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. Here, we reviewed the dose intensity and toxicity for concomitant weekly cisplatin and radiotherapy in patients with head and neck cancer. METHODS: Fifty-three patients with untreated head and neck cancer were enrolled and evaluated at our institution from April 2006 to April 2010. Weekly cisplatin (40 mg/m(2)) was given on weeks 1, 2, 3, 5, 6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks. RESULTS: Fifty-one patients (96.2%) received the full dose of radiotherapy, while the course was disrupted by adverse events in two. Over the course of the chemotherapy, 31 patients (58.5%) received more than 200 mg/m(2) cisplatin. The toxicity was manageable in all except one patient, who died of sepsis after completing treatment. The 2-year overall survival rate and local progression-free rate for all patients were 93.7% and 88.0%, respectively. The primary site showed a complete response in 52 patients (98.1%) and a partial response in 1 patient (1.9%). The primary disease was well controlled by chemoradiotherapy in 47 patients (88.7%). CONCLUSIONS: Weekly cisplatin could be easier to manage than three-weekly cisplatin, because patients can be monitored more regularly for toxicity allowing the schedule to be altered if required. This regimen appears to be a suitable alternative to three-weekly high-dose cisplatin with concomitant radiotherapy.
• Relationship between diseased lung tissues on computed tomography and motion of fiducial marker near lung cancer.

  Yuya Onodera, Noriko Nishioka, Koichi Yasuda, Noriyuki Fujima, Mylin Torres, Tamotsu Kamishima, Noriko Ooyama, Rikiya Onimaru, Satoshi Terae, Satoshi Ooizumi, Masaharu Nishimura, Hiroki Shirato

  International journal of radiation oncology, biology, physics 79 (5) 1408 - 13 0360-3016 2011/04/01 [Refereed][Not invited]
   

  PURPOSE: For lung cancer patients with poor pulmonary function because of emphysema or fibrosis, it is important to predict the amplitude of internal tumor motion to minimize the irradiation of the functioning lung tissue before undergoing stereotactic body radiotherapy. METHODS AND MATERIALS: Two board-certified diagnostic radiologists independently assessed the degree of pulmonary emphysema and fibrosis on computed tomography scans in 71 patients with peripheral lung tumors before real-time tumor-tracking radiotherapy. The relationships between the computed tomography findings of the lung parenchyma and the motion of the fiducial marker near the lung tumor were investigated. Of the 71 patients, 30 had normal pulmonary function, and 29 had obstructive pulmonary dysfunction (forced expiratory volume in 1 s/forced vital capacity ratio of <70%), 6 patients had constrictive dysfunction (percentage of vital capacity <80%), and 16 had mixed dysfunction. RESULTS: The upper region was associated with smaller tumor motion, as expected (p = .0004), and the presence of fibrosis (p = .088) and pleural tumor contact (p = .086) were weakly associated with tumor motion. The presence of fibrotic changes in the lung tissue was associated with smaller tumor motion in the upper region (p <.05) but not in the lower region. The findings of emphysema and pulmonary function tests were not associated with tumor motion. CONCLUSION: Tumors in the upper lung region with fibrotic changes have smaller motion than those in the upper region of the lungs without fibrotic changes. The tumor motion in the lower lung region was not significantly different between patients with and without lung fibrosis. Emphysema was not associated with the amplitude of tumor motion.
• Long-term outcomes of fractionated stereotactic radiotherapy for intracranial skull base benign meningiomas in single institution.

  Onodera S, Aoyama H, Katoh N, Taguchi H, Yasuda K, Yoshida D, Surtherland K, Suzuki R, Ishikawa M, Gerard B, Terasaka S, Shirato H

  Japanese journal of clinical oncology 4 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 α/β 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.
• Radiotherapy for glottic T1N0 carcinoma with slight hypofractionation and standard overall treatment time: importance of overall treatment time.

  Onimaru R, Hasegawa M, Yasuda K, Homma A, Oridate N, Fukuda S, Shirato H

  Jpn J Clin Oncol 1 41 (1) 103 - 9 1465-3621 2011 [Refereed][Not invited]
   

  OBJECTIVE: We retrospectively investigated treatment outcomes in patients with glottic T1 carcinoma treated with 65 Gy in 26 fractions four times a week and discuss the importance of the overall treatment time. METHODS: Two hundred one patients with glottic T1 carcinoma were evaluated. Sixty-five Gray in 26 fractions were delivered for 200 patients, whereas 1 patient received 62.5 Gy in 25 fractions. We delivered radiotherapy once daily four times a week in this period, for a weekly dose of 10 Gy. Weekdays except Wednesday were treatment days. RESULTS: The overall survival rate was 96.8 ± 1.3% (standard error) at 3 years and 90.8 ± 2.2% at 5 years. The local control rate was 91.9 ± 2.0% at 3 years and 89.8 ± 2.3% at 5 years. In patients with an overall treatment time equal to or longer than 47 days, the local control rate was 82.6 ± 6.0% at both 3 and 5 years. In the patients with overall treatment time equal to or less than 46 days, the local control rate was 94.6 ± 1.9% at 3 years and 91.8 ± 2.4% at 5 years. There was a significant difference between these two groups (P = 0.0349). A severe late radiation reaction occurred in one patient. He experienced severe laryngeal edema that required tracheotomy at 6 months after the completion of radiotherapy. The tracheotomy was closed at 14 months after completion of radiotherapy. CONCLUSIONS: Overall treatment time seems to be an important factor for a good local control rate for glottic T1N0 carcinoma even when treated with slight hypofractionation.
• Low-dose craniospinal irradiation and ifosfamide, cisplatin and etoposide for non-metastatic embryonal tumors in the central nervous system.

  Koichi Yasuda, Hiroshi Taguchi, Yutaka Sawamura, Jun Ikeda, Hidefumi Aoyama, Kenji Fujieda, Nobuaki Ishii, Masaaki Kashiwamura, Yoshinobu Iwasaki, Hiroki Shirato

  Japanese journal of clinical oncology 38 (7) 486 - 92 0368-2811 2008/07 [Refereed][Not invited]
   

  OBJECTIVE: The current study was conducted to evaluate the effects of low-dose craniospinal irradiation (CSI) combined with chemotherapy on non-metastatic embryonal tumors in the central nervous system (CNS), including medulloblastoma and supra-tentorial primitive neuroectodermal tumors (ST-PNET). METHODS: All patients were treated according to the following protocol. After surgery, the patients < or =5 years old received 18 Gy and the patients >5 years old received 24 Gy CSI. The dose to the primary tumor bed was 39.6-54 Gy. Chemotherapy consisted of ifosfamide, cisplatin and etoposide (ICE chemotherapy). RESULTS: Sixteen patients aged 0.5-20.4 (median 6.1) years were enrolled and followed for 11-165 (median 112) months. Both 5-year actuarial overall survival (OAS) and progression-free survival (PFS) were 81% (95% confidence interval (CI): 62-100%) for the 16 patients. Both 5-year OAS and PFS were 82% (CI: 59-100%) for the patients with medulloblastoma and 80% (CI: 45-100%) for the patients with ST-PNET. Both 5-year OAS and PFS were 75% for the eight patients < or =5 years old and 88% for the eight patients >5 years old. Both 5-year OAS and PFS were 100% for six average-risk patients (3 years or older, total resection and posterior fossa) and 70% for 10 poor-risk patients (others). The median total intellectual quotient at the last follow-up was 85 (ranging from 48 to 103) in 12 patients who were followed for 3-145 (median 49) months. Eight patients received hormone replacement therapy. CONCLUSION: Low-dose CSI and ICE chemotherapy may have a role as a treatment option for a subset of patients with non-metastatic embryonal tumors in the CNS.
• 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 0360-3016 2008 [Refereed][Not invited]
  

MISC

• 【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 免疫チェックポイント阻害薬と放射線治療

  安田 耕一, 志藤 元泰, 小泉 富基, 高橋 周平, 藤田 祥博, 大塚 愛美, 宮崎 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  30-  (1)  23  -28  2022/07
• 高齢者(特に80歳以上)頭頸部癌の治療戦略-何を指標にどのように治療を行うか- 高齢者頭頸部癌の放射線治療

  安田 耕一  頭頸部癌  48-  (2)  140  -140  2022/05
• 咽喉頭癌に対するシスプラチン超選択的動注併用放射線治療(RADPLAT)による頸部制御の検討

  加納 里志, 対馬 那由多, 鈴木 崇祥, 浜田 誠二郎, 吉田 大介, 打浪 雄介, 安田 耕一, 本間 明宏  頭頸部癌  48-  (2)  151  -151  2022/05
• 高齢の頭頸部悪性腫瘍に対する放射線治療の後ろ向き検討

  安田 耕一, 打浪 雄介, 浜田 誠二郎, 鈴木 崇祥, 対馬 那由多, 田口 純, 清水 康, 加納 里志, 本間 明宏  頭頸部癌  48-  (2)  200  -200  2022/05
• 局所進行上咽頭癌におけるadaptive radiotherapyに関する検討

  打浪雄介, 安田耕一, 藤田祥博, 高橋周平, 大塚愛美, 田口純, 清水康, 加納里志, 本間明宏, 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  35th-  2022
• 強度変調放射線治療(IMRT)を行った下咽頭癌における再発症例の検討

  大塚愛美, 安田耕一, 湊川英樹, 出倉康裕, 青山英史, 清水伸一, 鈴木隆介, 宮本直樹, 清水伸一, 鈴木崇祥, 対馬那由多, 加納里志, 田口純, 清水康, 本間明宏, 清水伸一  Japanese Journal of Radiology  40-  (Supplement)  2022
• Nasopharyngeal cancer

  安田耕一  耳鼻咽喉科・頭頚部外科  94-  (11)  2022
• 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
• 放射線治療

  安田 耕一  耳鼻咽喉科臨床 補冊  (補冊157)  43  -43  2021/06
• 咽喉頭扁平上皮癌IMRTの照射中における線量分布変化に関する解析

  安田 耕一, 打浪 雄介, 湊川 英樹, 小泉 富基, 大塚 愛美, 藤田 祥博, 井戸川 寛志, 鈴木 崇祥, 対馬 那由多, 加納 里志, 本間 明宏  頭頸部癌  47-  (2)  210  -210  2021/05
• CCRTを施行した頭頸部癌患者に対する予防的胃瘻増設の有用性の検討

  加納 里志, 対馬 那由多, 鈴木 崇祥, 井戸川 寛志, 浜田 誠二郎, 横川 泰三, 安田 耕一, 湊川 英樹, 打浪 雄介, 本間 明宏  頭頸部癌  47-  (2)  211  -211  2021/05
• 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
• 頭皮原発血管肉腫に対する化学療法および強度変調放射線照射による集学的治療の有用性

  前田 拓, 北條 正洋, 林 利彦, 山本 有平, 安田 耕一  日本皮膚悪性腫瘍学会学術大会プログラム・抄録集  36回-  153  -153  2020/12
• 頭皮原発血管肉腫に対する化学療法および強度変調放射線照射による集学的治療の有用性

  前田 拓, 北條 正洋, 林 利彦, 山本 有平, 安田 耕一  日本皮膚悪性腫瘍学会学術大会プログラム・抄録集  36回-  153  -153  2020/12
• 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
• 上・中・下咽頭癌に対する陽子線治療の初期経験

  安田 耕一, 湊川 英樹, 出倉 康裕, 対馬 那由多, 鈴木 崇祥, 加納 里志, 鬼丸 力也, 清水 伸一, 本間 明宏, 青山 英史  頭頸部癌  46-  (2)  161  -161  2020/07
• 休日による総治療期間延長に対して1回線量増加の方法を組み合わせて放射線治療を行った早期声門癌の検討

  出倉 康裕, 安田 耕一, 湊川 英樹, 対馬 那由多, 鈴木 崇祥, 加納 里志, 鬼丸 力也, 本間 明宏, 青山 英史  頭頸部癌  46-  (2)  179  -179  2020/07
• 頭頸部粘膜悪性黒色腫に対する術後陽子線治療30GyE/5回の初期経験

  湊川 英樹, 安田 耕一, 出倉 康裕, 鈴木 正宣, 中丸 裕爾, 中薗 彬, 鈴木 崇祥, 対馬 那由多, 加納 里志, 鬼丸 力也, 清水 伸一, 本間 明宏, 青山 英史  頭頸部癌  46-  (2)  188  -188  2020/07
• 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
• 当科における局所進行外耳道扁平上皮癌の治療成績の検討

  加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 対馬 那由多, 鈴木 崇祥, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏  頭頸部癌  45-  (3)  300  -304  2019/10  

  我々は、局所進行外耳道扁平上皮癌に対する治療成績、特にドセタキセル、シスプラチン、5-FUの併用(TPF)の化学療法同時併用放射線療法(CCRT)の治療成績と安全性、および腫瘍の進展範囲と予後との関係を検討した。対象は当科で根治治療を行った外耳道癌扁平上皮癌で、ピッツバーグ分類のT3-4の21症例とした。その結果、硬膜と顎関節への進展が頸部転移と相関を示し、顎関節への進展が局所再発と相関を示した。全症例の2年粗生存率(OS)は61.1%、2年局所制御率(LC)は52.1%であった。CCRT症例では、TPF併用の2年OSは85.7%、それ以外では25.0%、TPF併用の2年LCは57.1%、それ以外では25.0%であった。また、TPF併用CCRTにおけるG3以上の白血球減少は55%、好中球減少は45%であった。TPF併用のCCRTは局所進行外耳道扁平上皮癌に対して高い有効性と安全性を示した。(著者抄録)
• 乳癌に対するコーンビームCTによる患者セットアップ精度の評価

  谷井 大介, 安田 耕一, 細木 和則, 小澤 公太, 蛯名 慶也, 岩井 良夫  共済医報  68-  (Suppl.)  114  -114  2019/10
• 脾臓への放射線照射が奏功した脾機能亢進症の1例

  岩崎 愛美, 安田 耕一, 遠藤 知之, 大東 寛幸, 清水 伸一, 鬼丸 力也, 豊嶋 崇徳, 白土 博樹  日本医学放射線学会秋季臨床大会抄録集  55回-  S518  -S518  2019/09
• 強度変調X線治療および強度変調陽子線治療における皮膚炎と皮膚線量に関する検討

  安田 耕一, 湊川 英樹, 出倉 康裕, 対馬 那由多, 鈴木 崇祥, 加納 里志, 水町 貴諭, 鬼丸 力也, 清水 伸一, 本間 明宏, 白土 博樹  頭頸部癌  45-  (2)  134  -134  2019/05
• 外耳道癌における強度変調陽子線治療と強度変調X線治療との線量分布の比較

  出倉 康裕, 安田 耕一, 湊川 英樹, 対馬 那由多, 鈴木 崇祥, 加納 里志, 水町 貴諭, 鬼丸 力也, 清水 伸一, 本間 明宏, 白土 博樹  頭頸部癌  45-  (2)  138  -138  2019/05
• 頭頸部癌化学放射線療法におけるEPA高配合栄養機能食品(プロシュア)の有用性の検討

  水町 貴諭, 加納 里志, 本間 明宏, 赤澤 美樹子, 長谷川 千春, 城石 陽子, 岡本 千秋, 熊谷 聡美, 西村 雅勝, 高崎 裕代, 武田 宏司, 安田 耕一, 湊川 英樹, 出倉 康裕, 鬼丸 力也, 白土 博樹, 福田 諭  癌と化学療法  46-  (4)  685  -689  2019/04  

  頭頸部癌に対する化学放射線療法により生じる代表的な副作用には口腔粘膜炎と体重減少があげられる。今回われわれは、中咽頭癌、下咽頭癌症例にてシスプラチンと放射線療法を同時併用する化学放射線療法施行症例において、ω3系脂肪酸高配合栄養機能食品であるプロシュアの口腔粘膜炎と体重減少に対する有用性の検討を行った。放射線治療開始から終了までの期間プロシュアを投与し、最大体重減少率、口腔粘膜炎、化学放射線療法完遂率についてプロシュアの介入を行っていない過去の当科症例を対照群として比較検討を行った。プロシュア投与群は対照群と比べ体重減少率の改善(7.3% vs 10.3%、p<0.01)、口腔粘膜炎の改善を認めた(CTCAE v3.0 Grade 3以上;24% vs 58%、p<0.05)が、化学放射線療法完遂率は両群の差を認めなかった(77% vs 60%、NS)。プロシュアの投与が化学放射線療法施行中において、体重減少や口腔粘膜炎の改善に寄与する可能性が示唆された。(著者抄録)
• 強度変調放射線治療中に皮下気腫をきたし,再検証を要した頭頸部癌患者の1例

  湊川 英樹, 安田 耕一, 白土 博樹, 土屋 和彦, 鈴木 隆介, 宮本 直樹, 坂下 智博, 本間 明宏, 福田 諭  Japanese Journal of Radiology  37-  (Suppl.)  4  -4  2019/02
• 頭頸部癌患者の口腔支持療法と地域連携

  秦 浩信, 吉川 和人, 今待 賢治, 村井 知佳, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政  頭頸部癌  44-  (4)  380  -386  2018/12  

  頭頸部癌治療では様々な機能障害や、有害事象により患者のQOLが著しく低下する。多くの場合、治療後緩やかに改善するが、様々な不具合を受容しながら生活している。長期生存者の口腔管理の継続は重要な課題である。2012年度から開始された全国共通がん医科歯科連携講習会により、全国で14,000名以上がん診療連携歯科医が登録され、連携の受け入れ体制が整った。北海道大学病院で2011年に行った、2007年から2010年までの4年間の実態調査では、退院後に院内外で口腔管理を継続できたのは34.3%で、地域歯科医院に依頼したものは7.5%に過ぎなかった。今回行った2011年から2016年までの6年間の調査では、退院後口腔管理を継続できたのは70.5%であり、地域歯科医院に依頼したものは40.4%と著明に増加した。頭頸部癌患者のQOLに寄与するため、適切な口腔管理を地域歯科医院と共に継続することが肝要である。(著者抄録)
• 深層学習に基づく画像特徴量を利用した放射線治療用CT画像における転移性骨腫瘍の検出に関する検討

  渡邊はるな, 藤後廉, 小川貴弘, 長谷山美紀, 安田耕一, THA Khin Khin, 工藤與亮, 白土博樹  電気・情報関係学会北海道支部連合大会講演論文集(CD-ROM)  2018-  ROMBUNNO.87  2018/10/27  [Not refereed][Not invited]
  
• 喉頭癌cT3の喉頭温存治療(CRT vs RADPLAT) 喉頭癌に対する超選択的動注と放射線同時併用療法

  本間 明宏, 加納 里志, 水町 貴諭, 中薗 彬, 鈴木 崇祥, 坂下 智博, 福田 諭, 鬼丸 力也, 安田 耕一, 湊川 英樹, 出倉 康裕, 土屋 和彦, 白土 博樹  日本気管食道科学会会報  69-  (5)  319  -320  2018/10
• 【核医学の放射線治療への新規応用】PETの放射線治療への応用 特に頭頸部癌に関して

  安田 耕一  臨床放射線  63-  (9)  961  -967  2018/09
• Quality of Survivalを考慮した頭頸部癌支持療法 頭頸部がん患者の口腔支持療法と地域連携

  秦 浩信, 吉川 和人, 今待 賢治, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政  頭頸部癌  44-  (2)  115  -115  2018/05
• 当科における局所進行外耳道扁平上皮癌の治療成績の検討

  加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏  頭頸部癌  44-  (2)  181  -181  2018/05
• Quality of Survivalを考慮した頭頸部癌支持療法 頭頸部がん患者の口腔支持療法と地域連携

  秦 浩信, 吉川 和人, 今待 賢治, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政  頭頸部癌  44-  (2)  115  -115  2018/05  [Refereed][Not invited]
  
• 当科における局所進行外耳道扁平上皮癌の治療成績の検討

  加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏  頭頸部癌  44-  (2)  181  -181  2018/05  [Refereed][Not invited]
  
• 同時期に異所性に発生した悪性腫瘍に対して、二部位同時にIMRTを施行した症例

  湊川 英樹, 安田 耕一, 白土 博樹, 土屋 和彦, 原田 八重, 水町 貴諭, 坂下 智博, 本間 明宏, 福田 諭, 石嶋 漢, 宮本 直樹, 高尾 聖心, 鈴木 隆介, 松浦 妙子, 牧永 綾乃, 田村 昌也  Japanese Journal of Radiology  36-  (Suppl.)  6  -6  2018/02  [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]
  
• Analysis of Threshold Doses for Radiation Induced Liver Parenchymal Changes on MRI after Real TimeeImage 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  [Not 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]
  
• PETの放射線治療への応用 特に頭頸部癌に関して

  安田 耕一  核医学  54-  (Suppl.)  S139  -S139  2017/09
• 分子イメージングを用いた放射線治療

  安田 耕一  JSMI Report  10-  (2)  29  -32  2017/05  [Not refereed][Not invited]
   

  代表的な低酸素イメージングである[18F]fluoromisonidazole(FMISO)-PETを放射線治療に応用するためには、低酸素の領域を正確に同定する必要があり、高性能なPETが不可欠である。そのため新たな仕組みのPETが開発された。検出器にCdTe半導体を用いることでγ線を直接電気信号に変換することができ、検出器が小型化され、高い空間分解能を示している。1)FMISO-PET画像のコントラストと半導体PET、2)FMISO-PET画像の再現性、3)治療前FMISO-PETと再現部位の関係、4)頭頸部癌以外におけるFMISO-PETの応用、について述べた。
• 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  頭けい部癌  43-  (2)  221  -221  2017/05  [Not refereed][Not invited]
  
• FMISO-PET during intensity-modulated radiotherapy can predict more accurately than pre-therapeutic and post-therapeutic PET for head and neck cancer.

  Shozo Okamoto, Tohru Shiga, Koichi Yasuda, Shiro Watanabe, Keiichi Magota, Rikiya Onimaru, Kazuhiko Tsuchiya, Yuji Kuge, Nagara Tamaki  JOURNAL OF NUCLEAR MEDICINE  58-  2017/05  [Refereed][Not invited]
  
• 下咽頭癌に対する強度変調放射線治療(IMRT)と強度変調陽子線治療(IMPT)の治療計画の比較

  土屋和彦, 安田耕一, 原田八重, 鬼丸力也, 白土博樹  Japanese Journal of Radiology  35-  (Suppl.)  10  -10  2017/02  [Not refereed][Not invited]
  
• 高次医療連携システムによる医療情報の有効活用について 患者と医療者のためのがん治療の道標の可視化 患者中心のがん診断・治療ナビゲーションシステム開発

  白土 博樹, 安田 耕一, 熊木 康雄, 上杉 正人  医療情報学連合大会論文集  36回-  (1)  126  -127  2016/11  [Not refereed][Not invited]
  
• 気管内挿管下全身麻酔管理で陽子線治療を実施した小児がんの2症例(Proton beam therapy for pediatric cancer with endotracheal intubation under the general anesthesia: A report of two cases)

  橋本 孝之, 敦賀 健吉, 小林 浩之, 井口 晶裕, 本多 昌平, 杉山 未奈子, 安田 耕一, 宮城 久之, 山口 秀, 藤田 憲明, 大島 淳二郎, 長 祐子, 鬼丸 力也, 清水 伸一, 寺坂 俊介, 森本 裕二, 白土 博樹  日本小児血液・がん学会雑誌  53-  (4)  366  -366  2016/11  [Not refereed][Not invited]
  
• Development of Patient-centered Navigation System of Cancer Diagnosis and Treatment

  白土博樹, 安田耕一, 熊木康雄, 上杉正人  医療情報学  36-  (Supplement 1)  126‐127  2016/11/01  [Not refereed][Not invited]
  
• High Reproducibility of FMISO PET with high-definition semiconductor PET in patients with head and neck cancer.

  Tohru Shiga, Shozo Okamoto, Wataru Takeuchi, Atsuro Suzuki, Koichi Yasuda, Keiichi Magota, Shiro Watanabe, Kenji Hirata, Yuji Kuge, Keiji Kobashi, Nagara Tamaki  JOURNAL OF NUCLEAR MEDICINE  57-  2016/05
• 上咽頭癌再発例におけるFMISO‐PETと放射線治療に関する解析

  安田耕一, 西川由記子, 岡本祥三, 伊藤陽一, 土屋和彦, 志賀哲, 鬼丸力也, 久下裕司, 玉木長良, 白土博樹  頭けい部癌  42-  (2)  158  -158  2016/05  [Not refereed][Not invited]
  
• 中咽頭扁平上皮癌に対する化学放射線療法施行症例の臨床的検討

  水町貴諭, 坂下智博, 加納里志, 畠山博充, 本間明宏, 土屋和彦, 安田耕一, 鬼丸力也, 白土博樹, 福田諭  頭けい部癌  42-  (2)  181  -181  2016/05  [Not refereed][Not invited]
  
• 下咽頭癌に対する化学放射線療法後の嚥下障害―欧米の報告との比較―

  本間明宏, 畠山博充, 水町貴諭, 加納里志, 坂下智博, 鬼丸力也, 土屋和彦, 安田耕一, 白土博樹, 福田諭  頭けい部癌  42-  (2)  214  -214  2016/05  [Not refereed][Not invited]
  
• 分子イメージングを用いた放射線治療

  安田耕一, 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, 加藤徳雄, 久下裕司, 玉木長良, 白土博樹, 白土博樹  JSMI Report  9-  (2)  83  -83  2016/04/25  [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]
  
• 当院における下咽頭癌に対する強度変調放射線治療(IMRT)の初期経験

  土屋和彦, 安田耕一, 原田八重, 鬼丸力也, 白土博樹  Japanese Journal of Radiology  34-  (Suppl.)  11  -11  2016/02  [Not refereed][Not invited]
  
• 椎体IMRTとその精度に関する研究

  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  34-  (Suppl.)  5  -5  2016/02  [Not refereed][Not invited]
  
• Indications for superselective intra-arterial cisplatin infusion and concomitant radiotherapy in cases of hypopharyngeal cancer

  Jun Furusawa, Akihiro Homma, Rikiya Onimaru, Tomohiro Sakashita, Daisuke Yoshida, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda  Journal of Otolaryngology of Japan  119-  (5)  782  -783  2016  [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]
  
• 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]
  
• 半導体PETを用いた頭頸部癌FMISO‐PETの再現性

  志賀哲, 岡本祥三, 安田耕一, 孫田恵一, 久下裕司, 竹内渉, 鈴木敦郎, 小橋啓司, 小橋啓司, 玉木長良  核医学  52-  (3)  265  -265  2015/09  [Not refereed][Not invited]
  
• 当院における下咽頭癌に対する強度変調放射線治療(IMRT)の初期臨床成績

  土屋和彦, 安田耕一, 鬼丸力也, 白土博樹, 本間明宏, 福田諭, 清水康, 秋田弘俊  頭けい部癌  41-  (2)  254  -254  2015/05  [Not refereed][Not invited]
  
• 当科における嗅神経芽細胞腫に対する放射線治療成績の検討

  森崇, 土屋和彦, 西川昇, 鬼丸力也, 小野寺俊輔, 安田耕一, 白土博樹  Jpn J Radiol  33-  (Suppl.)  4  -4  2015/02  [Not refereed][Not invited]
  
• Serial changes of hypoxia and glucose metabolism in head and neck cancer after Intensity Modulated Radiation Therapy

  S. Okamoto, T. Shiga, K. Yasuda, K. Magota, K. Kasai, S. Watanabe, Y. Kuge, H. Shirato, N. Tamaki  EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING  41-  S196  -S196  2014/10  [Not refereed][Not invited]
  
• FMISO‐PETによる低酸素と糖代謝分布の相関についての検討

  WATANABE SHIRO, OKAMOTO SHOZO, YASUDA KOICHI, SHIGA SATORU, SONTA KEIICHI, KASAI KATSUHIKO, KUGE YUJI, SHIRATO HIROKI, TAMAKI NAGARA  核医学  51-  (3)  265  -265  2014/09  [Not refereed][Not invited]
  
• Hypoxic information evaluated FMISO-PET was independent of glucose metabolic activity

  Watanabe Shiro, Okamoto Shozo, Shiga Tohru, Yasuda Koichi, Magota Keiichi, Kasai Katsuhiko, Kuge Yuji, Shirato Hiroki, Tamaki Nagara  JOURNAL OF NUCLEAR MEDICINE  55-  2014/05  [Refereed][Not invited]
  
• 局所進行頭頸部癌に対する導入化学療法後のweekly CDDP併用化学放射線療法の安全性と有用性の検討

  MIZUMACHI TAKATSUGU, HONMA AKIHIRO, SAKASHITA TOMOHIRO, KANO SATOSHI, HATAKEYAMA HIROMITSU, SHIMIZU YASUSHI, AKITA HIROTOSHI, TSUCHIYA KAZUHIKO, YASUDA KOICHI, ONIMARU RIKIYA, SHIRATO HIROKI, FUKUDA SATOSHI  頭けい部癌  40-  (2)  177  -177  2014/05  [Not refereed][Not invited]
  
• 当院における下咽頭癌に対する強度変調放射線治療(IMRT)の初期経験

  TSUCHIYA KAZUHIKO, YASUDA KOICHI, ONIMARU RIKIYA, SHIRATO HIROKI, HONMA AKIHIRO, FUKUDA SATOSHI, SHIMIZU YASUSHI, AKITA HIROTOSHI  頭けい部癌  40-  (2)  257  -257  2014/05  [Not refereed][Not invited]
  
• 下咽頭癌に対するRADPLATとweekly CDDP併用化学放射線治療の比較検討

  FURUSAWA JUN, HONMA AKIHIRO, SAKASHITA TOMOHIRO, HATAKEYAMA HIROMITSU, KANO SATOSHI, MIZUMACHI TAKATSUGU, TSUCHIYA KAZUHIKO, YOSHIDA DAISUKE, YASUDA KOICHI, SHIRATO HIROKI, FUKUDA SATOSHI  頭けい部癌  40-  (2)  198  -198  2014/05  [Not refereed][Not invited]
  
• Concomitant weekly cisplatin and radiotherapy for oropharyngeal squamous cell carcinoma

  Takatsugu Mizumachi, Akihiro Homma, Tomohiro Sakashita, Satoshi Kano, Hiromitsu Hatakeyama, Kazuhiko Tsuchiya, Kouichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Satoshi Fukuda  Japanese Journal of Head and Neck Cancer  40-  (1)  66  -70  2014/04  [Not refereed][Not invited]
   

  The most common chemoradiotherapy regimen is high-dose (100 mg/m2) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. A recent study demonstrated that HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) patients showed good prognosis. Here, we reviewed the efficacy of concomitant weekly cisplatin and radiotherapy in patients with OPSCC. Twenty-two patients with untreated OPSCC were enrolled and evaluated at our institution from July 2006 to June 2012. Weekly cisplatin (40 mg/m2) was given at weeks 1, 2, 3, 5, 6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks. The presence of HPV was analyzed using the multiplex PCR method. Median follow-up time was 38.6 months for surviving patients. Of the 22 oropharyngeal carcinomas, 13 (59%) were HPV-positive. Twenty-one patients (95.4%) received the full dose of radiotherapy. Over the course of the chemotherapy, 14 patients (63.6%) received more than 200 mg/m2 cisplatin. The acute and late toxicity was manageable in all cases. HPV-positive patients had better three-year overall survival rates (92.3% vs 66.7%) than HPV-negative patients. For HPV-positive patients, 1 of 13 died of distant metastasis, whereas for HPV-negative patients, 1 of 9 died of local recurrence and 2 of 9 died of distant metastasis. Because of its favorable outcome and lower toxicity, concomitant weekly cisplatin and radiotherapy appears to be a suitable treatment for HPV-positive OPSCC.
• Naming rule for radiation therapy

  YASUDA KOICHI, TSUCHIYA KAZUHIKO, INOUE TETSUYA, NISHIOKA KENTARO, HARADA KEIICHI, NISHIKAWA YUKIKO, ONIMARU RIKIYA, SHIMIZU SHIN'ICHI, KATO NORIO, KINOSHITA RUMIKO, ONODERA SHUNSUKE, SHIRATO HIROKI, SUZUKI TAKASUKE, FUJITA KATSUHISA, TSUJI SHINTARO, YAMASAKI RIE  Jpn J Radiol  32-  (Supplement)  7  2014/02/25  [Not refereed][Not invited]
  
• 放射線療法に関する名付けルール(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  Japanese Journal of Radiology  32-  (Suppl.)  7  -7  2014/02  [Not refereed][Not invited]
  
• 頸部転移性骨腫瘍におけるスポットスキャニング照射法を用いた陽子線治療の線量分布評価

  YOSHIMURA TAKAAKI, YASUDA KOICHI, TORAMATSU CHIE, TAKAO SEISHIN, MATSUURA TAEKO, NIHONGI HIDEAKI, KINOSHITA RUMIKO, ONIMARU RIKIYA, SHIRATO HIROKI, ISHIKAWA MASAZUMI  Jpn J Radiol  32-  (Suppl.)  7  -7  2014/02  [Not refereed][Not invited]
  
• 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

  NISHIKAWA YUKIKO, HARADA KEIICHI, NISHIOKA KENTARO, YASUDA KOICHI, INOUE TETSUYA, TSUCHIYA KAZUHIKO, ONODERA SHUNSUKE, KINOSHITA RUMIKO, KATO NORIO, SHIMIZU SHIN'ICHI, ONIMARU RIKIYA, SHIRATO HIROKI, SUZUKI TAKASUKE, ISHIKAWA MASAZUMI  Jpn J Radiol  32-  (Suppl.)  5  -5  2014/02  [Not refereed][Not invited]
  
• The Impact of FMISO-PET Before Treatment in Nasopharyngeal Cancer Patients

  K. Yasuda, K. Tsuchiya, S. Okamoto, R. Onimaru, T. Shiga, K. Harada, R. Suzuki, Y. Kuge, N. Tamaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  87-  (2)  S644  -S644  2013/10  [Not refereed][Not invited]
  
• 頭頚部癌に対するIMRTにおける腫瘍低酸素の経時的変化

  OKAMOTO SHOZO, SHIGA SATORU, YASUDA KOICHI, MAGOTA KEIICHI, KASAI KATSUHIKO, KUGE YUJI, SHIRATO HIROKI, TAMAKI NAGARA  核医学  50-  (3)  218  2013/09/30  [Not refereed][Not invited]
  
• 頭頸部癌に対するIMRTにおける腫瘍低酸素の経時的変化

  岡本 祥三, 志賀 哲, 安田 耕一, 孫田 恵一, 葛西 克彦, 久下 裕司, 白土 博樹, 玉木 長良  核医学  50-  (3)  S208  -S208  2013/09  [Not refereed][Not invited]
  
• 半導体PETによるがん低酸素部位の同定及び放射線治療への応用

  YASUDA KOICHI  Isot News  (712)  2  -6  2013/08/01  [Not 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.
• 動注化学療法による化学放射線療法~上顎洞癌を中心に~

  HONMA AKIHIRO, HATAKEYAMA HIROMITSU, KANO SATOSHI, MIZUMACHI TAKATSUGU, SAKASHITA TOMOHIRO, YOSHIDA DAISUKE, ONIMARU RIKIYA, TSUCHIYA KAZUHIKO, YASUDA KOICHI, SHIRATO HIROKI, FUJII MASAHITO, FUKUDA SATOSHI  頭けい部癌  39-  (2)  134  2013/05/21  [Not refereed][Not invited]
  
• 化学放射線療法の現状と役割 動注化学療法による化学放射線療法 上顎洞癌を中心に

  本間 明宏, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 吉田 大介, 鬼丸 力也, 土屋 和彦, 安田 耕一, 白土 博樹, 藤井 正人, 福田 諭  頭頸部癌  39-  (2)  134  -134  2013/05  [Not refereed][Not invited]
  
• 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―

  TSUCHIYA KAZUHIKO, YASUDA KOICHI, NISHIKAWA YUKIKO, KINOSHITA RUMIKO, ONIMARU RIKIYA, HARADA KEIICHI, INOUE TETSUYA, KATO NORIO, SHIMIZU SHIN'ICHI, SHIRATO HIROKI, NISHIOKA TAKESHI, SUZUKI KEISHIRO, TAGUCHI HIROSHI, HASEGAWA MASAKAZU, ORIDATE NOBUHIKO, HONMA AKIHIRO, SUZUKI SEIGO, HATAKEYAMA HIROMITSU, KANO SATOSHI, MIZUMACHI TAKATSUGU, SAKASHITA TOMOHIRO, FUKUDA SATOSHI, TAKEUCHI HIROSHI, TAGUCHI JUN  耳鼻咽喉科展望  56-  (補冊2)  174  -175  2013/05  [Not refereed][Not invited]
  
• II‐IV期上咽頭癌に対する化学放射線同時併用療法:併用化学療法に関する後ろ向き比較検討

  TSUCHIYA KAZUHIKO, YASUDA KOICHI, KINOSHITA RUMIKO, ONIMARU RIKIYA, SHIRATO HIROKI, HONMA AKIHIRO, FUKUDA SATOSHI, SHIMIZU YASUSHI, AKITA HIROTOSHI  頭けい部癌  39-  (2)  218  -218  2013/05  [Not refereed][Not invited]
  
• 当科で放射線治療を施行した頭頸部原発小細胞癌症例の検討

  NISHIKAWA YUKIKO, YASUDA KOICHI, TSUCHIYA KAZUHIKO, ONIMARU RIKIYA, SHIRATO HIROKI, HONMA AKIHIRO, TAKEUCHI HIROSHI, TAGUCHI ATSUSHI  Jpn J Radiol  31-  (Suppl.I)  12  -12  2013/02  [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  72回-  S381  -S382  2013/02  [Not refereed][Not invited]
  
• Retrospective Comparison Between Cisplatin Plus Fluorouracil and Weekly Cisplatin in Concurrent Chemoradiation Therapy Setting for Stage II-IV Nasopharyngeal Carcinoma

  K. Tsuchiya, K. Yasuda, Y. Nishikawa, R. Kinoshita, R. Onimaru, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  84-  (3)  S484  -S485  2012/11  [Not refereed][Not invited]
  
• Salvage surgery for local recurrence after concomitant radiotherapy and superselective arterial infusion of cisplatin in patients with squamous cell carcinoma cancer of the maxillary sinus

  HONMA AKIHIRO, ORIDATE NOBUHIKO, SUZUKI SEIGO, SUZUKI FUMIYUKI, HATAKEYAMA HIROMITSU, KANO SATOSHI, MIZUMACHI TAKATSUGU, SAKASHITA TOMOHIRO, YOSHIDA DAISUKE, ONIMARU RIKIYA, TSUCHIYA KAZUHIKO, YASUDA KOICHI, SHIRATO HIROKI, FUKUDA SATOSHI  耳鼻と臨床  58-  (Suppl.1)  S52  -S56  2012/11  [Not refereed][Not invited]
   

  This retrospective study aimed to assess the role of salvage surgery for local recurrence after concomitant radiotherapy and superselective arterial infusion of cisplatin (RADPLAT) in patients with squamous cell carcinoma cancer of the maxillary sinus as an initial treatment. Forty-one patients were treated by RADPLAT between 1999 and 2009. Local recurrence in the primary site was observed in 12 patients of whom 9 could undergo further salvage surgery. Primary disease control was achieved in 7 of these patients (successful salvage rate, 58.3%). Successful salvage rates for T3, T4a and T4b primary disease were 66.7% (2/3), 66.7% (4/6) and 33.3% (1/3), respectively. The 5-year overall survival rate was 73.6% in all patients. Severe postoperative complication was seen in one patient. Prognosis of patients with locally recurring maxillary sinus squamous cell carcinoma after RADPLAT is relatively good. This is because residual/recurrent tumor was located in anterior portion of the face in most cases. This result should be taken into consideration when the initial treatment plan is decided and the choice of salvage surgery for such recurrent cases should be carefully determined.
• 当科で導入化学療法を施行した頭頸部局所進行扁平上皮癌症例の治療成績

  天野 虎次, 田口 純, 木下 一郎, 合田 智宏, 本間 理央, 竹内 啓, 清水 康, 安田 耕一, 土屋 和彦, 白土 博樹, 本間 明宏, 福田 諭, 秋田 弘俊  日本癌治療学会誌  47-  (3)  2112  -2112  2012/10  [Not refereed][Not invited]
  
• 頭頚部癌に対するFMISO‐PETの再現性評価

  岡本祥三, 志賀哲, 安田耕一, 孫田恵一, 葛西克彦, 久下裕司, 白土博樹, 玉木長良  核医学  49-  (3)  217  2012/08/31  [Not refereed][Not invited]
  
• 頭頸部癌に対するFMISO-PETの再現性評価

  岡本 祥三, 志賀 哲, 安田 耕一, 孫田 恵一, 葛西 克彦, 久下 裕司, 白土 博樹, 玉木 長良  核医学  49-  (3)  S197  -S197  2012/08  [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]
  
• FMISO PET検査における低酸素領域の半定量:基準値としての後頸部筋と血液の比較

  葛西克彦, 岡本祥三, 志賀哲, 安田耕一, 孫田惠一, 加藤千恵次, 久下裕司, 白土博樹, 玉木長良  核医学  49-  (3)  S197  -S197  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]
  
• 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]
  
• 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

  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  132年会-  (1)  118  -118  2012/03  [Not refereed][Not invited]
  
• 頭頚部癌の放射線治療前後におけるFMISO集積の初期経過

  岡本祥三, 竹井俊樹, 志賀哲, 玉木長良, 安田耕一, 白土博樹, 久下裕司, 森本裕一, 竹内渉  Jpn J Radiol  30-  (Supplement 1)  7  2012/02/25  [Not refereed][Not invited]
  
• 頭頸部癌の放射線治療前後におけるFMISO集積の初期経過

  岡本 祥三, 竹井 俊樹, 志賀 哲, 玉木 長良, 安田 耕一, 白土 博樹, 久下 裕司, 森本 裕一, 竹内 渉  Japanese Journal of Radiology  30-  (Suppl.I)  7  -7  2012/02  [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-  (Suppl.I)  5  -5  2012/02  [Not refereed][Not invited]
  
• 上咽頭癌再発症例に対する再照射例の検討

  鬼丸力也, 安田耕一, 西川昇, 米山理奈, 白土博樹, 本間明宏, 折舘伸彦, 福田諭  Jpn J Radiol  30-  (Suppl.I)  5  -5  2012/02  [Not refereed][Not invited]
  
• 声門癌(T1N0)に対する北大病院での放射線治療成績

  鬼丸力也, 白土博樹, 安田耕一, 長谷川雅一  Jpn J Radiol  30-  (Suppl.I)  13  -13  2012/02  [Not refereed][Not invited]
  
• マルチベンダに対応した放射線治療計画管理システムの開発

  辻真太朗, 鈴木隆介, 安田耕一, 藤田勝久, 宮崎智夫, 石川正純, 白土博樹  日本放射線技術学会総会学術大会予稿集  68回-  134  -134  2012/02  [Not refereed][Not invited]
  
• 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

  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総会抄録集  71回-  S316  -S316  2012/02  [Not refereed][Not invited]
  
• Real-time Tumor-tracking Radiation Therapy for Lymphoma of the Stomach

  Katoh N, Suzuki R, Shimizu S, Inoue T, Yasuda K, Onimaru R, Kimura R, Kato M, Ishikawa M, Shirato H  International Journal of Radiation Oncology Biology Physics  84-  (3)  S722  2012  [Refereed][Not invited]
  
• 当院で施行した頭頚部局所進行扁平上皮癌に対するDCF(docetaxel,cisplatin,5‐FU)導入化学療法の検討

  田口純, 天野虎次, 木下一郎, 合田智宏, 本間理央, 竹内啓, 清水康, 安田耕一, 土屋和彦, 鬼丸力也, 本間明宏, 福田諭, 秋田弘俊  日本臨床腫瘍学会学術集会プログラム・抄録集  10th-  179  -180  2012  [Not refereed][Not invited]
  
• 当科で導入化学療法を施行した頭頚部局所進行扁平上皮癌症例の治療成績

  天野虎次, 田口純, 木下一郎, 合田智宏, 本間理央, 竹内啓, 清水康, 安田耕一, 土屋和彦, 白土博樹, 本間明宏, 福田諭, 秋田弘俊  日本癌治療学会学術集会(CD-ROM)  50th-  (3)  ROMBUNNO.PS2-008  -2112  2012  [Not refereed][Not invited]
  
• 食道癌IMRT(強度変調放射線治療)の初期経験

  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  56-  (2)  176  -177  2011/12  [Not refereed][Not invited]
  
• 頭頸部癌の放射線治療前後におけるFMISO集積の初期経過

  岡本祥三, 竹井俊樹, 志賀哲, 玉木長良, 安田耕一, 白土博樹, 久下裕司, 森本裕一, 竹内渉  核医学  48-  (4)  436  -436  2011/11  [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  2011/10  [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.
• 頭頚部癌に対する放射線治療経過における低酸素と糖代謝の変化

  岡本祥三, 安田耕一, 志賀哲, 竹井俊樹, 孫田恵一, 久下裕司, 白土博樹, 玉木長良  核医学  48-  (3)  344  2011/09/30  [Not refereed][Not invited]
  
• 頭頸部癌に対する放射線治療経過における低酸素と糖代謝の変化

  岡本 祥三, 安田 耕一, 志賀 哲, 竹井 俊樹, 孫田 恵一, 久下 裕司, 白土 博樹, 玉木 長良  核医学  48-  (3)  S282  -S282  2011/09  [Not refereed][Not invited]
  
• 放射線治療におけるPETの利用

  鬼丸力也, 安田耕一, 加藤徳男, 白土博樹, 志賀哲, 玉木長良, 本間明宏, 折舘伸彦, 福田諭  頭けい部癌  37-  (2)  185  2011/05/20  [Not refereed][Not invited]
  
• Correlation of FMISO PET and outcome from radiation therapy in patients with nasopharyngeal cancer

  YASUDA KOICHI, OKAMOTO SHOZO, SHIGA SATORU, ONIMARU RIKIYA, HASEGAWA MASAICHI, KUGE YUJI, TAKEUCHI WATARU, UMEGAKI KIKUO, TAMAKI NAGARA, SHIRATO HIROKI  頭けい部癌  37-  (2)  256  2011/05/20  [Not refereed][Not invited]
  
• 放射線治療の進歩と将来展望 放射線治療におけるPETの利用

  鬼丸 力也, 安田 耕一, 加藤 徳男, 白土 博樹, 志賀 哲, 玉木 長良, 本間 明宏, 折舘 伸彦, 福田 諭  頭頸部癌  37-  (2)  185  -185  2011/05  [Not refereed][Not invited]
  
• FMISO PETと上咽頭癌患者に対する放射線療法の成績の相関性(Correlation of FMISO PET and outcome from radiation therapy in patients with nasopharyngeal cancer)

  安田 耕一, 岡本 祥三, 志賀 哲, 鬼丸 力也, 長谷川 雅一, 久下 裕司, 竹内 渉, 梅垣 菊男, 玉木 長良, 白土 博樹  頭頸部癌  37-  (2)  256  -256  2011/05  [Not refereed][Not invited]
  
• 頭頸部進行癌に対する集学的治療“導入化学療法→化学放射線同時併用療法”

  本間明宏, 清水康, 折舘伸彦, 鬼丸力也, 鈴木清護, 畠山博充, 加納里志, 水町貴諭, 坂下智博, 安田耕一, 秋田弘俊, 白土弘樹, 福田諭  頭けい部癌  37-  (2)  233  -233  2011/05  [Not refereed][Not invited]
  
• 頭頸部扁平上皮癌N+症例における放射線動注化学療法後の頸部評価―Wait and See Policyは成立するか―

  坂下智博, 本間明宏, 折舘伸彦, 鈴木清護, 畠山博充, 加納里志, 水町貴諭, 古沢純, 稲村直哉, 福田諭, 吉田大介, 鬼丸力也, 安田耕一, 白土博樹  頭けい部癌  37-  (2)  231  -231  2011/05  [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.
• 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.
• 頭頸部リンパ節腫瘍における放射線治療効果予測

  高尾聖心, 但野茂, 田口大志, 安田耕一, 鬼丸力也, 石川正純, 鈴木隆介, GERARD Bengua, 白土博樹  日本生体医工学会大会プログラム・論文集(CD-ROM)  50th-  ROMBUNNO.O1-9-5  2011  [Not refereed][Not invited]
  
• 巨大リンパ節転移を伴う上咽頭癌の一例

  西川昇, 長谷川雅一, 安田耕一, 鬼丸力也, 白土博樹  Jpn J Radiol  29-  (Suppl.I)  5  -5  2011/01  [Not refereed][Not invited]
  
• 頭頚部癌の放射線治療前後におけるFMISO集積の初期経過

  岡本祥三, 安田耕一, 安田耕一, 竹井俊樹, 志賀哲, 久下裕司, 久下裕司, 白土博樹, 白土博樹, 玉木長良  核医学  47-  (3)  S220  2010/09/30  [Not refereed][Not invited]
  
• 頭頸部癌の放射線治療前後におけるFMISO集積の初期経過

  岡本 祥三, 安田 耕一, 竹井 俊樹, 志賀 哲, 久下 裕司, 白土 博樹, 玉木 長良  核医学  47-  (3)  374  -374  2010/09  [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  2010/07/25  [Not refereed][Not invited]
  
• H&N癌に対する18F-fluoromisonidazole PETの有用性とIMRTへの応用(The impact of 18F-fluoromisonidazole PET for H&N cancer and the applying for IMRT)

  安田 耕一, 長谷川 雅一, 鬼丸 力也, 木下 留美子, 加藤 徳雄, 田口 大志, 清水 伸一, 井上 哲也, 小野寺 俊輔, 溝口 史樹, 青山 英史, 白土 博樹, 志賀 哲, 岡本 祥三, 玉木 長良, 石川 正純, Sutherland Kenneth, Bengua Gerard, 宮本 直樹, 鈴木 隆介  Japanese Journal of Radiology  28-  (Suppl.I)  14  -14  2010/07  [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-  (Suppl.I)  7  -7  2010/07  [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-  (Suppl.I)  7  -7  2010/07  [Not refereed][Not invited]
  
• Experimental MR imaging of zirconia ceramic joint implants at 1.5 and 3 T

  T. Kamishima, N. Kitamura, M. Amemiya, K. Ishizaka, F. Kato, K. Yasuda, H. Shirato, S. Terae  CLINICAL RADIOLOGY  65-  (5)  387  -390  2010/05  [Not refereed][Not invited]
  
• 化学放射線治療後の頸部郭清の必要性について

  本間明宏, 折舘伸彦, 鈴木章之, 鈴木清護, 原敏浩, 加納里志, 水町貴諭, 古沢純, 稲村直哉, 福田諭, 吉田大介, 鬼丸力也, 安田耕一, 白土博樹  頭けい部癌  36-  (2)  191  -191  2010/05  [Not refereed][Not invited]
  
• 頭頸部癌に対するweekly cisplatinと放射線同時併用療法の検討

  稲村直哉, 本間明宏, 折舘伸彦, 鈴木清護, 鈴木章之, 原敏浩, 真栄田裕行, 加納里志, 水町貴諭, 福田諭, 鬼丸力也, 長谷川雅一, 安田耕一, 白土博樹  頭けい部癌  36-  (2)  206  -206  2010/05  [Not refereed][Not invited]
  
• 頭頸部原発・髄外性形質細胞腫に対する放射線治療成績の多施設調査研究

  佐々木良平, 安田耕一, 阿部栄輔, 内田伸江, 河島光彦, 芝本雄太, 加賀美芳和, 塩山善之, 宇野隆, 中田健生, 冨士原将之, 高田佳江  頭けい部癌  36-  (2)  212  -212  2010/05  [Not refereed][Not invited]
  
• Clinical results of intensity modulated radiotherapy (IMRT) for head and neck cancer: Experience of Hokkaido University Hospital

  Rikiya Onimaru, Masakazu Hasegawa, Koichi Yasuda, Rumiko Kinoshita, Hiroki Shirato, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda  Toukeibu Gan  35-  (3)  245  -249  2009/10  [Not refereed][Not invited]
   

  We evaluated the clinical outcome of 37 patients who had received intensity modulated radiation therapy (IMRT) in Hokkaido University Hospital from May 2002 to December 2007. Thirteen patients had nasopharyngeal cancer, 19 had oropharyngeal cancer, 3 had hypopharyngeal cancer, 1 had maxillary sinus cancer, and 1 had oral cancer. One patient who had oropharyngeal cancer died of pharyngeal abscess which was a treatment-related complication. Three patients died of other cancers. One patient with nasopharyngeal cancer had local recurrence. In patients with oropharyngeal cancer, recurrence at the primary site occurred in 3 patients, and residual/recurrence at neck lymph nodes occurred in 2 patients. One patient with hypopharyngeal cancer had residual neck lymph node metastasis. Some patients experienced severe reactions to the radiation. One patient had pharyngeal abscess and died of this treatment complication. One patient who had nasopharyngeal cancer experienced hearing loss and angle closure glaucoma. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
• 頭頚部原発・髄外性形質細胞腫に対する放射線治療成績の多施設調査研究

  佐々木良平, 河辺哲也, 阿部英輔, 内田伸江, 安田耕一, 宇野隆, 冨士原雅之, 塩山善之, 芝本雄太, 山田章吾  日本放射線腫よう学会誌  21-  (Supplement 1)  136  2009/08/19  [Not refereed][Not invited]
  
• 機能温存をめざした頭頸部癌治療update 強度変調放射線治療(intensity modulated radiotherapy;IMRT)

  鬼丸力也, 木下留美子, 長谷川雅一, 安田耕一, 白土博樹  ENTONI  (103)  14  -20  2009/06  [Not refereed][Not invited]
   

  頭頸部癌に対する放射線治療は形態・機能温存を目的とした治療であるが、晩期反応に苦しむ患者さんも多かった。従来の放射線治療の欠点を解消すべく発展してきた強度変調放射線治療(intensity modulated radiotherapy;IMRT)は腫瘍には十分な線量を、リスク臓器には少ない線量を照射することを可能にした。IMRTを行う際には、CTで標的体積を設定する必要があるが、その際には正確な病期診断が必要である。また、治療計画の最適化や検証などの作業が必要であり、人手と時間を要する治療である。IMRTにより視神経などのリスク臓器のそばまで浸潤した腫瘍を従来の放射線治療よりも合併症を少なく治療できると期待されている一方、リスク臓器と指定しなかった臓器には高線量が照射される可能性があり注意が必要である。(著者抄録)
• 北海道大学病院での頭頸部癌に対する強度変調放射線治療の成績

  ONIMARU RIKIYA, HASEGAWA MASAICHI, YASUDA KOICHI, KINOSHITA RUMIKO, SHIRATO HIROKI, HONMA AKIHIRO, ORIDATE NOBUHIKO, FUKUDA SATOSHI  頭けい部癌  35-  (2)  65  -249  2009/05/20  [Not refereed][Not invited]
   

  We evaluated the clinical outcome of 37 patients who had received intensity modulated radiation therapy (IMRT) in Hokkaido University Hospital from May 2002 to December 2007. Thirteen patients had nasopharyngeal cancer, 19 had oropharyngeal cancer, 3 had hypopharyngeal cancer, 1 had maxillary sinus cancer, and 1 had oral cancer.<br>One patient who had oropharyngeal cancer died of pharyngeal abscess which was a treatment-related complication. Three patients died of other cancers.<br>One patient with nasopharyngeal cancer had local recurrence. In patients with oropharyngeal cancer, recurrence at the primary site occurred in 3 patients, and residual/recurrence at neck lymph nodes occurred in 2 patients. One patient with hypopharyngeal cancer had residual neck lymph node metastasis.<br>Some patients experienced severe reactions to the radiation. One patient had pharyngeal abscess and died of this treatment complication. One patient who had nasopharyngeal cancer experienced hearing loss and angle closure glaucoma.
• 強度変調放射線治療(IMRT)の中長期成績 北海道大学病院での頭頸部癌に対する強度変調放射線治療の成績

  鬼丸 力也, 長谷川 雅一, 安田 耕一, 木下 留美子, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭  頭頸部癌  35-  (2)  65  -65  2009/05  [Not refereed][Not invited]
  
• 上咽頭癌に対するCDDP,5‐FUを用いた放射線化学療法の治療成績

  木下留美子, 長谷川雅一, 安田耕一, 田口大志, 鬼丸力也, 土屋和彦, 西岡健, 本間明宏, 折館伸彦, 福田諭, 白土博樹  頭けい部癌  35-  (2)  93  -93  2009/05  [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  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学術集会抄録集  68回-  S267  -S267  2009/02  [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  68回-  S307  -S308  2009/02  [Not refereed][Not invited]
  
• Clinical results of intensity modulated radiotherapy (IMRT) for head and neck cancer: Experience of Hokkaido University Hospital

  Rikiya Onimaru, Masakazu Hasegawa, Koichi Yasuda, Rumiko Kinoshita, Hiroki Shirato, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda  Toukeibu Gan  35-  (3)  245  -249  2009  [Not refereed][Not invited]
   

  We evaluated the clinical outcome of 37 patients who had received intensity modulated radiation therapy (IMRT) in Hokkaido University Hospital from May 2002 to December 2007. Thirteen patients had nasopharyngeal cancer, 19 had oropharyngeal cancer, 3 had hypopharyngeal cancer, 1 had maxillary sinus cancer, and 1 had oral cancer. One patient who had oropharyngeal cancer died of pharyngeal abscess which was a treatment-related complication. Three patients died of other cancers. One patient with nasopharyngeal cancer had local recurrence. In patients with oropharyngeal cancer, recurrence at the primary site occurred in 3 patients, and residual/recurrence at neck lymph nodes occurred in 2 patients. One patient with hypopharyngeal cancer had residual neck lymph node metastasis. Some patients experienced severe reactions to the radiation. One patient had pharyngeal abscess and died of this treatment complication. One patient who had nasopharyngeal cancer experienced hearing loss and angle closure glaucoma. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
• 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]
  
• 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

  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  20-  (Supplement 1)  128  2008/09/22  [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  44回-  S521  -S521  2008/09  [Not refereed][Not invited]
  
• 切除不能膵臓癌に対する強度変調放射線治療(IMRT)に向けての基礎的研究

  安田耕一  Radiat Med  26-  (Suppl.I)  5  -5  2008/04  [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  [Not refereed][Not invited]
  
• 動態追跡照射時の肺腫瘍の動きに関連する因子の検討

  小野寺祐也, 西岡典子, 安田耕一, 藤間憲幸, 鬼丸力也, 清水伸一, 白土博樹  日本医学放射線学会総会抄録集  67回-  S193  -S193  2008/02  [Not refereed][Not invited]
  
• 脊椎脊髄病変に対する最新の放射線治療 脊椎脊髄病変に対する強度変調放射線治療(IMRT)

  溝口史樹, 安田耕一, 青山英史, 白土博樹  脊椎脊髄ジャーナル  20-  (7)  781  -785  2007/07  [Not refereed][Not invited]
  
• 胆嚢粘液癌の一例

  安田耕一  Radiat Med  25-  (Suppl.I)  30  -30  2007/04  [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  2007/02/28  [Not refereed][Not invited]
  
• 多発肺腫瘍に対する3ヵ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  66回-  S233  -S233  2007/02  [Not refereed][Not invited]
  
• Low-dose craniospinal irradiation (CSI) with computed tomographic (CT) simulation and ifosfamide, cisplatin, and etopiside for non-metastatic embryonal tumors in the central nervous system

  H. Taguchi, K. Yasuda, H. Aoyama, Y. Sawamura, J. Ikeda, K. Fujieda, Y. Iwasaki, H. Shirato  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS  69-  (3)  S241  -S241  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  2007/01  [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.
• 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.
• 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.
• 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]
  

Industrial Property Rights

• 特許第6940088号:治療実績評価支援装置、治療実績評価支援方法、および治療実績評価支援プログラム  

  白土 博樹, 上杉 正人, 安田 耕一, 熊木 康雄, 三浦 孝豊, 苧野 博司  株式会社ジェイマックシステム, 国立大学法人北海道大学  202103015621186076
• 特許第6220310号:医用画像情報システム、医用画像情報処理方法及びプログラム  2017/10/06

  松崎 和喜, 森本 裕一, 竹内 渉, 梅垣 菊男, 志賀 哲, 安田 耕一  株式会社日立製作所  201703019383159939

Awards & Honors

• 2022/11 JASTRO Japanese Society for Radiation Oncology Excellent Educational Lecture Award in 2022
   IMRT for Head ana Neck Cancer
• 2017/04 日本医学放射線学会 Bronze Medal (Cypos award)
   Treatment outcome after Radiation Therapy for Mucosal Malignant Melanoma of Head and Neck 

  受賞者: 安田 耕一
• 2014/12 Japanese Society for Radiation Oncology (JASTRO) The 20th Umegaki award
   [18F]fluoromisonidazole and a New PET System With Semiconductor Detectors and a Depth of Interaction System for Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer 

  受賞者: Koichi Yasuda
• 2013/04 Japan Radiological Society (JRS) Silver Medal (Cypos award)
   The Locational Relationship between Pretreatment Uptake Area of FMISO and Local Recurrence Site 

  受賞者: Koichi Yasuda

Research Grants & Projects

• 頭頸部癌に対する定位的及び適応放射線治療による腫瘍内高線量ブースト試験

  北海道大学病院：医師主導治験及び特定臨床研究実施に係る加速化に向けた研究支援プログラム / スタートアップ支援事業

  Date (from‐to) : 2023/04 -2024/03 

  Author : 安田耕一
• Development of less toxic radiotherapy using IMPT for head and neck cancer

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

  Date (from‐to) : 2019/04 -2023/03 

  Author : 安田 耕一, 加納 里志, 水町 貴諭, 高尾 聖心, 田村 昌也

   

  後ろ向き観察研究の自主臨床計画書を作成し、当施設の審査会にて承認された。 スポットスキャニングIMPTにおける皮膚、唾液腺、舌、粘膜の線量を大幅に低減させる手法の開発に取り組んだ。皮膚に関しては当院で過去に実施された放射線治療患者の線量分布および皮膚炎の程度を解析し、皮膚炎発症に最も関連する皮膚線量のパラメーターを解析した。DVH(dose-volume histogram)解析において、皮膚のV65Gy（65Gy以上照射される皮膚の体積）が皮膚炎グレード3発症に関連する独立因子であることを突き止めた。皮膚炎発症と線量に関するモデル作成について検討を開始した。スポットスキャニングIMPTにおいて、局所的な皮膚線量を低減するプランニング法の開発を開始した。耳下腺及び舌に関しても同様に、線量低減のプランニング法の開発を開始した。粘膜線量低減のために、頭頸部癌におけるPTV(planning target volume) margin（照射ターゲットの位置の不確かさのために付与するマージン）の検証を行った。照射中に撮像可能なCBCT（cone-beam CT）を用いて照射前後の頭頸部の各領域の動きの変化を検証した。各領域に最適なPTV marginを個別に付与する（variable PTV marginの設定）方法の基礎的知見を得た。従来の放射線治療法で治療された頭頸部癌患者に対しQOL調査を行った。四大副作用、つまり皮膚炎、口渇、味覚障害、粘膜炎に関して、患者が感じる「辛さ」を客観的に把握するための調査項目を決定し、調査を開始した。
• Proton therapy targeting hypoxic cancer

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

  Date (from‐to) : 2016/04 -2019/03 

  Author : Yasuda Koichi, NAM Jin Min, Nishikawa Yukiko

   

  We developed a simulation system for spot-scanning proton therapy targeting hypoxic volume in cancer. Intensity-modulated proton therapy (IMPT) plans using spot-scanning proton therapy system were generated in 10 nasopharyngeal carcinoma patients, and the plans were compared with intensity-modulated X-ray therapy (IMXT). The doses of the parotid gland and the oral cavity and the probabilities of complications were lower in IMPT than IMXT. It was shown that spot-scanning proton therapy was more useful than X-ray therapy for targeting tumor hypoxia.
• 癌に対する線量増加放射線治療の理論確立:FMISO-PETを用いた再酸素化の証明

  文部科学省：科学研究費補助金(基盤研究(C))

  Date (from‐to) : 2013 -2015 

  Author : 岡本 祥三

   

  研究分担者 安田耕一
• Radiotherapy targeting hypoxic cancer cells: research for biologically appropriate method of dose delivery

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

  Date (from‐to) : 2013 -2015 

  Author : YASUDA Koichi, NISHIKAWA Yukiko

   

  Although hypoxic cancer cell is shown to be radio-resistance in vitro and vivo, the clinical impact of cancer-hypoxia is not clear. Before radiation therapy, we performed FMISO-PET, which is one of hypoxia imagings. The locational relationship between the site of FMISO uptake and local relapse was examined. In the analysis of small voxel (1 x 1 x 2mm), it was indicated that the site with higher FMISO uptake had a higher probability of local recurrence than lower uptake in relapse patients. The simulation study of dose-escalation radiation therapy targeting hypoxic region was performed. Some results of this research was published at the annual American Society of Radiation Oncology meeting, which is world-leading conference in radiation oncology.

Educational Activities

Teaching Experience