研究者情報

マスター

アカウント（マスター）

• 氏名

  田口　大志(タグチ　ヒロシ), タグチ　ヒロシ

所属（マスター）

• 北海道大学病院　放射線科

所属（マスター）

• 北海道大学病院　放射線科

独自項目

syllabus

• 2021, 基本医学研究, Master's Thesis Research in Medical Sciences, 修士課程, 医学院, 放射線生物学、放射線腫瘍学、放射線治療
• 2021, 基本医学総論, Basic Principles of Medicine, 修士課程, 医学院, 放射線生物学、放射線腫瘍学、放射線治療
• 2021, 医学総論, Principles of Medicine, 博士後期課程, 医学院, 放射線生物学、放射線腫瘍学、放射線治療
• 2021, 基盤医学研究, Dissertation Research in Medical Sciences, 博士後期課程, 医学院, 放射線生物学、放射線腫瘍学、放射線治療
• 2021, 臨床医学研究, Dissertation Research in Clinical Medicine, 博士後期課程, 医学院, 放射線生物学、放射線腫瘍学、放射線治療
• 2021, 放射線医学, Radiation Medicine, 学士課程, 医学部, 放射線生物学、放射線腫瘍学、放射線治療
• 2021, 放射線腫瘍学, Radiation Oncology, 学士課程, 医学部, 放射線腫瘍学

researchmap

プロフィール情報

学位

• 博士（医学）（北海道大学）

プロフィール情報

• 姓

  田口, タグチ

• 名

  大志, ヒロシ

• ID各種

  201801004081227806

業績リスト

研究分野

• ライフサイエンス / 放射線科学

論文

• Application of motion prediction based on a long short-term memory network for imaging dose reduction in real-time tumor-tracking radiation therapy.

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

  Physica medica : PM : an international journal devoted to the applications of physics to medicine and biology : official journal of the Italian Association of Biomedical Physics (AIFB) 125 104507 - 104507 2024年09月 

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

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

  Physics and imaging in radiation oncology 31 100623 - 100623 2024年07月 

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

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

  Advances in radiation oncology 9 5 101464 - 101464 2024年05月 

  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年03月17日 

  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.
• 北大病院放射線治療科関連施設における乳癌の放射線治療に関するアンケート結果リンパ節領域に対する照射について

  木下 留美子, 田口 大志, 高橋 周平, 宮崎 智彦, 森 崇, 西岡 健太郎, 橋本 孝之, 青山 英史

  北海道外科雑誌 68 2 163 - 164 北海道外科学会 2023年12月
• Real-time tumor-tracking radiotherapy with SyncTraX for primary liver tumors requiring isocenter shift†.

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

  Journal of radiation research 2023年11月22日 

  The SyncTraX series enables real-time tumor-tracking radiotherapy through the real-time recognition of a fiducial marker using fluoroscopic images. In this system, the isocenter should be located within approximately 5-7.5 cm from the marker, depending on the version, owing to the limited field of view. If the marker is placed away from the tumor, the isocenter should be shifted toward the marker. This study aimed to investigate stereotactic body radiotherapy (SBRT) outcomes of primary liver tumors treated with SyncTraX in cases where the isocenter was shifted marginally or outside the planning target volume (PTV). Twelve patients with 13 liver tumors were included in the analysis. Their isocenter was shifted toward the marker and was placed marginally or outside the PTV. The prescribed doses were generally 40 Gy in four fractions or 48 Gy in eight fractions. The overall survival (OS) and local control (LC) rates were calculated using the Kaplan-Meier method. All patients completed the scheduled SBRT. The median distance between the fiducial marker and PTV centroid was 56.0 (interquartile range [IQR]: 52.7-66.7) mm. By shifting the isocenter toward the marker, the median distance between the marker and isocenter decreased to 34.0 (IQR: 33.4-39.7) mm. With a median follow-up period of 25.3 (range: 6.9-70.0) months, the 2-year OS and LC rates were 100.0% (95% confidence interval: 100-100). An isocenter shift makes SBRT with SyncTraX feasible in cases where the fiducial marker is distant from the tumor.
• 胸部食道がん化学放射線療法における重症放射線食道炎に関する後方視的研究

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

  北海道医学雑誌 98 2 139 - 140 北海道医学会 2023年11月
• Individualized Stereotactic Ablative Radiotherapy for Lung Tumors: The iSABR Phase 2 Nonrandomized Controlled Trial.

  Michael F Gensheimer, Harriet Gee, Hiroki Shirato, Hiroshi Taguchi, John M Snyder, Alexander L Chin, Lucas K Vitzthum, Peter G Maxim, Heather A Wakelee, Joel Neal, Millie Das, Daniel T Chang, Elizabeth Kidd, Steven L Hancock, David B Shultz, Kathleen C Horst, Quynh-Thu Le, Samantha Wong, Eleanor Brown, Ngan Nguyen, Rachel Liang, Billy W Loo Jr, Maximilian Diehn

  JAMA oncology 9 11 1525 - 1534 2023年11月01日 

  IMPORTANCE: Stereotactic ablative radiotherapy (SABR) is used for treating lung tumors but can cause toxic effects, including life-threatening damage to central structures. Retrospective data suggested that small tumors up to 10 cm3 in volume can be well controlled with a biologically effective dose less than 100 Gy. OBJECTIVE: To assess whether individualizing lung SABR dose and fractionation by tumor size, location, and histological characteristics may be associated with local tumor control. DESIGN, SETTING, AND PARTICIPANTS: This nonrandomized controlled trial (the iSABR trial, so named for individualized SABR) was a phase 2 multicenter trial enrolling participants from November 15, 2011, to December 5, 2018, at academic medical centers in the US and Japan. Data were analyzed from December 9, 2020, to May 10, 2023. Patients were enrolled in 3 groups according to cancer type: initial diagnosis of non-small cell lung cancer (NSCLC) with an American Joint Committee on Cancer 7th edition T1-3N0M0 tumor (group 1), a T1-3N0M0 new primary NSCLC with a history of prior NSCLC or multiple NSCLCs (group 2), or lung metastases from NSCLC or another solid tumor (group 3). INTERVENTION: Up to 4 tumors were treated with once-daily SABR. The dose ranged from 25 Gy in 1 fraction for peripheral tumors with a volume of 0 to 10 cm3 to 60 Gy in 8 fractions for central tumors with a volume greater than 30 cm3. MAIN OUTCOME: Per-group freedom from local recurrence (same-lobe recurrence) at 1 year, with censoring at time of distant recurrence, death, or loss to follow-up. RESULTS: In total, 217 unique patients (median [IQR] age, 72 [64-80] years; 129 [59%] male; 150 [69%] current or former smokers) were enrolled (some multiple times). There were 240 treatment courses: 79 in group 1, 82 in group 2, and 79 in group 3. A total of 285 tumors (211 [74%] peripheral and 74 [26%] central) were treated. The most common dose was 25 Gy in 1 fraction (158 tumors). The median (range) follow-up period was 33 (2-109) months, and the median overall survival was 59 (95% CI, 49-82) months. Freedom from local recurrence at 1 year was 97% (90% CI, 91%-99%) for group 1, 94% (90% CI, 87%-97%) for group 2, and 96% (90% CI, 89%-98%) for group 3. Freedom from local recurrence at 5 years ranged from 83% to 93% in the 3 groups. The proportion of patients with grade 3 to 5 toxic effects was low, at 5% (including a single patient [1%] with grade 5 toxic effects). CONCLUSIONS AND RELEVANCE: The results of this nonrandomized controlled trial suggest that individualized SABR (iSABR) used to treat lung tumors may allow minimization of treatment dose and is associated with excellent local control. Individualized dosing should be considered for use in future trials. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01463423.
• Real-World Results of Stereotactic Body Radiotherapy for 399 Medically Operable Patients with Stage I Histology-Proven Non-Small Cell Lung Cancer.

  Hiroshi Onishi, Yoshiyuki Shioyama, Yasuo Matsumoto, Yukinori Matsuo, Akifumi Miyakawa, Hideomi Yamashita, Haruo Matsushita, Masahiko Aoki, Keiji Nihei, Tomoki Kimura, Hiromichi Ishiyama, Naoya Murakami, Kensei Nakata, Atsuya Takeda, Takashi Uno, Takuma Nomiya, Hiroshi Taguchi, Yuji Seo, Takafumi Komiyama, Kan Marino, Shinichi Aoki, Masaki Matsuda, Tomoko Akita, Masahide Saito

  Cancers 15 17 2023年09月01日 

  Surgery is the standard treatment for stage I non-small cell lung cancer (NSCLC); however, no clear randomized trial demonstrates its superiority to stereotactic body radiotherapy (SBRT) regarding survival. We aimed to retrospectively evaluate the treatment outcomes of SBRT in operable patients with stage I NSCLC using a large Japanese multi-institutional database to show real-world outcome. Exactly 399 patients (median age 75 years; 262 males and 137 females) with stage I (IA 292, IB 107) histologically proven NSCLC (adenocarcinoma 267, squamous cell carcinoma 96, others 36) treated at 20 institutions were reviewed. SBRT was prescribed at a total dose of 48-70 Gy in 4-10 fractions. The median follow-up period was 38 months. Local progression-free survival rates were 84.2% in all patients and 86.1% in the T1, 78.6% in T2, 89.2% in adenocarcinoma, and 70.5% in squamous cell subgroups. Overall 3-year survival rates were 77.0% in all patients: 90.7% in females, 69.6% in males, and 41.2% in patients with pulmonary interstitial changes. Fatal radiation pneumonitis was observed in two patients, all of whom had pulmonary interstitial changes. This real-world evidence will be useful in shared decision-making for optimal treatment, including SBRT for operable stage I NSCLC, particularly in older 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年08月 

  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.
• Clinical results of proton beam radiotherapy for inoperable stage III non-small cell lung cancer: a Japanese national registry study.

  Hitoshi Tatebe, Hideyuki Harada, Keita Mori, Hiromitsu Iwata, Tetsuo Akimoto, Masao Murakami, Takahiro Waki, Takashi Ogino, Masatoshi Nakamura, Hiroshi Taguchi, Haruhiko Nakayama, Miyako Satouchi, Hidefumi Aoyama

  Journal of radiation research 64 Supplement_1 i8-i15  2023年06月16日 [査読有り]
   

  This study presents the first data of a Japanese nationwide multi-institutional cohort and compares them with the findings of systematic literature reviews on radiation therapies and inoperable stage III non-small cell lung cancer (NSCLC) conducted by the Lung Cancer Working Group in the Particle Beam Therapy (PBT) Committee and Subcommittee at Japanese Society for Radiation Oncology. The Lung Cancer Working Group extracted eight reports and compared their data with those of the PBT registry from May 2016 to June 2018. All the analyzed 75 patients aged ≤80 years underwent proton therapy (PT) with concurrent chemotherapy for inoperable stage III NSCLC. The median follow-up period of the surviving patients was 39.5 (range, 1.6-55.6) months. The 2- and 3-year overall survival (OS) and progression-free survival rates were 73.6%/64.7% and 28.9%/25.1%, respectively. During the follow-up period, six patients (8.0%) had adverse events of Grade ≥ 3, excluding abnormal laboratory values. These included esophagitis in four patients, dermatitis in one and pneumonitis in one. Adverse events of Grade ≥ 4 were not observed. The results of these PBT registry data in patients with inoperable stage III NSCLC suggest that the OS rate was at least equivalent to that of radiation therapy using X-rays and that the incidence of severe radiation pneumonitis was low. PT may be an effective treatment to reduce toxicities of healthy tissues, including the lungs and heart, in patients with inoperable stage III NSCLC.
• PO-2122 Effect of early fractional lymphocyte loss on lymphopenia probability models for NSCLC

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

  Radiotherapy and Oncology 182 S1909 - S1911 2023年05月
• Particle beam therapy for pelvic recurrence of colorectal cancer: a registry data analysis in Japan and a systematic review

  Shigeyuki Murayama, Shigeru Yamada, Yuichi Hiroshima, Hirotoshi Takiyama, Hiroshi Taguchi, Takuya Kimoto, Makoto Anzai, Yasuhito Hagiwara, Kazuaki Yasui, Keita Mori, Soichiro Ishihara, Hideki Ueno, Shinichi Shimizu, Hidefumi Aoyama, Hiroshi Tsuji, Hideyuki Sakurai

  Journal of Radiation Research 64 Supplement_1 i25 - i33 2023年04月28日 

  Abstract The aim of this study was to investigate the efficacy and safety of particle beam therapy (PBT) with proton or carbon ion beam for pelvic recurrence of colorectal cancer (PRCC) by comparing the clinical outcomes of a dataset of prospectively enrolled patients for PBT with those from the literature, which were collected by a systematic review of external X-ray radiotherapy (XRT) and PBT. Patients with PRCC treated at 14 domestic facilities between May 2016 and June 2019 and entered the database for prospective observational follow-up were analyzed. The registry data analyzed included 159 PRCC patients treated with PBT of whom 126 (79%) were treated with carbon ion radiation therapy (CIRT). The 3-year overall survival and local control rate were 81.8 and 76.4%, respectively. Among these PRCC patients, 5.7% had Grade 3 or higher toxicity. Systematic search of PubMed and Cochrane databases published from January 2000 to September 2020 resulted in 409 abstracts for the primary selection. Twelve studies fulfilled the inclusion criteria. With one additional publication, 13 studies were selected for qualitative analysis, including 9 on XRT and 4 on PBT. There were nine XRT studies, which included six on 3D conformal radiotherapy and three on stereotactic body radiation therapy, and four PBT studies included three on CIRT and one on proton therapy. A pilot meta-analysis using literatures with median survival time extractable over a 20-month observation period suggested that PBT, especially CIRT, may be a promising treatment option for PRCC not amenable to curative resection.
• Analysis of particle therapy registries based on a unified treatment policy for esophageal cancer.

  Sunao Tokumaru, Hitoshi Ishikawa, Toshinori Soejima, Takuya Kimoto, Yosuke Takakusagi, Hiroyasu Tamamura, Hitoshi Wada, Hiroshi Taguchi, Yusuke Uchinami, Yuichi Hiroshima, Hidehiro Hojo, Takashi Kamei, Manabu Muto, Masataka Igeta

  Journal of radiation research 2023年04月07日 

  This study aimed to evaluate the efficacy and safety of particle therapy (proton beam therapy and carbon-ion radiotherapy) for esophageal cancer by analyzing prospective nationwide registry data from particle therapy facilities throughout Japan. Patients diagnosed with esophageal cancer who received particle therapy between May 2016 and June 2018 were recruited from the registries of 12 particle therapy centers in Japan. Eventually, we enrolled 174 patients who met the inclusion criteria. Of the 174 patients, 137 (78.7%) were male, with a median age of 69 years (range: 41-88 years). Clinical stages included I (n = 55; 31.6%), II (n = 31; 17.8%), III (n = 82; 47.1%), IV (n = 3; 1.7%) and unknown (n = 3; 1.7%) (Union for International Cancer Control, seventh edition), and the median follow-up period was 908 days (range: 76-1669 days) for all patients. The 3-year overall survival (OS) rate, the 3-year progression-free survival (PFS) rate and the 3-year local control (LC) rates were 60.5, 53.2 and 72.7%, respectively. For each clinical stage, the 3-year OS rates were I, 84.8%; II, 60.3% and III, 42.9%; the 3-year PFS rates were I, 71.9%; II, 58.3% and III, 37.0% and the 3-year LC were I, 78.4%; II, 79.8% and III, 65.2%, respectively. Notably, four patients (2.3%) with ≥Grade 3 cardiopulmonary toxicities were observed (Common Terminology Criteria for Adverse Events, version 5.0). Our study showed that particle therapy for esophageal cancer has lower rates of adverse cardiopulmonary events than X-ray radiotherapy.
• 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 2023年03月
• 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年02月07日 

  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.
• 肝細胞癌陽子線治療効果予測におけるADC値指標の検討

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

  Japanese Journal of Radiology 41 Suppl. 10 - 10 (公社)日本医学放射線学会 2023年02月
• Study of hepatic toxicity in small liver tumors after photon or proton therapy based on factors predicting the benefits of proton.

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

  The British journal of radiology 96 1144 20220720 - 20220720 2023年01月12日 

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

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

  Medical Physics 2022年12月03日
• 内科・外科による消化器病共同診療の現況と展望 当科における切除可能境界膵癌に対する術前治療の現状

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

  日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集 131回・125回 28 - 28 日本消化器病学会-北海道支部 2022年09月
• 【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 (有)科学評論社 2022年07月
• 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年07月
• 北海道大学病院放射線治療科関連施設における子宮頸癌に対する根治放射線治療に関するアンケート結果について

  木下 留美子, 打浪 雄介, 高橋 周平, 小泉 富基, 森 崇, 西岡 健太郎, 田口 大志, 橋本 孝之, 高邑 明夫, 西岡 井子, 北原 利博, 土屋 和彦, 井上 哲也, 有本 卓郎, 出倉 康裕, 米坂 祥朗, 鈴木 恵士郎, 川島 和之, 小野寺 俊輔, 喜多村 圭, 長谷川 雅一, 鬼丸 力也, 富田 雅義, 池田 潤, 西山 典明, 青山 英史

  北海道放射線医学雑誌 2 13 - 18 (NPO)メディカルイメージラボ 2022年03月 

  子宮頸癌に対する根治的放射線治療において子宮内から照射を行う腔内照射は必要不可欠な要素である。腔内照射の設備の維持・更新および子宮頸癌根治照射人数等について北海道大学病院放射線治療科関連病院にアンケートを行った。道内の施設の子宮頸癌根治照射人数は年間10人以下の施設が大半で、腔内照射設備を保有している施設の年間の腔内照射人数は5-9人が4施設、10人以上が2施設であった。腔内照射設備を保有している6施設の内4施設で設備の維持・更新が採算面で難しいという理由で腔内照射の休止を検討している事が明らかとなった。北海道内の子宮頸癌に対する根治照射を継続して行うためには、腔内照射設備を持つ施設への適切な紹介システムの構築と腔内照射が可能な施設の地域性を考慮した適切な集約化が必要と考えられた。(著者抄録)
• Real-time CT image generation based on voxel-by-voxel modeling of internal deformation by utilizing the displacement of fiducial markers.

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

  Medical physics 48 9 5311 - 5326 2021年09月 [査読有り]
   

  PURPOSE: To show the feasibility of real-time CT image generation technique utilizing internal fiducial markers that facilitate the evaluation of internal deformation. METHODS: In the proposed method, a linear regression model that can derive internal deformation from the displacement of fiducial markers is built for each voxel in the training process before the treatment session. Marker displacement and internal deformation are derived from the four-dimensional computed tomography (4DCT) dataset. In the treatment session, the three-dimensional deformation vector field is derived according to the marker displacement, which is monitored by the real-time imaging system. The whole CT image can be synthesized by deforming the reference CT image with a deformation vector field in real-time. To show the feasibility of the technique, image synthesis accuracy and tumor localization accuracy were evaluated using the dataset generated by extended NURBS-Based Cardiac-Torso (XCAT) phantom and clinical 4DCT datasets from six patients, containing 10 CT datasets each. In the validation with XCAT phantom, motion range of the tumor in training data and validation data were about 10 and 15 mm, respectively, so as to simulate motion variation between 4DCT acquisition and treatment session. In the validation with patient 4DCT dataset, eight CT datasets from the 4DCT dataset were used in the training process. Two excluded inhale CT datasets can be regarded as the datasets with large deformations more than training dataset. CT images were generated for each respiratory phase using the corresponding marker displacement. Root mean squared error (RMSE), normalized RMSE (NRMSE), and structural similarity index measure (SSIM) between the original CT images and the synthesized CT images were evaluated as the quantitative indices of the accuracy of image synthesis. The accuracy of tumor localization was also evaluated. RESULTS: In the validation with XCAT phantom, the mean NRMSE, SSIM, and three-dimensional tumor localization error were 7.5 ± 1.1%, 0.95 ± 0.02, and 0.4 ± 0.3 mm, respectively. In the validation with patient 4DCT dataset, the mean RMSE, NRMSE, SSIM, and three-dimensional tumor localization error in six patients were 73.7 ± 19.6 HU, 9.2 ± 2.6%, 0.88 ± 0.04, and 0.8 ± 0.6 mm, respectively. These results suggest that the accuracy of the proposed technique is adequate when the respiratory motion is within the range of the training dataset. In the evaluation with a marker displacement larger than that of the training dataset, the mean RMSE, NRMSE, and tumor localization error were about 100 HU, 13%, and <2.0 mm, respectively, except for one case having large motion variation. The performance of the proposed method was similar to those of previous studies. Processing time to generate the volumetric image was <100 ms. CONCLUSION: We have shown the feasibility of the real-time CT image generation technique for volumetric imaging.
• 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 (一社)日本小児血液・がん学会 2021年08月 

  陽子線治療は通常のX線による放射線治療に比べて線量集中性に優れ,標的への線量を保ったまま周囲の正常組織線量を低減することで,小児がん患者の急性期並びに晩期有害事象の軽減が可能である.2016年4月からは20歳未満の限局性固形悪性腫瘍に対する根治的な陽子線照射が保険適応となり,各施設で小児がんの陽子線治療実施件数が増加傾向にある.局所領域再発に対する再照射は,腫瘍進行抑制・症状緩和と,時に治癒や長期の腫瘍制御による健康状態・QOLの維持をもたらす可能性がある.小児患者に対する再照射における重要臓器・器官の累積耐容線量や安全性は確立していないが,中枢神経腫瘍に対する陽子線再照射により,有害事象の発生を抑えた良好な治療成績が報告されている.今後,小児がん再発の治療選択肢における陽子線再照射の有用性については,前向き臨床試験での評価が必要と考える.(著者抄録)
• 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 (一社)日本小児血液・がん学会 2021年08月
• 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年08月 [査読有り]
   

  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.
• 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年03月10日 [査読有り]
   

  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.
• A case of radio-insensitive SMARCA4-deficient thoracic undifferentiated carcinoma with severe right heart failure.

  Shotaro Ito, Hajime Asahina, Naoko Yamaguchi, Utano Tomaru, Tadashi Hasegawa, Yutaka Hatanaka, Kanako C Hatanaka, Hiroshi Taguchi, Taisuke Harada, Hiroshi Ohira, Daisuke Ikeda, Hidenori Mizugaki, Eiki Kikuchi, Junko Kikuchi, Jun Sakakibara-Konishi, Naofumi Shinagawa, Satoshi Konno

  Respiratory medicine case reports 32 101364 - 101364 2021年 [査読有り]
   

  SMARCA4-deficient thoracic sarcomatoid tumors were characterized by inactivating mutations of SMARCA4 and often found in the chest of young and middle-aged males with a smoking history. Recently, SMARCA4-deficient thoracic sarcomatoid tumors were reported to represent primarily smoking-associated undifferentiated/de-differentiated carcinomas rather than primary thoracic sarcomas. The main complication of this tumor is compression of the respiratory tract and/or blood vessels. A 39-year-old man presented with a 2-month history of fever and dyspnea. Computed tomography revealed a mediastinal tumor invading the right and left pulmonary arteries. Because of severe right heart failure, we considered him ineligible for bronchoscopy. We scheduled palliative irradiation with 40 Gy/20 Fr to improve hemodynamics and perform endobronchial ultrasound transbronchial needle aspiration later. However, irradiation was ineffective, and his general condition deteriorated quickly and he died after a 7-week hospitalization. An autopsy revealed that the diagnosis was SMARCA4-deficient thoracic undifferentiated carcinoma. It has been reported that this tumor is insensitive to radiotherapy and there were some cases which responded to an immune checkpoint inhibitor. Therefore, when caring for patients with mediastinal tumors that invade and compress the trachea and large vessels, it is important to consider this tumor as a differential diagnosis and try to make a pathological diagnosis as soon as possible.
• 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年 [査読有り]
   

  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年12月 [査読有り]
   

  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.
• 動体追跡陽子線照射における気管支内視鏡的放射線治療用マーカー留置術の検討

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

  気管支学 42 6 576 - 576 (NPO)日本呼吸器内視鏡学会 2020年11月
• 動体追跡陽子線照射における気管支内視鏡的放射線治療用マーカー留置術の検討

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

  気管支学 42 6 576 - 576 (NPO)日本呼吸器内視鏡学会 2020年11月
• 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 2020年11月
• 膵癌に対するS-1併用術前化学放射線療法(S-1併用NACRT)の治療成績

  小泉 富基, 加藤 徳雄, 中村 透, 川本 泰之, 田口 大志, 打浪 雄介, 清水 伸一, 青山 英史

  日本医学放射線学会秋季臨床大会抄録集 56回 S103 - S103 (公社)日本医学放射線学会 2020年10月
• 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年10月
• 動体追跡陽子線照射における気管支内視鏡的放射線治療用マーカー留置術の検討

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

  気管支学 42 Suppl. S277 - S277 (NPO)日本呼吸器内視鏡学会 2020年06月
• Analysis of treatment process time for real-time-image gated-spot-scanning proton-beam therapy (RGPT) system.

  Yoshimura T, Shimizu S, Hashimoto T, Nishioka K, Katoh N, Inoue T, Taguchi H, Yasuda K, Matsuura T, Takao S, Tamura M, Ito YM, Matsuo Y, Tamura H, Horita K, Umegaki K, Shirato H

  Journal of applied clinical medical physics 21 2 38 - 49 2019年12月 [査読有り][通常論文]
   

  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.
• 胸部食道扁平上皮癌に対する術前補助化学療法・根治切除術および根治的化学放射線療法についての後方視的検討

  中積 宏之, 村中 徹人, 川本 泰之, 小松 嘉人, 結城 敏志, 中野 真太郎, 澤田 憲太郎, 坂本 直哉, 打浪 雄介, 田口 大志, 白土 博樹, 海老原 裕磨, 七戸 俊明, 平野 聡

  北海道医学雑誌 94 2 120 - 121 北海道医学会 2019年11月
• 局所進行食道癌に対してspot scanning法による根治的化学陽子線療法を施行した一例

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

  日本医学放射線学会秋季臨床大会抄録集 55回 S520 - S520 (公社)日本医学放射線学会 2019年09月
• Initial Clinical Outcomes of Real-Time-Image Gated Spot-Scanning Proton Beam Therapy for Hepatocellular Carcinomas

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

  International Journal of Radiation Oncology*Biology*Physics 105 1 E222 - E223 2019年09月
• Impact of organ motion on volumetric and dosimetric parameters in stomach lymphomas treated with intensity-modulated radiotherapy.

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

  Journal of applied clinical medical physics 20 8 78 - 86 2019年08月 [査読有り][通常論文]
   

  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.
• 巨大下腸間膜静脈瘤に対しPTOを施行した1例

  中村 友亮, 高橋 文也, 木野田 直也, 川畑 久美子, 田口 大志, 宮本 憲幸, 上久保 康弘

  Japanese Journal of Radiology 37 Suppl. 9 - 9 (公社)日本医学放射線学会 2019年02月
• 腎AVM Type III(Cirsoid type)をB-glueで塞栓した1例

  木野田 直也, 高橋 文也, 中村 友亮, 川畑 久美子, 田口 大志, 宮本 憲幸, 池城 卓, 加藤 大祐

  Japanese Journal of Radiology 37 Suppl. 10 - 10 (公社)日本医学放射線学会 2019年02月
• IVC近傍のHCCに対するLip TAI/TACE併用RFAの検討

  宮本 憲幸, 中村 友亮, 木野田 直也, 高橋 文也, 川畑 久美子, 田口 大志

  IVR: Interventional Radiology 33 3 311 - 311 (一社)日本インターベンショナルラジオロジー学会 2018年11月
• 肝IVRにおけるトロンボポエチン受容体作動薬の使用経験

  中村 友亮, 宮本 憲幸, 木野田 直也, 川畑 久美子, 高橋 文也, 田口 大志

  IVR: Interventional Radiology 33 3 311 - 311 (一社)日本インターベンショナルラジオロジー学会 2018年11月
• 肝腹側に突出する巨大HCCに対してTACEを施行し、右胃大網静脈が排血路になっていると考えられた2例

  木野田 直也, 中村 友亮, 川畑 久美子, 高橋 文也, 宮本 憲幸, 田口 大志

  IVR: Interventional Radiology 33 3 311 - 311 (一社)日本インターベンショナルラジオロジー学会 2018年11月
• ERBD及びPTBD困難な急性胆管炎に対して一期的に経皮経胆嚢管的胆管ドレナージを施行した2例

  加藤 大祐, 高橋 文也, 田口 大志, 宮本 憲幸

  IVR: Interventional Radiology 33 3 312 - 312 (一社)日本インターベンショナルラジオロジー学会 2018年11月
• 右結腸動脈からLipiodol-TACEを行ったHCCの1例

  高橋 文也, 中村 友亮, 木野田 直也, 田口 大志, 宮本 憲幸, 加藤 大祐, 志村 亮祐

  IVR: Interventional Radiology 33 3 312 - 312 (一社)日本インターベンショナルラジオロジー学会 2018年11月
• B-RTOが困難であった胃静脈瘤に対しPTOを行った3例

  高橋 文也, 木野田 直也, 中村 友亮, 田口 大志, 宮本 憲幸, 加藤 大祐

  IVR: Interventional Radiology 33 3 314 - 314 (一社)日本インターベンショナルラジオロジー学会 2018年11月
• 胆嚢に近接した肝腫瘍に対するHydrodissection RFAの検討

  宮本 憲幸, 木野田 直也, 加藤 大貴, 工藤 京平, 川畑 久美子, 井上 哲也, 高橋 文也, 中村 友亮, 田口 大志

  日本医学放射線学会秋季臨床大会抄録集 54回 S488 - S488 (公社)日本医学放射線学会 2018年09月
• 20mm以上のHCCに対するmonopolar RFAとbipolar RFAの比較

  宮本 憲幸, 中村 友亮, 木野田 直也, 高橋 文也, 田口 大志, 加藤 大祐, 山口 晃典

  IVR: Interventional Radiology 33 1 55 - 55 (一社)日本インターベンショナルラジオロジー学会 2018年05月
• HCCに対するDEB-TACE後のbilomaに対して胆管内瘻化した1例

  宮本 憲幸, 中村 友亮, 木野田 直也, 高橋 文也, 田口 大志, 加藤 大祐, 志村 亮祐

  IVR: Interventional Radiology 33 1 55 - 55 (一社)日本インターベンショナルラジオロジー学会 2018年05月
• 胆嚢炎に対するPTGBD留置後に発生した胆嚢仮性動脈瘤の1例

  中村 友亮, 宮本 憲幸, 木野田 直也, 川畑 久美子, 高橋 文也, 田口 大志, 村川 力彦

  IVR: Interventional Radiology 33 1 56 - 56 (一社)日本インターベンショナルラジオロジー学会 2018年05月
• 腎AVM Type III(Cirsoid type)をB-glueで塞栓した1例

  高橋 文也, 中村 友亮, 木野田 直也, 田口 大志, 宮本 憲幸, 池城 卓, 加藤 大祐

  IVR: Interventional Radiology 33 1 57 - 57 (一社)日本インターベンショナルラジオロジー学会 2018年05月
• 巨大下腸間膜静脈瘤に対しPTOを施行した1例

  高橋 文也, 中村 友亮, 木野田 直也, 田口 大志, 宮本 憲幸, 加藤 大祐, 藤井 宝顕, 上久保 康弘

  IVR: Interventional Radiology 33 1 57 - 57 (一社)日本インターベンショナルラジオロジー学会 2018年05月
• 経脾静脈的に塞栓術を施行した2例

  木野田 直也, 中村 友亮, 川畑 久美子, 高橋 文也, 田口 大志, 宮本 憲幸

  IVR: Interventional Radiology 33 1 57 - 57 (一社)日本インターベンショナルラジオロジー学会 2018年05月
• PODの初期使用経験

  高橋 文也, 中村 友亮, 木野田 直也, 田口 大志, 宮本 憲幸, 加藤 大祐, 山口 晃典

  IVR: Interventional Radiology 33 1 58 - 58 (一社)日本インターベンショナルラジオロジー学会 2018年05月
• Biloma after Transcatheter Arterial Chemoembolization with Drug-Eluting Beads Managed with Sclerotherapy and Stent Placement

  Noriyuki Miyamoto, Yusuke Nakamura, Naoya Kinota, Bunya Takahashi, Hiroshi Taguchi, Ryosuke Shimura, Daisuke Kato

  Interventional Radiology 3 2 80 - 83 2018年 [査読有り][通常論文]
  
• 多発腎動脈瘤を伴う腎動静脈瘻に対し複数回のTAEを施行した1例

  森田 亮, 曽山 武士, 阿保 大介, 作原 祐介, 工藤 與亮, 佐藤 幸彦, 田口 大志, 佐澤 陽, 梶山 政義

  IVR: Interventional Radiology 31 4 374 - 375 (一社)日本インターベンショナルラジオロジー学会 2017年01月
• Amplatzer Vascular Plug 4と金属コイルを併用し塞栓術を施行した総肝動脈瘤の1例

  加藤 大祐, 志村 亮祐, 田口 大志, 宮本 憲幸, 佐藤 幸彦, 阿保 大介

  IVR: Interventional Radiology 31 4 376 - 376 (一社)日本インターベンショナルラジオロジー学会 2017年01月
• 気管支動脈瘤蔓状血管腫破裂に対しTAEが著効した1例

  森田 亮, 曽山 武士, 阿保 大介, 作原 祐介, 佐藤 幸彦, 田口 大志, 吉田 司, 矢部 勇人, 横尾 慶紀, 梶山 政義

  日本医学放射線学会秋季臨床大会抄録集 51回 S561 - S561 (公社)日本医学放射線学会 2015年09月
• Prognostic Significance of Clusterin Expression in Advanced-Stage Cervical Cancer Treated With Curative Intended Radiotherapy

  Hidemichi Watari, Rumiko Kinoshita, Yimin Han, Lei Wang, Masayoshi Hosaka, Hiroshi Taguchi, Kazuhiko Tsuchiya, Shinya Tanaka, Hiroki Shirato, Noriaki Sakuragi

  INTERNATIONAL JOURNAL OF GYNECOLOGICAL CANCER 22 3 465 - 470 2012年03月 [査読有り][通常論文]
   

  Objective: Overexpression of clusterin (CLU), an antiapoptotic molecule, has been reported to induce resistance to radiotherapy (RT) in a variety of cancer cell types. The aim of this study was to evaluate the significance of CLU expression to predict survival of patients with advanced-stage cervical cancer who received curative intended RT. Methods: Biopsy tissue specimens of advanced-stage cervical cancer before curative intended RT were obtained from 34 patients who were treated at Hokkaido University Hospital between 1998 and 2008 and whose complete medical records were available. The expression of CLU protein was analyzed by immunohistochemistry. Findings were evaluated in relation to several clinicopathological factors. Survival analyses were performed using the Kaplan-Meier curves and the log-rank test. Independent prognostic factors were determined by multivariate Cox regression analysis. Results: Clusterin protein was mainly present in the cytoplasm of cervical cancer cells. The expression of CLU protein in cervical cancer tissues before curative intended RT was not significantly related to any clinicopathological factors analyzed, including age, clinical stage, histologic type, and response to RT. Univariate analysis on prognostic factors showed that histologic type (P = 0.001), and CLU expression (P = 0.02) were related to survival. Multivariate analysis revealed that both histologic type (P = 0.002), and CLU expression (P = 0.02) were independent prognostic factors for overall survival. Conclusion: We conclude that CLU could be a new molecular marker to predict overall survival of patients with advanced-stage cervical cancer treated with curative intended RT.
• 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 - 879 2011年11月 [査読有り][通常論文]
   

  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 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. (C) 2011 Elsevier Inc.
• Efficacy of therapy for advanced hepatocellular carcinoma: Intra-arterial 5-fluorouracil and subcutaneous interferon with image-guided radiation

  Makoto Chuma, Hiroshi Taguchi, Yoshiya Yamamoto, Shinichi Shimizu, Mitsuru Nakanishi, Koji Ogawa, Takuya Sho, Hiromasa Horimoto, Tomoe Kobayashi, Masato Nakai, Katsumi Terashita, Yusuke Sakuhara, Daisuke Abo, Yoko Tsukuda, Seiji Tsunematsu, Shuhei Hige, Mototsugu Kato, Hiroki Shirato, Masahiro Asaka

  JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 26 7 1123 - 1132 2011年07月 [査読有り][通常論文]
   

  Background and Aim: To evaluate the efficacy of intra-arterial 5-fluorouracil (5-FU) and subcutaneous interferon (IFN) combined with image-guided radiation therapy (IGRT) in advanced hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). Methods: Twenty HCC patients with PVTT were treated with 5-FU and IFN combined with image-guided radiation therapy (IGRT) (IGRT group), and as controls, 20 patients with PVTT were treated with 5-FU and IFN alone (non-IGRT group). Overall survival (OS) time, response rates, time to progression (TTP) and safety were compared across groups. Results: Complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) of PVTT were 5%, 55%, 40% and 0% in the IGRT group and 0%, 30%, 35% and 35%, in the non-IGRT group, respectively. CR, PR, SD, and PD of the whole tumor were 0%, 35%, 45% and 20% in the IGRT group and 0%, 30%, 35% and 35%, in the non-IGRT group, respectively. Overall median survival was significantly longer in the IGRT group (12.0 months 95% confidence interval [CI], 9.3-17.6 months) than in the non-IGRT group (9.1 months [95% Cl, 5.5-11.1 months]) (P = 0.041). TTP was significantly longer in the IGRT group (6.9 months [95% CI, 5.6-10.2 months]) than in the non-IGRT group (4.0 months [95% Cl, 3.3-6.4 months]) (P = 0.034). Conclusions: The response rates, median OS time and TTP in patients with advanced HCC with PVTT who received this novel combination therapy of intra-arterial 5-FU and subcutaneous IFN with TORT are encouraging, and this combination therapy warrants further investigation.
• Long-term Outcomes of Fractionated Stereotactic Radiotherapy for Intracranial Skull Base Benign Meningiomas in Single Institution

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

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 41 4 462 - 468 2011年04月 [査読有り][通常論文]
   

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

  Takao S, Tadano S, Taguchi H, Yasuda K, Onimaru R, Ishikawa M, Bengua G, Suzuki R, Shirato H

  Int J Radiat Oncol Biol Phys 81 3 871 - 9 2011年 [査読有り][通常論文]
  
• Clinical outcomes of stereotactic brain and/or body radiotherapy for patients with oligometastatic lesions

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

  Japanese Journal of Clinical Oncology 40 8 788 - 794 2010年04月 [査読有り][通常論文]
   

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

  S. Takao, S. Tadano, H. Taguchi, H. Shirato

  6TH WORLD CONGRESS OF BIOMECHANICS (WCB 2010), PTS 1-3 31 1483 - + 2010年 [査読有り][通常論文]
   

  This study proposes a computational simulation method to calculate therapeutic outcomes in radiotherapy for head and neck carcinoma. As a tumor shrinks due to radiation exposure, it was possible to express the radiotherapeutic effects in terms of tumor volume changes and geometric distortion. The shrinking was assumed to conform to the deformation of solid body. The relationships between radiation energy and tumor deformation were estimated from solid mechanics equations. The simulation model was applied to six clinical cases of lymph node metastasis in patients with head and neck carcinoma. Three-dimensional solid models of tumors were constructed based on computed tomography (CT) images taken before the start of treatment. Follow up CT images were also taken weekly during the treatment period, to evaluate the changes in tumor volumes. The values of parameters prescribing tumor radiosensitivity or growth rates of tumor cells were identified so that the calculated results fit the clinical results. The simulated results represented the tumor decreases well in all cases. Average differences between measured and calculated tumor volume for all the cases were less than 10%. In conclusions, simulation results show that the simulation model can be applied to a variety of clinical cases by determining the tumor parameters appropriately.
• Clinical outcomes of stereotactic brain and/or body radiotherapy for patients with oligometastatic lesions.

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

  Jpn J Clin Oncol 40 8 788 - 94 2010年 [査読有り][通常論文]
  
• High Dose Three-Dimensional Conformal Boost Using the Real-Time Tumor Tracking Radiotherapy System in Cervical Cancer Patients Unable to Receive Intracavitary Brachytherapy

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

  YONSEI MEDICAL JOURNAL 51 1 93 - 99 2010年01月 [査読有り][通常論文]
   

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

  Takao, S, Tadano, S, Taguchi, H, Shirato, H

  Proceedings of the 8th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering 2009年06月 [査読有り][通常論文]
  
• 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年09月22日 [査読無し][通常論文]
  
• 動体追跡装置を用い安全域3mmで行ったホルモン非併用の前立腺癌放射線治療

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

  日本放射線腫よう学会誌 20 Supplement 1 143  2008年09月22日 [査読無し][通常論文]
  
• 75歳以上の高齢者に対する子宮頚癌の放射線治療

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

  日本放射線腫よう学会誌 20 Supplement 1 146  2008年09月22日 [査読無し][通常論文]
  
• 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 - 492 2008年07月 [査読有り][通常論文]
   

  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 <= 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 <= 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.
• Real-time tumor-tracking radiotherapy for adrenal tumors

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

  Radiotherapy and Oncology 87 3 418 - 424 2008年06月 [査読有り][通常論文]
   

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

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

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 70 3 931 - 934 2008年03月 [査読有り][通常論文]
   

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

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

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 70 2 374 - 381 2008年02月 [査読有り][通常論文]
   

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

  Atsushi Sano, Junko Kikuchi, Yoshiteru Kobayashi, Hiroshi Taguchi, Munehiro Yokoyama

  Japanese Journal of Gastroenterological Surgery 41 11 1898 - 1903 2008年 

  Endocrine cell carcinoma (ECC) of the esophagus is a rare form of esophageal carcinoma having a dismal prognosis due to its aggressive malignancy. We report the case of a patient with ECC managed by resection and adjuvant chemotherapy. A 56-year-old man, suffering one month of postprandial epigastralgia, was found in esophagography and esophagoscopy to have an elevated 4cm lesion of the middle and lower thoracic esophagus. Biopsy specimens were histologically diagnosted as undifferentiated carcinoma. We judged the man to be a candidate for curative surgery after preoperative examination found no distant organ metastasis, lymph node metastasis, direct adjacent tissue invasion. We conducted thoracic esophagectomy with three-field lymph node dissection and retrosternal reconstruction by gastric tube. Immunohistochemically, the tumor in the resected specimen stained positive for synaptophysin, chromogranin A, and NSE, yielding a definitive diagnosis of nonsmall-cell ECC, pT2pN2M0 pStage III. Postoperatively, he underwent 4 courses of adjuvant chemotherapy with CDDP and VP-16. He remains alive without evidence of recurrence in the 37 months as of this writing. Operative indications should be carefully determined due to the high risk of invasiveness. Multidisciplinary treatment such as chemotherapy could bring relatively long survival even after radical resection. ©2008 The Japanese Society of Gastroenterological Surgery.
• Intercepting radiotherapy using a real-time tumor-tracking radiotherapy system for highly selected patients with hepatocellular carcinoma unresectable with other modalities

  Hiroshi Taguchi, Yusuke Sakuhara, Shuhei Hige, Kei Kitamura, Yasuhiro Osaka, Daisuke Abo, Daichi Uchida, Akihiro Sawada, Toshiya Kamiyama, Tadashi Shimizu, Hiroki Shirato, Kazuo Miyasaka

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 69 2 376 - 380 2007年10月 [査読有り][通常論文]
   

  Purpose: To assess the clinical outcome of intercepting radiotherapy, in which radiotherapy is delivered only when a tumor in motion enters a target area, using a real-time tumor-tracking radiotherapy (RTRT) system for patients with hepatocellular carcinoma who were untreatable with other modalities because the tumors were adjacent to crucial organs or located too deep beneath the skin surface. Methods and Materials: Eighteen tumors, with a mean diameter of 36 mm, were studied in 15 patients. All tumors were treated on a hypofractionated schedule with a tight margin for setup and organ motion using a 2.0-mm fiducial marker in the liver and the RTRT system. The most commonly used dose of radiotherapy was 48 Gy in 8 fractions. Sixteen lesions were treated with a BED10 of 60 Gy or more (median, 76.8 Gy). Results: With a mean follow-up period of 20 months (range, 3-57 months), the overall survival rate was 39% at 2 years after RTRT. The 2-year local control rate was 83% for initial RTRT but was 92% after allowance for reirradiation using RTRT, with a Grade 3 transient gastric ulcer in 1 patient and Grade 3 transient increases of aspartate amino transaminase in 2 patients. Conclusions: Intercepting radiotherapy using RTRT provided effective focal high doses to liver tumors. Because the fiducial markers for RTRT need not be implanted into the tumor itself, RTRT can be applied to hepatocellular carcinoma in patients who are not candidates for other surgical or nonsurgical treatments. (c) 2007 Elsevier Inc.
• Efficacy of preoperative radiotherapy to portal vein tumor thrombus in the main trunk or first branch in patients with hepatocellular carcinoma

  Toshiya Kamiyama, Kazuaki Nakanishi, Hideki Yokoo, Munenori Tahara, Takahito Nakagawa, Hirofumi Kamachi, Hiroshi Taguchi, Hiroki Shirato, Michiaki Matsushita, Satoru Todo

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 12 5 363 - 368 2007年10月 [査読有り][通常論文]
   

  Background The prognosis of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) in the main trunk or the first branch is very poor. Methods. Radiotherapy (RT) to PVTT was followed by hepatectomy within 2 weeks. The dose used was 30-36 Gy, in 10-12 fractions, for 15-20 days. The efficacy of preoperative RT to PVTT in the main trunk or first branch was evaluated by comparing results in patients who underwent hepatectomy (group R; n = 15) with preoperative RT and those without preoperative RT (group N; n = 28). Results. The 1-, 3-, and 5-year survival rates in group R were 86.2%, 43.5%, and 34.8%, respectively, while these values in group N were 39.0 %, 13.1 %, and 13.1 %, respectively. The survival curve of group R was significantly better than that of group N (P = 0.0359). In group R, five (83.3 %) of six patients whose tumor thrombus was completely necrosed (based on pathological examination) and whose follow-up period was over 2 years survived for more than 2 years. Female sex (P = 0.0066), multiple tumors (P = 0.0369), and absence of preoperative RT (P = 0.0359) were ranked as significant factors for a poor prognosis by univariate analysis. Multivariate analysis revealed absence of preoperative RT and female sex to be significant factors for a poor prognosis. Conclusion. Preoperative RT to PVTT in the main trunk or first branch improved the prognosis of patients with HCC with PVTT, and could be a promising new modality in the treatment of these patients.
• Feasibility study of real-time tumor-tracking radiotherapy for adrenal tumors: Three-dimensional movement of internal fiducial gold markers measured in supine and prone patient positions

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

  International Journal of Radiation Oncology Biology Physics 69 3 S675  2007年 [査読有り][通常論文]
  
• Speed and amplitude of lung tumor motion precisely detected in four-dimensional setup and in real-time tumor-tracking radiotherapy

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

  INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 64 4 1229 - 1236 2006年03月 [査読有り][通常論文]
   

  Background: To reduce the uncertainty of registration for lung tumors, we have developed a four-dimensional (4D) setup system using a real-time tumor-tracking radiotherapy system. Methods and Materials: During treatment planning and daily setup in the treatment room, the trajectory of the internal fiducial marker was recorded for 1 to 2 min at the rate of 30 times per second by the real-time tumor-tracking radiotherapy system. To maximize gating efficiency, the patient's position on the treatment couch was adjusted using the 4D setup system with fine on-line remote control of the treatment couch. Results: The trajectory of the marker detected in the 4D setup system was well visualized and used for daily setup. Various degrees of interfractional and intrafractional changes in the absolute amplitude and speed of the internal marker were detected. Readjustments were necessary during each treatment session, prompted by baseline shifting of the tumor position. Conclusion: The 4D setup system was shown to be useful for reducing the uncertainty of tumor motion and for increasing the efficiency of gated irradiation. Considering the interfractional and intrafractional changes in speed and amplitude detected in this study, intercepting radiotherapy is the safe and cost-effective method for 4D radiotherapy using real-time tracking technology. (C) 2006 Elsevier Inc.
• High dose three-dimensional conformal boost (3DCB) using an orthogonal diagnostic X-ray set-up for patients with gynecological malignancy: a new application of real-time tumor-tracking system

  R Yamamoto, A Yonesaka, S Nishioka, H Watari, T Hashimoto, D Uchida, H Taguchi, T Nishioka, B Miyasaka, N Sakuragi, H Shirato

  RADIOTHERAPY AND ONCOLOGY 73 2 219 - 222 2004年11月 [査読有り][通常論文]
   

  The feasibility and accuracy of high dose three-dimensional conformal boost (3DCB) using three internal fiducial markers and a two-orthogonal X-ray set-up of the real-time tumor-tracking system on patients with gynecological malignacy were investigated in 10 patients. The standard deviation of the distribution of systematic deviations (Sigma) was reduced from 3.8, 4.6, and 4.9 mm in the manual setup to 2.3. 2.3 and 2.7 mm, in the set-up using the internal markers. The average standard deviation of the distribution of random deviations (sigma) was reduced from 3.7. 5.0, and 4.5 mm in the manual set-up to 3.3, 3.0, and 4.2 mm in the marker set-up. The appropriate PTV margin was estimated to be 10.2, 12.8, and 12.9 mm in the manual set-up and 6.9, 6.7, and 8.3 mm in the gold marker set-up, respectively, using the formula 2Sigma+0.7sigma. Set-up of the patients with three markers and two fluoroscopy is useful to reduce PTV margin and perform 3DCB. (C) 2004 Published by Elsevier Ireland Ltd.

MISC

• 免疫チェックポイント阻害薬と放射線治療—Clinical evidences for the combination of immune checkpoint inhibitor and radiation therapy—特集 がん免疫療法の展望 : 免疫チェックポイント阻害薬の併用療法に中心に ; 免疫チェックポイント阻害薬の併用療法のエビデンス

  安田 耕一, 志藤 元泰, 小泉 富基, 高橋 周平, 藤田 祥博, 大塚 愛美, 宮﨑 智彦, 西川 昇, 打浪 雄介, 森 崇, 西岡 健太郎, 木下 留美子, 田口 大志, 加藤 徳雄, 橋本 孝之, 青山 英史 腫瘍内科 = Clinical oncology / 腫瘍内科編集委員会 編 30 (1) 23 -28 2022年07月
• 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(Web) 58 (2) 2021年
• 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年
• 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年
• 膵癌に対するS-1併用術前化学放射線療法(S-1併用NACRT)の治療成績

  小泉富基, 加藤徳雄, 中村透, 川本泰之, 田口大志, 打浪雄介, 清水伸一, 青山英史 日本医学放射線学会秋季臨床大会抄録集 56th 2020年
• 局所進行食道癌に対してspot scanning法による根治的化学陽子線療法を施行した一例

  宮崎 智彦, 打浪 雄介, 田口 大志, 加藤 徳雄, 清水 伸一, 白土 博樹, 中積 宏之, 中野 真太郎, 坂本 直哉, 高尾 聖心, 田村 昌也, 松浦 妙子 日本医学放射線学会秋季臨床大会抄録集 55回 S520 -S520 2019年09月 [査読無し][通常論文]
  
• A retrospective analysis of neoadjuvant chemotherapy followed by surgery or definitive chemoradiotherapy in patients with advanced esophageal squamous cell carcinoma.

  Hiroshi Nakatsumi, Yoshito Komatsu, Shintaro Nakano, Kentaro Sawada, Tetsuhito Muranaka, Yasuyuki Kawamoto, Satoshi Yuki, Yusuke Uchinami, Hiroshi Taguchi, Hiroki Shirato, Yuma Ebihara, Toshiaki Shichinohe, Satoshi Hirano, Naoya Sakamoto JOURNAL OF CLINICAL ONCOLOGY 37 (4) 2019年02月
• CVポートの留置後合併症 アプローチ部位別の比較検討

  加藤 大祐, 山口 晃典, 高橋 文也, 田口 大志, 宮本 憲幸 Japanese Journal of Radiology 36 (Suppl.) 8 -8 2018年02月 [査読無し][通常論文]
  
• 微細な側副路を介し描出される動脈性腹腔内出血に対しWedge下NBCA圧入によるTAEで止血を得た1例

  高橋 文也, 加藤 大祐, 山口 晃典, 田口 大志, 宮本 憲幸, 松本 隆祐 IVR: Interventional Radiology 32 (4) 323 -323 2018年01月 [査読無し][通常論文]
  
• von Recklinghausen病に合併した腰動脈破綻に対してTAEを施行した1例

  加藤 大祐, 山口 晃典, 高橋 文也, 田口 大志, 宮本 憲幸, 丹羽 弘貴 IVR: Interventional Radiology 32 (4) 323 -323 2018年01月 [査読無し][通常論文]
  
• 肝外側区下面のHCCに対してhydrodissection CT透視下RFAを施行した1例

  宮本 憲幸, 加藤 大祐, 山口 晃典, 高橋 文也, 田口 大志 IVR: Interventional Radiology 32 (4) 324 -324 2018年01月 [査読無し][通常論文]
  
• 門脈に接するHCCに対して門脈バルーン閉塞下RFAを施行した2例

  加藤 大祐, 山口 晃典, 高橋 文也, 田口 大志, 宮本 憲幸 IVR: Interventional Radiology 32 (4) 324 -324 2018年01月 [査読無し][通常論文]
  
• 体位変換、息こらえ法による鎖骨下静脈径の変化

  加藤 大祐, 山口 晃典, 高橋 文也, 田口 大志, 宮本 憲幸 IVR: Interventional Radiology 32 (4) 326 -326 2018年01月 [査読無し][通常論文]
  
• 多量腹水合併悪性胆道狭窄に対して一期的経皮経肝的金属ステント留置術を行い減黄が得られた1例

  高橋文也, 加藤大祐, 山口晃典, 田口大志, 宮本憲幸, 山田竜太郎, 服部理史, 森田亮 IVR 32 (4) 2018年
• HCCに対するLipTAI/TACE併用RFAのablative margin評価と局所制御

  宮本憲幸, 加藤大祐, 山口晃典, 高橋文也, 田口大志, 森田亮, 梶山政義 IVR 32 (4) 2018年
• 妊娠中に増大した孤発性結節性硬化症に伴う腎血管筋脂肪腫に対するTAEの1例

  山口 晃典, 加藤 大祐, 高橋 文也, 田口 大志, 宮本 憲幸, 山村 満恵, 小山 雅之 IVR: Interventional Radiology 32 (4) 323 -323 2018年01月 [査読無し][通常論文]
  
• 直腸癌に対する術前化学放射線療法の経験

  松井 博紀, 水上 達三, 大畑 多嘉宣, 高橋 徹, 橋本 卓, 阿部 厚憲, 田口 大志 北海道外科雑誌 62 (2) 179 -180 2017年12月 [査読無し][通常論文]
  
• 妊娠中に増大した孤発性結節性硬化症に伴う腎血管筋脂肪腫に対しTAEを繰り返した1例

  中村 友亮, 木野田 直也, 川畑 久美子, 高橋 文也, 田口 大志, 宮本 憲幸, 山村 満恵, 小山 雅之, 山口 晃典, 加藤 大祐 日本医学放射線学会秋季臨床大会抄録集 53回 S506 -S507 2017年08月 [査読無し][通常論文]
  
• 肝癌に対するBipolar RF systemの使用経験

  宮本憲幸, 加藤大祐, 志村亮祐, 田口大志, 佐藤幸彦, 森田亮 IVR 32 (1) 2017年
• 肝細胞癌RFA後急性増悪に関する因子の検討

  宮本憲幸, 加藤大祐, 志村亮祐, 田口大志, 佐藤幸彦, 森田亮, 梶山政義, 平松一秀 IVR 32 (1) 2017年
• 当院におけるRFA時のHydrodissection

  加藤大祐, 志村亮祐, 田口大志, 宮本憲幸, 佐藤幸彦, 森田亮, 梶山政義 IVR 32 (1) 2017年
• Stereotactic Body Radiation Therapy Using a Real-time Tumor-Tracking Radiation Therapy System for Hepatocellular Carcinomas

  Y. Uchinami, N. Katoh, D. Abo, K. Harada, T. Inoue, H. Taguchi, R. Onimaru, S. Shimizu, Y. Sakuhara, K. Ogawa, T. Kamiyama, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 96 (2) E155 -E155 2016年10月 [査読無し][通常論文]
  
• 多発肝動脈瘤を呈したSAMの1例

  森田亮, 佐藤幸彦, 梶山政義, 田口大志, 阿部敬 IVR 31 (2) 2016年
• 肝原発類上皮血管内皮腫に対してTACE/RFAを施行した1例

  山口晃典, 加藤大祐, 高橋文也, 田口大志, 宮本憲幸, 深谷進司, 菊地慶介, 森田亮 日本医学放射線学会秋季臨床大会抄録集 52nd 2016年
• 肝細胞癌のRFAにおけるHydrodissectionの手技成否因子

  加藤大祐, 志村亮祐, 山口晃典, 田口大志, 宮本憲幸, 森田亮, 梶山政義 日本医学放射線学会秋季臨床大会抄録集 52nd 2016年
• 気管支動脈瘤蔓状血管腫破裂に対しTAEが著効した1例

  森田亮, 佐藤幸彦, 梶山政義, 田口大志, 吉田司, 矢部勇人, 横尾慶紀 IVR 31 (2) 2016年
• 肝静脈短絡を有する仮性肝動脈瘤に対して塞栓術を行った1例

  佐藤幸彦, 森田亮, 梶山政義, 田口大志 Japanese Journal of Radiology 34 (Supplement) 2016年
• 眼窩転移をきたした浸潤性小葉癌の1例

  松澤 文彦, 阿部 厚憲, 濱口 純, 鈴木 崇史, 永生 高広, 近藤 信夫, 堀江 幸弘, 玉川 光春, 田口 大志, 及能 健一 乳癌の臨床 30 (2) 133 -139 2015年04月 [査読無し][通常論文]
   

  乳癌眼窩転移の頻度は0.04%とまれである。乳癌術後6年で眼窩転移をきたした浸潤性小葉癌の1例を経験した。症例は56歳の女性で、左乳癌に対し乳房切除術および腋窩リンパ節郭清術を施行された。病理組織学的診断ではinvasive lobular carcinoma、pT2、pN2a(level I:9/12、level II:1/1)、pM0、pStage IIIA、ER(+)、PgR(+)、HER2(-)であった。術後エピルビシン(100mg/m2)+シクロフォスファミド(600mg/m2)療法、ドセタキセル(60mg/m2)療法を行い、続いてアナストロゾールの内服を開始した。患者の希望により5年経過後も内服を継続中であったが術後5年9ヵ月の時点で左眼瞼腫脹を認め、頭部MRIで左眼窩に異常陰影を認めた。眼窩部の生検で異形細胞の増殖を認め、上皮性マーカーのAE1/AE3の免疫染色より乳癌眼窩転移の診断に至った。5-FU(500mg/m2)+エピルビシン(100mg/m2)+シクロフォスファミド(500mg/m2)療法および左眼窩への放射線照射(30Gy/10回/2週間)を行い眼部症状は改善傾向であったが、化学療法開始後1年で腹膜転移による汎発性腹膜炎を発症し手術加療を要した。経過は良好で術後26目に退院となったが、眼窩転移後2年で癌性腹膜炎により死亡した。死亡までの期間で眼部症状の増悪を認めなかった。(著者抄録)
• 肝内門脈静脈短絡に対し塞栓術を施行した1例

  森田亮, 佐藤幸彦, 梶山政義, 田口大志, 高瀬崇宏, 林学 IVR 30 (3) 2015年
• 帯広厚生病院における喉頭癌治療の検討

  吉岡 巌, 小柴 茂, 松宮 弘, 田口 大志 日本農村医学会雑誌 63 (1) 9 -18 2014年05月 [査読無し][通常論文]
   

  喉頭癌は頭頸部癌の中でも頻度が高い疾患であり,当院のような地方病院においては診断から治療を最後まで行なうことが多い悪性疾患である。2000年1月より2010年4月までに,1次治療をした喉頭癌121例を対象とした。治療成績では疾患特異的5年生存率は,病期別にstageI:100%,stageII:81.8%,stageIII:100%,stageIVa:72.5%であった。stageIIIは生存率が高い一方,喉頭温存率が低かった。治療成績を評価するとともに,今後の機能温存を考えた治療について検討した。(著者抄録)
• 北海道大学病院における上咽頭癌の治療 10年間(2000〜2010)のまとめ

  土屋 和彦, 安田 耕一, 西川 由記子, 木下 留美子, 鬼丸 力也, 原田 慶一, 井上 哲也, 加藤 徳雄, 清水 伸一, 白土 博樹, 西岡 健, 鈴木 恵士郎, 田口 大志, 長谷川 雅一, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 福田 諭, 竹内 啓, 田口 純 耳鼻咽喉科展望 56 (補冊2) 174 -175 2013年05月 [査読無し][通常論文]
  
• 肝臓への放射線治療用病変識別マーカー留置

  作原 祐介, 阿保 大介, 加藤 徳雄, 田口 大志, 曽山 武士, 白土 博樹 日本医学放射線学会学術集会抄録集 72回 S310 -S310 2013年02月 [査読無し][通常論文]
  
• 北海道大学病院における乳房温存療法の治療成績

  木下 留美子, 清水 伸一, 西岡 健太郎, 原田 慶一, 小野寺 俊輔, 田口 大志, 細田 充主, 田口 和典, 高橋 弘昌, 白土 博樹 日本医学放射線学会学術集会抄録集 71回 S318 -S318 2012年02月 [査読無し][通常論文]
  
• Pattern of ipsilateral breast tumor recurrence after breast conservation therapy

  R. Kinoshita, S. Shimizu, K. Tsuchiya, N. Kato, H. Shirato, H. Taguchi, M. Takahashi, H. Takahashi Japanese Journal of Clinical Radiology 56 (13) 1813 -1818 2011年12月10日 [査読無し][通常論文]
   

  Between 1988 and 2008, 489 patients received breast conservation therapy at Hokkaido University. Among them, we identified and analyzed 20 ipsilateral breast tumor recurrences.75% of recurrence was occurred in the same quadrant of the primary tumor. Twelve patients received mastectomy, seven patients received local tumor excision.17 of 20 patients are alive without disease. Salvage breast-conserving therapy may be feasible for certain condition.
• 乳房温存療法後局所再発症例の検討

  木下 留美子, 清水 伸一, 土屋 和彦, 加藤 徳雄, 田口 大志, 高橋 將人, 高橋 弘昌, 白土 博樹 臨床放射線 56 (13) 1813 -1818 2011年12月 [査読無し][通常論文]
   

  乳房温存術および温存乳房に対する術後放射線治療を施行した489例のうち、局所再発を認めた20例(中央値46歳)について報告した。手術は乳房扇状部分切除9例、乳房円状部分切除11例、リンパ節郭清17例で、化学療法を7例に、術後ホルモン療法を5例に行った。照射線量は45Gy/18frが10例、50Gy/20frが10例であった。病理学的分類はStage 0が6例、IAが8例、IIAが4例、IIBが1例、化学療法後のStage yIIAが1例であった。局所再発までの期間は8〜180ヵ月(中央値40ヵ月)で、15例は初発時と同一領域、5例は異なる領域に認め、照射野内18例、照射野辺縁2例であった。再発に対する治療は12例で乳房切除術を施行し、うち1例は手術前後に化学療法を行った。7例は腫瘤切除を行い、うち5例は術後放射線照射を行った。手術を拒否した1例でホルモン療法を行った。再発後最長193ヵ月の経過観察で、無病生存が17例、担癌生存3例であった。
• 乳房温存術後放射線治療中および直後に発症する肺障害についての検討

  淡河 恵津世, 中村 和正, 山内 智香子, 白石 憲史郎, 楠原 和朗, 小堀 賢一, 青木 昌彦, 田口 大志, 佐々木 智成 日本医学放射線学会学術集会抄録集 70回 S213 -S213 2011年02月 [査読無し][通常論文]
  
• 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年 [査読無し][通常論文]
  
• 【胸部の最新画像情報2011】 乳房温存術後放射線治療中および直後における肺障害についての検討

  淡河 恵津世, 中村 和正, 楠原 和朗, 小堀 賢一, 青木 昌彦, 田口 大志, 佐々木 智成, 黒田 覚, 藤井 収, 松本 陽, 山内 智香子, 早渕 尚文 臨床放射線 56 (1) 113 -120 2011年01月 [査読無し][通常論文]
   

  2004年1月〜2008年8月の5年間に乳癌診療ガイドラインに準じ、乳房温存術後の放射線治療が行われた早期乳癌患者を対象に放射線治療中〜治療後3ヵ月以内に肺炎(間質性肺炎)を起こした症例を把握するために全国の主要な放射線治療施設598施設にアンケート調査を郵送した。234施設(39%)から回答が得られた。598施設には放射線治療施設完備が不十分な施設も含まれていたため、放射線腫瘍学会認定・準認定協力施設合計が259施設であることを考慮すると約90%の回答となった。5年間の早期乳房温存術後放射線施行症例数は49016例で、放射線治療中〜治療後3ヵ月以内の発症は21例(約0.04%)であった。21例について更に検証すると、放射線治療中の発症が5例(24%)、照射直後から照射後3ヵ月以内の発症が16例(76%)であった。後者の発症時期は照射直後3例、照射終了後1週間1例、照射終了1〜3ヵ月12例であった。
• 乳房温存療法後局所再発症例の検討

  木下 留美子, 清水 伸一, 土屋 和彦, 加藤 徳雄, 田口 大志, 高橋 将人, 高橋 弘昌, 白土 博樹 日本医学放射線学会秋季臨床大会抄録集 46回 S506 -S506 2010年08月 [査読無し][通常論文]
  
• 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 Japanese Journal of Radiology 28 (Suppl.I) 7 -7 2010年07月 [査読無し][通常論文]
  
• 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年07月 [査読無し][通常論文]
  
• Oligometastases症例に対する定位放射線治療の有用性についての検討

  井上 哲也, 加藤 徳雄, 青山 英史, 鬼丸 力也, 石川 正純, 田口 大志, 白土 博樹 日本医学放射線学会学術集会抄録集 69回 S193 -S194 2010年02月 [査読無し][通常論文]
  
• 乳房温存術後放射線治療中および直後における肺障害についての検討

  淡河 恵津世, 中村 和正, 楠原 和朗, 小堀 賢一, 青木 昌彦, 田口 大志, 佐々木 智成, 黒田 覚, 藤井 収, 早渕 尚文 日本医学放射線学会学術集会抄録集 69回 S229 -S230 2010年02月 [査読無し][通常論文]
  
• 0805 頭頸部リンパ節腫瘍の放射線治療効果予測におけるパラメータ同定(GS16-2:診断・治療2)

  高尾 聖心, 但野 茂, 田口 大志, 白土 博樹 バイオエンジニアリング講演会講演論文集 2009 (22) 129 -129 2010年01月08日
• 1P1-C07 頭頸部リンパ節腫瘍における放射線治療シミュレーション

  高尾 聖心, 但野 茂, 田口 大志, 白土 博樹 ロボティクス・メカトロニクス講演会講演概要集 2010 "1P1 -C07(1)"-"1P1-C07(2)" 2010年 

  The importance of accurate prediction of the radiotherapeutic effect has increased recently with developing the irradiation techniques. The authors have proposed a novel computational method to simulate changes in tumor volume during the treatment. In this work, the method was applied to six clinical cases of metastatic cervical lymph nodes to examine the feasibility of clinical application of this method. The volume change in tumor shrinkage during treatment was formulated mathematically using analogical equations of an elastic deformation in solid mechanics. The values of simulation parameters were determined for each case so that calculated tumor volume change could be obeyed actual tumor volume change through the treatment. The average difference between the calculated and measured volumes for the six cases was 9.9%. The simulation method was able to represent various patterns of decreases in tumor volume in the cases of metastatic cervical lymph nodes.
• Conventionally Fractionated Stereotactic Radiotherapy for Vestibular Schwannoma: A Single Institutional Long-term Outcomes

  H. Aoyama, N. Takeichi, S. Onodera, H. Taguchi, Y. Sawamura, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 78 (3) S8 -S9 2010年 [査読無し][通常論文]
  
• Computational Simulation of Three-dimensional Tumor Geometry during Radiotherapy

  Seishin Takao, S. Tadano, H. Taguchi, H. Shirato IFMBE Proceedings 23 2083 -2087 2009年12月01日 [査読無し][通常論文]
   

  In Radiotherapy, shapes of tumors are important information to determine irradiation area and energy. In this study a simulation method is proposed to calculate changes of tumor geometry during radiotherapy. Relationships between tumor geometry and the amount of radiation energy were estimated from fundamental equations in solid mechanics as a mechanical analogy. Parameters between the radiotherapeutic effect and the geometric factor were defined as reduction resistance and reduction ratio. The values of these parameters were initially determined based on a widely-used radiobiological model (Linear-Quadratic model) and then revised by comparing with the change of actual tumor shape. To simulate uneven tumor shrinkage, the values of reduction resistance were varied depending on the tumor heterogeneity. Finite element models of tumors were constructed from CT images taken before the start of radiotherapy. For precise assessment of therapeutic effect, it would be useful to examine tumor morphological features. Three-dimensional (3D) tumor shape was represented in twodimensional (2D) map like a global map. Distances from origin (center of gravity of the tumor) to surface were visually indicated by colors in this map. Tumor volumes were indicated by sizes of the maps. Tumors in head and neck were analyzed in this study. Simulation results of tumor geometries were compared with actual tumor geometries and found to have similar tendencies. The 2D color maps enabled to evaluate the 3D morphological features of the tumors. Therefore this study provides the methodology to evaluate changes of 3D tumor geometry during radiotherapy. © 2009 International Federation of Medical and Biological Engineering.
• Computer simulation of radiotherapy for malignant tumor - A mechanical analogy method

  Seishin Takao, Shigeru Tadano, Hiroshi Taguchi, Hiroki Shirato Journal of Biomechanical Science and Engineering 4 (4) 576 -588 2009年12月01日 [査読無し][通常論文]
   

  A new simulation method was developed that considered a tumor as a solid body and therapeutic response as deformation of the tumor using mechanical analogy. As radiation exposure to the tumor was related to the external force to the solid body, the geometrical change of the tumor could be estimated from fundamental equations in solid mechanics. A change in tumor volume was calculated using finite element (FE) method. The FE models were constructed from CT images of patients before the radiotherapy. The initial radiotherapeutic parameters of tumor radioresistance and repopulation rate were determined based on a linear-quadratic model and then revised by the comparison with actual tumor volume change. Three patients with uterine cervix carcinoma were applied in this method. Simulation results well showed tendencies of tumor volume changes with radiotherapy. In addition, this method could provide the appropriate value of radiotherapeutic parameters for individual case. In conclusion, our approach could calculate three-dimensional tumor deformation during the course of radiotherapy and will provide useful information for more effective treatment.
• 乳房温存手術後接線照射における被照射腋窩リンパ節領域の検討

  田口 大志, 清水 伸一, 木下 留美子, 白土 博樹, 高橋 弘昌, 高橋 將人, 細田 充主, 藤堂 省 北海道外科雑誌 54 (2) 188 -188 2009年12月 [査読無し][通常論文]
  
• 【放射線治療の現在】 臨床 動体追跡放射線治療10年の経験

  加藤 徳雄, 鬼丸 力也, 田口 大志, 清水 伸一, 白土 博樹 映像情報Medical 41 (12) 1222 -1227 2009年11月 [査読無し][通常論文]
  
• Analysis of three-dimensional characteristics in tumor morphology

  Seishin Takao, Shigeru Tadano, Hiroshi Taguchi, Hiroki Shirato Journal of Biomechanical Science and Engineering 4 (2) 221 -229 2009年09月07日 [査読無し][通常論文]
   

  Precise assessment of therapeutic response in radiotherapy has been an important issue in the field of radiation oncology. This study proposed a methodology to evaluate therapeutic response based on tumor geometries. Three-dimensional (3D) tumor shapes were obtained from follow-up CT scans taken once a week throughout the treatment period. Tumor geometries were represented in two-dimensional (2D) surface geometry maps. These maps indicated the distances from the tumor center to surface at each azimuthal and horizontal angle by colors, in order to represent the characteristics of tumor morphologies. This method was applied to three clinical cases of head and neck cancer. The changes of tumor geometries could be represented visually and quantitatively using surface geometry maps. These maps provided valuable information about tumors for accurate diagnosis of tumor response to radiotherapy. Copyright © 2009 by The Japan Society of Mechanical Engineers.
• 当院における病院間連携による放射線治療業務

  小笠原弘, 大浦大輔, 水野淨司, 鬼丸力也, 田口大志, 長谷川雅一 日本放射線腫よう学会誌 21 (Supplement 1) 249 2009年08月19日 [査読無し][通常論文]
  
• Oligometastases症例に対する定位放射線治療の有用性についての検討

  井上哲也, 加藤徳雄, 青山英史, 鬼丸力也, 石川正純, 田口大志, 白土博樹 日本放射線腫よう学会誌 21 (Supplement 1) 159 2009年08月19日 [査読無し][通常論文]
  
• 【肝細胞癌の治療2009〜2011】 肝細胞癌の治療法 放射線療法

  田口 大志, 白土 博樹 コンセンサス癌治療 8 (3) 160 -163 2009年08月 [査読無し][通常論文]
  
• 力学アナロジーに基づく放射線治療中の腫瘍形状変化シミュレーション

  高尾 聖心, 但野 茂, 田口 大志, 白土 博樹 生体医工学 47 (3) 323 -323 2009年06月 [査読無し][通常論文]
  
• 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, 折舘 伸彦, 福田 諭, 白土 博樹 頭頸部癌 35 (2) 93 -93 2009年05月 [査読無し][通常論文]
  
• 放射線治療におけるFDG‐PETでのSUVと正確な標的体積設定への影響因子

  藤野賢治, 田口大志, 加藤徳雄, 木下留美子, 鬼丸力也, 長谷川雅一, 溝口史樹, 青山英史, 白土博樹, 志賀哲, 玉木長良, 加藤千恵次, 梶智人 Radiat Med 27 (Supplement 1) 6 2009年04月25日 [査読無し][通常論文]
  
• 放射線治療におけるFDG-PETでのSUVと正確な標的体積設定への影響因子

  藤野 賢治, 田口 大志, 加藤 徳雄, 木下 留美子, 鬼丸 力也, 長谷川 雅一, 溝口 史樹, 青山 英史, 白土 博樹, 志賀 哲, 玉木 長良, 加藤 千恵次, 梶 智人 Japanese Journal of Radiology 27 (Suppl.) 6 -6 2009年04月 [査読無し][通常論文]
  
• CT透視下経気管支生検にて診断した末梢小型肺癌に対し、動体追跡放射線照射で治療した症例の検討

  竹内 裕, 品川 尚文, 大泉 聡史, 西村 正治, 田口 大志, 鬼丸 力也, 小野寺 祐也, 白土 博樹 肺癌 49 (1) 126 -126 2009年02月 [査読無し][通常論文]
  
• 117 腫瘍の三次元表面形状マッピング(GS1:診断・治療のバイオメカニクス)

  高尾 聖心, 但野 茂, 田口 大志, 白土 博樹 バイオエンジニアリング講演会講演論文集 2008 (21) 33 -34 2009年01月22日
• CT透視下経気管支生検にて診断した末梢小型肺癌に対し、動体追跡放射線照射で治療した症例の検討

  竹内 裕, 品川 尚文, 伊藤 健一郎, 水柿 秀紀, 山田 範幸, 菊地 英毅, 菊地 順子, 小西 純, 田口 大志, 鬼丸 力也, 小野寺 祐也, 白土 博樹, 大泉 聡史, 西村 正治 肺癌 48 (5) 612 -612 2008年10月 [査読無し][通常論文]
  
• A318 放射線治療による腫瘍形状変化のシミュレーション(生体のモデリング・シミュレーション)

  高尾 聖心, 但野 茂, 田口 大志, 白土 博樹 バイオフロンティア講演会講演論文集 2008 (19) 115 -116 2008年09月22日
• 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年09月 [査読無し][通常論文]
  
• 【肝がん撲滅へ向けて】 肝がんの診断・治療の現状と最近の進歩 肝がんに対する放射線治療

  田口 大志, 中馬 誠, 白土 博樹 綜合臨床 57 (6) 1765 -1772 2008年06月 [査読無し][通常論文]
   

  肝細胞癌に対する放射線治療は従来、転移病巣に対する姑息照射として用いられていたが、最近では他modalityで制御困難な部位に対して集学的治療の一環として組み入れられることが多くなってきた。さらに、3次元原体照射や定位照射に代表される照射技術の進歩により、非腫瘍部肝組織への線量を低減させることが可能となり、根治的意図を持った治療も可能となってきている。肝細胞癌に対する放射線治療は主として外照射療法であり、本稿は外照射療法を念頭に置いたものである。以下に上記役割を踏まえ、当科での治療経験も含め外照射療法に関して記述する。(著者抄録)
• 極細径気管支鏡を用いたCT透視下経気管支生検にて診断し、動体追跡放射線照射で治療した末梢小型肺癌の検討

  竹内 裕, 品川 尚文, 伊藤 健一郎, 中野 浩輔, 水柿 秀紀, 山田 範幸, 朝比奈 肇, 菊地 英毅, 菊地 順子, 本村 文宏, 田口 大志, 鬼丸 力也, 白土 博樹, 大泉 聡史, 山崎 浩一, 西村 正治 気管支学 30 (Suppl.) S157 -S157 2008年05月 [査読無し][通常論文]
  
• 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, 白土 博樹, 宮坂 和男 Radiation Medicine 26 (Suppl.I) 3 -3 2008年04月 [査読無し][通常論文]
  
• 治療(非小細胞肺癌) 画像誘導放射線治療と強度変調放射線治療

  白土 博樹, 鬼丸 力也, 石川 正純, 田口 大志, 加藤 徳雄, 清水 伸一 MOOK肺癌の臨床 2008-2009 319 -326 2008年03月 [査読無し][通常論文]
  
• 定位放射線治療による予後改善に関する研究 T2N0M0非小細胞肺癌の体幹部放射線治療の線量増加試験に関する研究

  白土博樹, 鬼丸力也, 田口大志, 加藤徳雄, 石川正純 定位放射線治療による予後改善に関する研究 平成19年度 総括研究報告書 9-10 2008年 [査読無し][通常論文]
  
• 【肝胆膵の癌に対する放射線療法】 高度脈管腫瘍栓を伴う進行肝癌に対する動体追跡照射併用肝動注療法の有用性

  中馬 誠, 白土 博樹, 田口 大志, 山本 義也, 荘 拓也, 山本 桂子, 夏井坂 光輝, 山本 洋一, 中西 満, 髭 修平, 浅香 正博 胆と膵 28 (臨増特大) 735 -739 2007年10月 [査読無し][通常論文]
   

  高度進行肝癌に対してIFN併用肝動注療法の有用性が報告されているが、予後はいまだ厳しい。腫瘍の位置をリアルタイムに把握し、これに合わせた放射線照射法;動体追跡照射療法が開発され、他臓器癌で照射野の縮小と治療の改善効果が得られている。今回われわれは、高度脈管腫瘍栓に対して動体追跡照射を行うことで、経門脈的肝内転移、経静脈的肺転移の抑制と肝予備能の改善により予後の向上が望めると考え、門脈および肝静脈腫瘍塞栓を伴う高度進行肝癌に対して動体追跡照射療法、IFN併用肝動注療法の有用性を検討したので報告する。(著者抄録)
• 【Image-guided Radiotherapy-現状と将来】 画像誘導放射線治療と強度変調放射線治療

  鬼丸 力也, 藤野 賢治, 加藤 徳雄, 田口 大志, 木下 留美子, 芹澤 慈子, 井上 哲也, 長谷川 雅一, 青山 英史, 大坂 康博, 白土 博樹 臨床放射線 52 (8) 961 -966 2007年08月 [査読無し][通常論文]
  
• 当院におけるMU値検証システムについて

  鈴木 恵士郎, 白土 博樹, 青山 英史, 鬼丸 力也, 加藤 徳雄, 田口 大志, 藤野 賢治, 吉田 有里, 宮坂 和男, 熊谷 まなみ, 藤田 勝久 Radiation Medicine 25 (Suppl.I) 8 -8 2007年04月 [査読無し][通常論文]
  
• 頭頸部癌のDOC併用放射線療法 副作用軽減を目的としたステロイド使用について

  小野寺 俊輔, 木下 留美子, 藤野 賢治, 加藤 徳雄, 田口 大志, 鬼丸 力也, 大阪 康博, 清水 伸一, 鈴木 恵士郎, 西岡 健, 白土 博樹 Radiation Medicine 25 (Suppl.I) 15 -15 2007年04月 [査読無し][通常論文]
  
• 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年02月 [査読無し][通常論文]
  
• 動体追跡装置を用いた前立腺癌の放射線治療のPSA再発及び副作用発生率

  大坂 康博, 青山 英史, 田口 大志, 加藤 徳雄, 木下 留美子, 藤野 賢治, 鬼丸 力也, 鈴木 恵士郎, 白土 博樹 日本医学放射線学会学術集会抄録集 66回 S247 -S247 2007年02月 [査読無し][通常論文]
  
• 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年 [査読無し][通常論文]
  
• 【胸部の最新画像情報2007】 CT FDG-PET fusion imageの肺癌放射線治療計画への利用

  藤野 賢治, 田口 大志, 加藤 徳雄, 青山 英史, 鈴木 恵士郎, 鬼丸 力也, 木下 留美子, 安田 耕一, 白土 博樹, 加藤 知恵次, 志賀 哲, 玉木 長良, 小野寺 俊輔 臨床放射線 52 (1) 137 -144 2007年 [査読無し][通常論文]
   

  肺癌の放射線治療計画にFDG-PETを用いstandardized uptake value(SUV)の数値で腫瘍の局在範囲を決定できるようにするための基礎的研究として、現在一般に行われているCT-planningと比較して劣らずにgross tumor volumeを設定できるか否かをファントム実験で検討した。結果、息止め下でのFDG-PET施行は、肺のように体内で呼吸性移動する臓器の癌においてSUVを真の値に近づけるうえでCT-planningより優れている可能性が示唆された。
• Intercepting irradiation for abdominal organ tumor using real time tracking radiation therapy (RTRT) system

  Rikiya Onimaru, H. Taguchi, N. Katoh, Y. Sakuhara, D. Abo, H. Shirato, K. Miyasaka Japanese Journal of Clinical Radiology 51 1165 -1170 2006年11月14日 [査読無し][通常論文]
   

  We have developed real time tracking radiation therapy (RTRT) system and treated hepatocellular carcinoma (HCC) and metastatic adrenal gland tumor using RTRT system. We reported our initial experience. Although results seem to be promising, clinical trial is needed to confirm our results.
• 手術不能Stage I非小細胞肺癌に対する動体追跡照射のマージンと効果の探索的検討

  鬼丸力也, 白土博樹, 藤野賢治, 田口大志, 加藤徳雄, 木下留美子, 鈴木恵士郎, 青山英史, 宮坂和男 日本放射線腫よう学会誌 18 (Supplement 1) 217 2006年10月25日 [査読無し][通常論文]
  
• プラスチックシンチレーションファイバー検出器の応答特性に関する基礎的検討

  笈田将皇, 石川正純, 藤野賢治, 加藤徳雄, 田口大志, 白土博樹, 渡辺良晴 日本放射線腫よう学会誌 18 (Supplement 1) 199 2006年10月25日 [査読無し][通常論文]
  
• 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年10月25日 [査読無し][通常論文]
  
• 【体幹部定位放射線治療】 動体追跡照射装置を用いた腹部臓器への迎撃照射

  鬼丸 力也, 田口 大志, 加藤 徳雄, 作原 祐介, 阿保 大介, 白土 博樹, 宮坂 和男 臨床放射線 51 (10) 1165 -1170 2006年10月 [査読無し][通常論文]
  
• 放射線照射中における解剖学的変化について 腫瘍体積,正常組織体積の解析

  木下 留美子, 土屋 和彦, 田口 大志, 鈴木 恵士郎, 西岡 健, 白土 博樹, 大森 桂一 頭頸部癌 32 (2) 200 -200 2006年05月 [査読無し][通常論文]
  
• 前立腺癌における動体追跡装置を用いた尿道線量低減強度変調放射線治療の検討

  大坂 康博, 青山 英史, 田口 大志, 加藤 徳雄, 木下 留美子, 藤野 賢治, 鬼丸 力也, 鈴木 恵士郎, 白土 博樹, 宮坂 和男 日本医学放射線学会学術集会抄録集 65回 S211 -S211 2006年02月 [査読無し][通常論文]
  
• Prediction of four-dimensional (4D) tumor response using finite element method (FEM) and radiobiological model for adaptive radiotherapy

  H. Taguchi, S. Takao, Y. Kogure, H. Shirato, S. Tadano, K. Suzuki, R. Onimaru, N. Katoh, R. Kinoshita INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 66 (3) S596 -S596 2006年 [査読無し][通常論文]
  
• 甲状腺未分化癌の放射線およびドセタキセル治療

  高田 尚幸, 古井 秀典, 大野 正博, 田口 大志, 青山 英史, 中駄 邦博, 高橋 弘昌 北海道医学雑誌 80 (6) 619 -619 2005年11月 [査読無し][通常論文]
  
• 放射線治療効果の向上を目指した新手法開発とその臨床応用 動体追跡照射装置を用いた放射線治療

  鬼丸 力也, 白土 博樹, 藤野 賢治, 田口 大志, 加藤 徳雄, 大坂 康博, 清水 伸一, 青山 英史, 鈴木 恵士郎 日本放射線影響学会大会講演要旨集 48回 75 -75 2005年11月 [査読無し][通常論文]
  
• 体幹部定位放射線治療 動体追跡照射装置を用いた迎撃照射

  鬼丸 力也, 藤野 賢治, 田口 大志, 加藤 徳雄, 木下 留美子, 鈴木 恵士郎, 青山 英史, 白土 博樹 日本放射線腫瘍学会誌 17 (Suppl.1) 61 -61 2005年10月 [査読無し][通常論文]
  
• 粒子線,IMRTのあたらしい放射線治療 高精度光子線治療の現状と将来

  白土 博樹, 大坂 康博, 篠原 信雄, 鬼丸 力也, 鈴木 恵士郎, 加藤 紀雄, 山崎 浩一, 藤野 賢治, 木下 留美子, 田口 大志 日本癌治療学会誌 40 (2) 208 -208 2005年09月 [査読無し][通常論文]
  
• 放射線治療の新展開 バイオ・メカニカルデザインを取り入れた放射線治療計画

  白土 博樹, 但野 茂, 高野 聖心, 田口 大志, 鬼丸 力也, 鈴木 恵士郎 日本癌学会総会記事 64回 319 -319 2005年09月 [査読無し][通常論文]
  
• 肺腫瘍の胸部単純写真での存在部位から推定する通常の放射線治療でのinternal margin

  鬼丸 力也, 藤野 賢治, 白土 博樹, 鈴木 恵士郎, 田口 大志, 加藤 徳雄, 木下 留美子, 宮坂 和男 日本医学放射線学会学術集会抄録集 64回 S344 -S344 2005年02月 [査読無し][通常論文]
  
• 動態追跡照射による非切除肝細胞癌の治療成績

  田口 大志, 内田 大地, 鬼丸 力也, 大阪 康博, 喜多村 圭, 白土 博樹, 宮坂 和男 日本医学放射線学会学術集会抄録集 64回 S228 -S228 2005年02月 [査読無し][通常論文]
  
• Feasibility study of real-time tumor-tracking radiotherapy (RTRT) for highly-selected patients with hepatocellular carcinoma (HCC) untreatable with other modalities

  H Taguchi, Y Osaka, K Kitamura, D Abo, A Sawada, S Hige, T Kamiyama, T Shimizu, H Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 63 (2) S160 -S160 2005年 [査読無し][通常論文]
  
• Long-term outcome of fractionated small-field irradiation (FSR) for vestibular schwannoma in patients followed for more than five years

  N Katoh, T Sakamoto, H Aoyama, W Sakai, H Taguchi, K Suzuki, K Tsuchiya, S Fukuda, H Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 63 (2) S264 -S265 2005年 [査読無し][通常論文]
  
• 胸部食道癌I期症例の検討

  高木 克, 西尾 正道, 明神 美弥子, 西山 典明, 田口 大志 北海道外科雑誌 49 (2) 216 -216 2004年12月 [査読無し][通常論文]
  
• 前立腺癌の動体追跡装置を用いた尿道線量低減強度変調放射線治療

  大坂 康博, 青山 英史, 鬼丸 力也, 田口 大志, 木下 留美子, 加藤 徳雄, 鈴木 恵士郎, 白土 博樹, 宮坂 和男 日本放射線腫瘍学会誌 16 (Suppl.1) 91 -91 2004年10月 [査読無し][通常論文]
  
• 【放射線治療における事故防止と対策】 多忙な日常診療の中に潜むリスクとその対策

  西尾 正道, 明神 美弥子, 西山 典明, 田口 大志, 高木 克 臨床放射線 49 (9) 1093 -1099 2004年09月 [査読無し][通常論文]
  
• 再発乳癌に対する私の治療方針 乳癌術後再発における放射線治療の役割 局所領域再発と鎖骨上リンパ節単独再発の比較

  明神 美弥子, 西尾 正道, 西山 典明, 田口 大志, 田村 元, 荻田 征美 日本乳癌学会総会プログラム抄録集 12回 132 -132 2004年06月 [査読無し][通常論文]
  
• T2N0声門癌の治療成績

  高木 克, 西尾 正道, 明神 美弥子, 西山 典明, 田口 大志, 田中 克彦, 中村 成弘, 川原 弘匡 頭頸部腫瘍 30 (2) 203 -203 2004年05月 [査読無し][通常論文]
  
• 【頭頸部腫瘍の放射線治療がわかる】 放射線照射方法とその治療 Chemoradiation

  明神 美弥子, 西山 典明, 田口 大志, 高木 克, 西尾 正道, 田中 克彦 JOHNS 20 (2) 195 -200 2004年02月 [査読無し][通常論文]
  
• 胸部食道癌I期症例の検討

  高木 克, 西尾 正道, 明神 美弥子, 西山 典明, 田口 大志 日本医学放射線学会雑誌 64 (2) S210 -S210 2004年02月 [査読無し][通常論文]
  
• 子宮頸癌術後断端再発に対する放射線治療成績

  田口 大志, 西尾 正道, 明神 美弥子, 西山 典明, 高木 克 日本医学放射線学会雑誌 64 (2) S213 -S213 2004年02月 [査読無し][通常論文]
  
• 乳がん転移性脳腫瘍の治療選択

  明神 美弥子, 西尾 正道, 西山 典明, 田口 大志, 高木 克, 荻田 征美, 田村 元, 竹原 めぐみ 北海道外科雑誌 48 (2) 238 -238 2003年12月 [査読無し][通常論文]
  
• Neoadjuvant chemotherapyを併用した子宮頸癌III期症例の検討

  田口 大志, 西山 典明, 明神 美弥子, 西尾 正道 日本医学放射線学会雑誌 63 (9) 608 -608 2003年11月 [査読無し][通常論文]
  
• 事故防止と対策 多忙な日常診療の中に潜むリスクとその対策

  西尾 正道, 明神 美弥子, 西山 典明, 田口 大志, 高木 克 日本放射線腫瘍学会誌 15 (Suppl.1) 62 -62 2003年10月 [査読無し][通常論文]
  
• 下咽頭癌の放射線治療の変遷と結果

  明神 美弥子, 西尾 正道, 西山 典明, 田口 大志, 高木 克 日本放射線腫瘍学会誌 15 (Suppl.1) 97 -97 2003年10月 [査読無し][通常論文]
  
• 声門癌T2N0症例の放射線治療成績と今後

  高木 克, 西尾 正道, 明神 美弥子, 西山 典明, 田口 大志 日本放射線腫瘍学会誌 15 (Suppl.1) 126 -126 2003年10月 [査読無し][通常論文]
  
• 頭頸部・食道重複癌に対する治療法の検討

  田口 大志, 西尾 正道, 明神 美弥子, 西山 典明, 高木 克 日本放射線腫瘍学会誌 15 (Suppl.1) 125 -125 2003年10月 [査読無し][通常論文]
  
• 【食道癌治療 最近の話題】 食道表在癌の放射線治療

  西尾 正道, 明神 美弥子, 西山 典明, 田口 大志 臨床消化器内科 18 (11) 1499 -1506 2003年09月 [査読無し][通常論文]
   

  食道表在癌のevidenceは,レトロスペクティブな非実験的研究の報告が多く,手術治療とEMRと放射線治療の厳密な比較は困難である.しかしリンパ節転移の明らかでない症例は放射線治療の良い適応となる.原病生存率で比較すると,最近の報告ではリンパ節転移のない症例ではsm癌の遠隔成績は手術療法と放射線治療はほぼ同等である.今後の非切除治療では治癒しにくく,切除が必要な症例の選別が必要であり,そのためには正確な深達度診断とリンパ節転移や脈管侵襲の情報をもとにした治療法の検討が必要である.又,総合的な視点では重複癌への対応も重要な課題である
• 放射線治療を主体とした食道癌の非切除治療

  西尾 正道, 明神 美弥子, 西山 典明, 田口 大志, 高木 克 日本癌治療学会誌 38 (2) 269 -269 2003年09月 [査読無し][通常論文]
  
• 低線量率腔内照射による子宮頸部扁平上皮癌の治療成績

  田口 大志, 西尾 正道, 明神 美弥子, 西山 典明, 高木 克 日本癌治療学会誌 38 (2) 478 -478 2003年09月 [査読無し][通常論文]
  
• 子宮頸癌根治照射における低線量率腔内照射の線量率効果について 線源交換前後の症例検討

  田口 大志, 西尾 正道, 明神 美弥子, 西山 典明, 高木 克 日本放射線腫瘍学会誌 15 (3) 231 -232 2003年09月 [査読無し][通常論文]
  
• 多重がんの最近の知見と臨床 頭頸部多重癌の臨床(放射線科の立場より)

  西尾 正道, 明神 美弥子, 西山 典明, 田口 大志, 高木 克, 田中 克彦, 浅野 勝士 頭頸部腫瘍 29 (3) 515 -520 2003年09月 [査読無し][通常論文]
   

  放射線治療を行った頭頸部癌2144例のうち,多重癌は313例(男275例,女38例,平均62歳)であった.原発部位別多重癌率は口腔17.7%,上咽頭6.0%,中咽頭24.5%,下咽頭32.5%,喉頭20.4%,鼻・副鼻腔4.9%であった.治療中の他癌重複は52例,半年以内に発見が66例,一年以内が87例であった.多重癌の組み合わせは食道癌,頭頸部癌,肺癌,胃癌が高頻度で,特に上部消化管臓器同士の重複と,喉頭癌と肺癌の重複が多かった.多重癌発生部位は頭頸部375部位,他部が316部位であった.多重癌の84%に根治目的治療を行い,頭頸部癌の治療は70%が放射線治療主体で,うち原発巣の治療として23.2%に小線源治療を行った.小線源治療は舌癌が主で,中咽頭癌には198Au粒子を使用した.初発癌が頭頸部癌の多重癌233例の累積生存率は5年52%,10年30%,15年17%であったが,頭部癌が治癒状態で他癌・他病死例を打ち切りとした原病生存率は各々82%,78%,72%であった
• 多重がんの最近の知見と臨床 頭頸部多重癌の臨床 放射線科の立場より

  西尾 正道, 明神 美弥子, 西山 典明, 田口 大志, 田中 克彦, 浅野 勝士 頭頸部腫瘍 29 (2) 290 -290 2003年05月 [査読無し][通常論文]
  
• T3・T4-N0喉頭癌の治療成績

  西山 典明, 西尾 正道, 明神 美弥子, 田口 大志, 田中 克彦, 浅野 勝士 頭頸部腫瘍 29 (2) 332 -332 2003年05月 [査読無し][通常論文]
  
• Body Shellを用いた胸腔内腫瘍に対する定位的放射線治療

  西山 典明, 西尾 正道, 明神 美弥子, 田口 大志 日本医学放射線学会雑誌 63 (2) S255 -S255 2003年02月 [査読無し][通常論文]
  
• 低線量率腔内照射による子宮頸癌の治療成績

  田口 大志, 西尾 正道, 明神 美弥子, 西山 典明 日本医学放射線学会雑誌 63 (2) S178 -S178 2003年02月 [査読無し][通常論文]
  
• 頭蓋咽頭腫に対する縮小手術と定位放射線照射の併用

  長谷川 雅一, 白土 博樹, 青山 英史, 鬼丸 力也, 田口 大志, 加藤 扶美, 宮坂 和男 日本医学放射線学会雑誌 61 (2) S79 -S79 2001年02月 [査読無し][通常論文]
  

共同研究・競争的資金等の研究課題

• 肺癌に対する陽子線治療の選択基準確立に向けた心肺相互作用勘案NTCPモデル構築

  日本学術振興会：科学研究費助成事業

  研究期間 : 2022年04月 -2025年03月 

  代表者 : 青山 英史, 鈴木 隆介, 宮本 直樹, 高尾 聖心, 金平 孝博, 橋本 孝之, 小橋 啓司, 西岡 健太郎, 田口 大志
• 微小空間画像による極低侵襲・マーカーレス実時間画像誘導放射線治療技法の開発

  日本学術振興会：科学研究費助成事業

  研究期間 : 2018年04月 -2021年03月 

  代表者 : 清水 伸一, 宮本 直樹, 高尾 聖心, 梅垣 菊男, 橋本 孝之, 木下 留美子, 吉村 高明, 西岡 健太郎, 加藤 徳雄, 田口 大志, 松浦 妙子

   

  動体追跡放射線治療は、体内特徴点情報をX線透視画像によって得ているため(1)治療用放射線とは別のX線被ばくが生じる (2) 特徴点として金マーカ等の挿入が必要となる、等が問題となる。情報取得のためにX線透視する領域を極限まで微小とする、X線透視を用いずMRI技術で体内情報を得て用いる、などX線被ばくの低減もしくは排除を目標とした。動体追跡のため必要な体内情報をリアルタイムで取得するにはX線が未だ最適であるが、その範囲を限局する手法が本研究で模索された。また治療準備に際してX線を用いず、MRI画像データで臓器位置を描出する試みに成功し、今後の研究の推進に期待が持たれた。
• 4次元定位放射線治療の基礎

  日本学術振興会：科学研究費助成事業

  研究期間 : 2005年 -2009年 

  代表者 : 白土 博樹, 金子 純一, 西山 修輔, 加藤 千恵次, 青山 英史, 関 興一, 鬼丸 力也, 西岡 健, 森田 浩一, 伊達 広行, 高田 英治, 富岡 智, 工藤 與亮, 小野寺 祐也, 神島 保, 鬼丸 力也, 清水 伸一, 作原 祐介, 大山 徳子, 阿保 大介, 田口 大志

   

  2対のシンチレータBGOと位置検出型光電子増倍管とコリメータにて4次元(時空間)定位を可能とするポジトロン・エミッション位置決め装置FPELを開発し、ポジトロンエミッターの量がある値を超えると0.1mmの精度で5mm直径の45MeV電子線ビームの自動的照射が行われる制御が可能な、4次元定位電子線自動照射実験装置を完成した。同装置にて、ヒトの呼吸運動を擬して周期的に動く小動物を利用し、この小動物に植えた腫瘍に対する45MeV電子線ビームの4次元定位放射線治療を行い、金マーカーなしで、腫瘍近傍のポジトロン・エミッターからの信号だけで、腫瘍を制御することに成功し、4次元定位放射線治療の基礎が整った。