研究者データベース

安田 耕一(ヤスダ コウイチ)
北海道大学病院 放射線科
助教

基本情報

所属

  • 北海道大学病院 放射線科

職名

  • 助教

学位

  • 博士(医学)(2012年06月 北海道大学)

科研費研究者番号

  • 00431362

J-Global ID

研究キーワード

  • IMPT   陽子線治療   半導体PET   FMISO   IMRT   頭頸部癌   低酸素   PET   放射線治療   

研究分野

  • ライフサイエンス / 放射線科学 / 放射線治療

職歴

  • 2017年04月 - 現在 北海道大学病院 放射線治療科 助教
  • 2012年09月 - 2017年03月 北海道大学大学院医学研究科連携研究センター分子・細胞イメージング部門 特任助教
  • 2015年04月 - 2015年09月 スタンフォード大学医学部 放射線腫瘍学分野 客員研究員

学歴

  • 2008年04月 - 2012年06月   北海道大学大学院医学研究科

研究活動情報

論文

  • 咽喉頭癌に対するシスプラチン超選択的動注併用放射線治療(RADPLAT)による頸部制御の検討
    加納 里志, 対馬 那由多, 鈴木 崇祥, 浜田 誠二郎, 吉田 大介, 打浪 雄介, 安田 耕一, 本間 明宏
    頭頸部癌 48 2 151 - 151 (一社)日本頭頸部癌学会 2022年05月
  • 高齢の頭頸部悪性腫瘍に対する放射線治療の後ろ向き検討
    安田 耕一, 打浪 雄介, 浜田 誠二郎, 鈴木 崇祥, 対馬 那由多, 田口 純, 清水 康, 加納 里志, 本間 明宏
    頭頸部癌 48 2 200 - 200 (一社)日本頭頸部癌学会 2022年05月
  • Yoshinori Imamura, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Ichiro Ota, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Tomoya Yokota, Susumu Okano, Kaoru Tanaka, Takuma Onoe, Yosuke Ariizumi, Akihiro Homma
    Japanese journal of clinical oncology 52 4 293 - 302 2022年04月06日 
    Salivary gland malignancies are rare neoplasms that have a broad histological spectrum and a variety of biologic behaviors. Salivary gland malignancies are known as chemo-resistant tumors, which render optimal treatment challenging. This review summarizes the role of systemic therapy for salivary gland malignancies. To date, the advantage of adding concurrent chemotherapy has remained undefined for both postoperative and inoperable locally advanced salivary gland malignancy patients undergoing radiotherapy. For recurrent/metastatic disease, local and/or systemic treatment options should be discussed in a multidisciplinary setting with consideration to both patient needs and tumor factors. For symptomatic patients or those who may compromise organ function, palliative systemic therapy can be a reasonable option based on the results of phase II studies. Platinum combination regimens as first-line therapy have been widely accepted. Personalized therapies have become established options, particularly for androgen receptor-positive, HER2-positive and NTRK fusion-positive salivary gland malignancies (i.e. androgen receptor and HER2 in salivary duct carcinoma and NTRK3 in secretory carcinoma). For patients with adenoid cystic carcinoma, multi-targeted tyrosine kinase inhibitors have also been developed. Anti-PD1 checkpoint inhibitors have shown limited activity to date. Investigation of active systemic treatments for salivary gland malignancy remains a significant unmet need. Future directions might include a more comprehensive genomic screening approach (usually next-generation sequencing-based) and combination strategies using immune checkpoint inhibitors. These are rare malignancies that require ongoing effort in the conduct of high-quality clinical trials.
  • Yuki Saito, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Ichiro Ota, Tomoya Yokota, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Susumu Okano, Yoshinori Imamura, Yosuke Ariizumi, Ryuichi Hayashi
    Japanese journal of clinical oncology 52 7 692 - 698 2022年04月05日 
    It was not until around 2000 that human papillomavirus-related oropharyngeal carcinoma was recognized as carcinoma with clinical presentations different from nonrelated head and neck carcinoma. Twenty years after and with the revision of the tumor-node-metastasis classification in 2017, various clinical trials focused on human papillomavirus-related oropharyngeal carcinoma to improve the prognosis and quality of life of patients with this disease. However, the incidence of human papillomavirus-related cancers is increasing, which is expected to be particularly prominent in Japan, where human papillomavirus vaccination is not widely available. In this review, we describe the current status of clinical trials (mainly focused on initial surgery and radiation dose reduction) for, primary and secondary prevention of, and the present status of human papillomavirus-related oropharyngeal carcinoma in Japan.
  • Ryo Ishii, Akira Ohkoshi, Naomi Kiyota, Kazuto Matsuura, Koichi Yasuda, Yoshinori Imamura, Yuki Saito, Akihiro Homma
    Japanese journal of clinical oncology 52 4 313 - 321 2022年02月15日 
    There are no established guidelines for managing older patients with head and neck cancer. Most clinical trials that define current standard therapy included few elderly patients. On the other hand, there is great variability in patients' comorbidities, physical functions, cognitive function, familial and financial background and values. The key point appears to be appropriate geriatric assessment, clarifying the patients' outcomes and a multidisciplinary team approach, including the treatment decision-making policy. Although these processes should be scientific in nature, the evidence for the treatment of elderly head and neck patients is very limited. This review summarizes the evidence available regarding the management of geriatric assessment, each treatment modality and the multidisciplinary team approach for older patients with head and neck cancers.
  • Noriyuki Fujima, V Carlota Andreu-Arasa, Sara K Meibom, Gustavo A Mercier, Minh Tam Truong, Kenji Hirata, Koichi Yasuda, Satoshi Kano, Akihiro Homma, Kohsuke Kudo, Osamu Sakai
    BMC cancer 21 1 900 - 900 2021年08月06日 [査読有り]
     
    BACKGROUND: This study aimed to assess the utility of deep learning analysis using pretreatment FDG-PET images to predict local treatment outcome in oropharyngeal squamous cell carcinoma (OPSCC) patients. METHODS: One hundred fifty-four OPSCC patients who received pretreatment FDG-PET were included and divided into training (n = 102) and test (n = 52) sets. The diagnosis of local failure and local progression-free survival (PFS) rates were obtained from patient medical records. In deep learning analyses, axial and coronal images were assessed by three different architectures (AlexNet, GoogLeNET, and ResNet). In the training set, FDG-PET images were analyzed after the data augmentation process for the diagnostic model creation. A multivariate clinical model was also created using a binomial logistic regression model from a patient's clinical characteristics. The test data set was subsequently analyzed for confirmation of diagnostic accuracy. Assessment of local PFS rates was also performed. RESULTS: Training sessions were successfully performed with an accuracy of 74-89%. ROC curve analyses revealed an AUC of 0.61-0.85 by the deep learning model in the test set, whereas it was 0.62 by T-stage, 0.59 by clinical stage, and 0.74 by a multivariate clinical model. The highest AUC (0.85) was obtained with deep learning analysis of ResNet architecture. Cox proportional hazards regression analysis revealed deep learning-based classification by a multivariate clinical model (P < .05), and ResNet (P < .001) was a significant predictor of the treatment outcome. In the Kaplan-Meier analysis, the deep learning-based classification divided the patient's local PFS rate better than the T-stage, clinical stage, and a multivariate clinical model. CONCLUSIONS: Deep learning-based diagnostic model with FDG-PET images indicated its possibility to predict local treatment outcomes in OPSCCs.
  • 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)
  • 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.
  • Satoshi Kano, Nayuta Tsushima, Takayoshi Suzuki, Seijiro Hamada, Taizo Yokokawa, Hiroshi Idogawa, Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Hidefumi Aoyama, Akihiro Homma
    International journal of clinical oncology 26 7 1179 - 1187 2021年07月 [査読有り]
     
    BACKGROUND: We investigated whether prophylactic percutaneous endoscopic gastrostomy (PEG) is used effectively for patients treated with definitive concurrent chemoradiotherapy (CCRT) and the predictors of the need for PEG. METHODS: 326 patients with laryngeal, oropharyngeal or hypopharyngeal cancers were retrospectively reviewed. RESULTS: The PEG tube use group had more favorable results than the total parenteral nutrition and nasogastric tube groups in terms of rate of serum albumin loss, incidence of severe fever and aspiration pneumonia, CCRT completion rate and hospitalization period. However, it was inferior to oral intake. Analysis of the relative risk of requiring enteral or parenteral nutrition revealed that performance status (PS) 2, primary site (supraglottis, oropharynx, or hypopharynx), N3 disease, and cisplatin were predictors of the need for nutritional support. CONCLUSIONS: Prophylactic PEG is effective for patients treated with definitive CCRT and is especially required for patients with PS2 or oropharyngeal cancer.
  • Nayuta Tsushima, Satoshi Kano, Takayoshi Suzuki, Hiroshi Idogawa, Daisuke Yoshida, Koichi Yasuda, Manami Otsuka, Hidefumi Aoyama, Akihiro Homma
    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2021年04月18日 [査読有り]
     
    PURPOSE: We have performed superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) for patients with maxillary sinus cancer. The promising treatment outcomes of this non-surgical treatment were reported in past studies. However, few clinical studies have been conducted to evaluate the outcome of salvage surgery following RADPLAT. The purpose of this study was to analyze the treatment outcomes of salvage surgery for patients with recurrent maxillary sinus cancer after RADPLAT. METHODS: We assessed 45 patients who had recurrence following RADPLAT between 1999 and 2017, and conducted a retrospective analysis. We excluded patients who did not complete RADPLAT. Patients were not considered to have completed RADPLAT if they underwent intra-arterial cisplatin less than three times or received a total radiation dose of less than 60 Gy. The primary endpoint was overall survival. The median follow-up period for surviving patients after recurrence was 5.1 years. RESULTS: Twenty-five of the 45 (56%) patients underwent salvage surgery. The 5-year overall survival rate was 68% in patients who underwent salvage surgery, while all patients who did not undergo salvage surgery died during the observation period. Fifteen of 24 (63%) patients with local recurrence underwent salvage surgery. Eight patients did not undergo salvage surgery because of unresectable disease; five of the eight patients had unresectable posterior extension. All nine patients with nodal recurrence underwent neck dissection. CONCLUSION: Treatment outcomes of salvage surgery following RADPLAT were favorable enough for it to be generally recommended. To reduce unresectable recurrence, the posterior section should be eradicated by RADPLAT.
  • 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.
  • 尿量の経日変化および前立腺体積が放射線治療時の前立腺の位置に与える影響(The Impact of Daily Urinary Volume Variations and Prostate Volume on Prostate Position During Radiotherapy)
    Nishioka Kentaro, Hashimoto Takayuki, Yokota Isao, Katoh Norio, Kinoshita Rumiko, Yasuda Koichi, Takao Seishin, Yoshimura Takaaki, Aoyama Hidefumi, Shimizu Shinichi
    日本医学放射線学会学術集会抄録集 80回 S193 - S194 2021年03月
  • The Impact of Daily Urinary Volume Variations and Prostate Volume on Prostate Position During Radiotherapy(和訳中)
    Nishioka Kentaro, Hashimoto Takayuki, Yokota Isao, Katoh Norio, Kinoshita Rumiko, Yasuda Koichi, Takao Seishin, Yoshimura Takaaki, Aoyama Hidefumi, Shimizu Shinichi
    日本医学放射線学会学術集会抄録集 80回 S193 - S194 2021年03月
  • Susumu Okano, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Takenori Ogawa, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Tomoya Yokota, Yoshinori Imamura, Yosuke Ariizumi, Tetsuo Akimoto, Ryuichi Hayashi
    Japanese journal of clinical oncology 51 2 173 - 179 2021年02月08日 [査読有り]
     
    In order to maximize the benefit of induction chemotherapy, practice based on a comprehensive interpretation of a large number of clinical trials, as in this review, is essential. The standard treatment for locally advanced squamous cell carcinoma of the head and neck is surgery or chemoradiation. However, induction chemotherapy followed by (chemo) radiotherapy may be used in some circumstances. Although many clinical trials of induction chemotherapy have been conducted, a rationale other than to preserve the larynx is still controversial. Selection of this modality should therefore be made with care. The current standard regimen for induction chemotherapy is docetaxel, cisplatin and 5-FU, but concerns remain about toxicity, cost and the duration of treatment. Regarding treatment after induction chemotherapy, it is also unclear whether radiation alone or chemoradiation is the better option. Furthermore, there is no answer as to what drugs should be used in combination with radiation therapy after induction chemotherapy. Several new induction chemotherapy treatment developments are currently underway, and future developments are expected. This review article summarizes the current position of induction chemotherapy for head and neck squamous cell carcinoma, based on the evidence produced to date, and discusses the future prospects for this treatment.
  • Yuji Nakamaru, Masanobu Suzuki, Satoshi Kano, Takatsugu Mizumachi, Nayuta Tsushima, Takayoshi Suzuki, Aya Honma, Akira Nakazono, Shogo Kimura, Rikiya Onimaru, Koichi Yasuda, Hiroki Shirato, Akihiro Homma
    Auris, nasus, larynx 48 1 131 - 137 2021年02月 [査読有り]
     
    OBJECTIVE: Despite of rapid advances in endoscopic surgery, the gold standard for sinonasal squamous cell carcinoma (SNSCC) surgery has remained the open approach with en-block resection due to the aggressive nature of SNSCC, including frequent recurrence and high mortality rate. For that reason, few studies have focused on SNSCC treated by endoscopic surgery alone. The objective of this study was to evaluate the usefulness of endoscopic surgery for patients with SNSCC. METHODS: A retrospective analysis was performed for 15 consecutive SNSCC patients who underwent endoscopic surgery without an open approach. We carefully selected patients whose tumor attachment sites could be fully visualized and completely resected through an endonasal approach. RESULTS: Of the fifteen patients, 4 patients (27%) were diagnosed with T1, 7 (47%) with T2, 4 (27%) with T3, and no patients with T4a or T4b disease. Four of the 15 (27%) patients showed positive surgical margins. The 5-yr overall survival, disease-specific survival, and local control rate was 72.4%, 79.6%, and 92.9%, respectively. The 5-yr disease-specific survival for T1, T2, and T3 disease was 100% and 75% and 75%, respectively. Patients with negative surgical margins had a better disease-specific survival rate than did those with positive surgical margins (p = 0.0253). CONCLUSION: Endoscopic surgery for patients with SNSCC appears to afford an effective method in selected cases. The achievement of negative surgical margins with a good view of the tumor attachment site was considered to be critical to the management of SNSCC.
  • Noriyuki Fujima, Yukie Shimizu, Daisuke Yoshida, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma, Koichi Yasuda, Rikiya Onimaru, Osamu Sakai, Kohsuke Kudo, Hiroki Shirato
    The journal of medical investigation : JMI 68 3.4 354 - 361 2021年 
    Purpose : To predict local control / failure by a multiparametric approach using magnetic resonance (MR)-derived tumor morphological and functional parameters in pharynx squamous cell carcinoma (SCC) patients. Materials and Methods : Twenty-eight patients with oropharyngeal and hypopharyngeal SCCs were included in this study. Quantitative morphological parameters and intratumoral characteristics on T2-weighted images, tumor blood flow from pseudo-continuous arterial spin labeling, and tumor diffusion parameters of three diffusion models from multi-b-value diffusion-weighted imaging as well as patients' characteristics were analyzed. The patients were divided into local control / failure groups. Univariate and multiparametric analysis were performed for the patient group division. Results : The value of morphological parameter of 'sphericity' and intratumoral characteristic of 'homogeneity' was revealed respectively significant for the prediction of the local control status in univariate analysis. Higher diagnostic performance was obtained with the sensitivity of 0.8, specificity of 0.75, positive predictive value of 0.89, negative predictive value of 0.6 and accuracy of 0.79 by multiparametric diagnostic model compared to results in the univariate analysis. Conclusion : A multiparametric analysis with MR-derived quantitative parameters may be useful to predict local control in pharynx SCC patients. J. Med. Invest. 68 : 354-361, August, 2021.
  • Kentaro Nishioka, Kento Gotoh, Takayuki Hashimoto, Takashige Abe, Takahiro Osawa, Ryuji Matsumoto, Isao Yokota, Norio Katoh, Rumiko Kinoshita, Koichi Yasuda, Toshiaki Yakabe, Takaaki Yoshimura, Seishin Takao, Nobuo Shinohara, Hidefumi Aoyama, Shinichi Shimizu, Hiroki Shirato
    BJR|Open 3 1 2021年01月 
    Objectives: The purpose of this study is to investigate whether verbal instructions are sufficient for bladder volume (BV) control not to deteriorate prostate position reproducibility in image-guided spot scanning proton therapy (SSPT) for localized prostate cancer. Methods: A total of 268 treatment sessions in 12 consecutive prostate cancer patients who were treated with image-guided SSPT with fiducial markers were retrospectively analyzed. In addition to strict rectal volume control procedures, simple verbal instructions to void urine one hour before the treatment were used here. The BV was measured by a Bladder Scan just before the treatment, and the prostate motion was measured by intraprostatic fiducial markers and two sets of X-ray fluoroscopy images. The correlation between the BV change and prostate motion was assessed by linear mixed-effects models and systematic and random errors according to the reproducibility of the BV. Results: The mean absolute BV change during treatment was from −98.7 to 86.3 ml (median 7.1 ml). The mean absolute prostate motion of the patients in the left-right direction was −1.46 to 1.85 mm; in the cranial-caudal direction it was −6.10 to 3.65 mm, and in the anteroposterior direction −1.90 to 5.23 mm. There was no significant relationship between the BV change and prostate motion during SSPT. The early and late genitourinary and gastrointestinal toxicity was minimal with a minimum follow up of 4.57 years. Conclusions: Simple verbal instructions about urination was suggested to be sufficient to control the BV not to impact on the prostate motion and clinical outcomes in image-guided SSPT. Careful attention to BV change is still needed when the seminal vesicle is to be treated. Advances in knowledge: Our data demonstrated that there was no apparent relationship between BV changes and prostate position reproducibility and simple verbal instruction about urination could be sufficient for image-guided SSPT.
  • Hideki Minatogawa, Koichi Yasuda, Yasuhiro Dekura, Seishin Takao, Taeko Matsuura, Takaaki Yoshimura, Ryusuke Suzuki, Isao Yokota, Noriyuki Fujima, Rikiya Onimaru, Shinichi Shimizu, Hidefumi Aoyama, Hiroki Shirato
    Journal of applied clinical medical physics 22 1 174 - 183 2021年01月 
    PURPOSE: To investigate potential advantages of adaptive intensity-modulated proton beam therapy (A-IMPT) by comparing it to adaptive intensity-modulated X-ray therapy (A-IMXT) for nasopharyngeal carcinomas (NPC). METHODS: Ten patients with NPC treated with A-IMXT (step and shoot approach) and concomitant chemotherapy between 2014 and 2016 were selected. In the actual treatment, 46 Gy in 23 fractions (46Gy/23Fx.) was prescribed using the initial plan and 24Gy/12Fx was prescribed using an adapted plan thereafter. New treatment planning of A-IMPT was made for the same patients using equivalent dose fractionation schedule and dose constraints. The dose volume statistics based on deformable images and dose accumulation was used in the comparison of A-IMXT with A-IMPT. RESULTS: The means of the Dmean of the right parotid gland (P < 0.001), right TM joint (P < 0.001), left TM joint (P < 0.001), oral cavity (P < 0.001), supraglottic larynx (P = 0.001), glottic larynx (P < 0.001), , middle PCM (P = 0.0371), interior PCM (P < 0.001), cricopharyngeal muscle (P = 0.03643), and thyroid gland (P = 0.00216), in A-IMPT are lower than those of A-IMXT, with statistical significance. The means of, D0.03cc , and Dmean of each sub portion of auditory apparatus and D30% for Eustachian tube and D0.5cc for mastoid volume in A-IMPT are significantly lower than those of A-IMXT. The mean doses to the oral cavity, supraglottic larynx, and glottic larynx were all reduced by more than 20 Gy (RBE = 1.1). CONCLUSIONS: An adaptive approach is suggested to enhance the potential benefit of IMPT compared to IMXT to reduce adverse effects for patients with NPC.
  • 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.
  • 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.
  • 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
  • Tomoya Yokota, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Takenori Ogawa, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Susumu Okano, Yoshinori Imamura, Yosuke Ariizumi, Ryuichi Hayashi
    Japanese journal of clinical oncology 50 10 1089 - 1096 2020年09月28日 [査読有り]
     
    Squamous cell carcinoma of the head and neck is characterized by an immunosuppressive environment and evades immune responses through multiple resistance mechanisms. A breakthrough in cancer immunotherapy employing immune checkpoint inhibitors has evolved into a number of clinical trials with antibodies against programmed cell death 1 (PD-1), its ligand PD-L1 and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) for patients with squamous cell carcinoma of the head and neck. CheckMate141 and KEYNOTE-048 were practice-changing randomized phase 3 trials for patients with platinum-refractory and platinum-sensitive recurrent or metastatic squamous cell carcinoma of the head and neck, respectively. Furthermore, many combination therapies using anti-CTLA-4 inhibitors, tyrosine kinase inhibitors and immune accelerators are currently under investigation. Thus, the treatment strategy of recurrent or metastatic squamous cell carcinoma of the head and neck is becoming more heterogeneous and complicated in the new era of individualized medicine. Ongoing trials are investigating immunotherapeutic approaches in the curative setting for locoregionally advanced disease. This review article summarizes knowledge of the role of the immune system in the development and progression of squamous cell carcinoma of the head and neck, and provides a comprehensive overview on the development of immunotherapeutic approaches in both recurrent/metastatic and locoregionally advanced diseases.
  • 安田 耕一
    癌と化学療法 47 7 1042 - 1045 (株)癌と化学療法社 2020年07月 [査読無し]
  • Shusuke Hirayama, Taeko Matsuura, Koichi Yasuda, Seishin Takao, Takaaki Fujii, Naoki Miyamoto, Kikuo Umegaki, Shinichi Shimizu
    Journal of applied clinical medical physics 21 4 42 - 50 2020年04月 [査読有り]
     
    PURPOSE: While a large amount of experimental data suggest that the proton relative biological effectiveness (RBE) varies with both physical and biological parameters, current commercial treatment planning systems (TPS) use the constant RBE instead of variable RBE models, neglecting the dependence of RBE on the linear energy transfer (LET). To conduct as accurate a clinical evaluation as possible in this circumstance, it is desirable that the dosimetric parameters derived by TPS ( D RBE = 1.1 ) are close to the "true" values derived with the variable RBE models ( D v RBE ). As such, in this study, the closeness of D RBE = 1.1 to D v RBE was compared between planning target volume (PTV)-based and robust plans. METHODS: Intensity-modulated proton therapy (IMPT) treatment plans for two Radiation Therapy Oncology Group (RTOG) phantom cases and four nasopharyngeal cases were created using the PTV-based and robust optimizations, under the assumption of a constant RBE of 1.1. First, the physical dose and dose-averaged LET (LETd ) distributions were obtained using the analytical calculation method, based on the pencil beam algorithm. Next, D v RBE was calculated using three different RBE models. The deviation of D v RBE from D RBE = 1.1 was evaluated with D99 and Dmax , which have been used as the evaluation indices for clinical target volume (CTV) and organs at risk (OARs), respectively. The influence of the distance between the OAR and CTV on the results was also investigated. As a measure of distance, the closest distance and the overlapped volume histogram were used for the RTOG phantom and nasopharyngeal cases, respectively. RESULTS: As for the OAR, the deviations of D max v RBE from D max RBE = 1.1 were always smaller in robust plans than in PTV-based plans in all RBE models. The deviation would tend to increase as the OAR was located closer to the CTV in both optimization techniques. As for the CTV, the deviations of D 99 v RBE from D 99 RBE = 1.1 were comparable between the two optimization techniques, regardless of the distance between the CTV and the OAR. CONCLUSION: Robust optimization was found to be more favorable than PTV-based optimization in that the results presented by TPS were closer to the "true" values and that the clinical evaluation based on TPS was more reliable.
  • Takaaki Yoshimura, Shinichi Shimizu, Takayuki Hashimoto, Kentaro Nishioka, Norio Katoh, Tetsuya Inoue, Hiroshi Taguchi, Koichi Yasuda, Taeko Matsuura, Seishin Takao, Masaya Tamura, Yoichi M Ito, Yuto Matsuo, Hiroshi Tamura, Kenji Horita, Kikuo Umegaki, Hiroki Shirato
    Journal of applied clinical medical physics 21 2 38 - 49 2020年02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.
  • H. Minatogawa, K. Yasuda, T. Matsuura, R. Onimaru, T. Yoshimura, S. Takao, Y. Matsuo, Y. Dekura, R. Suzuki, M. Tamura, N. Miyamoto, S. Shimizu, H. Shirato
    International Journal of Radiation Oncology*Biology*Physics 105 1 E394 - E394 2019年09月
  • Yusuke Uchinami, Ryusuke Suzuki, Norio Katoh, Hiroshi Taguchi, Koichi Yasuda, Naoki Miyamoto, Yoichi M Ito, Shinichi Shimizu, Hiroki Shirato
    Journal of applied clinical medical physics 20 8 78 - 86 2019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.
  • Noriyuki Fujima, Yukie Shimizu, Daisuke Yoshida, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma, Koichi Yasuda, Rikiya Onimaru, Osamu Sakai, Kohsuke Kudo, Hiroki Shirato
    Cancers 11 6 2019年06月10日 [査読有り][通常論文]
     
    The purpose of this study was to determine the predictive power for treatment outcome of a machine-learning algorithm combining magnetic resonance imaging (MRI)-derived data in patients with sinonasal squamous cell carcinomas (SCCs). Thirty-six primary lesions in 36 patients were evaluated. Quantitative morphological parameters and intratumoral characteristics from T2-weighted images, tumor perfusion parameters from arterial spin labeling (ASL) and tumor diffusion parameters of five diffusion models from multi-b-value diffusion-weighted imaging (DWI) were obtained. Machine learning by a non-linear support vector machine (SVM) was used to construct the best diagnostic algorithm for the prediction of local control and failure. The diagnostic accuracy was evaluated using a 9-fold cross-validation scheme, dividing patients into training and validation sets. Classification criteria for the division of local control and failure in nine training sets could be constructed with a mean sensitivity of 0.98, specificity of 0.91, positive predictive value (PPV) of 0.94, negative predictive value (NPV) of 0.97, and accuracy of 0.96. The nine validation data sets showed a mean sensitivity of 1.0, specificity of 0.82, PPV of 0.86, NPV of 1.0, and accuracy of 0.92. In conclusion, a machine-learning algorithm using various MR imaging-derived data can be helpful for the prediction of treatment outcomes in patients with sinonasal SCCs.
  • Mizumachi T, Kano S, Homma A, Akazawa M, Hasegawa C, Shiroishi Y, Okamoto C, Kumagai S, Nishimura M, Takasaki H, Takeda H, Yasuda K, Minatogawa H, Dekura Y, Onimaru R, Shirato H, Fukuda S
    Gan to kagaku ryoho. Cancer & chemotherapy 46 4 685 - 689 2019年04月 [査読無し][通常論文]
     
    BACKGROUND: Oral mucositis and body weight loss are the most critical conditions known to lead to the discontinuation of chemoradiotherapy for head and neck cancer. We investigated the effect of a nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)on body weight loss, oral mucositis, and the completion rate of chemoradiotherapy in patients with oropharyngeal and hypopharyngeal cancer. PATIENTS AND METHODS: The study group comprised patients with oropharyngeal and hypopharyngeal cancer who were treated with concomitant cisplatin and 70 Gy of radiotherapy. These patients received 2 packs of Prosure®per day during chemoradiotherapy. RESULTS: A total of 17 patients were included in this study. The reduction in body weight was significantly improved compared with that in the historical control group that did not receive Prosure®(7.3% vs 10.3%, p<0.01), and the rate of Grade 3-4 oral mucositis was significantly reduced for the patient groups that received Prosure®(CTCAE v3.0 GradeB3; 24% vs 58%, p<0.05). The completion rate of chemoradiotherapy was not significantly different between both groups(77% vs 60%, NS). CONCLUSIONS: A nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)had effects on oral mucositis and body weight loss in head and neck cancer patients treated with chemoradiotherapy.
  • Satoshi Kano, Shinya Morita, Yuji Nakamaru, Takatsugu Mizumachi, Nayuta Tsushima, Takayoshi Suzuki, Akira Nakazono, Atsushi Fukuda, Koichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Akihiro Homma
    Japanese Journal of Head and Neck Cancer 45 3 300 - 304 2019年 [査読有り][通常論文]
     
    © 2019, Japan Society for Head and Neck Cancer. All rights reserved. We analyzed the treatment outcomes and safety of concomitant chemoradiotherapy (CCRT), especially with a combination of docetaxel, cisplatin and 5FU (TPF), for local advanced external auditory canal squamous cell carcinomas. In addition, we analyzed the correlation between tumor invasion site and prognosis. The study comprised 21 patients with the following criteria: (1) external auditory canal squamous cell carcinomas which were subject to radical treatment at Hokkaido University Hospital between 2007 and 2017, and (2) T3–4 classified according to the University of Pittsburg system. As a result, tumor invasion into the dura or temporomandibular joint was associated with neck lymph node metastasis, and tumor invasion into the temporomandibular joint was associated with local recurrence. The 2-year overall survival rate (OS) and 2-year local control rate (LC) were 61.1% and 52.1% in all patients, respectively. In patients treated with CCRT, the 2-year OS was 85.7% in CCRT with TPF and 25.0% in CCRT with others, and the 2-year LC was 57.1% in CCRT with TPF and 25.0% in CCRT with others. Grade 3︲4 leucopenia and neutropenia occurred in 55% and 45% of patients treated with CCRT with TPF, respectively. CCRT with TPF shows high efficacy and safety for local advanced external auditory canal squamous cell carcinomas.
  • Haruna Watanabe, Ren Togo, Takahiro Ogawa, Miki Haseyama, Koichi Yasuda, Khin Khin Tha, Kohsuke Kudo, Hiroki Shirato
    Proceedings of SPIE - The International Society for Optical Engineering 11050 2019年01月01日 [査読無し][通常論文]
     
    © 2019 SPIE. In this paper, we propose a method to classify metastatic bone tumors using treatment-planning computed tomography images. The proposed method utilizes pre-trained deep convolutional neural network (DCNN) models as feature extractors and enables the metastatic bone tumor classification by using the obtained features. Performance of several state-of-the-art DCNN-based features was compared and evaluated in our experiment.
  • N Fujima, K Hirata, T Shiga, R Li, K Yasuda, R Onimaru, K Tsuchiya, S Kano, T Mizumachi, A Homma, K Kudo, H Shirato
    Clinical radiology 73 12 1059.e1-1059.e8  2018年12月 [査読有り][通常論文]
     
    AIM: To assess potential prognostic factors in pharynx squamous cell carcinoma (SCC) patients by quantitative morphological and intratumoural characteristics obtained by 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (FDG-PET/CT). MATERIALS AND METHODS: The cases of 54 patients with pharynx SCC who underwent chemoradiation therapy were analysed retrospectively. Using their FDG-PET data, the quantitative morphological and intratumoural characteristics of 14 parameters were calculated. The progression-free survival (PFS) and overall survival (OS) information was obtained from patient medical records. Univariate and multivariate analyses were performed to assess the 14 quantitative parameters as well as the T-stage, N-stage, and tumour location data for their relation to PFS and OS. When an independent predictor was suggested in the multivariate analysis, the parameter was further assessed using the Kaplan-Meier method. RESULTS: In the assessment of PFS, the univariate and multivariate analyses indicated the following as independent predictors: the texture parameter of homogeneity and the morphological parameter of sphericity. In the Kaplan-Meier analysis, the PFS rate was significantly improved in the patients who had both a higher value of homogeneity (p=0.01) and a higher value of sphericity (p=0.002). With the combined use of homogeneity and sphericity, the patients with different PFS rates could be divided more clearly. CONCLUSION: The quantitative parameters of homogeneity and sphericity obtained by FDG-PET can be useful for the prediction of the PFS of pharynx SCC patients, especially when used in combination.
  • K. Yasuda, S. Takao, Y. Matsuo, T. Yoshimura, M. Tamura, H. Minatogawa, Y. Dekura, T. Matsuura, R. Onimaru, T. Shiga, S. Shimizu, K. Umegaki, H. Shirato
    International Journal of Radiation Oncology*Biology*Physics 102 3 e378 - e378 2018年11月
  • Noriyuki Fujima, Kenji Hirata, Tohru Shiga, Koichi Yasuda, Rikiya Onimaru, Kazuhiko Tsuchiya, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma, Kohsuke Kudo, Hiroki Shirato
    Quantitative imaging in medicine and surgery 8 8 788 - 795 2018年09月 [査読有り][通常論文]
     
    Background: To investigate the utility of quantitative morphological and intratumoral characteristics obtained by 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) for the prediction of treatment outcome in patients with nasal or paranasal cavity squamous cell carcinoma (SCC). Methods: Twenty-four patients with nasal or paranasal cavity SCC who received curative non-surgical therapy (a combination of super-selective arterial cisplatin infusion and radiotherapy) were retrospectively analyzed. From pre-treatment FDG-PET data, a total of 13 parameters of quantitative morphological characteristics (tumor volume, surface area and sphericity), intratumoral characteristics (the maximum and mean standard uptake value, three intratumoral histogram and four textural parameters) and total lesion glycolysis (TLG) were respectively calculated. Information regarding the treatment outcome was determined from the histological diagnosis or clinical follow-up. Each of the 13 quantitative parameters as well as T- and N-stage was assessed for its relation to treatment outcome of local control or failure. Results: In univariate analysis, significant differences in surface area and sphericity between the local control and failure groups were observed. The receiver operating characteristic (ROC) curve analysis showed that sphericity had the highest accuracy of 0.88. In the multivariate analysis, sphericity was revealed as an independent predictor of the local control or failure. Conclusions: The quantitative parameters of sphericity are useful to predict the treatment outcome in patients with nasal or paranasal SCC.
  • Kentaro Nishioka, Anussara Prayongrat, Kota Ono, Shunsuke Onodera, Takayuki Hashimoto, Norio Katoh, Tetsuya Inoue, Rumiko Kinoshita, Koichi Yasuda, Takashi Mori, Rikiya Onimaru, Hiroki Shirato, Shinichi Shimizu
    Journal of radiation research 59 suppl_1 i63-i71 - i71 2018年03月01日 [査読有り][通常論文]
     
    This is a report of a single-institution prospective study evaluating the safety of a spot-scanning dedicated, small 360-degree gantry, synchrotron-based proton beam therapy (PBT) system. Data collection was performed for 56 patients with 59 treatment sites who received proton beam therapy at Hokkaido University Hospital between March 2014 and July 2015. Forty-one patients were male and 15 were female. The median age was 66 years. The primary lesion sites were prostate (n = 17), bone/soft tissue (n = 10), liver (n = 7), lung (n = 6), central nervous system (n = 5), colon (n = 2), pancreas (n = 2), kidney (n = 2) and others (n = 5). Chemotherapy was administered in 11 patients. The prescribed total dose was from 20 to 76 GyE (Radiobiological equivalent dose, RBE = 1.1), with the median dose of 65 GyE in 4 to 35 fractions. No PBT-related Common Terminology Criteria for Adverse Events Grade 4 or 5 toxicities were observed; the incidence of early PBT-related Grade 4 adverse events was 0% (95% confidence interval 0 to 6.38%). The most common Grade 3 toxicities were hematologic toxicity (12.5%) unlikely to be related to the PBT. One patient developed a left femoral neck fracture (Grade 3) at 14.5 months after PBT for chondrosarcoma of the left pelvis. The pathological findings showed no other malignancies, suggesting that it was possibly related to the PBT. In conclusion, the spot-scanning dedicated, synchrotron-based PBT system is feasible, but further studies on its long-term safety and efficacy are warranted.
  • Hironobu Hata, Kazuhito Yoshikawa, Kenji Imamachi, Chika Murai, Michihiro Ueda, Tatsumi Nagahashi, Noriaki Nishiyama, Kouichi Yasuda, Akihiro Honma, Yoshimasa Kitagawa
    Japanese Journal of Head and Neck Cancer 44 4 380 - 386 2018年 
    Due to various functional disorders and adverse events with head and neck cancer treatment, the QOL of cancer survivors markedly decreases. In many cases, there is a gradual improvement in QOL, though patients experience various discomforts daily. A critical issue is how long long-term survivors can continue to manage their oral condition. Since 2012, cooperating cancer dentists have been registered and presently there are more than 14,000 such dentists in Japan, creating a framework for referring such cancer patients to dentists in general practice. In 2011, for patients who were treated from 2007 to 2010, we performed a survey of continued oral management after discharge from Hokkaido University Hospital. After discharge, 34.3% of cases continued oral management, but when limited to patients in the care of general practice dentists, the rate was only 7.5%. In this study of patients from 2011 to 2016, the patients who continued oral management after discharge and the patients in the care of general practice dentists were higher, at 70.5% and 40.4%. It is essential that appropriate oral management in cooperation with local dental clinics is continued to improve the QOL of head and neck cancer patients.
  • Yukiko Nishikawa, Koichi Yasuda, Shozo Okamoto, Yoichi M Ito, Rikiya Onimaru, Tohru Shiga, Kazuhiko Tsuchiya, Shiro Watanabe, Wataru Takeuchi, Yuji Kuge, Hao Peng, Nagara Tamaki, Hiroki Shirato
    Radiation oncology (London, England) 12 1 148 - 148 2017年09月06日 [査読有り][通常論文]
     
    BACKGROUND: Hypoxic cancer cells are thought to be radioresistant and could impact local recurrence after radiotherapy (RT). One of the major hypoxic imaging modalities is [18F]fluoromisonidazole positron emission tomography (FMISO-PET). High FMISO uptake before RT could indicate radioresistant sites and might be associated with future local recurrence. The predictive value of FMISO-PET for intra-tumoral recurrence regions was evaluated using high-resolution semiconductor detectors in patients with nasopharyngeal carcinoma after intensity-modulated radiotherapy (IMRT). METHODS: Nine patients with local recurrence and 12 patients without local recurrence for more than 3 years were included in this study. These patients received homogeneous and standard doses of radiation to the primary tumor irrespective of FMISO uptake. The FMISO-PET image before RT was examined via a voxel-based analysis, which focused on the relationship between the degree of FMISO uptake and recurrence region. RESULTS: In the pretreatment FMISO-PET images, the tumor-to-muscle ratio (TMR) of FMISO in the voxels of the tumor recurrence region was significantly higher than that of the non-recurrence region (p < 0.0001). In the recurrent patient group, a TMR value of 1.37 (95% CI: 1.36-1.39) corresponded to a recurrence rate of 30%, the odds ratio was 5.18 (4.87-5.51), and the area under the curve (AUC) of the receiver operating characteristic curve was 0.613. In all 21 patients, a TMR value of 2.42 (2.36-2.49) corresponded to an estimated recurrence rate of 30%, and the AUC was only 0.591. CONCLUSIONS: The uptake of FMISO in the recurrent region was significantly higher than that in the non-recurrent region. However, the predictive value of FMISO-PET before IMRT is not sufficient for up-front dose escalation for the intra-tumoral high-uptake region of FMISO. Because of the higher mean TMR of the recurrence region, a new hypoxic imaging method is needed to improve the sensitivity and specificity for hypoxia.
  • Shozo Okamoto, Tohru Shiga, Koichi Yasuda, Shiro Watanabe, Kenji Hirata, Ken-Ichi Nishijima, Keiichi Magota, Katsuhiko Kasai, Rikiya Onimaru, Kazuhiko Tuchiya, Yuji Kuge, Hiroki Shirato, Nagara Tamaki
    European journal of nuclear medicine and molecular imaging 43 12 2147 - 2154 2016年11月 [査読有り][通常論文]
     
    PURPOSE: The purpose of this study was to prospectively investigate reoxygenation in the early phase of fractionated radiotherapy and serial changes of tumoricidal effects associated with intensity-modulated radiation therapy (IMRT) in patients with head and neck cancer (HNC) using F-18 fluoromisonidazole (FMISO) PET and F-18 fluorodeoxyglucose (FDG) PET. METHODS: Patients with untreated HNC underwent FMISO-PET and FDG-PET studies prospectively. A PET evaluation was conducted before each IMRT (Pre-IMRT), during IMRT (at 30 Gy/15 fr) (Inter-IMRT), and after completion of IMRT (70 Gy/35 fr) (Post-IMRT). FMISO-PET images were scanned by a PET/CT scanner at 4 h after the FMISO injection. We quantitatively analyzed the FMISO-PET images of the primary lesion using the maximum standardized uptake (SUVmax) and tumor-to-muscle ratio (TMR). The hypoxic volume (HV) was calculated as an index of tumor hypoxia, and was defined as the volume when the TMR was ≥ 1.25. Each FDG-PET scan was started 1 h after injection. The SUVmax and metabolic tumor volume (MTV) values obtained by FDG-PET were analyzed. RESULTS: Twenty patients finished the complete PET study protocol. At Pre-IMRT, 19 patients had tumor hypoxia in the primary tumor. In ten patients, the tumor hypoxia disappeared at Inter-IMRT. Another seven patients showed the disappearance of tumor hypoxia at Post-IMRT. Two patients showed tumor hypoxia at Post-IMRT. The FMISO-PET results showed that the reduction rates of both SUVmax and TMR from Pre-IMRT to Inter-IMRT were significantly higher than the corresponding reductions from Inter-IMRT to Post-IMRT (SUVmax: 27 % vs. 10 %, p = 0.025; TMR: 26 % vs. 12 %, p = 0.048). The reduction rate of SUVmax in FDG-PET from Pre-IMRT to Inter-IMRT was similar to that from Inter-IMRT to Post-IMRT (47 % vs. 48 %, p = 0.778). The reduction rate of the HV in FMISO-PET from Pre-IMRT to Inter-IMRT tended to be larger than that from Inter-IMRT to Post-IMRT (63 % vs. 40 %, p = 0.490). Conversely, the reduction rate of the MTV in FDG-PET from Pre-IMRT to Inter-IMRT was lower than that from Inter-IMRT to Post-IMRT (47 % vs. 74 %, p = 0.003). CONCLUSIONS: Both the intensity and the volume of tumor hypoxia rapidly decreased in the early phase of radiotherapy, indicating reoxygenation of the tumor hypoxia. In contrast, the FDG uptake declined gradually with the course of radiotherapy, indicating that the tumoricidal effect continues over the entire course of radiation treatment.
  • Takayoshi Suzuki, Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Fumiyuki Suzuki, Satoshi Fukuda
    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 273 10 3331 - 6 2016年10月 [査読有り][通常論文]
     
    We sought to evaluate the efficacy and feasibility of superselective intra-arterial infusion of high-dose cisplatin with concomitant radiotherapy (hereafter RADPLAT) for head and neck squamous cell cancer (hereafter HNSCC) patients with retropharyngeal lymph node (hereafter RPLN) metastasis. A retrospective case series review was conducted at University medical center in Japan. Ten HNSCC patients with RPLN metastasis treated by RADPLAT were analyzed. The ascending pharyngeal artery was targeted for the treatment of RPLN metastasis in 9 patients. The median total dose of cisplatin was 26.6 mg/m(2) (mean 31.5 mg/m(2), range 11.7-87.9 mg/m(2)). In the remaining patient, the RPLN was supplied by the ascending palatine artery. As grade 3 and 4 adverse effects, leukopenia was observed in three, mucositis in four and nausea in one patient. No neurological complications were observed in any patients. Metastatic RPLNs were evaluated as a complete response in all patients. There was no recurrence of RPLN metastasis in any patients. Four patients remain alive without any evidence of disease and six patients died of disease. The 5-year overall survival rate was 50 %. We have shown that superselective intra-arterial cisplatin infusion for RPLNs was a feasible and effective approach for HNSCC patients with RPLN metastasis.
  • Akihiro Homma, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Rinnosuke Kuramoto, Yuji Nakamaru, Rikiya Onimaru, Kazuhiko Tsuchiya, Daisuke Yoshida, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda
    PloS one 11 8 e0161734  2016年 [査読有り][通常論文]
     
    OBJECTIVE: Late toxicity after concurrent chemoradiotherapy (CCRT), such as dysphagia, in patients with squamous cell carcinoma of the head and neck has received a good deal of attention recently. The gastrostomy tube (G-tube) dependence rate 1 year after CCRT was reported to be 16.7-42.9% in Western countries. We evaluated swallowing outcomes after CCRT in patients with hypopharyngeal cancer (HPC) treated in our hospital and compared them with previous reports. METHODS: We reviewed 96 consecutive patients with a HPC treated by radiotherapy with intravenous or intra-arterial chemotherapy between 2006 and 2013 at Hokkaido University Hospital, Sapporo, Japan. RESULTS: At 1 month after CCRT, 13 patients (13.7%) used a G-tube, whereas 5/91 (5.5%) and 4/81 (4.9%) used a G-tube at 3 and 6 months, respectively. Two patients used a G-tube at 12 and 24 months after CCRT (G-tube use rate: 2.8% at 12 months, and 3.2% at 24 months). The variables female, posterior wall primary, stage IV, ECOG performance status of 2, and smoking status were significantly associated with G-tube use at 12 months after CCRT, whereas the route of cisplatin administration was not related to G-tube use (p = 0.303). CONCLUSIONS: The G-tube use rate up to 1year could be lower in Japanese patients than in Western patients according to previous reports. In particular, Japanese patients resume oral intake sooner than Western patients. Further study of the incidence of dysphagia after CCRT by ethnicity is required to clarify the differences in dysphagia after CCRT.
  • Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Jun Furusawa, Satoshi Kano, Takatsugu Mizumachi, Satoshi Iizuka, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda
    International journal of clinical oncology 20 6 1081 - 5 2015年12月 [査読有り][通常論文]
     
    BACKGROUND: Pyriform sinus squamous cell carcinoma (SCC) has one of the worst prognoses of all upper aerodigestive tract cancers. Improving clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists. METHODS: We investigated 30 patients with pyriform sinus SCC to verify the effectiveness of weekly cisplatin chemotherapy with concurrent radiotherapy. Cisplatin was administered at a dose of 40 mg/m(2) on weeks 1, 2, 3, 5, 6, and 7 during definitive radiotherapy with the aim of preserving the larynx. RESULTS: All 30 patients achieved definitive radiotherapy at a median dose of 70 Gy (range 64-70 Gy). Cisplatin was administrated concomitantly a median of five times (range 2-6 times). Persistent or recurrent primary disease was observed in four patients (13 %). Persistent or recurrent nodal metastasis was observed in five patients (17 %). Nine salvage surgeries were performed for eight patients, of whom seven survived without any evidence of disease. Post-operative complications were observed in two patients (22 %). The 5-year overall survival and locoregional control rates were 87 and 96 %, respectively. The 5-year laryngeal preservation rate was 74 %. CONCLUSIONS: The regimen of weekly cisplatin CRT may be effective for pyriform sinus SCC; however, there were problems with strong selection bias in the current study due to the large number of T2 patients. Salvage surgery was safe and was able to improve the survival rate. This chemoradiation regimen was considered successful in preserving laryngeal function.
  • Jun Furusawa, Akihiro Homma, Rikiya Onimaru, Tomohiro Sakashita, Daisuke Yoshida, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda
    Auris, nasus, larynx 42 6 443 - 8 2015年12月 [査読有り][通常論文]
     
    OBJECTIVE: We retrospectively assessed the indications for superselective intra-arterial infusion of cisplatin with concomitant radiotherapy (RADPLAT) in patients with hypopharyngeal cancer (HPC). METHODS: Between April 2000 and March 2013, 41 previously untreated patients received superselective intra-arterial infusion of cisplatin (100-120mg/m(2) per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional radiotherapy (65-70Gy). RESULTS: During the median follow-up period of 5.5 years, a statistically significant difference in the 5-year overall survival was noted between patients with N0-1 (n=14) and N2b-3 disease (n=27). One-half of deaths were observed to be the result of distant metastasis. The 5-year local control and overall survival were significantly better in patients with unilateral than in those with bilateral primary tumors. All the patients with T4b disease (n=3) died of disease within 2 years. CONCLUSION: Indications for RADPLAT in patients with HPC were defined as patients with unilateral tumors staged as T3-4a and N0-1.
  • Akihiro Homma, Yuji Nakamaru, Tomohiro Sakashita, Rikiya Onimaru, Shunsuke Terasaka, Kazuhiko Tsuchiya, Daisuke Yoshida, Koichi Yasuda, Hiromitsu Hatakeyama, Jun Furusawa, Takatsugu Mizumachi, Satoshi Kano, Hiroki Shirato, Satoshi Fukuda
    Auris, nasus, larynx 42 5 377 - 81 2015年10月 [査読有り][通常論文]
     
    OBJECTIVE: Here we report our experience of patients with squamous cell carcinoma (SCC) of the nasal cavity and ethmoid sinus (NC&ES) together with an analysis of treatment outcomes. METHODS: A retrospective analysis was performed using data from 25 consecutive patients treated between 2000 and 2012. Four patients were diagnosed with T1, 3 with T2, 4 with T3, 7 with T4a, and 7 with T4b disease. No patient had lymph node metastasis. RESULTS: Twelve patients were treated with surgery with/without radiotherapy and with/without chemotherapy. Of these, 4 underwent endoscopic surgery without an open approach and 3 required an anterior skull base approach. Thirteen were treated with radiotherapy; 1 with radiotherapy alone, and 4 and 8 with intravenous and intra-arterial chemotherapy, respectively. The 5-yr overall survival for T1-3, T4a, and T4b disease was 53.9%, 71.4%, and 29.0%, respectively. The 5-yr disease-specific survival for T1-3, T4a, and T4b disease was 74.1%, 71.4%, and 29.0%, respectively. CONCLUSION: Our treatment policy for patients with SCC of NC&ES, which basically follows the NCCN guideline, was considered to be appropriate. However, several points in terms of surgery and non-surgical approach remain to be solved through further research.
  • Akihiro Homma, Tomohiro Sakashita, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Yuji Nakamaru, Daisuke Yoshida, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda
    Acta oto-laryngologica 135 9 950 - 4 2015年09月 [査読有り][通常論文]
     
    CONCLUSIONS: Superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) is considered to be one of the treatments of choice for patients with adenoid cystic carcinoma (ACC) who prefer not to undergo radical surgery. OBJECTIVE: To evaluate the efficacy of RADPLAT for patients with ACC of the head and neck. PATIENTS AND METHODS: Between 2001-2010, nine patients with untreated ACC were given superselective intra-arterial infusion of cisplatin (100-120 mg/m(2)/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and radiotherapy (65-70 Gy). RESULTS: Five patients had tumors arising in the base of the tongue, two in the maxillary sinus, and the remaining two in the nasopharynx. The median follow-up period was 9 years 7 months (9;7) (range = 4;6-12;5), and the 5-year local control (LC), overall survival (OS), and disease-free survival rates were 88.9%, 88.9%, and 55.6%, respectively. The 10-year OS rate was 57.1%, but all patients who remained alive for over 10 years are still alive with disease. Primary tumor recurrence was observed in five of the nine patients, with the median time to recurrence being 6 years (range = 4-9 years). Five of the nine patients had distant metastasis, and of these three patients also had primary recurrence.
  • Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Jun Furusawa, Satoshi Kano, Takatsugu Mizumachi, Satoshi Iizuka, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda
    Acta oto-laryngologica 135 8 853 - 8 2015年08月 [査読有り][通常論文]
     
    CONCLUSION: Grade ≥ 3 mucositis/stomatitis and inability to feed orally were problematic for patients undergoing cetuximab-based bioradiotherapy (BRT) as well as platinum-based chemoradiotherapy (CRT). Severe mucositis/stomatitis and radiation dermatitis should be addressed carefully in patients undergoing cetuximab-based BRT as well. OBJECTIVES: The efficacy of cetuximab-based BRT in locally advanced head and neck squamous cell carcinomas has been established. However, the safety of cetuximab-based BRT in comparison with platinum-based CRT is currently under investigation. METHOD: This study retrospectively analyzed 14 patients undergoing cetuximab-based BRT and 29 patients undergoing platinum-based CRT to compare the incidence of acute toxicities. In the BRT group, an initial cetuximab loading dose of 400 mg/m(2) was delivered 1 week before the start of radiotherapy. Seven weekly infusions of 250 mg/m(2) of cetuximab followed during the definitive radiotherapy. In the CRT group, cisplatin was administered at a dose of 40 mg/m(2) weekly during the definitive radiotherapy. RESULTS: The BRT group had a higher incidence of Grade ≥ 3 radiation dermatitis than did the CRT group (43% vs 3%, respectively, p < 0.01). The incidence rate of Grade ≥ 3 mucositis/stomatitis was 64.3% and 41.4% in the BRT and CRT group, respectively (p = 0.1484), while the incidence rate of the inability to feed orally was 38.5% and 55.2%, respectively (p = 0.2053).
  • Takatsugu Mizumachi, Akihiro Homma, Tomohiko Kakizaki, Tomohiro Sakashita, Satoshi Kano, Hiromitsu Hatakeyama, Kazuhiko Tsuchiya, Koichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Jun Taguchi, Yasushi Shimizu, Ichiro Kinoshita, Hirotoshi Akita, Satoshi Fukuda
    International journal of clinical oncology 20 3 431 - 7 2015年06月 [査読有り][通常論文]
     
    BACKGROUND: The aim of this study was to evaluate the feasibility of induction docetaxel, cisplatin, and 5-fluorouracil chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS: Between 2010 and 2013, 30 patients with Stage IV HNSCC were treated in Hokkaido University Hospital with three cycles of induction chemotherapy (docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2), day 1; and 5-fluorouracil 750 mg/m(2)/day 120 h continuous infusion, every 3 weeks) followed by concurrent weekly cisplatin (40 mg/m(2), on weeks 1, 2, 3, 5, 6 and 7) chemoradiotherapy. RESULTS: Three courses of induction chemotherapy were performed in 25 patients (83%) with grade 3-4 toxicities during induction chemotherapy observed in 22 patients (73%). The major toxicities were hematologic, with 22 cases (73%) showing grade 3-4 neutropenia. Radiotherapy was completed (70 Gy) in 29 patients (97%), while a total of 19 patients (63%) completed five (13 patients) or six (6 patients) courses of chemotherapy. During concurrent chemoradiotherapy, no grade 4 hematological toxicities were observed. Grade 4 dermatitis was observed in one patient, and grade 3 mucositis was observed in 12 patients. There were no treatment-related deaths during the induction chemotherapy or concurrent chemoradiotherapy. The 1- and 2-year progression-free survival rates and the 1- and 2-year overall survival rates were 86%, 72%, and 89%, 81%, respectively. CONCLUSION: Sequential therapy composed of induction chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy is feasible, showing encouraging results in patients with locally advanced HNSCC. Concurrent weekly cisplatin chemoradiotherapy following induction chemotherapy appears to be a suitable alternative to three-weekly high-dose cisplatin therapy.
  • Takashi Mori, Rikiya Onimaru, Shunsuke Onodera, Kazuhiko Tsuchiya, Koichi Yasuda, Hiromitsu Hatakeyama, Hiroyuki Kobayashi, Shunsuke Terasaka, Akihiro Homma, Hiroki Shirato
    Radiation oncology (London, England) 10 1 88 - 88 2015年04月15日 [査読有り][通常論文]
     
    BACKGROUND: Olfactory neuroblastoma (ONB) is a rare tumor originating from olfactory epithelium. Here we retrospectively analyzed the long-term treatment outcomes and toxicity of radiotherapy for ONB patients for whom computed tomography (CT) and three-dimensional treatment planning was conducted to reappraise the role of radiotherapy in the light of recent advanced technology and chemotherapy. METHODS: Seventeen patients with ONB treated between July 1992 and June 2013 were included. Three patients were Kadish stage B and 14 were stage C. All patients were treated with radiotherapy with or without surgery or chemotherapy. The radiation dose was distributed from 50 Gy to 66 Gy except for one patient who received 40 Gy preoperatively. RESULTS: The median follow-up time was 95 months (range 8-173 months). The 5-year overall survival (OS) and relapse-free survival (RFS) rates were estimated at 88% and 74%, respectively. Five patients with stage C disease had recurrence with the median time to recurrence of 59 months (range 7-115 months). Late adverse events equal to or above Grade 2 in CTCAE v4.03 were observed in three patients. CONCLUSION: Multimodal therapy including radiotherapy with precise treatment planning based on CT simulation achieved an excellent local control rate with acceptable toxicity and reasonable overall survival for patients with ONB.
  • Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Jun Furusawa, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda
    European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 271 10 2767 - 70 2014年10月 [査読有り][通常論文]
     
    The efficacy of elective neck irradiation (ENI) for patients with N0 carcinoma of the maxillary sinus has been controversial. The purpose of our study was to investigate the incidence of late neck recurrence and the mortality rate from regional disease in patients with N0 maxillary sinus cancer after superselective cisplatin infusion and concomitant radiotherapy (RADPLAT) without ENI. We retrospectively analyzed 48 patients with N0 maxillary sinus cancer who underwent RADPLAT. Chemotherapy consisted of 100-120 mg/m(2) superselective intra-arterial cisplatin administered at a median rate of four times weekly. Concurrent radiation therapy was administered at a median dose of 65 Gy without ENI. Late neck recurrence was observed in 8.3% (4/48). Three patients underwent salvage neck dissection and survived without any evidence of disease. The remaining patient did not undergo neck dissection due to coexistence with distant metastasis, and he died of regional disease. The mortality rate from regional disease was calculated to be 2% (1/48). The incidence of late neck recurrence was not frequent, and the mortality rate from regional disease was low. Salvage neck dissection was considered to be feasible for patients with late neck recurrence. When definitive radiotherapy and concomitant chemotherapy are applied, it is considered that ENI is not required for cases of N0 maxillary sinus cancer.
  • Chowdhury Nusrat Fatema, Songji Zhao, Yan Zhao, Wenwen Yu, Ken-ichi Nishijima, Koichi Yasuda, Yoshimasa Kitagawa, Nagara Tamaki, Yuji Kuge
    BMC cancer 14 692 - 692 2014年09月22日 [査読有り][通常論文]
     
    BACKGROUND: Radiotherapy is an important treatment strategy for head and neck cancers. Tumor hypoxia and repopulation adversely affect the radiotherapy outcome. Accordingly, fractionated radiotherapy with dose escalation or altered fractionation schedule is used to prevent hypoxia and repopulation. 18F-fluoromisonidazole (FMISO) and 18F-fluorothymidine (FLT) are noninvasive markers for assessing tumor hypoxia and proliferation, respectively. Thus, we evaluated the dynamic changes in intratumoral hypoxic and proliferative states following radiotherapy using the dual tracers of 18F-FMISO and 3H-FLT, and further verified the results by immunohistochemical staining of pimonidazole (a hypoxia marker) and Ki-67 (a proliferation marker) in human head and neck cancer xenografts (FaDu). METHODS: FaDu xenografts were established in nude mice and assigned to the non-radiation-treated control and two radiation-treated groups (10- and 20-Gy). Tumor volume was measured daily. Mice were sacrificed 6, 24, and 48 hrs and 7 days after radiotherapy. 18F-FMISO, and 3H-FLT and pimonidazole were injected intravenously 4 and 2 hrs before sacrifice, respectively. Intratumoral 18F-FMISO and 3H-FLT levels were assessed by autoradiography. Pimonidazole and Ki-67 immunohistochemistries were performed. RESULTS: In radiation-treated mice, tumor growth was significantly suppressed compared with the control group, but the tumor volume in these mice gradually increased with time. Visual inspection showed that intratumoral 18F-FMISO and 3H-FLT distribution patterns were markedly different. Intratumoral 18F-FMISO level did not show significant changes after radiotherapy among the non-radiation-treated control and radiation-treated groups, whereas 3H-FLT level markedly decreased to 59 and 45% of the non-radiation-treated control at 6 hrs (p<0.0001) and then gradually increased with time in the 10- and 20-Gy-radiation-treated groups. The pimonidazole-positive hypoxic areas were visually similar in both the non-radiation-treated control and radiation-treated groups. No significant differences were observed in the percentage of pimonidazole-positive cells and Ki-67 index. CONCLUSION: Intratumoral 18F-FMISO level did not change until 7 days, whereas 3H-FLT level markedly decreased at 6 hrs and then gradually increased with time after a single dose of radiotherapy. The concomitant monitoring of dynamic changes in tumor hypoxia and proliferation may provide important information for a better understanding of tumor biology after radiotherapy and for radiotherapy planning, including dose escalation and altered fractionation schedules.
  • Sakashita T, Homma A, Hatakeyama H, Kano S, Mizumachi T, Furusawa J, Yoshida D, Fujima N, Onimaru R, Tsuchiya K, Yasuda K, Shirato H, Suzuki F, Fukuda S
    Br J Oral Maxillofac Surg 52 4 323 - 8 2014年04月 [査読有り][通常論文]
     
    Our aim was to evaluate the feasibility of salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy. We retrospectively analysed the records of 61 patients with cancer of the maxillary sinus who were treated in this way. Chemotherapy comprised 100-120 mg/m(2) superselective intra-arterial infusions of cisplatin given a median of 4 times weekly (range 2-5). Concurrent radiotherapy was given in a median dose of 65 Gy (range 24-70 Gy). Persistent or recurrent cancer of the maxillary sinus was found in 17 patients, of whom 11 had salvage surgery. The disease was controlled in 8 of the 11, and 7 of the 11 survived with no evidence of disease. Their 5-year overall survival was 61%. Two of the 11 developed serious operative complications. Salvage surgery for patients with persistent or recurrent cancer of the maxillary sinus treated by superselective chemoradiotherapy is both safe and successful. Salvage surgery is a good option when this sort of persistent or recurrent cancer is followed up after the regimen of chemoradiotherapy described.
  • Homma A, Sakashita T, Yoshida D, Onimaru R, Tsuchiya K, Suzuki F, Yasuda K, Hatakeyama H, Furusawa J, Mizumachi T, Kano S, Inamura N, Taki S, Shirato H, Fukuda S
    Br J Cancer 109 12 2980 - 2986 2013年12月 [査読有り][通常論文]
     
    Background: The purpose of this study was to evaluate the efficacy of superselective cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with the squamous cell carcinoma of maxillary sinus (SCC-MS). Methods: Between 1999 and 2010, 54 patients were given superselective intra-arterial infusions of cisplatin (100-120mgm(-2) per week) with simultaneous intra-venous infusions of thiosulfate to neutralise cisplatin toxicity and conventional radiotherapy (65-70 Gy). Results: One patient (1.9%) was diagnosed with T2, 14 (25.9%) with T3, 27 (50%) with T4a, and 12 (22.2%) with T4b disease. Lymph-node involvement was present in 12 patients (22.2%). During the median follow-up period of 6.4 years, the 5-year local progression-free and overall survival rates were 65.8 and 67.9% for all patients, respectively. No patient died as a result of treatment toxicity or experienced a cerebrovascular accident. Osteonecrosis (n-5), brain necrosis (n-1), and ocular/ visual problems (n = 14) were observed as late adverse reactions. Conclusion: We have shown excellent overall survival and local progression-free rate in SCC-MS patients treated by RADPLAT with acceptable rates of acute and late toxicity. A multi-institutional trial is needed to prove that this strategy is a feasible and effective approach for the treatment of SCC-MS.
  • Kentaro Nishioka, Shinichi Shimizu, Rumiko Kinoshita, Tetsuya Inoue, Shunsuke Onodera, Koichi Yasuda, Keiichi Harada, Yukiko Nishikawa, Rikiya Onimaru, Hiroki Shirato
    Radiation oncology (London, England) 8 185 - 185 2013年07月23日 [査読有り][通常論文]
     
    BACKGROUND: In-room cone-beam computerized tomography (CBCT) imaging is a promising method to reduce setup errors, especially in organs such as the bladder that often have large intrafractional variations due to organ movement. CBCT image quality is limited by low contrast and imaging artifacts, but few data have been reported about inter-observer variability of bladder boundary delineation on CBCT. The aim of this work was to analyze and evaluate the inter-observer contouring uncertainties of bladder boundary delineation on CBCT images in a prospective fashion. METHODS: Five radiation oncologists contoured 10 bladders using the CBCT datasets of consecutive 10 patients (including 4 females) who were irradiated to the pelvic region. Prostates were also contoured in male patients. Patients who had had prostatectomy were excluded. The coefficient of variation (COV), conformity index (CI(gen)), and coordinates of center-of-mass (COM) of the bladder and prostate were calculated for each patient. RESULTS: The mean COV for the bladder and prostate was 0.08 and 0.20, respectively. The mean CI(gen) of the bladder and prostate was 0.81 and 0.66, respectively. The root mean square (RMS) of the inter-observer standard deviation (σ) of the COM displacement in the left-right (LR) and anterior-posterior (AP) direction was 0.79, 0.87 and 0.54 for the bladder and 0.63, 0.99 and 1.72 for the prostate. Regarding the mean COV and CI(gen) for the bladder, the differences between males and females were not significant. CONCLUSIONS: Inter-observer variability for bladder delineation on CBCT images was substantially small regardless of gender. We believe that our results support the applicability of CBCT in adaptive radiotherapy for bladder cancer.
  • Tomohiro Sakashita, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda
    Auris, nasus, larynx 40 2 211 - 5 2013年04月 [査読有り][通常論文]
     
    OBJECTIVES: Although three-weekly high-dose (100mg/m(2)) cisplatin (three cycles) chemoradiotherapy has been considered a standard regimen for patients with advanced head and neck squamous cell carcinomas (HNSCC), this protocol is associated with significant acute and late toxicities. Therefore, weekly cisplatin at a dose of 40mg/m(2) has been used at our institution since 2006. This retrospective study was aimed at assessing the oncologic efficacy of weekly cisplatin chemoradiotherapy for the control of nodal metastasis. METHODS: We analyzed 28 patients with node-positive HNSCC treated with weekly cisplatin and concurrent radiotherapy. Computed tomography was performed 4-8 weeks after the completion of chemoradiotherapy to evaluate nodal response. If residual neck disease was apparent or suspected, we performed early salvage neck dissection (ND). In cases with a complete response (CR), we took a "wait and see" approach. When no viable tumor cells were observed in the surgical specimens obtained by ND, nodal metastasis was defined as controlled by weekly cisplatin chemoradiotherapy alone. RESULTS: Nodal metastasis was evaluated as having a CR in 20 patients (71%). Eight patients (29%) underwent early salvage ND. Recurrent primary tumors were observed in the other four patients (14%). Salvage primary resection and associated ND were performed for these four patients. In 7 of 12 patients undergoing ND, no viable tumor cells were observed. In 23of 28 patients, neck diseases were controlled by chemoradiotherapy alone (not including salvage by ND). In 27 of 28 patients, neck diseases were controlled by the overall treatment (including salvage by ND). The rate of nodal control by chemoradiotherapy alone and by the overall treatment was found to be 82.0% and 96.3%, respectively, using the Kaplan-Meier method. The three-year overall and disease free survival rates were 86.8% and 80.8%, respectively. CONCLUSION: Concomitant weekly cisplatin at a dose of 40mg/m(2) chemoradiotherapy showed a good control rate of not only primary lesions but also neck diseases.
  • Shozo Okamoto, Tohru Shiga, Koichi Yasuda, Yoichi M Ito, Keiichi Magota, Katsuhiko Kasai, Yuji Kuge, Hiroki Shirato, Nagara Tamaki
    Journal of nuclear medicine : official publication, Society of Nuclear Medicine 54 2 201 - 7 2013年02月 [査読有り][通常論文]
     
    UNLABELLED: Tumor hypoxia is well known to be radiation resistant. (18)F-fluoromisonidazole ((18)F-FMISO) PET has been used for noninvasive evaluation of hypoxia. Quantitative evaluation of (18)F-FMISO uptake is thus expected to play an important role in the planning of dose escalation radiotherapy. However, the reproducibility of (18)F-FMISO uptake has remained unclarified. We therefore investigated the reproducibility of tumor hypoxia by using quantitative analysis of (18)F-FMISO uptake. METHODS: Eleven patients with untreated head and neck cancer underwent 2 (18)F-FMISO PET/CT scans ((18)F-FMISO(1) and (18)F-FMISO(2)) with a 48-h interval prospectively. All images were acquired at 4 h after (18)F-FMISO injection for 10 min. The maximum standardized uptake (SUVmax), tumor-to-blood ratio (TBR), and tumor-to-muscle ratio (TMR) of (18)F-FMISO uptake were statistically compared between the 2 (18)F-FMISO scans by use of intraclass correlation coefficients (ICCs). The hypoxic volume was calculated as the area with a TBR of greater than or equal to 1.5 or the area with a TMR of greater than or equal to 1.25 to assess differences in hypoxic volume between the 2 (18)F-FMISO scans. The distances from the maximum uptake locations of the (18)F-FMISO(1) images to those of the (18)F-FMISO(2) images were measured to evaluate the locations of (18)F-FMISO uptake. RESULTS: The SUVmax (mean ± SD) for (18)F-FMISO(1) and (18)F-FMISO(2) was 3.16 ± 1.29 and 3.02 ± 1.12, respectively, with the difference between the 2 scans being 7.0% ± 4.6%. The TBRs for (18)F-FMISO(1) and (18)F-FMISO(2) were 2.98 ± 0.83 and 2.97 ± 0.64, respectively, with a difference of 9.9% ± 3.3%. The TMRs for (18)F-FMISO(1) and (18)F-FMISO(2) were 2.25 ± 0.71 and 2.19 ± 0.67, respectively, with a difference of 7.1% ± 5.3%. The ICCs for SUVmax, TBR, and TMR were 0.959, 0.913, and 0.965, respectively. The difference in hypoxic volume based on TBR was 1.8 ± 1.8 mL, and the difference in hypoxic volume based on TMR was 0.9 ± 1.3 mL, with ICCs of 0.986 and 0.996, respectively. The maximum uptake locations of the (18)F-FMISO(1) images were different from those of the (18)F-FMISO(2) images and were within the full width at half maximum of the PET/CT scanner, except in 1 case. CONCLUSION: The values for (18)F-FMISO PET uptake and hypoxic volume in head and neck tumors between the 2 (18)F-FMISO scans were highly reproducible. Such high reproducibility of tumor hypoxia is promising for accurate radiation planning.
  • Koichi Yasuda, Rikiya Onimaru, Shozo Okamoto, Tohru Shiga, Norio Katoh, Kazuhiko Tsuchiya, Ryusuke Suzuki, Wataru Takeuchi, Yuji Kuge, Nagara Tamaki, Hiroki Shirato
    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 85 1 142 - 147 2013年01月 [査読有り][通常論文]
     
    Purpose: The impact of a new type of positron emission tomography (New PET) with semiconductor detectors using F-18-labeled fluoromisonidazole (FMISO)-guided intensity modulated radiation therapy (IMRT) was compared with a state-of-the-art PET/computed tomography (PET/CT) system in nasopharyngeal cancer (NPC) patients. Methods and Materials: Twenty-four patients with non-NPC malignant tumors (control group) and 16 patients with NPC were subjected to FMISO-PET. The threshold of the tumor-to-muscle (T/M) ratio in each PET scan was calculated. The hypoxic volume within the gross tumor volume (GTVh) was determined using each PET ((NewPET)GTVh and (PET/CT)GTVh, respectively). Dose escalation IMRT plans prescribing 84 Gy to each GTVh were carried out. Results: The threshold of the T/M ratio was 1.35 for New PET and 1.23 for PET/CT. The mean volume of NewPETGTVh was significantly smaller than that of PET/CTGTVh (1.5 +/- 1.6 cc vs 4.7 +/- 4.6 cc, respectively; P = .0020). The dose escalation IMRT plans using New PET were superior in dose distribution to those using PET/CT. Dose escalation was possible in all 10 New PET-guided plans but not in 1 PET/CT-guided plan, because the threshold dose to the brainstem was exceeded. Conclusions: New PET was found to be useful for accurate dose escalation in FMISO-guided IMRT for patients with NPC. (c) 2013 Elsevier Inc.
  • Yasuda K, Onimaru R, Okamoto S, Shiga T, Katoh N, Tsuchiya K, Suzuki R, Takeuchi W, Kuge Y, Tamaki N, Shirato H
    Int J Radiat Oncol Biol Phys 85 1 142 - 7 2013年 [査読有り][通常論文]
  • Norio Katoh, Koichi Yasuda, Tohru Shiga, Masakazu Hasegawa, Rikiya Onimaru, Shinichi Shimizu, Gerard Bengua, Masayori Ishikawa, Nagara Tamaki, Hiroki Shirato
    International journal of radiation oncology, biology, physics 82 4 e671-6 - E676 2012年03月15日 [査読有り][通常論文]
     
    PURPOSE: We compared two treatment planning methods for stereotactic boost for treating nasopharyngeal carcinoma (NPC): the use of conventional whole-body bismuth germanate (BGO) scintillator positron emission tomography (PET(CONV)WB) versus the new brain (BR) PET system using semiconductor detectors (PET(NEW)BR). METHODS AND MATERIALS: Twelve patients with NPC were enrolled in this study. [(18)F]Fluorodeoxyglucose-PET images were acquired using both the PET(NEW)BR and the PET(CONV)WB system on the same day. Computed tomography (CT) and two PET data sets were transferred to a treatment planning system, and the PET(CONV)WB and PET(NEW)BR images were coregistered with the same set of CT images. Window width and level values for all PET images were fixed at 3000 and 300, respectively. The gross tumor volume (GTV) was visually delineated on PET images by using either PET(CONV)WB (GTV(CONV)) images or PET(NEW)BR (GTV(NEW)) images. Assuming a stereotactic radiotherapy boost of 7 ports, the prescribed dose delivered to 95% of the planning target volume (PTV) was set to 2000 cGy in 4 fractions. RESULTS: The average absolute volume (±standard deviation [SD]) of GTV(NEW) was 15.7 ml (±9.9) ml, and that of GTV(CONV) was 34.0 (±20.5) ml. The average GTV(NEW) was significantly smaller than that of GTV(CONV) (p = 0.0006). There was no statistically significant difference between the maximum dose (p = 0.0585) and the mean dose (p = 0.2748) of PTV. The radiotherapy treatment plan based on the new gross tumor volume (PLAN(NEW)) significantly reduced maximum doses to the cerebrum and cerebellum (p = 0.0418) and to brain stem (p = 0.0041). CONCLUSION: Results of the present study suggest that the new brain PET system using semiconductor detectors can provide more accurate tumor delineation than the conventional whole-body BGO PET system and may be an important tool for functional and molecular radiotherapy treatment planning.
  • Sasaki R, Yasuda K, Abe E, Uchida N, Kawashima M, Uno T, Fujiwara M, Shioyama Y, Kagami Y, Shibamoto Y, Nakata K, Takada Y, Kawabe T, Uehara K, Nibu K, Yamada S
    International journal of radiation oncology, biology, physics 82 2 626 - 34 2012年02月01日 [査読有り][通常論文]
     
    PURPOSE: The purpose of this study was to elucidate the efficacy and optimal method of radiotherapy in the management of solitary extramedullary plasmacytoma occurring in the head and neck regions (EMPHN). METHODS AND MATERIALS: Sixty-seven patients (43 male and 24 female) diagnosed with EMPHN between 1983 and 2008 at 23 Japanese institutions were reviewed. The median patient age was 64 years (range, 12-83). The median dose administered was 50 Gy (range, 30-64 Gy). Survival data were calculated by the Kaplan-Meier method. RESULTS: The median follow-up duration was 63 months. Major tumor sites were nasal or paranasal cavities in 36 (54%) patients, oropharynx or nasopharynx in 16 (23%) patients, orbita in 6 (9%) patients, and larynx in 3 (5%) patients. The 5- and 10-year local control rates were 95% and 87%, whereas the 5- and 10-year disease-free survival rates were 56% and 54%, respectively. There were 5 (7.5%), 12 (18%), and 8 (12%) patients who experienced local failure, distant metastasis, and progression to multiple myeloma, respectively. In total, 18 patients died, including 10 (15%) patients who died due to complications from EMPHN. The 5- and 10-year overall survival (OS) rates were 73% and 56%, respectively. Radiotherapy combined with surgery was identified as the lone significant prognostic factor for OS (p = 0.04), whereas age, gender, radiation dose, tumor size, and chemotherapy were not predictive. No patient experienced any severe acute morbidity. CONCLUSIONS: Radiotherapy was quite effective and safe for patients with EMPHN. Radiotherapy combined with surgery produced a better outcome according to survival rates. These findings require confirmation by further studies with larger numbers of patients with EMPHN.
  • 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11月01日 [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(3) before treatment, in 6 patients with head and neck carcinomas were analyzed in this study. Three fiducial markers implanted in mouthpieces were used for the fusion of CT images. Changes in the location of the lymph nodes were measured on the basis of these fiducial markers. RESULTS: The surface geometry maps showed convex regions in red and concave regions in blue to ensure that the characteristics of the 3D tumor geometries are simply understood visually. After the irradiation of 66 to 70 Gy in 2 Gy daily doses, the patterns of the colors had not changed significantly, and the maps before and during treatment were strongly correlated (average correlation coefficient was 0.808), suggesting that the tumors shrank uniformly, maintaining the original characteristics of the shapes in all 6 patients. The movement of the gravitational center of the lymph nodes during the treatment period was everywhere less than ±5 mm except in 1 patient, in whom the change reached nearly 10 mm. CONCLUSIONS: The surface geometry map was useful for an accurate evaluation of the changes in volume and 3D shapes of metastatic lymph nodes. The fusion of the initial and follow-up CT images based on fiducial markers enabled an analysis of changes in the location of the targets. Metastatic cervical lymph nodes in patients were suggested to decrease in size without significant changes in the 3D shape during radiotherapy. The movements of the gravitational center of the lymph nodes were almost all less than ±5 mm.
  • Homma A, Inamura N, Oridate N, Suzuki S, Hatakeyama H, Mizumachi T, Kano S, Sakashita T, Onimaru R, Yasuda K, Shirato H, Fukuda S
    Jpn J Clin Oncol 41 8 980 - 6 2011年08月 [査読有り][通常論文]
     
    OBJECTIVE: The most common chemoradiotherapy regimen is high-dose (100 mg/m(2)) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. Here, we reviewed the dose intensity and toxicity for concomitant weekly cisplatin and radiotherapy in patients with head and neck cancer. METHODS: Fifty-three patients with untreated head and neck cancer were enrolled and evaluated at our institution from April 2006 to April 2010. Weekly cisplatin (40 mg/m(2)) was given on weeks 1, 2, 3, 5, 6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks. RESULTS: Fifty-one patients (96.2%) received the full dose of radiotherapy, while the course was disrupted by adverse events in two. Over the course of the chemotherapy, 31 patients (58.5%) received more than 200 mg/m(2) cisplatin. The toxicity was manageable in all except one patient, who died of sepsis after completing treatment. The 2-year overall survival rate and local progression-free rate for all patients were 93.7% and 88.0%, respectively. The primary site showed a complete response in 52 patients (98.1%) and a partial response in 1 patient (1.9%). The primary disease was well controlled by chemoradiotherapy in 47 patients (88.7%). CONCLUSIONS: Weekly cisplatin could be easier to manage than three-weekly cisplatin, because patients can be monitored more regularly for toxicity allowing the schedule to be altered if required. This regimen appears to be a suitable alternative to three-weekly high-dose cisplatin with concomitant radiotherapy.
  • Onodera Y, Nishioka N, Yasuda K, Fujima N, Torres M, Kamishima T, Ooyama N, Onimaru R, Terae S, Ooizumi S, Nishimura M, Shirato H
    Int J Radiat Oncol Biol Phys 79 5 1408 - 13 2011年04月01日 [査読有り][通常論文]
     
    PURPOSE: For lung cancer patients with poor pulmonary function because of emphysema or fibrosis, it is important to predict the amplitude of internal tumor motion to minimize the irradiation of the functioning lung tissue before undergoing stereotactic body radiotherapy. METHODS AND MATERIALS: Two board-certified diagnostic radiologists independently assessed the degree of pulmonary emphysema and fibrosis on computed tomography scans in 71 patients with peripheral lung tumors before real-time tumor-tracking radiotherapy. The relationships between the computed tomography findings of the lung parenchyma and the motion of the fiducial marker near the lung tumor were investigated. Of the 71 patients, 30 had normal pulmonary function, and 29 had obstructive pulmonary dysfunction (forced expiratory volume in 1 s/forced vital capacity ratio of <70%), 6 patients had constrictive dysfunction (percentage of vital capacity <80%), and 16 had mixed dysfunction. RESULTS: The upper region was associated with smaller tumor motion, as expected (p = .0004), and the presence of fibrosis (p = .088) and pleural tumor contact (p = .086) were weakly associated with tumor motion. The presence of fibrotic changes in the lung tissue was associated with smaller tumor motion in the upper region (p <.05) but not in the lower region. The findings of emphysema and pulmonary function tests were not associated with tumor motion. CONCLUSION: Tumors in the upper lung region with fibrotic changes have smaller motion than those in the upper region of the lungs without fibrotic changes. The tumor motion in the lower lung region was not significantly different between patients with and without lung fibrosis. Emphysema was not associated with the amplitude of tumor motion.
  • Onodera S, Aoyama H, Katoh N, Taguchi H, Yasuda K, Yoshida D, Surtherland K, Suzuki R, Ishikawa M, Gerard B, Terasaka S, Shirato H
    Japanese journal of clinical oncology 41 4 462 - 468 4 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 α/β ratio of 2.0 Gy was 82.0 Gy (range, 60-106 Gy). RESULTS: The 5-year overall survival was 95.7 (95% confidence interval: 87.3-100)% after initial treatment and 96.2 (88.8-100)% after fractionated stereotactic radiotherapy. The 5-year overall survival and local control rate of patients who received fractionated stereotactic radiotherapy alone were both 100%. The 5-year progression-free survival and local control rate after fractionated stereotactic radiotherapy were all 100% with a tumor volume of <9.1 cc and 68.2 (37.2-99.2) and 75.8 (45.2-100)% for the tumors 9.1 cc, respectively. The difference was significant in progression-free survival (P = 0.022) and local control rate (P = 0.044). The local control rate was significantly worse in patients who received fractionated stereotactic radiotherapy for relapsed tumors (P = 0.01). No late radiation damage was observed in the follow-up period. CONCLUSIONS: The long-term outcome suggests that fractionated stereotactic radiotherapy is a safe and effective treatment for intracranial skull base benign meningioma, especially for those who have tumors <9.1 cc or would receive fractionated stereotactic radiotherapy with or without surgery as the initial treatment.
  • Onimaru R, Hasegawa M, Yasuda K, Homma A, Oridate N, Fukuda S, Shirato H
    Jpn J Clin Oncol 41 1 103 - 9 1 2011年 [査読有り][通常論文]
     
    OBJECTIVE: We retrospectively investigated treatment outcomes in patients with glottic T1 carcinoma treated with 65 Gy in 26 fractions four times a week and discuss the importance of the overall treatment time. METHODS: Two hundred one patients with glottic T1 carcinoma were evaluated. Sixty-five Gray in 26 fractions were delivered for 200 patients, whereas 1 patient received 62.5 Gy in 25 fractions. We delivered radiotherapy once daily four times a week in this period, for a weekly dose of 10 Gy. Weekdays except Wednesday were treatment days. RESULTS: The overall survival rate was 96.8 ± 1.3% (standard error) at 3 years and 90.8 ± 2.2% at 5 years. The local control rate was 91.9 ± 2.0% at 3 years and 89.8 ± 2.3% at 5 years. In patients with an overall treatment time equal to or longer than 47 days, the local control rate was 82.6 ± 6.0% at both 3 and 5 years. In the patients with overall treatment time equal to or less than 46 days, the local control rate was 94.6 ± 1.9% at 3 years and 91.8 ± 2.4% at 5 years. There was a significant difference between these two groups (P = 0.0349). A severe late radiation reaction occurred in one patient. He experienced severe laryngeal edema that required tracheotomy at 6 months after the completion of radiotherapy. The tracheotomy was closed at 14 months after completion of radiotherapy. CONCLUSIONS: Overall treatment time seems to be an important factor for a good local control rate for glottic T1N0 carcinoma even when treated with slight hypofractionation.
  • Koichi Yasuda, Hiroshi Taguchi, Yutaka Sawamura, Jun Ikeda, Hidefumi Aoyama, Kenji Fujieda, Nobuaki Ishii, Masaaki Kashiwamura, Yoshinobu Iwasaki, Hiroki Shirato
    Japanese journal of clinical oncology 38 7 486 - 92 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 < or =5 years old received 18 Gy and the patients >5 years old received 24 Gy CSI. The dose to the primary tumor bed was 39.6-54 Gy. Chemotherapy consisted of ifosfamide, cisplatin and etoposide (ICE chemotherapy). RESULTS: Sixteen patients aged 0.5-20.4 (median 6.1) years were enrolled and followed for 11-165 (median 112) months. Both 5-year actuarial overall survival (OAS) and progression-free survival (PFS) were 81% (95% confidence interval (CI): 62-100%) for the 16 patients. Both 5-year OAS and PFS were 82% (CI: 59-100%) for the patients with medulloblastoma and 80% (CI: 45-100%) for the patients with ST-PNET. Both 5-year OAS and PFS were 75% for the eight patients < or =5 years old and 88% for the eight patients >5 years old. Both 5-year OAS and PFS were 100% for six average-risk patients (3 years or older, total resection and posterior fossa) and 70% for 10 poor-risk patients (others). The median total intellectual quotient at the last follow-up was 85 (ranging from 48 to 103) in 12 patients who were followed for 3-145 (median 49) months. Eight patients received hormone replacement therapy. CONCLUSION: Low-dose CSI and ICE chemotherapy may have a role as a treatment option for a subset of patients with non-metastatic embryonal tumors in the CNS.

その他活動・業績

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  • 加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 対馬 那由多, 鈴木 崇祥, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏 頭頸部癌 45 (3) 300 -304 2019年10月 
    我々は、局所進行外耳道扁平上皮癌に対する治療成績、特にドセタキセル、シスプラチン、5-FUの併用(TPF)の化学療法同時併用放射線療法(CCRT)の治療成績と安全性、および腫瘍の進展範囲と予後との関係を検討した。対象は当科で根治治療を行った外耳道癌扁平上皮癌で、ピッツバーグ分類のT3-4の21症例とした。その結果、硬膜と顎関節への進展が頸部転移と相関を示し、顎関節への進展が局所再発と相関を示した。全症例の2年粗生存率(OS)は61.1%、2年局所制御率(LC)は52.1%であった。CCRT症例では、TPF併用の2年OSは85.7%、それ以外では25.0%、TPF併用の2年LCは57.1%、それ以外では25.0%であった。また、TPF併用CCRTにおけるG3以上の白血球減少は55%、好中球減少は45%であった。TPF併用のCCRTは局所進行外耳道扁平上皮癌に対して高い有効性と安全性を示した。(著者抄録)
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    谷井 大介, 安田 耕一, 細木 和則, 小澤 公太, 蛯名 慶也, 岩井 良夫 共済医報 68 (Suppl.) 114 -114 2019年10月
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    安田 耕一, 湊川 英樹, 出倉 康裕, 対馬 那由多, 鈴木 崇祥, 加納 里志, 水町 貴諭, 鬼丸 力也, 清水 伸一, 本間 明宏, 白土 博樹 頭頸部癌 45 (2) 134 -134 2019年05月
  • 外耳道癌における強度変調陽子線治療と強度変調X線治療との線量分布の比較
    出倉 康裕, 安田 耕一, 湊川 英樹, 対馬 那由多, 鈴木 崇祥, 加納 里志, 水町 貴諭, 鬼丸 力也, 清水 伸一, 本間 明宏, 白土 博樹 頭頸部癌 45 (2) 138 -138 2019年05月
  • 水町 貴諭, 加納 里志, 本間 明宏, 赤澤 美樹子, 長谷川 千春, 城石 陽子, 岡本 千秋, 熊谷 聡美, 西村 雅勝, 高崎 裕代, 武田 宏司, 安田 耕一, 湊川 英樹, 出倉 康裕, 鬼丸 力也, 白土 博樹, 福田 諭 癌と化学療法 46 (4) 685 -689 2019年04月 
    頭頸部癌に対する化学放射線療法により生じる代表的な副作用には口腔粘膜炎と体重減少があげられる。今回われわれは、中咽頭癌、下咽頭癌症例にてシスプラチンと放射線療法を同時併用する化学放射線療法施行症例において、ω3系脂肪酸高配合栄養機能食品であるプロシュアの口腔粘膜炎と体重減少に対する有用性の検討を行った。放射線治療開始から終了までの期間プロシュアを投与し、最大体重減少率、口腔粘膜炎、化学放射線療法完遂率についてプロシュアの介入を行っていない過去の当科症例を対照群として比較検討を行った。プロシュア投与群は対照群と比べ体重減少率の改善(7.3% vs 10.3%、p<0.01)、口腔粘膜炎の改善を認めた(CTCAE v3.0 Grade 3以上;24% vs 58%、p<0.05)が、化学放射線療法完遂率は両群の差を認めなかった(77% vs 60%、NS)。プロシュアの投与が化学放射線療法施行中において、体重減少や口腔粘膜炎の改善に寄与する可能性が示唆された。(著者抄録)
  • 強度変調放射線治療中に皮下気腫をきたし,再検証を要した頭頸部癌患者の1例
    湊川 英樹, 安田 耕一, 白土 博樹, 土屋 和彦, 鈴木 隆介, 宮本 直樹, 坂下 智博, 本間 明宏, 福田 諭 Japanese Journal of Radiology 37 (Suppl.) 4 -4 2019年02月
  • 秦 浩信, 吉川 和人, 今待 賢治, 村井 知佳, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政 頭頸部癌 44 (4) 380 -386 2018年12月 
    頭頸部癌治療では様々な機能障害や、有害事象により患者のQOLが著しく低下する。多くの場合、治療後緩やかに改善するが、様々な不具合を受容しながら生活している。長期生存者の口腔管理の継続は重要な課題である。2012年度から開始された全国共通がん医科歯科連携講習会により、全国で14,000名以上がん診療連携歯科医が登録され、連携の受け入れ体制が整った。北海道大学病院で2011年に行った、2007年から2010年までの4年間の実態調査では、退院後に院内外で口腔管理を継続できたのは34.3%で、地域歯科医院に依頼したものは7.5%に過ぎなかった。今回行った2011年から2016年までの6年間の調査では、退院後口腔管理を継続できたのは70.5%であり、地域歯科医院に依頼したものは40.4%と著明に増加した。頭頸部癌患者のQOLに寄与するため、適切な口腔管理を地域歯科医院と共に継続することが肝要である。(著者抄録)
  • 渡邊はるな, 藤後廉, 小川貴弘, 長谷山美紀, 安田耕一, THA Khin Khin, 工藤與亮, 白土博樹 電気・情報関係学会北海道支部連合大会講演論文集(CD-ROM) 2018 ROMBUNNO.87 2018年10月27日 [査読無し][通常論文]
  • 本間 明宏, 加納 里志, 水町 貴諭, 中薗 彬, 鈴木 崇祥, 坂下 智博, 福田 諭, 鬼丸 力也, 安田 耕一, 湊川 英樹, 出倉 康裕, 土屋 和彦, 白土 博樹 日本気管食道科学会会報 69 (5) 319 -320 2018年10月
  • Quality of Survivalを考慮した頭頸部癌支持療法 頭頸部がん患者の口腔支持療法と地域連携
    秦 浩信, 吉川 和人, 今待 賢治, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政 頭頸部癌 44 (2) 115 -115 2018年05月
  • 当科における局所進行外耳道扁平上皮癌の治療成績の検討
    加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏 頭頸部癌 44 (2) 181 -181 2018年05月
  • Quality of Survivalを考慮した頭頸部癌支持療法 頭頸部がん患者の口腔支持療法と地域連携
    秦 浩信, 吉川 和人, 今待 賢治, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政 頭頸部癌 44 (2) 115 -115 2018年05月 [査読有り][通常論文]
  • 当科における局所進行外耳道扁平上皮癌の治療成績の検討
    加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏 頭頸部癌 44 (2) 181 -181 2018年05月 [査読有り][通常論文]
  • 同時期に異所性に発生した悪性腫瘍に対して、二部位同時にIMRTを施行した症例
    湊川 英樹, 安田 耕一, 白土 博樹, 土屋 和彦, 原田 八重, 水町 貴諭, 坂下 智博, 本間 明宏, 福田 諭, 石嶋 漢, 宮本 直樹, 高尾 聖心, 鈴木 隆介, 松浦 妙子, 牧永 綾乃, 田村 昌也 Japanese Journal of Radiology 36 (Suppl.) 6 -6 2018年02月 [査読無し][通常論文]
  • 乳癌眼窩尖部転移により視力低下をきたし、放射線治療により著明な改善を認めた1例
    湊川 英樹, 安田 耕一, 打浪 雄介, 白土 博樹, 土屋 和彦, 加藤 徳雄, 木下 留美子, 石田 直子, 山下 啓子, 石嶋 漢 Japanese Journal of Radiology 36 (Suppl.) 11 -11 2018年02月 [査読無し][通常論文]
  • 清水伸一, 小橋啓司, 伊藤陽一, PRAYONGRAT Anussara, 加藤徳雄, 安田耕一, 出倉康裕, 木元拓也, 白土博樹 日本放射線腫瘍学会高精度放射線外部照射部会学術大会プログラム・抄録集 31st (CD-ROM) 39 2018年 [査読無し][通常論文]
  • N. Katoh, Y. Uchinami, S. Takao, K. Yasuda, K. Harada, T. Inoue, T. Matsuura, T. Hashimoto, S. Shimizu, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 99 (2) E159 -E160 2017年10月 [査読無し][通常論文]
  • T. Inoue, S. Watanabe, K. Harada, K. Yasuda, N. Katoh, S. Okamoto, T. Shiga, Y. Kuge, N. Tamaki, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 99 (2) E466 -E466 2017年10月 [査読無し][通常論文]
  • PETの放射線治療への応用 特に頭頸部癌に関して
    安田 耕一 核医学 54 (Suppl.) S139 -S139 2017年09月
  • 分子イメージングを用いた放射線治療
    安田 耕一 JSMI Report 10 (2) 29 -32 2017年05月 [査読無し][通常論文]
     
    代表的な低酸素イメージングである[18F]fluoromisonidazole(FMISO)-PETを放射線治療に応用するためには、低酸素の領域を正確に同定する必要があり、高性能なPETが不可欠である。そのため新たな仕組みのPETが開発された。検出器にCdTe半導体を用いることでγ線を直接電気信号に変換することができ、検出器が小型化され、高い空間分解能を示している。1)FMISO-PET画像のコントラストと半導体PET、2)FMISO-PET画像の再現性、3)治療前FMISO-PETと再現部位の関係、4)頭頸部癌以外におけるFMISO-PETの応用、について述べた。
  • 安田 耕一, 加藤 徳雄, 岡本 祥三, 木下 留美子, 志賀 哲, 水町 貴諭, 畠山 博充, 本間 明宏, 田口 純, 清水 康, 森 崇, 土屋 和彦, 白土 博樹 頭頸部癌 43 (2) 221 -221 2017年05月 [査読無し][通常論文]
  • Shozo Okamoto, Tohru Shiga, Koichi Yasuda, Shiro Watanabe, Keiichi Magota, Rikiya Onimaru, Kazuhiko Tsuchiya, Yuji Kuge, Nagara Tamaki JOURNAL OF NUCLEAR MEDICINE 58 2017年05月 [査読有り][通常論文]
  • 土屋 和彦, 安田 耕一, 原田 八重, 鬼丸 力也, 白土 博樹 Japanese Journal of Radiology 35 (Suppl.) 10 -10 2017年02月 [査読無し][通常論文]
  • 高次医療連携システムによる医療情報の有効活用について 患者と医療者のためのがん治療の道標の可視化 患者中心のがん診断・治療ナビゲーションシステム開発
    白土 博樹, 安田 耕一, 熊木 康雄, 上杉 正人 医療情報学連合大会論文集 36回 (1) 126 -127 2016年11月 [査読無し][通常論文]
  • 橋本 孝之, 敦賀 健吉, 小林 浩之, 井口 晶裕, 本多 昌平, 杉山 未奈子, 安田 耕一, 宮城 久之, 山口 秀, 藤田 憲明, 大島 淳二郎, 長 祐子, 鬼丸 力也, 清水 伸一, 寺坂 俊介, 森本 裕二, 白土 博樹 日本小児血液・がん学会雑誌 53 (4) 366 -366 2016年11月 [査読無し][通常論文]
  • 白土博樹, 安田耕一, 熊木康雄, 上杉正人 医療情報学 36 (Supplement 1) 126‐127 2016年11月01日 [査読無し][通常論文]
  • Tohru Shiga, Shozo Okamoto, Wataru Takeuchi, Atsuro Suzuki, Koichi Yasuda, Keiichi Magota, Shiro Watanabe, Kenji Hirata, Yuji Kuge, Keiji Kobashi, Nagara Tamaki JOURNAL OF NUCLEAR MEDICINE 57 2016年05月
  • 安田 耕一, 西川 由記子, 岡本 祥三, 伊藤 陽一, 土屋 和彦, 志賀 哲, 鬼丸 力也, 久下 裕司, 玉木 長良, 白土 博樹 頭頸部癌 42 (2) 158 -158 2016年05月 [査読無し][通常論文]
  • 水町 貴諭, 坂下 智博, 加納 里志, 畠山 博充, 本間 明宏, 土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 福田 諭 頭頸部癌 42 (2) 181 -181 2016年05月 [査読無し][通常論文]
  • 本間 明宏, 畠山 博充, 水町 貴諭, 加納 里志, 坂下 智博, 鬼丸 力也, 土屋 和彦, 安田 耕一, 白土 博樹, 福田 諭 頭頸部癌 42 (2) 214 -214 2016年05月 [査読無し][通常論文]
  • 安田耕一, 安田耕一, 岡本祥三, 西川由記子, 伊藤陽一, 志賀哲, 井上哲也, 森崇, 豊永拓哉, 鬼丸力也, 渡邊史郎, 土屋和彦, 竹内渉, 加藤徳雄, 加藤徳雄, 久下裕司, 玉木長良, 白土博樹, 白土博樹 JSMI Report 9 (2) 83 2016年04月25日 [査読無し][通常論文]
  • Clinical application for molecular imaging(Therapy) 分子イメージングを用いた放射線治療
    安田 耕一, 岡本 祥三, 西川 由記子, 伊藤 陽一, 志賀 哲, 井上 哲也, 森 崇, 豊永 拓哉, 鬼丸 力也, 渡邊 史郎, 土屋 和彦, 竹内 渉, 加藤 徳雄, 久下 裕司, 玉木 長良, 白土 博樹 JSMI Report 9 (2) 83 -83 2016年04月 [査読無し][通常論文]
  • 土屋 和彦, 安田 耕一, 原田 八重, 鬼丸 力也, 白土 博樹 Japanese Journal of Radiology 34 (Suppl.) 11 -11 2016年02月 [査読無し][通常論文]
  • 安田 耕一, 清水 伸一, 橋本 孝之, Sutherland Ken, 白土 博樹, 土屋 和彦, 加藤 徳雄, 鬼丸 力也, 木下 留美子, 井上 哲也, 西岡 健太郎, 西川 由記子, 森 崇, 原田 慶一, 原田 八重, 鈴木 隆介, 寅松 千枝, 松浦 妙子, 高尾 聖心, 宮本 直樹, 伊藤 陽一 Japanese Journal of Radiology 34 (Suppl.) 5 -5 2016年02月 [査読無し][通常論文]
  • 古沢 純, 本間 明宏, 鬼丸 力也, 坂下 智博, 吉田 大介, 畠山 博充, 水町 貴諭, 加納 里志, 土屋 和彦, 安田 耕一, 白土 博樹, 福田 諭 日本耳鼻咽喉科学会会報 119 (5) 782 -783 2016年 [査読無し][通常論文]
  • T. Inoue, S. Okamoto, S. Watanabe, K. Yasuda, N. Katoh, K. Harada, R. Onimaru, T. Shiga, N. Tamaki, Y. Kuge, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 93 (3) E390 -E391 2015年11月 [査読無し][通常論文]
  • Y. Nishikawa, K. Yasuda, S. Okamoto, Y. M. Ito, T. Mori, R. Onimaru, T. Shiga, K. Tsuchiya, S. Watanabe, W. Takeuchi, N. Katoh, Y. Kuge, N. Tamaki, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 93 (3) E337 -E337 2015年11月 [査読無し][通常論文]
  • 志賀 哲, 岡本 祥三, 安田 耕一, 孫田 恵一, 久下 裕司, 竹内 渉, 鈴木 敦郎, 小橋 啓司, 玉木 長良 核医学 52 (3) 265 -265 2015年09月 [査読無し][通常論文]
  • 土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏, 福田 諭, 清水 康, 秋田 弘俊 頭頸部癌 41 (2) 254 -254 2015年05月 [査読無し][通常論文]
  • 森 崇, 土屋 和彦, 西川 昇, 鬼丸 力也, 小野寺 俊輔, 安田 耕一, 白土 博樹 Japanese Journal of Radiology 33 (Suppl.) 4 -4 2015年02月 [査読無し][通常論文]
  • S. Okamoto, T. Shiga, K. Yasuda, K. Magota, K. Kasai, S. Watanabe, Y. Kuge, H. Shirato, N. Tamaki EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 41 S196 -S196 2014年10月 [査読無し][通常論文]
  • 渡邊 史郎, 岡本 祥三, 安田 耕一, 志賀 哲, 孫田 恵一, 葛西 克彦, 久下 裕司, 白土 博樹, 玉木 長良 核医学 51 (3) 265 -265 2014年09月 [査読無し][通常論文]
  • Watanabe Shiro, Okamoto Shozo, Shiga Tohru, Yasuda Koichi, Magota Keiichi, Kasai Katsuhiko, Kuge Yuji, Shirato Hiroki, Tamaki Nagara JOURNAL OF NUCLEAR MEDICINE 55 2014年05月 [査読有り][通常論文]
  • 水町 貴諭, 本間 明宏, 坂下 智博, 加納 里志, 畠山 博充, 清水 康, 秋田 弘俊, 土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 福田 諭 頭頸部癌 40 (2) 177 -177 2014年05月 [査読無し][通常論文]
  • 土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏, 福田 諭, 清水 康, 秋田 弘俊 頭頸部癌 40 (2) 257 -257 2014年05月 [査読無し][通常論文]
  • 古沢 純, 本間 明宏, 坂下 智博, 畠山 博充, 加納 里志, 水町 貴諭, 土屋 和彦, 吉田 大介, 安田 耕一, 白土 博樹, 福田 諭 頭頸部癌 40 (2) 198 -198 2014年05月 [査読無し][通常論文]
  • 水町 貴諭, 本間 明宏, 坂下 智博, 加納 里志, 畠山 博充, 土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 福田 諭 頭頸部癌 40 (1) 66 -70 2014年04月 [査読無し][通常論文]
     
    当院にてCDDP 40mg/m2/週併用の化学放射線療法を行った中咽頭扁平上皮癌新鮮例22例に対して臨床的検討を行った。22例中13例がHPV陽性であった。放射線治療は本人希望にて50Gyで終了した1例以外は全例70Gy完遂できた。CDDPの平均投与量は179mg/m2であった。有害事象はGrade4以上は認めなかったが、Grade3の粘膜炎が16例(73%)、好中球減少、皮膚炎が各4例(18%)認めた。原発病変に対する一次治療効果は、HPV陰性の1例がPRであったが、21例はCRとなった。頸部に対しては22例全例CRとなった。HPV陽性例の3年粗生存率は92.3%であったのに対し陰性例は66.7%であった。統計学的有意差は得られなかったが、HPV陽性例の方が予後が良好な傾向にあった。HPV陽性例は導入化学療法を先行させた症例が多かったものの、本治療における治療成績は良好で十分な効果が期待できると思われた。HPV陰性例に対しては一次治療効果は良好であるものの再発や転移を来す症例が陽性例に比べ多く生じた。(著者抄録)
  • 安田耕一, 土屋和彦, 井上哲也, 西岡健太郎, 原田慶一, 西川由記子, 鬼丸力也, 清水伸一, 加藤徳雄, 木下留美子, 小野寺俊介, 白土博樹, 鈴木隆介, 藤田勝久, 辻真太郎, 山崎理衣 Jpn J Radiol 32 (Supplement) 7 2014年02月25日 [査読無し][通常論文]
  • 放射線療法に関する名付けルール(Naming rule for radiation therapy)
    安田 耕一, 土屋 和彦, 井上 哲也, 西岡 健太郎, 原田 慶一, 西川 由記子, 鬼丸 力也, 清水 伸一, 加藤 徳雄, 木下 留美子, 小野寺 俊介, 白土 博樹, 鈴木 隆介, 藤田 勝久, 辻 真太郎, 山崎 理衣 Japanese Journal of Radiology 32 (Suppl.) 7 -7 2014年02月 [査読無し][通常論文]
  • 吉村 高明, 安田 耕一, 寅松 千枝, 高尾 聖心, 松浦 妙子, 二本木 英明, 木下 留美子, 鬼丸 力也, 白土 博樹, 石川 正純 Japanese Journal of Radiology 32 (Suppl.) 7 -7 2014年02月 [査読無し][通常論文]
  • 西川 由記子, 原田 慶一, 西岡 健太郎, 安田 耕一, 井上 哲也, 土屋 和彦, 小野寺 俊輔, 木下 留美子, 加藤 徳雄, 清水 伸一, 鬼丸 力也, 白土 博樹, 鈴木 隆介, 石川 正純 Japanese Journal of Radiology 32 (Suppl.) 5 -5 2014年02月 [査読無し][通常論文]
  • K. Yasuda, K. Tsuchiya, S. Okamoto, R. Onimaru, T. Shiga, K. Harada, R. Suzuki, Y. Kuge, N. Tamaki, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 87 (2) S644 -S644 2013年10月 [査読無し][通常論文]
  • 岡本祥三, 志賀哲, 安田耕一, 孫田恵一, 葛西克彦, 久下裕司, 白土博樹, 玉木長良 核医学 50 (3) 218 2013年09月30日 [査読無し][通常論文]
  • 岡本 祥三, 志賀 哲, 安田 耕一, 孫田 恵一, 葛西 克彦, 久下 裕司, 白土 博樹, 玉木 長良 核医学 50 (3) S208 -S208 2013年09月 [査読無し][通常論文]
  • 安田耕一 Isot News (712) 2 -6 2013年08月01日 [査読無し][通常論文]
  • M. Ishikawa, S. Tanabe, S. Yamaguchi, N. Ukon, T. Yamanaka, K. Sutherland, N. Miyamoto, R. Suzuki, N. Katoh, K. Yasuda, H. Shirato Medical Physics 40 (6) 162 2013年06月 [査読無し][通常論文]
     
    Purpose: Molecular imaging is one of the important modalities in delineating tumors particularly in radiotherapy treatment planning. If the real‐time tumor position can be detected using molecular imaging during radiotherapy, it may be helpful for gated irradiation. A feasibility study on a beam gating system for radiotherapy using real‐time molecular imaging was conducted by the prototype and simulating a parallel plane PET system. Methods: Assuming that the motion of the positron source is constrained to the central plane, the source position can be calculated from a cross point of the Line of Response (LOR) and the central plane between detector surfaces. If a positron source is located at the ISO center, distribution of the cross points might be blurred due to random/scattered coincidence. Center Located Ratio (CLR) was defined as a ratio of LORs passing through the ISO center divided by the entire LORs. When dislocation for perpendicular direction is occurred, a distribution of cross points will be spread out and associated decrease of CLR value will be expected. Results: The behavior between real measurement and simulation was similar on proto‐type experiments, however, the Result from simulation for demonstrator might be different from actual measurement. RTRT system recognizes the position of a gold marker in the rate of 30 fps using two X‐ray television systems. It is shown that 15,000 events per second will be needed for an appropriate gating irradiation to recognize discrepancy over 2mm of time resolution in the parallel plane PET system demonstrator. Conclusion: A feasibility study was carried out to verify the potential for gating irradiation of tumors with real‐time molecular imaging using a parallel plane PET system. For an parallel plane PET system demonstrator, the possibility of detecting the tumor position with an accuracy of 2 mm from the ISO center with 500 events. This research was a part of the “Innovation COE Program for Future Drug Discovery and Medical Care” project and partially supported by the Grant‐in‐Aid for Project for Developing Innovation Systems of the Japanese Ministry of Education, Culture, Sports, Science and Technology. © 2013, American Association of Physicists in Medicine. All rights reserved.
  • 本間明宏, 畠山博充, 加納里志, 水町貴諭, 坂下智博, 吉田大介, 鬼丸力也, 土屋和彦, 安田耕一, 白土博樹, 藤井正人, 福田諭 頭けい部癌 39 (2) 134 2013年05月21日 [査読無し][通常論文]
  • 化学放射線療法の現状と役割 動注化学療法による化学放射線療法 上顎洞癌を中心に
    本間 明宏, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 吉田 大介, 鬼丸 力也, 土屋 和彦, 安田 耕一, 白土 博樹, 藤井 正人, 福田 諭 頭頸部癌 39 (2) 134 -134 2013年05月 [査読無し][通常論文]
  • 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]
  • 土屋 和彦, 安田 耕一, 木下 留美子, 鬼丸 力也, 白土 博樹, 本間 明宏, 福田 諭, 清水 康, 秋田 弘俊 頭頸部癌 39 (2) 218 -218 2013年05月 [査読無し][通常論文]
  • 西川 由記子, 安田 耕一, 土屋 和彦, 鬼丸 力也, 白土 博樹, 本間 明宏, 竹内 啓, 田口 純 Japanese Journal of Radiology 31 (Suppl.I) 12 -12 2013年02月 [査読無し][通常論文]
  • 安田 耕一, 土屋 和彦, 岡本 祥三, 鬼丸 力也, 志賀 哲, 加藤 徳雄, 原田 慶一, 久下 裕司, 玉木 長良, 白土 博樹 日本医学放射線学会学術集会抄録集 72回 S381 -S382 2013年02月 [査読無し][通常論文]
  • K. Tsuchiya, K. Yasuda, Y. Nishikawa, R. Kinoshita, R. Onimaru, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 84 (3) S484 -S485 2012年11月 [査読無し][通常論文]
  • 本間 明宏, 折舘 伸彦, 鈴木 清護, 鈴木 章之, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 吉田 大介, 鬼丸 力也, 土屋 和彦, 安田 耕一, 白土 博樹, 福田 諭 耳鼻と臨床 58 (Suppl.1) S52 -S56 2012年11月 [査読無し][通常論文]
     
    大量シスプラチンの超選択的動注療法と放射線治療の同時併用療法を1999年から2009年までに北海道大学病院で行った上顎洞原発扁平上皮癌未治療例41例についての救済手術について検討した。原発巣が残存あるいは再発した例は12例あり、そのうちの9例に救済手術が行われた。9例のうち7例は、その後原発巣の再発なく経過し、原発巣の救済率は全体で7/12=58.3%、T別ではT3:66.7%(2/3)、T4a:66.7%(4/6)、T4b:33.3%(1/3)であった。全症例の5年粗生存率は73.6%であった。術後合併症は、遊離皮弁による再建を行った症例で重篤な合併症が出現した。救済率が比較的良好であったのは、再発が前方に生じた例が多かったためと考えられた。以上の結果を、今後の症例の初回治療の選択、救済手術を行うかどうかの参考にしていきたい。(著者抄録)
  • 当科で導入化学療法を施行した頭頸部局所進行扁平上皮癌症例の治療成績
    天野 虎次, 田口 純, 木下 一郎, 合田 智宏, 本間 理央, 竹内 啓, 清水 康, 安田 耕一, 土屋 和彦, 白土 博樹, 本間 明宏, 福田 諭, 秋田 弘俊 日本癌治療学会誌 47 (3) 2112 -2112 2012年10月 [査読無し][通常論文]
  • 岡本祥三, 志賀哲, 安田耕一, 孫田恵一, 葛西克彦, 久下裕司, 白土博樹, 玉木長良 核医学 49 (3) 217 2012年08月31日 [査読無し][通常論文]
  • 岡本 祥三, 志賀 哲, 安田 耕一, 孫田 恵一, 葛西 克彦, 久下 裕司, 白土 博樹, 玉木 長良 核医学 49 (3) S197 -S197 2012年08月 [査読無し][通常論文]
  • 低酸素イメージングと放射線治療(Hypoxia imaging and Radiation therapy)
    安田 耕一, 鬼丸 力也, 岡本 祥三, 志賀 哲, 加藤 徳雄, 玉木 長良, 白土 博樹 日本癌学会総会記事 71回 84 -85 2012年08月 [査読無し][通常論文]
  • 葛西 克彦, 岡本 祥三, 志賀 哲, 安田 耕一, 孫田 惠一, 加藤 千恵次, 久下 裕司, 白土 博樹, 玉木 長良 核医学 49 (3) S197 -S197 2012年08月 [査読無し][通常論文]
  • リンフォーマの画像診断と新規治療のプラクティス 皮膚悪性リンパ腫に対する放射線治療
    鬼丸 力也, 清水 伸一, 土屋 和彦, 加藤 徳雄, 木下 留美子, 井上 哲也, 小野寺 俊輔, 安田 耕一, 西岡 健太郎, 白土 博樹 日本皮膚悪性腫瘍学会学術大会プログラム・抄録集 28回 82 -82 2012年06月 [査読無し][通常論文]
  • 加藤徳雄, 鬼丸力也, 安田耕一, 志賀哲, 土屋和彦, 岡本祥三, 玉木長良, 白土博樹 日本薬学会年会要旨集 132nd (1) 118 2012年03月05日 [査読無し][通常論文]
  • 放射線を利用した画像診断・治療の最前線 先進的放射線治療におけるPETの役割
    加藤 徳雄, 鬼丸 力也, 安田 耕一, 志賀 哲, 土屋 和彦, 岡本 祥三, 玉木 長良, 白土 博樹 日本薬学会年会要旨集 132年会 (1) 118 -118 2012年03月 [査読無し][通常論文]
  • 岡本祥三, 竹井俊樹, 志賀哲, 玉木長良, 安田耕一, 白土博樹, 久下裕司, 森本裕一, 竹内渉 Jpn J Radiol 30 (Supplement 1) 7 2012年02月25日 [査読無し][通常論文]
  • 頭頸部癌の放射線治療前後におけるFMISO集積の初期経過
    岡本 祥三, 竹井 俊樹, 志賀 哲, 玉木 長良, 安田 耕一, 白土 博樹, 久下 裕司, 森本 裕一, 竹内 渉 Japanese Journal of Radiology 30 (Suppl.I) 7 -7 2012年02月 [査読無し][通常論文]
  • 米山 理奈, 安田 耕一, 加藤 徳雄, 鬼丸 力也, 白土 博樹 Japanese Journal of Radiology 30 (Suppl.I) 5 -5 2012年02月 [査読無し][通常論文]
  • 鬼丸 力也, 安田 耕一, 西川 昇, 米山 理奈, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭 Japanese Journal of Radiology 30 (Suppl.I) 5 -5 2012年02月 [査読無し][通常論文]
  • 鬼丸 力也, 白土 博樹, 安田 耕一, 長谷川 雅一 Japanese Journal of Radiology 30 (Suppl.I) 13 -13 2012年02月 [査読無し][通常論文]
  • 辻 真太朗, 鈴木 隆介, 安田 耕一, 藤田 勝久, 宮崎 智夫, 石川 正純, 白土 博樹 日本放射線技術学会総会学術大会予稿集 68回 134 -134 2012年02月 [査読無し][通常論文]
  • 加藤 徳雄, 鈴木 隆介, 井上 哲也, 安田 耕一, 鬼丸 力也, 清水 伸一, 木村 理奈, 石川 正純, 白土 博樹 日本医学放射線学会学術集会抄録集 71回 S316 -S316 2012年02月 [査読無し][通常論文]
  • Katoh N, Suzuki R, Shimizu S, Inoue T, Yasuda K, Onimaru R, Kimura R, Kato M, Ishikawa M, Shirato H International Journal of Radiation Oncology Biology Physics 84 (3) S722 2012年 [査読有り][通常論文]
  • 田口純, 天野虎次, 木下一郎, 合田智宏, 本間理央, 竹内啓, 清水康, 安田耕一, 土屋和彦, 鬼丸力也, 本間明宏, 福田諭, 秋田弘俊 日本臨床腫瘍学会学術集会プログラム・抄録集 10th 179 -180 2012年 [査読無し][通常論文]
  • 天野虎次, 田口純, 木下一郎, 合田智宏, 本間理央, 竹内啓, 清水康, 安田耕一, 土屋和彦, 白土博樹, 本間明宏, 福田諭, 秋田弘俊 日本癌治療学会学術集会(CD-ROM) 50th ROMBUNNO.PS2-008 2012年 [査読無し][通常論文]
  • 原田 慶一, 井上 哲也, 安田 耕一, 加藤 徳雄, 清水 伸一, 白土 博樹, Bengua Gerard, 石川 正純, 中積 宏之, 結城 敏志, 小松 嘉人 北海道外科雑誌 56 (2) 176 -177 2011年12月 [査読無し][通常論文]
  • 岡本 祥三, 竹井 俊樹, 志賀 哲, 玉木 長良, 安田 耕一, 白土 博樹, 久下 裕司, 森本 裕一, 竹内 渉 核医学 48 (4) 436 -436 2011年11月 [査読無し][通常論文]
  • 鬼丸 力也, 安田 耕一, 加藤 徳男, 白土 博樹, 志賀 哲, 岡本 祥三, 玉木 長良, 本間 明宏, 折舘 伸彦, 福田 諭 頭頸部癌 37 (3) 376 -380 2011年10月 [査読無し][通常論文]
     
    陽電子放射断層撮影(Positron emission tomography、PET)検査では機能・代謝情報を得ることができる。PETによる低酸素イメージングで得られた情報を放射線治療に応用し、放射線抵抗性を示す腫瘍内の低酸素領域への線量増加をしようという試みも報告されている。北海道大学病院では、核医学診療科が中心となってdetectorに半導体を用いたPETを開発し、臨床に用いている。また、[18F]fluoromisonidazole(FMISO)PETによる低酸素イメージングも行われており、それを用いた強度変調放射線治療(Intensity modulated radiation therapy、IMRT)を用いた線量増加についても検討を始めている。本シンポジウムでは、北海道大学病院での放射線治療におけるPETの利用について、上記の項目を中心に発表する。(著者抄録)
  • 岡本祥三, 安田耕一, 志賀哲, 竹井俊樹, 孫田恵一, 久下裕司, 白土博樹, 玉木長良 核医学 48 (3) 344 2011年09月30日 [査読無し][通常論文]
  • 岡本 祥三, 安田 耕一, 志賀 哲, 竹井 俊樹, 孫田 恵一, 久下 裕司, 白土 博樹, 玉木 長良 核医学 48 (3) S282 -S282 2011年09月 [査読無し][通常論文]
  • 鬼丸力也, 安田耕一, 加藤徳男, 白土博樹, 志賀哲, 玉木長良, 本間明宏, 折舘伸彦, 福田諭 頭けい部癌 37 (2) 185 2011年05月20日 [査読無し][通常論文]
  • 安田耕一, 岡本祥三, 志賀哲, 鬼丸力也, 長谷川雅一, 久下裕司, 竹内渉, 梅垣菊男, 玉木長良, 白土博樹 頭けい部癌 37 (2) 256 2011年05月20日 [査読無し][通常論文]
  • 放射線治療の進歩と将来展望 放射線治療におけるPETの利用
    鬼丸 力也, 安田 耕一, 加藤 徳男, 白土 博樹, 志賀 哲, 玉木 長良, 本間 明宏, 折舘 伸彦, 福田 諭 頭頸部癌 37 (2) 185 -185 2011年05月 [査読無し][通常論文]
  • FMISO PETと上咽頭癌患者に対する放射線療法の成績の相関性(Correlation of FMISO PET and outcome from radiation therapy in patients with nasopharyngeal cancer)
    安田 耕一, 岡本 祥三, 志賀 哲, 鬼丸 力也, 長谷川 雅一, 久下 裕司, 竹内 渉, 梅垣 菊男, 玉木 長良, 白土 博樹 頭頸部癌 37 (2) 256 -256 2011年05月 [査読無し][通常論文]
  • 本間 明宏, 清水 康, 折舘 伸彦, 鬼丸 力也, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 安田 耕一, 秋田 弘俊, 白土 博樹, 福田 諭 頭頸部癌 37 (2) 233 -233 2011年05月 [査読無し][通常論文]
  • 坂下 智博, 本間 明宏, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 古沢 純, 稲村 直哉, 福田 諭, 吉田 大介, 鬼丸 力也, 安田 耕一, 白土 博樹 頭頸部癌 37 (2) 231 -231 2011年05月 [査読無し][通常論文]
  • K. Yasuda, S. Okamoto, R. Onimaru, T. Shiga, M. Hasegawa, N. Katoh, Y. Kuge, K. Umegaki, N. Tamaki, H. Shirato INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 81 (2) S506 -S507 2011年 [査読無し][通常論文]
  • 鬼丸 力也, 安田 耕一, 加藤 徳男, 白土 博樹, 志賀 哲, 岡本 祥三, 玉木 長良, 本間 明宏, 折舘 伸彦, 福田 諭 頭頸部癌 37 (3) 376 -380 2011年 [査読無し][通常論文]
     
    陽電子放射断層撮影(Positron emission tomography, PET)検査では機能・代謝情報を得ることができる。PETによる低酸素イメージングで得られた情報を放射線治療に応用し,放射線抵抗性を示す腫瘍内の低酸素領域への線量増加をしようという試みも報告されている。北海道大学病院では,核医学診療科が中心となってdetectorに半導体を用いたPETを開発し,臨床に用いている。また,[<sup>18</sup>F]fluoromisonidazole(FMISO)PETによる低酸素イメージングも行われており,それを用いた強度変調放射線治療(Intensity modulated radiation therapy, IMRT)を用いた線量増加についても検討を始めている。本シンポジウムでは,北海道大学病院での放射線治療におけるPETの利用について,上記の項目を中心に発表する。
  • 鬼丸 力也, 安田 耕一, 加藤 徳男, 白土 博樹, 志賀 哲, 岡本 祥三, 玉木 長良, 本間 明宏, 折舘 伸彦, 福田 諭 頭頸部癌 = Head and neck cancer 37 (3) 376 -380 2011年 [査読無し][通常論文]
     
    Positron emission tomography (PET) can obtain functional information about tumors. There are some reports that intensity modulated radiation therapy (IMRT) planning was made using hypoxic imaging information obtained by PET. We used a semiconductor PET which was developed by the Department of Nuclear Medicine in Hokkaido University, where hypoxic imaging by [ 18 F] fluoromisonidazole (FMISO) PET is available. We are investigating a dose escalation planning study of IMRT using FMISO PET imaging, and report on the usage of PET for radiotherapy in Hokkaido University.
  • 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]
  • 西川 昇, 長谷川 雅一, 安田 耕一, 鬼丸 力也, 白土 博樹 Japanese Journal of Radiology 29 (Suppl.I) 5 -5 2011年01月 [査読無し][通常論文]
  • 岡本祥三, 安田耕一, 安田耕一, 竹井俊樹, 志賀哲, 久下裕司, 久下裕司, 白土博樹, 白土博樹, 玉木長良 核医学 47 (3) S220 2010年09月30日 [査読無し][通常論文]
  • 頭頸部癌の放射線治療前後におけるFMISO集積の初期経過
    岡本 祥三, 安田 耕一, 竹井 俊樹, 志賀 哲, 久下 裕司, 白土 博樹, 玉木 長良 核医学 47 (3) 374 -374 2010年09月 [査読無し][通常論文]
  • 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 Jpn J Radiol 28 (Supplement 1) 14 2010年07月25日 [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]
  • 長谷川 雅一, 安田 耕一, 吉田 大介, 加藤 徳雄, 鬼丸 力也, 浅野 剛, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭, 石川 正純, Bengua Gerard, Sutherland Kenneth, 宮本 直樹, 鈴木 隆介 Japanese Journal of Radiology 28 (Suppl.I) 7 -7 2010年07月 [査読無し][通常論文]
  • 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]
  • T. Kamishima, N. Kitamura, M. Amemiya, K. Ishizaka, F. Kato, K. Yasuda, H. Shirato, S. Terae CLINICAL RADIOLOGY 65 (5) 387 -390 2010年05月 [査読無し][通常論文]
  • 本間 明宏, 折舘 伸彦, 鈴木 章之, 鈴木 清護, 原 敏浩, 加納 里志, 水町 貴諭, 古沢 純, 稲村 直哉, 福田 諭, 吉田 大介, 鬼丸 力也, 安田 耕一, 白土 博樹 頭頸部癌 36 (2) 191 -191 2010年05月 [査読無し][通常論文]
  • 稲村 直哉, 本間 明宏, 折舘 伸彦, 鈴木 清護, 鈴木 章之, 原 敏浩, 真栄田 裕行, 加納 里志, 水町 貴諭, 福田 諭, 鬼丸 力也, 長谷川 雅一, 安田 耕一, 白土 博樹 頭頸部癌 36 (2) 206 -206 2010年05月 [査読無し][通常論文]
  • 佐々木 良平, 安田 耕一, 阿部 栄輔, 内田 伸江, 河島 光彦, 芝本 雄太, 加賀美 芳和, 塩山 善之, 宇野 隆, 中田 健生, 冨士原 将之, 高田 佳江 頭頸部癌 36 (2) 212 -212 2010年05月 [査読無し][通常論文]
  • 鬼丸 力也, 長谷川 雅一, 安田 耕一, 木下 留美子, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭 頭頸部癌 35 (3) 245 -249 2009年10月 [査読無し][通常論文]
     
    2002年5月から2007年12月までに北大病院放射線科にて強度変調放射線治療(Intensity modulated radiation therapy,IMRT)を行った37例を検討した。上咽頭13例、中咽頭19例、下咽頭3例、上顎1例、口腔1例であった。死亡は4例で認められた。治療終了後4ヵ月で中咽頭癌(後壁T3N0)が咽頭膿瘍後の誤嚥性肺炎で死亡したが、他の3名は他癌死であった。原発・頸部リンパ節残存・再発は、上咽頭癌で原発巣再発1例、中咽頭癌では原発巣再発が3例、頸部リンパ節転移・残存が2名、下咽頭癌では1例で頸部リンパ節残存があった。重篤な晩期反応は、中咽頭後壁の1名で咽頭膿瘍の発生による死亡があり、1例の上咽頭癌症例(CDDP併用)で聴力低下と偶角閉塞がみられた。(著者抄録)
  • 佐々木良平, 河辺哲也, 阿部英輔, 内田伸江, 安田耕一, 宇野隆, 冨士原雅之, 塩山善之, 芝本雄太, 山田章吾 日本放射線腫よう学会誌 21 (Supplement 1) 136 2009年08月19日 [査読無し][通常論文]
  • 鬼丸 力也, 木下 留美子, 長谷川 雅一, 安田 耕一, 白土 博樹 ENTONI (103) 14 -20 2009年06月 [査読無し][通常論文]
     
    頭頸部癌に対する放射線治療は形態・機能温存を目的とした治療であるが、晩期反応に苦しむ患者さんも多かった。従来の放射線治療の欠点を解消すべく発展してきた強度変調放射線治療(intensity modulated radiotherapy;IMRT)は腫瘍には十分な線量を、リスク臓器には少ない線量を照射することを可能にした。IMRTを行う際には、CTで標的体積を設定する必要があるが、その際には正確な病期診断が必要である。また、治療計画の最適化や検証などの作業が必要であり、人手と時間を要する治療である。IMRTにより視神経などのリスク臓器のそばまで浸潤した腫瘍を従来の放射線治療よりも合併症を少なく治療できると期待されている一方、リスク臓器と指定しなかった臓器には高線量が照射される可能性があり注意が必要である。(著者抄録)
  • 鬼丸力也, 長谷川雅一, 安田耕一, 木下留美子, 白土博樹, 本間明宏, 折舘伸彦, 福田諭 頭けい部癌 35 (2) 65 -249 2009年05月20日 [査読無し][通常論文]
     
    2002年5月から2007年12月までに北大病院放射線科にて強度変調放射線治療(Intensity modulated radiation therapy, IMRT)を行った37例を検討した。上咽頭13例,中咽頭19例,下咽頭3例,上顎1例,口腔1例であった。<br>死亡は4例で認められた。治療終了後4ヶ月で中咽頭癌(後壁T3N0)が咽頭膿瘍後の誤嚥性肺炎で死亡したが,他の3名は他癌死であった。原発・頸部リンパ節残存・再発は,上咽頭癌で原発巣再発1例,中咽頭癌では原発巣再発が3例,頸部リンパ節転移・残存が2名,下咽頭癌では 1例で頸部リンパ節残存があった。<br>重篤な晩期反応は,中咽頭後壁の1名で咽頭膿瘍の発生による死亡があり,1例の上咽頭癌症例(CDDP併用)で聴力低下と偶角閉塞がみられた。
  • 強度変調放射線治療(IMRT)の中長期成績 北海道大学病院での頭頸部癌に対する強度変調放射線治療の成績
    鬼丸 力也, 長谷川 雅一, 安田 耕一, 木下 留美子, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭 頭頸部癌 35 (2) 65 -65 2009年05月 [査読無し][通常論文]
  • 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]
  • 安田耕一, 白土博樹, 岡本祥三, 志賀哲, SUTHERLAND Ken, 加藤徳雄, 長谷川雅一, 鬼丸力也, BENGUA Gerard, 石川正純 日本医学放射線学会総会抄録集 68th S267 2009年02月28日 [査読無し][通常論文]
  • 18F-FMISO PETを用いたIMRT dose painting planの試み
    安田 耕一, 白土 博樹, 岡本 祥三, 志賀 哲, Sutherland Ken, 加藤 徳雄, 長谷川 雅一, 鬼丸 力也, Bengua Gerard, 石川 正純 日本医学放射線学会学術集会抄録集 68回 S267 -S267 2009年02月 [査読無し][通常論文]
  • 加藤 徳雄, 志賀 哲, 長谷川 雅一, 鬼丸 力也, 安田 耕一, 清水 伸一, ベングア・ジェラード, 石川 正純, 玉木 長良, 白土 博樹 日本医学放射線学会学術集会抄録集 68回 S307 -S308 2009年02月 [査読無し][通常論文]
  • 鬼丸力也, 長谷川雅一, 安田耕一, 木下留美子, 白土博樹, 本間明宏, 折舘伸彦, 福田諭 頭けい部癌 35 (3) 245 -249 2009年 [査読無し][通常論文]
     
    We evaluated the clinical outcome of 37 patients who had received intensity modulated radiation therapy (IMRT) in Hokkaido University Hospital from May 2002 to December 2007. Thirteen patients had nasopharyngeal cancer, 19 had oropharyngeal cancer, 3 had hypopharyngeal cancer, 1 had maxillary sinus cancer, and 1 had oral cancer. One patient who had oropharyngeal cancer died of pharyngeal abscess which was a treatment-related complication. Three patients died of other cancers. One patient with nasopharyngeal cancer had local recurrence. In patients with oropharyngeal cancer, recurrence at the primary site occurred in 3 patients, and residual/recurrence at neck lymph nodes occurred in 2 patients. One patient with hypopharyngeal cancer had residual neck lymph node metastasis. Some patients experienced severe reactions to the radiation. One patient had pharyngeal abscess and died of this treatment complication. One patient who had nasopharyngeal cancer experienced hearing loss and angle closure glaucoma. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
  • 長谷川雅一, 安田耕一, 吉田大介, 加藤徳雄, 鬼丸力也, 浅野剛, 白土博樹, 本間明宏, 折館伸彦, 福田諭 日本放射線腫よう学会誌 20 (Supplement 1) 223 2008年09月22日 [査読無し][通常論文]
  • 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]
  • 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]
  • 安田 耕一 Radiation Medicine 26 (Suppl.I) 5 -5 2008年04月 [査読無し][通常論文]
  • 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]
  • 小野寺 祐也, 西岡 典子, 安田 耕一, 藤間 憲幸, 鬼丸 力也, 清水 伸一, 白土 博樹 日本医学放射線学会学術集会抄録集 67回 S193 -S193 2008年02月 [査読無し][通常論文]
  • 溝口 史樹, 安田 耕一, 青山 英史, 白土 博樹 脊椎脊髄ジャーナル 20 (7) 781 -785 2007年07月 [査読無し][通常論文]
  • 安田 耕一 Radiation Medicine 25 (Suppl.I) 30 -30 2007年04月 [査読無し][通常論文]
  • 鬼丸力也, 藤野賢治, 田口大志, 加藤徳雄, 木下留美子, 安田耕一, 鈴木恵士郎, 白土博樹, 宮坂和男 日本医学放射線学会学術集会抄録集 66th S233 2007年02月28日 [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]
  • 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]
  • 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01月 [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。
  • Masaharu Fujino, T. Taguchi, T. Kato, H. Aoyama, K. Suzuki, R. Onimaru, R. Kinoshita, K. Yasuda, H. Shirato, C. Kato, S. Shiga, N. Tamaki, S. Onodera Japanese Journal of Clinical Radiology 52 (1) 137 -144 2007年 [査読無し][通常論文]
     
    We have investigated the feasibility of the integration of breath-holding FDG-PET image (BH-PET) into radiation treatment planning for non-small cell lung (NSCLC) cancer patients. BH-PET has its advantage in the prevention from the decrease of SUV due to the movement of tumor, especially in the case of small tumors, both in phantom experiments and in actual NSCLC cases. This might result in the reduction of the interobserver deviation of the contoured target volume among NSCLC patients, and would lead to the accurate stereotactic radiotherapy for tumors in the moving organs including lung, liver, and so on.
  • 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]
     
    We have investigated the feasibility of the integration of breath-holding FDG-PET image (BH-PET) into radiation treatment planning for non-small cell lung (NSCLC) cancer patients. BH-PET has its advantage in the prevention from the decrease of SUV due to the movement of tumor, especially in the case of small tumors, both in phantom experiments and in actual NSCLC cases. This might result in the reduction of the interobserver deviation of the contoured target volume among NSCLC patients, and would lead to the accurate stereotactic radiotherapy for tumors in the moving organs including lung, liver, and so on.
  • 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]

特許

受賞

  • 2017年04月 日本医学放射線学会 Bronze Medal (Cypos award)
     Treatment outcome after Radiation Therapy for Mucosal Malignant Melanoma of Head and Neck 
    受賞者: 安田 耕一
  • 2014年12月 日本放射線腫瘍学会 第20回 梅垣賞
     [18F]fluoromisonidazole and a New PET System With Semiconductor Detectors and a Depth of Interaction System for Intensity Modulated Radiation Therapy for Nasopharyngeal Cancer 
    受賞者: 安田 耕一
  • 2013年04月 日本医学放射線学会 Silver Medal (Cypos award)
     照射前FMISO-PETの集積部位と照射後再発の位置関係 
    受賞者: 安田 耕一

共同研究・競争的資金等の研究課題

  • IMPTを用いた「辛くない」頭頸部癌放射線治療法の開発
    日本学術振興会:科学研究費助成事業 基盤研究(C)
    研究期間 : 2019年04月 -2023年03月 
    代表者 : 安田 耕一, 加納 里志, 水町 貴諭, 高尾 聖心, 田村 昌也
     
    後ろ向き観察研究の自主臨床計画書を作成し、当施設の審査会にて承認された。 スポットスキャニングIMPTにおける皮膚、唾液腺、舌、粘膜の線量を大幅に低減させる手法の開発に取り組んだ。皮膚に関しては当院で過去に実施された放射線治療患者の線量分布および皮膚炎の程度を解析し、皮膚炎発症に最も関連する皮膚線量のパラメーターを解析した。DVH(dose-volume histogram)解析において、皮膚のV65Gy(65Gy以上照射される皮膚の体積)が皮膚炎グレード3発症に関連する独立因子であることを突き止めた。皮膚炎発症と線量に関するモデル作成について検討を開始した。スポットスキャニングIMPTにおいて、局所的な皮膚線量を低減するプランニング法の開発を開始した。耳下腺及び舌に関しても同様に、線量低減のプランニング法の開発を開始した。粘膜線量低減のために、頭頸部癌におけるPTV(planning target volume) margin(照射ターゲットの位置の不確かさのために付与するマージン)の検証を行った。照射中に撮像可能なCBCT(cone-beam CT)を用いて照射前後の頭頸部の各領域の動きの変化を検証した。各領域に最適なPTV marginを個別に付与する(variable PTV marginの設定)方法の基礎的知見を得た。従来の放射線治療法で治療された頭頸部癌患者に対しQOL調査を行った。四大副作用、つまり皮膚炎、口渇、味覚障害、粘膜炎に関して、患者が感じる「辛さ」を客観的に把握するための調査項目を決定し、調査を開始した。
  • 低酸素癌を標的とした陽子線治療に関する研究
    文部科学省:科学研究費補助金(若手研究(B))
    研究期間 : 2016年04月 -2019年03月 
    代表者 : 安田 耕一
  • 癌に対する線量増加放射線治療の理論確立:FMISO-PETを用いた再酸素化の証明
    文部科学省:科学研究費補助金(基盤研究(C))
    研究期間 : 2013年 -2015年 
    代表者 : 岡本 祥三
     
    研究分担者 安田耕一
  • 文部科学省:科学研究費補助金(若手研究(B))
    研究期間 : 2013年 -2015年 
    代表者 : 安田 耕一

教育活動情報

主要な担当授業

  • 基本医学研究
    開講年度 : 2021年
    課程区分 : 修士課程
    開講学部 : 医学院
    キーワード : 放射線生物学、放射線腫瘍学、放射線治療
  • 基本医学総論
    開講年度 : 2021年
    課程区分 : 修士課程
    開講学部 : 医学院
    キーワード : 放射線生物学、放射線腫瘍学、放射線治療
  • 医学総論
    開講年度 : 2021年
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 放射線生物学、放射線腫瘍学、放射線治療
  • 基盤医学研究
    開講年度 : 2021年
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 放射線生物学、放射線腫瘍学、放射線治療
  • 臨床医学研究
    開講年度 : 2021年
    課程区分 : 博士後期課程
    開講学部 : 医学院
    キーワード : 放射線生物学、放射線腫瘍学、放射線治療
  • 放射線医学
    開講年度 : 2021年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 放射線生物学、放射線腫瘍学、放射線治療
  • 放射線腫瘍学
    開講年度 : 2021年
    課程区分 : 学士課程
    開講学部 : 医学部
    キーワード : 放射線腫瘍学

大学運営

委員歴

  • 2021年01月 - 2023年01月   日本放射線腫瘍学会   医療安全委員会委員
  • 2020年 - 2021年   日本頭頸部癌学会   代議員
  • 2020年 - 2021年   日本頭頸部癌学会   診療ガイドライン委員会委員


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