研究活動情報

• DVH parameters and gastrointestinal/genitourinary toxicities in moderate hypofractionated salvage radiotherapy after radical prostatectomy
  Manami Otsuka; Hiroshi Taguchi; Ryusei Ashida; Hideki Minatogawa; Takuya Moriguchi; Norikata Takada; Satoru Maruyama; Toru Harabayashi; Noriaki Nishiyama
  Journal of Radiation Research, 67, 4, 656, 664, Oxford University Press (OUP), 2026年07月07日, ［査読有り］, ［筆頭著者］, ［国際誌］
  英語, 研究論文（学術雑誌）, Abstract
  
  This study aimed to evaluate the relationships between dose–volume histogram (DVH) parameters and gastrointestinal (GI) and genitourinary toxicity in patients who underwent moderate hypofractionated salvage radiotherapy after radical prostatectomy. We retrospectively reviewed patients who received moderate hypofractionated salvage radiotherapy (65 Gy in 26 fractions, four fractions per week) between 2013 and 2022. DVH parameters of the rectum, anal canal, whole bladder, bladder neck, and bladder trigone were assessed in relation to toxicity. Optimal cut-off values were determined using receiver operating characteristic curve analysis. Ninety-two patients were included, with a median follow-up of 5.2 years. Grade ≥ 2 acute rectal bleeding, acute anal pain, late rectal bleeding, and grade ≥ 1 late hematuria occurred in 13%, 24%, 14%, and 33% of patients, respectively. Acute GI toxicity was associated with low-to-moderate doses to the anal canal, whereas late rectal bleeding was associated with moderate-to-high doses to the rectum. In multivariable analysis, anal canal V20Gy and hypertension were independent predictors of acute rectal bleeding, and rectum V60Gy and acute rectal bleeding were independently associated with late rectal bleeding. These findings may contribute to establishing DVH thresholds that facilitate dose optimization in moderate hypofractionated salvage radiotherapy after radical prostatectomy.
• Optimal combination of heart and lung dose parameters in radiotherapy for locally advanced non-small cell lung carcinoma: a multicenter retrospective study
  Tomohiko Miyazaki; Koichi Yasuda; Hiroshi Taguchi; Hideki Minatogawa; Tetsuya Inoue; Rikiya Takashina; Manami Otsuka; Keiji Nakazato; Noriaki Nishiyama; Keiji Kobashi; Izuru Otake; Jun Sakakibara-Konishi; Satoshi Oizumi; Hajime Kikuchi; Takayuki Hashimoto; Hidefumi Aoyama
  Journal of Radiation Research, 67, 4, 591, 599, Oxford University Press (OUP), 2026年05月14日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  This study aimed to identify the optimal combination of heart and lung dose parameters associated with overall survival (OS) in patients with locally advanced non-small cell lung carcinoma (LA-NSCLC) receiving radiotherapy. Data from 278 patients treated definitively for LA-NSCLC at three institutions between 1 April 2013 and 31 October 2021 were retrospectively analyzed. Lung and heart dose parameters were categorized into high- or low-dose groups based on predefined thresholds for subsequent analysis. Univariable analysis of OS was conducted for all dose group combinations. The combination with the lowest P-value was identified as the most promising and included in the multivariable analysis along with other clinical factors. The combinations of mean heart dose (MHD)/lung V40 (LV40) (‘Vxx’ denotes the percentage of organ volume receiving ≥xx Gy) and heart V5 (HV5)/LV40 yielded the lowest P-values (P = 0.021). The thresholds for these dose parameters were MHD ≤24.4 Gy, HV5 ≤63% and LV40 ≤7.7%, respectively. Multivariable analysis incorporating clinical factors identified age ≥65 years (HR: 2.06, P = 0.002), performance status ≥1 (Hazard ratio [HR]: 1.68, P = 0.024), chemoradiotherapy (HR: 0.28, P < 0.001), current smoking history (HR: 2.21, P < 0.001), gross tumor volume (HR: 1.43, P = 0.007) and the MHD/LV40 combination (HR: 2.35, P = 0.003) as independent prognostic factors. While exploratory, this study highlights the clinical significance of the MHD/LV40 combination as a prognostic factor; integrating these parameters radiotherapy for LA-NSCLC may improve patient outcomes.
• Non-surgical definitive treatment and geriatric assessment in older patients with locally advanced head and neck cancer
  Koichi Yasuda; Yoshitaka Honma; Yuri Ueda; Satoshi Saito; Kazuto Matsuura; Tomohiko Miyazaki; Shuhei Takahashi; Fuki Koizumi; Manami Otsuka; Tomohiro Enokida; Yuki Saito; Kaoru Tanaka; Shinya Hiraoka; Takashi Mukaigawa; Yoshinori Imamura; Taiji Koyama; Susumu Okano; Tomoya Yokota; Takeshi Kodaira; Nobuhiro Hanai; Satoaki Nakamura; Naomi Kiyota
  Japanese Journal of Clinical Oncology, 56, 7, 805, 815, Oxford University Press (OUP), 2026年04月12日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Population aging is rapidly progressing worldwide, and Japan has the most advanced aging population. Consistent with this trend, the proportion of older patients with head and neck cancer has markedly increased. Non-surgical definitive treatment for locally advanced head and neck cancer consists of radiotherapy (RT) alone or RT combined with systemic therapy; however, optimal treatment selection in older patients remains challenging due to their increased vulnerability to treatment-related toxicities and the limited availability of age-specific evidence. This review summarizes current evidence on non-surgical treatment strategies and the role of geriatric assessment (GA) in older patients with locally advanced oropharyngeal, hypopharyngeal, and laryngeal cancers. Although concurrent chemoradiotherapy (CRT) with high-dose cisplatin remains the standard of care for fit patients, its survival benefit appears attenuated in patients aged 70 years or older. Alternative approaches, including weekly cisplatin-based CRT, RT with other systemic agents, or RT alone, are frequently considered; however, the strength of supporting evidence varies. International guidelines recommend that treatment decisions for older adults be based on overall health status rather than chronological age alone. GA provides a structured framework to evaluate vulnerability across multiple domains, but remains underutilized in routine practice. Individualized, GA-guided treatment strategies with multidisciplinary discussion are essential for optimizing outcomes in this growing patient population.
• Normal tissue complication probability model for severe radiation-induced lymphopenia in patients with pancreatic cancer treated with concurrent chemoradiotherapy
  Fuki Koizumi; Norio Katoh; Takahiro Kanehira; Yasuyuki Kawamoto; Toru Nakamura; Tatsuhiko Kakisaka; Miyako Myojin; Noriaki Nishiyama; Akio Yonesaka; Manami Otsuka; Rikiya Takashina; Hideki Minatogawa; Hajime Higaki; Yusuke Uchinami; Hiroshi Taguchi; Kentaro Nishioka; Koichi Yasuda; Naoki Miyamoto; Isao Yokota; Keiji Kobashi; Hidefumi Aoyama
  Physics and Imaging in Radiation Oncology, 33, 100690, 100690, Elsevier BV, 2025年01月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Impact of adaptive radiotherapy on survival in locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiotherapy
  Yusuke Uchinami; Koichi Yasuda; Hideki Minatogawa; Yasuhiro Dekura; Noboru Nishikawa; Rumiko Kinoshita; Kentaro Nishioka; Norio Katoh; Takashi Mori; Manami Otsuka; Naoki Miyamoto; Ryusuke Suzuki; Keiji Kobashi; Yasushi Shimizu; Jun Taguchi; Nayuta Tsushima; Satoshi Kano; Akihiro Homma; Hidefumi Aoyama
  Radiation Oncology Journal, 42, 1, 74, 82, Korean Society for Therapeutic Radiology and Oncology, 2024年03月31日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Purpose: To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT).Materials and Methods: Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival.Results: The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541).Conclusion: Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.
• Treatment outcomes of radiotherapy with concurrent weekly cisplatin in older patients with locally advanced head and neck squamous cell carcinoma
  Yusuke Uchinami; Koichi Yasuda; Satoshi Kano; Manami Otsuka; Seijiro Hamada; Takayoshi Suzuki; Nayuta Tsushima; Shuhei Takahashi; Yoshihiro Fujita; Tomohiko Miyazaki; Hajime Higaki; Jun Taguchi; Yasushi Shimizu; Tomohiro Sakashita; Akihiro Homma; Hidefumi Aoyama
  Discover Oncology, 14, 1, Springer Science and Business Media LLC, 2023年12月08日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Background
  
  Tri-weekly cisplatin and radiotherapy (CDDP + RT) is a standard of care for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) but is sometimes challenging to complete in older patients. Weekly CDDP + RT has shown mild toxicity compared to tri-weekly CDDP + RT for LA-HNSCC and is a promising option for older adults. We aimed to report the treatment outcomes and prognostic factors in patients with LA-HNSCC treated with weekly CDDP + RT.
  
  Methods
  
  We analyzed patients aged ≥ 70 years who started weekly CDDP + RT for LA-HNSCC between July 2006 and October 2022. LA-HNSCC includes cancer in the oropharynx, hypopharynx, or larynx with a clinical stage of 3 or 4 without distant metastases based on the Union for International Cancer Control staging system 8th edition. The radiation dose of 70 Gy was delivered in 35 fractions by 3-dimensional conformal radiotherapy, intensity-modulated radiotherapy, or proton beam therapy. The primary endpoint was the 3-year overall survival (OS), and the secondary endpoints were the 3-year progression-free survival (PFS) and 3-year cause-specific survival (CSS). The Kaplan–Meier method was used to calculate survival rates, and the log-rank test was used to evaluate statistical significance. A Cox proportional hazards model was used for the multivariate analysis of prognostic factors.
  
  Results
  
  The median age of the 49 patients was 72 (range: 70–78) years. The median CDDP dose was 200 (40–280) mg/ m², and 47 patients completed scheduled radiotherapy. Forty-eight patients (98.0%) had a performance status of ≥ 1 at the initial visit. The 3-year OS, PFS, and CSS were 80.9% (95% confidence interval [CI]: 64.8–90.7), 58.9% (95%CI: 42.7–73.3), and 85.0% (95%CI: 68.7–93.4), respectively. In the multivariate analysis, the cumulative CDDP dose (< 200 or ≥ 200 mg/m²) was a significant factor for OS (hazard ratio: 0.29 [95% CI 0.08–0.97], p = 0.044). There was one case of early mortality. Grade 3 or higher late adverse events were observed in four patients (8.2%).
  
  Conclusions
  
  Weekly CDDP + RT in older patients led to good survival outcomes with an acceptable rate of adverse events. CDDP should be administered at a dose of at least 200 mg/m² in older patients.
  
  Trial registration Retrospectively registered
• Predicting the daily gastrointestinal doses of stereotactic body radiation therapy for pancreatic cancer based on the shortest distance between the tumor and the gastrointestinal tract using daily computed tomography images
  Yusuke Uchinami; Takahiro Kanehira; Keiji Nakazato; Yoshihiro Fujita; Fuki Koizumi; Shuhei Takahashi; Manami Otsuka; Koichi Yasuda; Hiroshi Taguchi; Kentaro Nishioka; Naoki Miyamoto; Kohei Yokokawa; Ryusuke Suzuki; Keiji Kobashi; Keita Takahashi; Norio Katoh; Hidefumi Aoyama
  BJR|Open, 5, 1, Oxford University Press (OUP), 2023年08月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Objectives:
  
  We aimed to investigate whether daily computed tomography (CT) images could predict the daily gastroduodenal, small intestine, and large intestine doses of stereotactic body radiation therapy (SBRT) for pancreatic cancer based on the shortest distance between the gross tumor volume (GTV) and gastrointestinal (GI) tract.
  
  Methods:
  
  Twelve patients with pancreatic cancer received SBRT of 40 Gy in five fractions. We recalculated the reference clinical SBRT plan (PLAN_ref) using daily CT images and calculated the shortest distance from the GTV to each GI tract. The maximum dose delivered to 0.5 cc (D_0.5cc) was evaluated for each planning at-risk volume of the GI tract. Spearman’s correlation test was used to determine the association between the daily change in the shortest distance (Δshortest distance) and the ratio of ΔD_0.5cc dose to D_0.5cc dose in PLAN_ref (ΔD_0.5cc/PLAN_ref) for quantitative analysis.
  
  Results:
  
  The median shortest distance in PLAN_ref was 0 mm in the gastroduodenum (interquartile range, 0–2.7), 16.7 mm in the small intestine (10.0–23.7), and 16.7 mm in the large intestine (8.3–28.1 mm). The D_0.5cc of PLAN_ref in the gastroduodenum was >30 Gy in all patients, with 10 (83.3%) having the highest dose. A significant association was found between the Δshortest distance and ΔD_0.5cc/ PLAN_ref in the small or large intestine (p < 0.001) but not in the gastroduodenum (p = 0.404).
  
  Conclusions:
  
  The gastroduodenum had a higher D_0.5cc and predicting the daily dose was difficult. Daily dose calculations of the GI tract are recommended for safe SBRT.
  
  Advances in knowledge:
  
  This study aimed to predict the daily doses in SBRT for pancreatic cancer from the shortest distance between the GTV and the gastrointestinal tract. Daily changes in the shortest distance can predict the daily dose to the small or large intestines, but not to the gastroduodenum.
• Evaluation of short-term gastrointestinal motion and its impact on dosimetric parameters in stereotactic body radiation therapy for pancreatic cancer
  Yusuke Uchinami; Takahiro Kanehira; Yoshihiro Fujita; Naoki Miyamoto; Kohei Yokokawa; Fuki Koizumi; Motoyasu Shido; Shuhei Takahashi; Manami Otsuka; Koichi Yasuda; Hiroshi Taguchi; Keiji Nakazato; Keiji Kobashi; Norio Katoh; Hidefumi Aoyama
  Clinical and Translational Radiation Oncology, 39, 100576, 100576, Elsevier BV, 2023年03月, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Brain metastases in Japanese NSCLC patients: prognostic assessment and the use of osimertinib and immune checkpoint inhibitors—retrospective study
  Hajime Higaki; Kentaro Nishioka; Manami Otsuka; Noboru Nishikawa; Motoyasu Shido; Hideki Minatogawa; Yukiko Nishikawa; Rikiya Takashina; Takayuki Hashimoto; Norio Katoh; Hiroshi Taguchi; Rumiko Kinoshita; Koichi Yasuda; Takashi Mori; Yusuke Uchinami; Fuki Koizumi; Yoshihiro Fujita; Shuhei Takahashi; Takahiro Hattori; Noriaki Nishiyama; Hidefumi Aoyama
  Radiation Oncology, 18, 1, Springer Science and Business Media LLC, 2023年02月07日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Background
  
  The Graded Prognostic Assessment for lung cancer using molecular markers (Lung-molGPA) has not been validated for use with Japanese non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) and the factors impacting survival need to be assessed.
  
  Methods
  
  We retrospectively analyzed 294 NSCLC patients who were newly diagnosed with BM between 2013 and 2020 and had received radiotherapy for BM initially at the Hokkaido Cancer Center. We evaluated the effect on the prognosis of Lung-molGPA items, the expression of PD-L1 (classified as high, low, and no expression), and the treatment history. The main outcome was the survival measured from the day of the diagnosis of BM, and log-rank tests were performed to evaluate the results.
  
  Results
  
  The median overall survival (OS) times for adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, 2.5‒3.0, and 3.5‒4.0) were 5.5, 14.8, 28.3, and 39.0 months (p < 0.0001), respectively. The median survival times for non-adenocarcinoma by groups of GPA scores (0‒1.0, 1.5‒2.0, and 2.5‒3.0) were 3.2, 11.0, and 16.0 months (p = 0.0011), respectively. In adenocarcinoma patients with gene mutations, osimertinib significantly improved the outcome (median OS: 34.2 and 17.6 months with and without osimertinib, respectively (p = 0.0164)). There was no significant difference in the OS between patients who were initially treated with tyrosine-kinase inhibitor for BM and those who initially received radiotherapy (p = 0.5337). In patients tested for PD-L1 expression, the median survival times after the diagnosis of BM were 5.6, 22.5, and 9.3 months for the high-, low- and no-expression groups (p = 0.2198), respectively. Also, in patients with high PD-L1 expressions, those with ICI had survival (median OS, 8.6 months) than those without (median OS, 3.6 months).
  
  Conclusions
  
  We confirmed that Lung-molGPA successfully classified Japanese NSCLC patients with BM by the prognosis. Osimertinib prolonged survival of EGFR-positive NSCLC patients with BM, and ICI was effective in patients with high PD-L1 expressions.
• Distribution of human papilloma virus genotypes and treatment outcomes in definitive radiotherapy for cervical cancer
  Rumiko Kinoshita; Takashi Mitamura; Fumi Kato; Takahiro Hattori; Hajime Higaki; Shuhei Takahashi; Yoshihiro Fujita; Manami Otsuka; Fuki Koizumi; Yusuke Uchinami; Takashi Mori; Kentaro Nishioka; Takayuki Hashimoto; Yoichi M Ito; Hidemichi Watari; Hidefumi Aoyama
  Journal of Radiation Research, 64, 2, 463, 470, Oxford University Press (OUP), 2023年01月03日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Most oncogenic human papilloma virus (HPV) genotypes stratify into two species, α-7 HPV and α-9 HPV. There are several studies that evaluate the relationship between HPV species and treatment outcomes and reports that HPV species is prognostic. The HPV genotyping was conducted using biopsy specimens which had been stored in these studies. We conducted the study using the HPV test performed by cytology specimens which is less invasive and more useful in clinical settings. This study enrolled 46 patients who received HPV genotyping before the definitive radiotherapy. The results of the HPV genotyping were classified into HPVα-7, HPVα-9 and negatives. Of the 46 patients, 10 were positive for HPVα-7, 21 positive for HPVα-9 and 15 were negative. The median follow-up period was 38 months (range 4–142). The HPVα-7, HPVα-9 and negative groups showed the 3-year overall survival (OS; 59.3%, 80.4% and 72.2% [P = 0.25]); local control (LC; 67.5%, 81% and 80% [P = 0.78]); pelvic control (PC) (50%, 81% and 72.7% [P = 0.032]); pelvic lymph node (PLN) control (78.7%, 95% and 92.3% [P = 0.012]); distant metastasis free (DMF) survival (50%, 75.4% and 42.8% [P = 0.098]); and progression free survival (PFS) rate of patients (30%, 66.7% and 38.9% [P = 0.085]), respectively. Patients with HPVα-7 showed statistically significant poorer PC than the HPVα-9 group, in multivariate analysis. This result is consistent with previous studies for HPV positive patients. The HPV negativity rate was higher in this study than in other studies and further work on this may be needed for clinical use.
• Deformed dose restoration to account for tumor deformation and position changes for adaptive proton therapy
  Koichi Miyazaki; Yusuke Fujii; Takahiro Yamada; Takahiro Kanehira; Naoki Miyamoto; Taeko Matsuura; Koichi Yasuda; Yusuke Uchinami; Manami Otsuka; Hidefumi Aoyama; Seishin Takao
  Medical Physics, 50, 2, 675, 687, Wiley, 2022年12月29日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Background
  
  Online adaptation during intensity‐modulated proton therapy (IMPT) can minimize the effect of inter‐fractional anatomical changes, but remains challenging because of the complex workflow. One approach for fast and automated online IMPT adaptation is dose restoration, which restores the initial dose distribution on the updated anatomy. However, this method may fail in cases where tumor deformation or position changes occur.
  
  Purpose
  
  To develop a fast and robust IMPT online adaptation method named “deformed dose restoration (DDR)” that can adjust for inter‐fractional tumor deformation and position changes.
  
  Methods
  
  The DDR method comprises two steps: (1) calculation of the deformed dose distribution, and (2) restoration of the deformed dose distribution. First, the deformable image registration (DIR) between the initial clinical target volume (CTV) and the new CTV were performed to calculate the vector field. To ensure robustness for setup and range uncertainty and the ability to restore the deformed dose distribution, an expanded CTV‐based registration to maintain the dose gradient outside the CTV was developed. The deformed dose distribution was obtained by applying the vector field to the initial dose distribution. Then, the voxel‐by‐voxel dose difference optimization was performed to calculate beam parameters that restore the deformed dose distribution on the updated anatomy. The optimization function was the sum of total dose differences and dose differences of each field to restore the initial dose overlap of each field. This method only requires target contouring, which eliminates the need for organs at risk (OARs) contouring. Six clinical cases wherein the tumor deformation and/or position changed on repeated CTs were selected. DDR feasibility was evaluated by comparing the results with those from three other strategies, namely, not adapted (continuing the initial plan), adapted by previous dose restoration, and fully optimized.
  
  Results
  
  In all cases, continuing the initial plan was largely distorted on the repeated CTs and the dose‐volume histogram (DVH) metrics for the target were reduced due to the tumor deformation or position changes. On the other hand, DDR improved DVH metrics for the target to the same level as the initial dose distribution. Dose increase was seen for some OARs because tumor growth had reduced the relative distance between CTVs and OARs. Robustness evaluation for setup and range uncertainty (3 mm/3.5%) showed that deviation in DVH‐bandwidth for CTV D_95% from the initial plan was 0.4% ± 0.5% (Mean ± S.D.) for DDR. The calculation time was 8.1 ± 6.4 min.
  
  Conclusions
  
  An online adaptation algorithm was developed that improved the treatment quality for inter‐fractional anatomical changes and retained robustness for intra‐fractional setup and range uncertainty. The main advantage of this method is that it only requires target contouring alone and saves the time for OARs contouring. The fast and robust adaptation method for tumor deformation and position changes described here can reduce the need for offline adaptation and improve treatment efficiency.
• Detailed analysis of failure patterns using deformable image registration in hypopharyngeal cancer patients treated with sequential boost intensity‐modulated radiotherapy
  Manami Otsuka; Koichi Yasuda; Yusuke Uchinami; Nayuta Tsushima; Takayoshi Suzuki; Satoshi Kano; Ryusuke Suzuki; Naoki Miyamoto; Hideki Minatogawa; Yasuhiro Dekura; Takashi Mori; Kentaro Nishioka; Jun Taguchi; Yasushi Shimizu; Norio Katoh; Akihiro Homma; Hidefumi Aoyama
  Journal of Medical Imaging and Radiation Oncology, 67, 1, 98, 110, Wiley, 2022年11月14日, ［査読有り］, ［筆頭著者］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Introduction
  
  Sequential boost intensity‐modulated radiotherapy (SQB‐IMRT) uses two different planning CTs (pCTs) and treatment plans. SQB‐IMRT is a form of adaptive radiotherapy that allows for responses to changes in the shape of the tumour and organs at risk (OAR). On the other hand, dose accumulation with the two plans can be difficult to evaluate. The purpose of this study was to analyse patterns of loco‐regional failure using deformable image registration (DIR) in hypopharyngeal cancer patients treated with SQB‐IMRT.
  
  Methods
  
  Between 2013 and 2019, 102 patients with hypopharyngeal cancer were treated with definitive SQB‐IMRT at our institution. Dose accumulation with the 1st and 2nd plans was performed, and the dose to the loco‐regional recurrent tumour volume was calculated using the DIR workflow. Failure was classified as follows: (i) in‐field (≥95% of the recurrent tumour volume received 95% of the prescribed dose); (ii) marginal (20–95%); or (iii) out‐of‐field (<20%).
  
  Results
  
  After a median follow‐up period of 25 months, loco‐regional failure occurred in 34 patients. Dose–volume histogram analysis showed that all loco‐regional failures occurred in the field within 95% of the prescribed dose, with no marginal or out‐of‐field recurrences observed.
  
  Conclusion
  
  The dosimetric analysis using DIR showed that all loco‐regional failures were within the high‐dose region. More aggressive treatment may be required for gross tumours.
• Hyperfractionated intensity‐modulated proton therapy for pharyngeal cancer with variable relative biological effectiveness: A simulation study
  Koki Kasamatsu; Taeko Matsuura; Koichi Yasuda; Koichi Miyazaki; Seishin Takao; Masaya Tamura; Manami Otsuka; Yusuke Uchinami; Hidefumi Aoyama
  Medical Physics, 49, 12, 7815, 7825, Wiley, 2022年11月09日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Abstract
  
  Background
  
  The relative biological effectiveness (RBE) of proton is considered to be dependent on biological parameters and fractional dose. While hyperfractionated photon therapy was effective in the treatment of patients with head and neck cancers, its effect in intensity‐modulated proton therapy (IMPT) under the variable RBE has not been investigated in detail.
  
  Purpose
  
  To study the effect of variable RBE on hyperfractionated IMPT for the treatment of pharyngeal cancer. We investigated the biologically effective dose (BED) to determine the theoretical effective hyperfractionated schedule.
  
  Methods
  
  The treatment plans of three pharyngeal cancer patients were used to define the ΔBED for the clinical target volume (CTV) and soft tissue (acute and late reaction) as the difference between the BED for the altered schedule with variable RBE and conventional schedule with constant RBE. The ΔBED with several combinations of parameters (treatment days, number of fractions, and prescribed dose) was comprehensively calculated. Of the candidate schedules, the one that commonly gave a higher ΔBED for CTV was selected as the resultant schedule. The BED volume histogram was used to compare the influence of variable RBE and fractionation.
  
  Results
  
  In the conventional schedule, compared with the constant RBE, the variable RBE resulted in a mean 2.6 and 2.7 Gy reduction of BED_mean for the CTV and soft tissue (acute reaction) of the three plans, respectively. Moreover, the BED_mean for soft tissue (late reaction) increased by 7.4 Gy, indicating a potential risk of increased RBE. Comprehensive calculation of the ΔBED resulted in the hyperfractionated schedule of 80.52 Gy (RBE = 1.1)/66 fractions in 6.5 weeks. When variable RBE was used, compared with the conventional schedule, the hyperfractionated schedule increased the BED_mean for CTV by 7.6 Gy; however, this was associated with a 7.8 Gy increase for soft tissue (acute reaction). The BED_mean for soft tissue (late reaction) decreased by 2.4 Gy.
  
  Conclusion
  
  The results indicated a potential effect of the variable RBE on IMPT for pharyngeal cancer but with the possibility that hyperfractionation could outweigh this effect. Although biological uncertainties require conservative use of the resultant schedule, hyperfractionation is expected to be an effective strategy in IMPT for pharyngeal cancer.
• Graded Prognostic Assessment (GPA) for Patients With Lung Cancer and Brain Metastases: Initial Report of the Small Cell Lung Cancer GPA and Update of the Non-Small Cell Lung Cancer GPA Including the Effect of Programmed Death Ligand 1 and Other Prognostic Factors
  Paul W. Sperduto; Brian De; Jing Li; David Carpenter; John Kirkpatrick; Michael Milligan; Helen A. Shih; Tugce Kutuk; Rupesh Kotecha; Hajime Higaki; Manami Otsuka; Hidefumi Aoyama; Malie Bourgoin; David Roberge; Salah Dajani; Sean Sachdev; Jordan Gainey; John M. Buatti; William Breen; Paul D. Brown; Lisa Ni; Steve Braunstein; Matthew Gallitto; Tony J.C. Wang; Ryan Shanley; Emil Lou; Jay Shiao; Laurie E. Gaspar; Satoshi Tanabe; Toshimichi Nakano; Yi An; Veronica Chiang; Liang Zeng; Hany Soliman; Hesham Elhalawani; Daniel Cagney; Evan Thomas; Drexell H. Boggs; Manmeet S. Ahluwalia; Minesh P. Mehta
  International Journal of Radiation Oncology*Biology*Physics, 114, 1, 60, 74, Elsevier BV, 2022年09月, ［査読有り］, ［国際共著］, ［国際誌］
  研究論文（学術雑誌）
• SMARCB1欠損篩骨洞癌に対する強度変調陽子線治療 : 症例報告と文献レビュー
  宮﨑 智彦; 安田; 耕一; 志藤; 元泰; 小泉; 富基; 藤田; 祥博; 高橋; 周平; 湊川; 英樹; 大塚; 愛美; 加藤; 徳雄; 清水; 伸一; 青山 英史
  北海道放射線医学雑誌, 1, 1, 6, 2021年09月, ［査読有り］, ［国内誌］
• Salvage surgery improves the treatment outcome of patients with residual/recurrent maxillary sinus cancer after superselective intra-arterial cisplatin infusion with concomitant radiation therapy
  Nayuta Tsushima; Satoshi kano; Takayoshi Suzuki; Hiroshi Idogawa; Daisuke Yoshida; Koichi Yasuda; Manami Otsuka; Hidefumi Aoyama; Akihiro Homma
  European Archives of Oto-Rhino-Laryngology, 279, 2, 899, 905, Springer Science and Business Media LLC, 2021年04月18日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）
• Rare Clinical Course of Immunoglobulin G4-Related Inflammatory Abdominal Aortic Aneurysm with Multiple Rare Complications
  Yuji Naito; Tsukasa Miyatake; Manami Iwasaki; Atsushi Okuyama; Akio Takada; Koji Chiba; Masahiko Obata; Junichi Oba
  Case Reports in Vascular Medicine, 2019, 1, 7, Wiley, 2019年06月03日, ［査読有り］, ［国際誌］
  研究論文（学術雑誌）, Immunoglobulin G4- (IgG4-) related inflammatory abdominal aortic aneurysm (AAA) has been recognized as a manifestation of IgG4-related disease (IgG4-RD). We experienced one patient with multiple consecutive manifestations before and after endovascular stent grafting for IgG4-related inflammatory AAA (IAAA). A 71-year-old man was diagnosed with IgG4-RD due to increased IgG4 serum concentration, typical findings of parotid gland biopsy, and periaortitis in another hospital 2 years and 7 months before visiting our hospital. He came to our hospital because of abdominal pain and IAAA. He developed paraplegia after hospitalization and underwent endovascular stent grafting for the IAAA. About one month after stent grafting, he developed perforation of the sigmoid colon due to enteritis. He also had myocardial infarction. Finally, he died of intestinal bleeding. Here, we describe this case with rare, multiple, consecutive manifestations of IgG4-RD, some of which might be caused by IgG4-related IAAA or side effects of treatments rather than by IgG4-RD itself. We report this case because the clinical course seemed rare for IgG4-RD or IgG4-related IAAA. For treating IgG4-RD with IgG4-related IAAA, we should consider factors causing the symptoms and carefully select the proper treatment.

• 前立腺癌術後救済放射線治療における中等度寡分割照射の治療成績と晩期有害事象
  大塚愛美, 湊川英樹, 西川由記子, 西山典明, 更科武讓, 高田徳容, 丸山覚, 原林透, 第38回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, 2025年, ［筆頭著者］
• 前立腺全摘後救済照射における消化管・尿路毒性の検討
  大塚 愛美; 蘆田 隆晟; 田口 大志; 西山 典明; 森口 卓哉; 高田 徳容; 丸山 覚; 原林 透, 日本放射線腫瘍学会第38回学術大会プログラム・抄録集, 2025年, ［筆頭著者］
• Patterns of failure and late toxicities in hypopharyngeal cancer with intensity-modulated radiotherapy (IMRT): a retrospective analysis
  大塚愛美; 安田耕一; 湊川英樹; 出倉康裕; 小泉富貴; 鈴木隆介; 清水康; 本間明宏; 清水伸一; 青山英史, 第 80 回日本医学放射線学会総会プログラム・抄録集, 2021年, ［筆頭著者］
• 当院における下咽頭癌に対する根治的強度変調放射線治療（IMRT）の治療成績
  大塚愛美; 安田耕一; 湊川英樹; 宮本直樹; 鈴木隆介; 鈴木崇祥; 対馬那由多; 加納里志; 田口純; 清水康; 本間明宏; 清水伸一; 青山英史, 日本放射線腫瘍学会第33回学術大会プログラム・抄録集, 2020年, ［筆頭著者］
• 脾臓への放射線照射が奏功した脾機能亢進症の1例
  岩崎 愛美; 安田 耕一; 遠藤 知之; 大東 寛幸; 清水 伸一; 鬼丸 力也; 豊嶋 崇徳; 白土 博樹, 第55回日本医学放射線学会秋季臨床大会プログラム・抄録集, 2019年, ［筆頭著者］

• 【がん免疫療法の展望:免疫チェックポイント阻害薬の併用療法を中心に】免疫チェックポイント阻害薬の併用療法のエビデンス 免疫チェックポイント阻害薬と放射線治療
  安田 耕一; 志藤 元泰; 小泉 富基; 高橋 周平; 藤田 祥博; 大塚 愛美; 宮崎 智彦; 西川 昇; 打浪 雄介; 森 崇; 西岡 健太郎; 木下 留美子; 田口 大志; 加藤 徳雄; 橋本 孝之; 青山 英史
  月刊 腫瘍内科, 2020年07月