詳細

土井　啓至 （ドイ　ヒロシ）

  • 医学科　准教授
Last Updated :2024/04/23

コミュニケーション情報 byコメンテータガイド

  • コメント

    放射線治療全般、特に高精度放射線治療を中心に、困難な治療を安全に達成する診療と研究を行っています。

研究者情報

学位

  • 博士 (医学)（2012年03月 兵庫医科大学）

ホームページURL

J-Global ID

現在の研究分野（キーワード）

    放射線治療全般、特に高精度放射線治療を中心に、困難な治療を安全に達成する診療と研究を行っています。

経歴

  • 2024年04月 - 現在  近畿大学医学部放射線腫瘍学部門准教授
  • 2022年04月 - 2024年03月  近畿大学医学部放射線腫瘍学部門講師
  • 2020年04月 - 2022年03月  近畿大学医学部放射線腫瘍学部門講師
  • 2017年07月 - 2020年03月  近畿大学医学部放射線腫瘍学部門医学部講師
  • 2016年04月 - 2017年06月  明和キャンサークリニック放射線治療科科長
  • 2011年04月 - 2016年03月  兵庫医科大学放射線医学講座助教
  • 2012年05月 - 2013年06月  スタンフォード大学放射線腫瘍科客員研究員

所属学協会

  • 日本癌治療学会   欧州放射線腫瘍学会   米国放射線腫瘍学会   日本消化器病学会   日本放射線腫瘍学会   日本内科学会   日本医学放射線学会   

研究活動情報

論文

  • Wakabayashi K; Monzen H; Doi H; Inagaki T; Sonomura T
    Cureus 16 4 e57415  2024年04月 [査読有り]
  • Takuya Uehara; Yasumasa Nishimura; Kazuki Ishikawa; Masahiro Inada; Kenji Matsumoto; Hiroshi Doi; Hajime Monzen; Yukinori Matsuo
    Journal of radiation research 65 2 223 - 230 2024年01月 [査読有り]
     
    The present study aimed to evaluate whether an adapted plan with Ethos™ could be used for pharyngeal cancer. Ten patients with pharyngeal cancer who underwent chemoradiotherapy with available daily cone-beam computed tomography (CBCT) data were included. Simulated treatments were generated on the Ethos™ treatment emulator using CBCTs every four to five fractions for two plans: adapted and scheduled. The simulated treatments were divided into three groups: early (first-second week), middle (third-fourth week), and late (fifth-seventh week) periods. Dose-volume histogram parameters were compared for each period between the adapted and scheduled plans in terms of the planning target volume (PTV) (D98%, D95%, D50% and D2%), spinal cord (Dmax and D1cc), brainstem (Dmax) and ipsilateral and contralateral parotid glands (Dmedian and Dmean). The PTV D98%, D95% and D2% of the adapted plan were significantly higher than those of the scheduled plans in all periods, except for D98% in the late period. The adapted plan significantly reduced the spinal cord Dmax and D1cc compared with the scheduled plan in all periods. Ipsilateral and contralateral parotid glands Dmean of the adapted plan were lower than those of scheduled plan in the late period. In conclusion, the present study revealed that the adapted plans could maintain PTV coverage while reducing the doses to organs at risk in each period compared with scheduled plans.
  • Doi H; Ri A; Inada M; Tatsuno S; Uehara T; Matsuura T; Ishikawa K; Nakamatsu K; Hosono M; Nishimura Y
    International Journal of Clinical Oncology 28 12 1607 - 1615 2023年12月 [査読有り]
     
    BACKGROUND: This study aimed to reveal the long-term outcomes and late toxicities (> 5 years) after definitive intensity-modulated radiation therapy (IMRT) in patients with nasopharyngeal carcinoma (NPC). METHODS: Data from 43 patients (median age, 55 years; range, 17-72 years) with NPC who underwent definitive IMRT between 2001 and 2018 were analyzed. All patients were alive and disease-free 5 years after IMRT. A total dose of 70 (range, 66-70) Gy was delivered in 35 (33-35) fractions with concurrent cisplatin chemotherapy. RESULTS: The median follow-up duration was 119 (range, 61.5-242.1) months. Three patients developed locoregional failure at 79, 92, and 149 months after IMRT, respectively. Of these, 2 patients died of disease progression at 136 and 153 months after IMRT. One patient died of aspiration pneumonia 141 months after IMRT, despite salvage of the recurrent tumor by re-irradiation. In addition, one patient died of aspiration pneumonia 62 months after the IMRT. Thus, the 10-year overall survival, progression-free survival, and locoregional control rates were 98%, 92%, and 94%, respectively. Grade ≥ 2 and ≥ 3 late toxicities were observed in 28 (65%) and 9 (21%) patients, respectively. Nine second primary cancers, including five tongue cancers and two external auditory canal carcinomas, were observed in seven (16%) patients. CONCLUSION: Late recurrences, severe late toxicities, and second primary cancers were observed > 5 years after IMRT. A long-term follow-up of > 5 years is needed in patients with NPC.
  • Saori Tatsuno; Hiroshi Doi; Masahiro Inada; Takuya Uehara; Yutaro Wada; Kazuki Ishikawa; Kaoru Tanaka; Mutsukazu Kitano; Yasumasa Nishimura
    Strahlentherapie und Onkologie 2023年11月 [査読有り]
  • Yasuo Suehiro; Tetsuya Kajiyama; Ayaka Satoh; Hisashi Uemura; Takaya Nakagawa; Hajime Matsue; Hisashi Satoh; Naoto Takase; Hiroshi Doi
    General Thoracic and Cardiovascular Surgery Cases 2 1 94  2023年11月 [査読有り]
     
    Abstract Background Primary cardiac angiosarcomas are extremely rare and their prognosis is poor. Surgical resection is the first-line treatment; however, no clear standard of care has been clearly established because of the rarity of these tumors. Case presentation A 61-year-old man who had presented with dyspnea on exertion was referred to our hospital. Contrast-enhanced computed tomography revealed massive pericardial effusion and a 40-mm enhanced mass adherent to the anterior wall of the right atrium and involving the right coronary artery. Having diagnosed the mass as a cardiac tumor, we resected the mass under the guidance of epi-cardiac echocardiography guidance, which showed continuity between the tumor and the right atrium, reconstructed the right atrial free wall with a bovine pericardial patch, and performed coronary artery bypass grafting to the right coronary artery using the great saphenous vein. The right atrial wall was resected with adequate tumor-free margin. On the right ventricular side, we resected the right atrial wall 1 cm from the tumor, 2 cm from the atrioventricular groove. Because hemodynamic deterioration occurred after aortic declamping, intra-aortic balloon pumping and veno-arterial extracorporeal membrane oxygenation were instituted. Postoperatively, circulatory support devices were removed safely, and the patient was discharged on the 25th postoperative day. Histopathological examination of the surgical specimens resulted in a diagnosis of angiosarcoma, with positive surgical margins. Chemotherapy and radiotherapy (69 Gy in 30 fractions) were therefore initiated after discharge. To date, the patient has been alive and well with no recurrence of tumor for 4 years and 10 months since surgery. Discussion This case study suggests the usefulness of multimodality treatment comprising surgical resection and adjuvant therapy, for cardiac angiosarcoma.
  • Yuya Yanagi; Kazuki Kubo; Takaaki Ito; Kenji Nakamura; Makoto Hirata; Hiroshi Doi; Hajime Monzen
    Cureus 15 10 e46805  2023年10月 [査読有り]
  • Ito T; Monzen H; Kubo K; Kosaka H; Yanagi Y; Sakai Y; Inada M; Doi H; Nishimura Y
    Reports of Practical Oncology and Radiotherapy 28 3 399 - 406 2023年06月 [査読有り]
  • Yoshihiro Ueda; Jun-Ichi Fukunaga; Tatsuya Kamima; Yumiko Shimizu; Kazuki Kubo; Hiroshi Doi; Hajime Monzen
    Physical and engineering sciences in medicine Online ahead of print. 2023年05月 [査読有り]
     
    PURPOSE: To evaluate whether knowledge-based volumetric modulated arc therapy plans for prostate cancer with a multi-institution model (broad model) are clinically useful and effective as a standardization method. METHODS: A knowledge-based planning (KBP) model was trained with 561 prostate VMAT plans from five institutions with different contouring and planning policies. Five clinical plans at each institution were reoptimized with the broad and single institution model, and the dosimetric parameters and relationship between Dmean and the overlapping volume (rectum or bladder and target) were compared. RESULTS: The differences between the broad and single institution models in the dosimetric parameters for V50, V80, V90, and Dmean were: rectum; 9.5% ± 10.3%, 3.3% ± 1.5%, 1.7% ± 1.6%, and 3.6% ± 3.6%, (p < 0.001), bladder; 8.7% ± 12.8%, 1.5% ± 2.6%, 0.7% ± 2.4%, and 2.7% ± 4.6% (p < 0.02), respectively. The differences between the broad model and clinical plans were: rectum; 2.4% ± 4.6%, 1.7% ± 1.7%, 0.7% ± 2.4%, and 1.5% ± 2.0%, (p = 0.004, 0.015, 0.112, and 0.009) bladder; 2.9% ± 5.8%, 1.6% ± 1.9%, 0.9% ± 1.7%, and 1.1% ± 4.8%, (p < 0.018), respectively. Positive values indicate that the broad model has a lower value. Strong correlations were observed (p < 0.001) in the relationship between Dmean and the rectal and bladder volume overlapping with the target in the broad model (R = 0.815 and 0.891, respectively). The broad model had the smallest R2 of the three plans. CONCLUSIONS: KBP with the broad model is clinically effective and applicable as a standardization method at multiple institutions.
  • Inagaki T; Doi H; Inada M; Ishida N; Ri A; Tatsuno S; Wada Y; Uehara T; Nakamatsu K; Hosono M; Nishimura Y
    Strahlentherapie und Onkologie 199 5 465 - 476 2023年05月 [査読有り]
  • Wada Y; Monzen H; Ishida N; Ri A; Tatsuno S; Uehara T; Inada M; Doi H; Nakamatsu K; Hosono M; Nishimura Y
    Medical Dosimetry 48 3 193 - 196 2023年04月 [査読有り]
  • Inada M; Nishimura Y; Hanaoka K; Nakamatsu K; Doi H; Uehara T; Komanishi M; Ishii K; Kaida H; Hosono M
    Radiotherapy and Oncology In press 2023年01月 [査読有り]
  • Zhu Z; Ni J; Cai X; Su S; Zhuang H; Yang Z; Chen M; Ma S; Xie C; Xu Y; Li J; Ge H; Liu A; Zhao L; Rao C; Xie C; Bi N; Hui Z; Zhu G; Yuan Z; Wang J; Zhao L; Zhou W; Rim CH; Navarro-Martin A; Vanneste BGL; De Ruysscher D; Choi JI; Jassem J; Chang JY; Kepka L; Käsmann L; Milano MT; Van Houtte P; Suwinski R; Traverso A; Doi H; Suh YG; Noël G; Tomita N; Kowalchuk RO; Sio TT; Li B; Lu B; Fu X
    Translational Lung Cancer Research 11 9 1763 - 1795 2022年09月 [査読有り]
  • Oguma Y; Hosono M; Okajima K; Inoue E; Nakamatsu K; Doi H; Matsuura T; Inada M; Uehara T; Wada Y; Ri A; Yamamoto Y; Yoshimura K; Uemura H; Nishimura Y
    Radiation 2 3 273 - 284 2022年09月 [査読有り]
  • Inagaki T; Doi H; Ishida N; Ri A; Tatsuno S; Wada Y; Uehara T; Inada M; Nakamatsu K; Hosono M; Nishimura Y
    Cancers 14 4 933  2022年02月 [査読有り]
     
    Stereotactic body radiotherapy (SBRT) is a treatment option for early-stage lung cancer. The purpose of this study was to investigate the optimal dose distribution and prognostic factors for local control (LC) after SBRT for lung cancer. A total of 104 lung tumors from 100 patients who underwent SBRT using various treatment regimens were analyzed. Dose distributions were corrected to the biologically effective dose (BED). Clinical and dosimetric factors were tested for association with LC after SBRT. The median follow-up time was 23.8 months (range, 3.4-109.8 months) after SBRT. The 1- and 3-year LC rates were 95.7% and 87.7%, respectively. In univariate and multivariate analyses, pathologically confirmed squamous cell carcinoma (SQ), T2 tumor stage, and a Dmax < 125 Gy (BED10) were associated with worse LC. The LC rate was significantly lower in SQ than in non-SQ among tumors that received a Dmax < 125 Gy (BED10) (p = 0.016). However, there were no significant differences in LC rate between SQ and non-SQ among tumors receiving a Dmax ≥ 125 Gy (BED10) (p = 0.198). To conclude, SQ, T2 stage, and a Dmax < 125 Gy (BED10) were associated with poorer LC. LC may be improved by a higher Dmax of the planning target volume.
  • Tatsuno S; Doi H; Okada W; Inoue E; Nakamatsu K; Tanooka M; Tanaka M; Nishimura Y
    Scientific Reports 12 1 590  2022年01月 [査読有り]
     
    Abstract The risk factors for severe radiation pneumonitis (RP) in patients with lung cancer who undergo rotating gantry intensity-modulated radiation therapy (IMRT) using volumetric modulated arc therapy (VMAT) or helical tomotherapy (HT) are poorly understood. Fifty-two patients who received rotating gantry IMRT for locally advanced lung cancer were included in this retrospective study. In total, 31 and 21 patients received VMAT and HT, respectively. The median follow-up duration was 14 months (range, 5.2–33.6). Twenty (38%) and eight (15%) patients developed grade ≥ 2 and ≥ 3 RP, respectively. In multivariate analysis, lung V5 ≥ 40% was associated with grade ≥ 2 RP (P = 0.02), and past medical history of pneumonectomy and total lung volume ≤ 3260 cc were independently associated with grade ≥ 3 RP (P = 0.02 and P = 0.03, respectively). Rotating gantry IMRT was feasible and safe in patients with lung cancer undergoing definitive radiotherapy. Reducing lung V5 may decrease the risk of symptomatic RP, and care should be taken to avoid severe RP after radiotherapy in patients with a past medical history of pneumonectomy and small total lung volume.
  • Doi H; Fujiwara M; Beppu N; Yokoyama H; Harui S; Sugihara A; Yanagi H; Hishikawa Y; Yamanaka N; Kamikonya N
    Anticancer Research 42 11 5587 - 5595 2022年 [査読有り]
  • Takuya Uehara; Hajime Monzen; Mikoto Tamura; Masahiro Inada; Masakazu Otsuka; Hiroshi Doi; Kenji Matsumoto; Yasumasa Nishimura
    Radiation Oncology 16 1 236 - 236 2021年12月 [査読有り]
     
    Abstract Background The use of total body irradiation (TBI) with linac-based volumetric modulated arc therapy (VMAT) has been steadily increasing. Helical tomotherapy has been applied in TBI and total marrow irradiation to reduce the dose to critical organs, especially the lungs. However, the methodology of TBI with Halcyon™ linac remains unclear. This study aimed to evaluate whether VMAT with Halcyon™ linac can be clinically used for TBI. Methods VMAT planning with Halcyon™ linac was conducted using a whole-body computed tomography data set. The planning target volume (PTV) included the body cropped 3 mm from the source. A dose of 12 Gy in six fractions was prescribed for 50% of the PTV. The organs at risk (OARs) included the lens, lungs, kidneys, and testes. Results The PTV D98%, D95%, D50%, and D2% were 8.9 (74.2%), 10.1 (84.2%), 12.6 (105%), and 14.2 Gy (118%), respectively. The homogeneity index was 0.42. For OARs, the Dmean of the lungs, kidneys, lens, and testes were 9.6, 8.5, 8.9, and 4.4 Gy, respectively. The V12Gy of the lungs and kidneys were 4.5% and 0%, respectively. The Dmax of the testes was 5.8 Gy. Contouring took 1–2 h. Dose calculation and optimization was performed for 3–4 h. Quality assurance (QA) took 2–3 h. The treatment duration was 23 min. Conclusions A planning study of TBI with Halcyon™ to set up VMAT-TBI, dosimetric evaluation, and pretreatment QA, was established.
  • Inoue E; Okajima K; Doi H; Fukuda K; Oguma Y; Ri A; Nishikawa D; Yane K; Matsuura T; Nishimura Y
    Acta Oto-Laryngologica 141 11 1022 - 1026 2021年11月 [査読有り]
  • Sakisuka T; Kashiwagi N; Doi H; Takahashi H; Arisawa A; Matsuo C; Masuda Y; Inohara H; Sato K; Outani H; Outani H; Ishii K; Tomiyama N
    Molecular and Clinical Oncology 15 5 246 - 246 2021年11月 [査読有り]
     
    Although bone is the second-most frequent site of distant metastases of head and neck squamous cell carcinoma (HNSCC), variable prognostic factors in patients with bone metastases from HNSCC have not been fully investigated. The aim of the present study was to assess the prognostic factors affecting overall survival (OS) in these patients. The medical records of 97 patients at two institutions who developed bone metastases from HNSCC between January 2010 and December 2020 were retrospectively reviewed. A multivariate analysis using a Cox proportional hazards model was performed to identify potential clinical predictive factors for longer OS. The median OS was 7 months, and the 1- and 2-year OS rates for all patients were 35.4 and 19.2%, respectively. The independent predictive factors for longer OS were single bone metastasis, good performance status and administration of systemic chemotherapy. The median OS with each predictor was 10, 10 and 10.5 months, respectively. In a selected group of patients with these three factors, the OS was 14.5 months. In conclusion, single bone metastasis, a good performance status and systemic chemotherapy were independent predictors of longer OS in patients with HNSCC, but their contributions were limited.
  • Fujiwara M; Doi H; Igeta M; Suzuki H; Kitajima K; Tanooka M; Ishida T; Wakayama T; Yokoi T; Kuribayashi K; Kijima T; Hashimoto M; Kondo N; Matsumoto S; Hasegawa S; Kamikonya N; Yamakado K
    Anticancer Research 41 11 5793 - 5802 2021年11月 [査読有り]
     
    BACKGROUND/AIM: To evaluate the incidence and grade of radiation pneumonitis after volumetric modulated arc therapy (VMAT) performed for the treatment of non-small cell cancer (NSCLC). PATIENTS AND METHODS: Fifty consecutive non-surgical candidates with NSCLC underwent VMAT. Thirty-five patients had stage-III tumors and 15 had recurrent tumors. The prescribed radiation dose for the gross tumor and the elective nodal area was 69 Gy in 30 fractions and 51 Gy in 30 fractions, respectively. RESULTS: Radiation pneumonitis developed in 38 patients (76%, 38/50), and grade ≥2 radiation pneumonitis developed in 11 patients (22%, 11/50). The percentage of lung volume that received a dose in excess of 5 Gy (V5), V10, V20, V30, and the mean lung dose (MLD) in the bilateral and ipsilateral lung were significantly associated with the development of grade ≥2 radiation pneumonitis. CONCLUSION: The incidence and degree of radiation pneumonitis are acceptable following treatment of NSCLC with VMAT.
  • Wada Y; Monzen H; Otsuka M; Inada M; Doi H; Nakamatsu K; Nishimura Y
    Medical Dosimetry In press 2021年10月 [査読有り]
  • Uehara T; Doi H; Ishikawa K; Inada M; Tatsuno S; Wada Y; Oguma Y; Kawakami H; Nakamatsu K; Hosono M; Nishimura Y
    Head & Neck 43 10 3132 - 3141 2021年10月 [査読有り]
  • Wakabayashi K; Monzen H; Tamura M; Takei Y; Okuhata K; Anami S; Doi H; Nishimura Y
    Physics in Medicine and Biology 66 18 185013  2021年09月 [査読有り]
     
    We have developed soft rubber (SR) bolus that can be shaped in real-time by heating flexibly and repeatedly. This study investigated whether the SR bolus could be used as an ideal bolus, such as not changing of the beam characteristics and homogeneity through the bolus and high plasticity to adhere a patient in addition to real-time shapeable and reusability, in electron radiotherapy. Percentage depth doses (PDDs) and lateral dose profiles (LDPs) were obtained for 4, 6, and 9 MeV electron beams and were compared between the SR and conventional gel boluses. For the LDP at depth of 90% dose, the penumbra as lateral distance between the 80% and 20% isodose lines (P80-20) and the width of 90% dose level (r90) were compared. To evaluate adhesion, the air gap volume between the boluses and nose of a head phantom was evaluated on CT image. The dose profiles along the center axis for the 6 MeV electron beam with SR, gel, and virtual boluses (thickness = 5 mm) on the head phantom were also calculated for the irradiation of 200 monitor unit with a treatment planning system and the depth of the maximum dose (dmax) and maximum dose (Dmax) were compared. The PDDs,P80-20, andr90between the SR and gel boluses corresponded well (within 2%, 0.4 mm, and 0.7 mm, respectively). The air gap volumes of the SR and gel boluses were 3.14 and 50.35 cm3, respectively. Thedmaxwith SR, gel and virtual boluses were 8.0, 6.0, and 7.0 mm (no bolus: 12.0 mm), and theDmaxvalues were 186.4, 170.6, and 186.8 cGy, respectively. The SR bolus had the equivalent electron beam characteristics and homogeneity to the gel bolus and achieved excellent adhesion to a body surface, which can be used in electron radiotherapy as an ideal bolus.
  • Doi H; Yokoyama H; Beppu N; Fujiwara M; Harui S; Kakuno A; Yanagi H; Hishikawa Y; Yamanaka N; Kamikonya N
    Cancers 13 16 4112  2021年08月 [査読有り]
  • Masahiro Inada; Yasumasa Nishimura; Kazuki Ishikawa; Takuya Uehara; Yutaro Wada; Yasuo Oguma; Hiroshi Doi; Kiyoshi Nakamatsu
    Esophagus 18 3 638 - 644 2021年07月 [査読有り]
     
    BACKGROUND: The role of intensity-modulated radiation therapy in the treatment of cervical esophageal cancer remains unclear. The outcome of concurrent chemoradiotherapy for cervical esophageal squamous cell carcinoma using intensity-modulated radiation therapy was retrospectively evaluated. METHODS: Between 2004 and 2017, 36 patients with cervical esophageal cancer treated with intensity-modulated radiation therapy were included. Among these patients, one had stage II disease, three stage III, 19 stage IVA, and 13 stage IVB. All patients received radiotherapy at a dose of 60 Gy and concurrent platinum-based doublet chemotherapy. RESULTS: The median follow-up period for surviving patients was 36 months. Three-year locoregional control, progression-free survival, and overall survival rates were 54, 40, and 46%, respectively. Disease progression was noted in 20 out of 36 patients (56%). Grade 3 late toxicities were observed in four patients (three esophageal stenoses and one carotid artery stenosis). There were no grade 4-5 toxicities. Univariate analysis identified the duration of radiotherapy as a prognostic factor for overall survival. CONCLUSIONS: Chemoradiotherapy using intensity-modulated radiation therapy for locally advanced cervical esophageal carcinoma achieved satisfactory locoregional control and survival with acceptable toxicities.
  • Okuhata K; Monzen H; Tamura M; Matsumoto K; Otsuka M; Kubo K; Ueda Y; Uehara T; Doi H; Ishikawa K; Nishimura Y
    Anticancer Research 41 6 2925 - 2931 2021年06月 [査読有り]
     
    BACKGROUND/AIM: We investigated the plan complexity of volumetric modulated arc therapy (VMAT) with knowledge-based plan (KBP) for oropharyngeal cancer (OPC) with a single optimization and whether it could be used clinically. MATERIALS AND METHODS: KBP model was configured using 55 consecutive OPC and nasopharyngeal cancer plans. Plan complexity as a characteristic of multileaf collimator (MLC) motion and γ pass rate (2%/2 mm criterion) were compared between clinical manual plan (CMP) and KBP for other 10 plans. RESULTS: Plan complexity metrics that had significant differences (p<0.05) (CMP vs. KBP), were mean lateral displacement of MLC from central axis (15.82 mm vs. 18.90 mm), proportions of MLC aperture sizes of ≤5 mm (0.14 vs. 0.11), ≤10 mm (0.24 vs. 0.19), and ≤20 mm (0.41 vs. 0.34), and monitor units (578.68 vs. 505.04). The γ pass rate was 91.3% vs. 93.3%. CONCLUSION: Single optimized KBP for OPC had simple plan complexity features and comparable delivery accuracy to CMP, and could be clinically applied.
  • Okada W; Doi H; Tanooka M; Sano K; Nakamura K; Sakai Y; Shibata M; Tanaka M
    SAGE Open Medical Case Reports 9 2050313X211023688  2021年06月 [査読有り]
  • Doi H; Tamari K; Oh RJ; Nieder C
    Strahlentherapie und Onkologie 197 6 463 - 473 2021年06月 [査読有り]
     
    PURPOSE: To provide additional clinical data about the re-irradiation tolerance of the spinal cord. METHODS: This was a retrospective bi-institutional study of patients re-irradiated to the cervical or thoracic spinal cord with minimum follow-up of 6 months. The maximum dose (Dmax) and dose to 0.1cc (D0.1cc) were determined (magnetic resonance imaging [MRI]-defined cord) and expressed as equivalent dose in 2‑Gy fractions (EQD2) with an α/β value of 2 Gy. RESULTS: All 32 patients remained free from radiation myelopathy after a median follow-up of 12 months. Re-irradiation was performed after 6-97 months (median 15). In 22 cases (69%) the re-irradiation spinal cord EQD2 Dmax was higher than that of the first treatment course. Forty-eight of 64 treatment courses employed fraction sizes of 2.5 to 4 Gy to the target volume. The median cumulative spinal cord EQD2 Dmax was 80.7 Gy, minimum 61.12 Gy, maximum 114.79 Gy. The median cumulative spinal cord D0.1cc EQD2 was 76.1 Gy, minimum 61.12 Gy, maximum 95.62 Gy. Besides cumulative dose, other risk factors for myelopathy were present (single-course Dmax EQD2 ≥51 Gy in 9 patients, single-course D0.1cc EQD2 ≥51 Gy in 5 patients). CONCLUSION: Even patients treated to higher cumulative doses than previously recommended, or at a considerable risk of myelopathy according to a published risk score, remained free from this complication, although one must acknowledge the potential for manifestation of damage in patients currently alive, i.e., still at risk. Individualized decisions to re-irradiate after appropriate informed consent are an acceptable strategy, including scenarios where low re-irradiation doses to the spinal cord would compromise target coverage and tumor control probability to an unacceptable degree.
  • Wada Y; Monzen H; Tamura M; Otsuka M; Inada M; Ishikawa K; Doi H; Nakamatsu K; Nishimura Y
    Journal of Medical Physics 46 1 7 - 15 2021年05月 [査読有り]
     
    PURPOSE: We investigated the performance of the simplified knowledge-based plans (KBPs) in stereotactic body radiotherapy (SBRT) with volumetric-modulated arc therapy (VMAT) for lung cancer. MATERIALS AND METHODS: For 50 cases who underwent SBRT, only three structures were registered into knowledge-based model: total lung, spinal cord, and planning target volume. We performed single auto-optimization on VMAT plans in two steps: 19 cases used for the model training (closed-loop validation) and 16 new cases outside of training set (open-loop validation) for TrueBeam (TB) and Halcyon (Hal) linacs. The dosimetric parameters were compared between clinical plans (CLPs) and KBPs: CLPclosed, KBPclosed-TB and KBPclosed-Hal in closed-loop validation, CLPopen, KBPopen-TB and KBPopen-Hal in open-loop validation. RESULTS: All organs at risk were comparable between CLPs and KBPs except for contralateral lung: V5 of KBPs was approximately 3%-7% higher than that of CLPs. V20 of total lung for KBPs showed comparable to CLPs; CLPclosed vs. KBPclosed-TB and CLPclosed vs. KBPclosed-Hal: 4.36% ± 2.87% vs. 3.54% ± 1.95% and 4.36 ± 2.87% vs. 3.54% ± 1.94% (P = 0.54 and 0.54); CLPopen vs. KBPopen-TB and CLPopen vs. KBPopen-Hal: 4.18% ± 1.57% vs. 3.55% ± 1.27% and 4.18% ± 1.57% vs. 3.67% ± 1.26% (P = 0.19 and 0.27). CI95 of KBPs with both linacs was superior to that of the CLP in closed-loop validation: CLPclosed vs. KBPclosed-TB vs. KBPclosed-Hal: 1.32% ± 0.12% vs. 1.18% ± 0.09% vs. 1.17% ± 0.06% (P < 0.01); and open-loop validation: CLPopen vs. KBPopen-TB vs. KBPopen-Hal: 1.22% ± 0.09% vs. 1.14% ± 0.04% vs. 1.16% ± 0.05% (P ≤ 0.01). CONCLUSIONS: The simplified KBPs with limited number of structures and without planner intervention were clinically acceptable in the dosimetric parameters for lung VMAT-SBRT planning.
  • Koda Y; Kuribayashi K; Doi H; Kitajima K; Nakajima Y; Ishigaki H; Nakamura A; Minami T; Takahashi R; Yokoi T; Kijima T
    Oncology 99 3 161 - 168 2021年03月 [査読有り]
     
    <b><i>Background:</i></b> Cisplatin-pemetrexed combination chemotherapy is the current standard primary treatment for malignant pleural mesothelioma (MPM). It was first approved for untreated and unresectable MPM in the 2003 National Comprehensive Cancer Network (NCCN) guidelines. However, to date, standard treatments for patients with MPM who previously underwent chemotherapy, as recommended by the NCCN Malignant Pleural Mesothelioma guidelines, have been inadequate. To explore treatment options for such patients, we performed this retrospective study of patients who received irinotecan plus gemcitabine as second-line therapy for MPM. <b><i>Methods:</i></b> We investigated 62 patients diagnosed with unresectable MPM between January 2008 and October 2017 who experienced recurrence following cisplatin treatment (or carboplatin) plus pemetrexed or pemetrexed monotherapy as first-line treatment, and who underwent irinotecan plus gemcitabine combination therapy as second-line treatment. Irinotecan (60 mg/m<sup>2</sup>) and gemcitabine (800 mg/m<sup>2</sup>) were administered on days 1 and 8 every 3 weeks, including a 1-week washout period. Our endpoints were efficacy, survival period, and toxicity. <b><i>Results:</i></b> patients’ median age was 65 years (range 50–79), and the histological MPM types were epithelioid (<i>n</i> = 48), sarcomatoid (<i>n</i> = 6), biphasic (<i>n</i> = 6), and desmoplastic (<i>n</i> = 2). One patient experienced a partial response, 40 had stable disease, and 21 had progressive disease. The disease control rate was 66.1% and the response rate 2.1%. Additionally, the median progression-free and overall survival time were 5.7 and 11.3 months, respectively. The most common adverse events were neutropenia (32.2%), loss of appetite (16.1%), nausea/diarrhea (11.3%), and thrombocytopenia/phlebitis (9.7%). Grade 3 adverse events included neutropenia (12.9%) and thrombocytopenia/phlebitis (2.1%); however, all adverse events were managed with symptomatic therapy. <b><i>Conclusions:</i></b> Despite the fact that second-line irinotecan plus gemcitabine combination therapy did not produce marked tumor shrinkage, it achieved a relatively high disease control rate of &#x3e;65% with an acceptable toxicity profile. Hence, the combination of irinotecan plus gemcitabine may be considered for MPM treatment, with consideration of combination with immune checkpoint inhibitors as a potential next step.
  • Doi H; Tamari K; Masai N; Akino Y; Tatsumi D; Shiomi H; Oh RJ
    Clinical and Translational Oncology 23 2 229 - 239 2021年02月 [査読有り]
  • Takei Y; Monzen H; Tamura M; Doi H; Nishimura Y
    Journal of Applied Clinical Medical Physics 21 10 151 - 157 2020年09月 [査読有り]
     
    This study aimed to evaluate the possibility of reducing the imaging dose for image-guided radiotherapy by using planar kilovoltage orthogonal imaging and fiducial markers (kV-FM). We tested kilovoltage planar images under clinical imaging conditions for the pelvis (75 kVp, 200 mA, 50 ms) at a decreasing tube current (from 200 to 10 mA). Imaging doses were measured with a semiconductor detector. The visibility of the kV-FM, aspects of image quality (spatial resolution, low contrast resolution), and the resultant image registration reproducibility were evaluated using various shapes (folded, linear, tadpole-like) of fiducial markers containing 0.5% iron [Gold Anchor™ (GA); Naslund Medical AB, Huddinge, Sweden]. The GA phantom was created by placing these variously shaped GAs in an agar phantom. The imaging doses with 200 and 10 mA were approximately 0.74 and 0.04 mGy and they were correlated to the tube current (R2  = 0.999). Regardless of the marker's shape, the GA phantom ensured visibility even when the tube current was reduced to the minimum value (10 mA). The low contrast resolution was gradually decreased at less than 50 mA, but the spatial resolution did not change. Although the auto-registration function could not be used, manual-registration could be achieved with an accuracy of within 1 mm, even when the imaging dose was reduced to 1/20 of the clinical imaging condition for the pelvis. When using the GA as the fiducial marker, the imaging dose could be reduced to 1/20 of that used clinically while maintaining the accuracy of manual-registration using the kV-FM for image-guided radiotherapy of the pelvis.
  • Yasuhiro Nakajima; Kozo Kuribayashi; Hirotoshi Ishigaki; Akio Tada; Yoshiki Negi; Toshiyuki Minami; Ryo Takahashi; Hiroshi Doi; Kazuhiro Kitajima; Takashi Yokoi; Takashi Kijima
    Cancer Investigation 38 6 356 - 364 2020年07月 [査読有り]
  • Takuya Uehara; Hajime Monzen; Mikoto Tamura; Kazuki Ishikawa; Hiroshi Doi; Yasumasa Nishimura
    Journal of radiation research 61 3 499 - 505 2020年05月 [査読有り]
     
    The present study aimed to evaluate whether knowledge-based plans (KBP) from a single optimization could be used clinically, and to compare dose-volume histogram (DVH) parameters and plan quality between KBP with (KBPCONST) and without (KBPORIG) manual objective constraints and clinical manual optimized (CMO) plans for pharyngeal cancer. KBPs were produced from a system trained on clinical plans from 55 patients with pharyngeal cancer who had undergone intensity-modulated radiation therapy or volumetric-modulated arc therapy (VMAT). For another 15 patients, DVH parameters of KBPCONST and KBPORIG from a single optimization were compared with CMO plans with respect to the planning target volume (D98%, D50%, D2%), brainstem maximum dose (Dmax), spinal cord Dmax, parotid gland median and mean dose (Dmed and Dmean), monitor units and modulation complexity score for VMAT. The Dmax of spinal cord and brainstem and the Dmed and Dmean of ipsilateral parotid glands were unacceptably high for KBPORIG, although the KBPCONST DVH parameters met our goal for most patients. KBPCONST and CMO plans produced comparable DVH parameters. The monitor units of KBPCONST were significantly lower than those of the CMO plans (P < 0.001). Dose distribution of the KBPCONST was better than or comparable to that of the CMO plans for 13 (87%) of the 15 patients. In conclusion, KBPORIG was found to be clinically unacceptable, while KBPCONST from a single optimization was comparable or superior to CMO plans for most patients with head and neck cancer.
  • Inoue E, Doi H, Monzen H, Tamura M, Inada M, Ishikawa K, Nakamatsu K, Nishimura Y
    In Vivo 34 3 1095 - 1101 2020年05月 [査読有り]
  • Mikoto Tamura; Hajime Monzen; Kenji Matsumoto; Kazuki Kubo; Yoshihiro Ueda; Tatsuya Kamima; Masahiro Inada; Hiroshi Doi; Kiyoshi Nakamatsu; Yasumasa Nishimura
    Journal of Medical Physics 45 2 71 - 77 2020年04月 [査読有り]
     
    PURPOSE: This study aimed to investigate the influence of cleaned-up knowledge-based treatment planning (KBP) models on the plan quality for volumetric-modulated arc therapy (VMAT) of prostate cancer. MATERIALS AND METHODS: Thirty prostate cancer VMAT plans were enrolled and evaluated according to four KBP modeling methods as follows: (1) model not cleaned - trained by fifty other clinical plans (KBPORIG); (2) cases cleaned by removing plans that did not meet all clinical goals of the dosimetric parameters, derived from dose-volume histogram (DVH) (KBPC-DVH); (3) cases cleaned outside the range of ±1 standard deviation through the principal component analysis regression plots (KBPC-REG); and (4) cases cleaned using both methods (2) and (3) (KBPC-ALL). Rectal and bladder structures in the training models numbered 34 and 48 for KBPC-DVH, 37 and 33 for KBPC-REG, and 26 and 33 for KBPC-ALL, respectively. The dosimetric parameters for each model with one-time auto-optimization were compared. RESULTS: All KBP models improved target dose coverage and conformity and provided comparable sparing of organs at risks (rectal and bladder walls). There were no significant differences in plan quality among the KBP models. Nevertheless, only the KBPC-ALL model generated no cases of >1% V78 Gy (prescribed dose) to the rectal wall, whereas the KBPORIG, KBPC-DVH, and KBPC-REG models included two, four, and three cases, respectively, which were difficult to overcome with KBP because the planning target volume (PTV) and rectum regions overlapped. CONCLUSIONS: The cleaned-up KBP model based on DVH and regression plots improved plan quality in the PTV-rectum overlap region.
  • Hiroshi Doi; Mikoto Tamura; Kiyoshi Nakamatsu; Hajime Monzen; Yasumasa Nishimura
    Anticancer research 40 4 1981 - 1988 2020年04月 [査読有り]
     
    BACKGROUND/AIM: We aimed to elucidate the pathological findings following acute and late re-irradiation in a preclinical model. MATERIALS AND METHODS: Mice were divided into five treatment groups: sham-irradiation (Sham-IR), 10-12 Gy (Single IR Acute), 15 Gy (Single IR Late), 15 Gy followed by 10-12 Gy re-irradiation 7 days later (Re-IR Acute), or 15 Gy followed by 10-12 Gy re-irradiation 12 weeks later (Re-IR Late). Mice were sacrificed after either single irradiation or re-irradiation for pathological assessment. RESULTS: The Re-IR Late group had significantly lower numbers of crypts with apoptotic cells than those observed in mice in the Single IR Acute group. There were no significant differences between the Single IR Acute and re-IR Acute groups in cell proliferation or in a crypt survival assay. CONCLUSION: Re-irradiation with a long interval after the first irradiation may cause similar acute biological effects in normal intestine as observed following irradiation without re-irradiation.
  • Ayako Suzuki; Nobuo Kashiwagi; Hiroshi Doi; Kazunari Ishii; Katsumi Doi; Mutsukazu Kitano; Takenori Kozuka; Tomoko Hyodo; Masakatsu Tsurusaki; Yukinobu Yagyu; Katsuyuki Nakanishi
    Auris, nasus, larynx 47 2 262 - 267 2020年04月 [査読有り]
     
    OBJECTIVE: To report clinical features of bone metastases (BM) from head and neck squamous cell carcinoma (HNSCC). METHODS: Among 772 patients with HNSCC diagnosed at our hospital over 9 years, 30 patients (3.9%) had clinical evidence of BM (24 men and 6 women; mean age: 63 years). We assessed the time interval from the primary diagnosis to BM development, symptoms attributable to BM, presence of distant metastases to other organs, number of BM, sites of BM, morphologic changes on computed tomography (CT) images, treatment for BM, and overall survival (OS). RESULTS: BM at the initial stage were found in 9 patients with HNSCC (30%), and in 21 patients (70%) with HNSCC during the course of the disease. In the later patients, the median time interval from the primary diagnosis was 11.5 months. Nineteen patients (63%) did not have BM-related symptoms, 6 (20%) had pain, 3 (10%) had neurologic symptoms resulting from vertebral or skull metastases, and 2 (7%) had hypercalcemia. Seventeen patients (57%) showed bone-exclusive metastases, and 13 (43%) had distant metastases in other organs. Eleven patients (37%) had monostotic metastases (solitary BM), and 19 patients (63%) had polyostotic metastases (multiple BM). When combined, 9 patients (30%) showed bone-exclusive and monostotic metastases. The most commonly affected site was the thoracolumbar spine, accounting for 34% of total BM, followed by the pelvis (24%), shoulder and thorax (21%), and the extremities (17%). Notably, metastases to bones above the clavicle (craniofacial bones and cervical spine) accounted for only 3% of all bone lesions. CT images showed variable morphologic patterns with osteolytic type in 17 patients (57%), intertrabecular in 7 (23%), osteoblastic in 4 (13%), and mixed in 2 (7%). Systematic chemotherapy for BM was performed in 19 patients and radiotherapy in 18. The median survival time for patients with bone-exclusive and monostotic metastases was significantly longer than that for patients with multi-organ metastases or polyostotic metastases at 18.2 months vs. 5.7 months (p=0.02). Neither chemotherapy nor radiotherapy extended OS. CONCLUSION: Thirty percent of BM cases from HNSCC showed bone-exclusive and monostotic metastases. These patients tended to show a more favorable prognosis than patients with multi-organ metastases or polyostotic metastases.
  • Kimura K; Beppu N; Doi H; Kataoka K; Yamano T; Uchino M; Ikeda M; Ikeuchi H; Tomita N
    World Journal of Gastrointestinal Oncology 12 3 311 - 322 2020年03月 [査読有り]
  • Doi H; Kuribayashi K; Kitajima K; Yamakado K; Kijima T
    Clinical Lung Cancer 21 1 66 - 74 2020年01月 [査読有り]
  • Kuribayashi K; Doi H; Kijima T
    Expert Review of Respiratory Medicine 13 12 1189 - 1194 2019年12月 [査読有り][招待有り]
  • Monzen H; Tamura M; Kijima K; Otsuka M; Matsumoto K; Wakabayashi K; Choi MG; Yoon DK; Doi H; Akiyama H; Nishimura Y
    Physica Medica: European Journal of Medical Physics 66 29 - 35 2019年10月 [査読有り]
  • Masahiro Inada; Yasumasa Nishimura; Kazuki Ishikawa; Kiyoshi Nakamatsu; Yutaro Wada; Takuya Uehara; Kohei Fukuda; Shimpei Anami; Hiroshi Doi; Shuichi Kanamori
    Esophagus 16 4 371 - 376 2019年10月 [査読有り]
     
    BACKGROUND: We retrospectively compared the 7th and the 8th editions of The American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) TNM classification in the cohort of survival of the patients with esophageal squamous cell carcinoma (ESCC) treated by definitive radiotherapy. METHODS: We included in this study 403 patients with ESCC who underwent radiotherapy or chemoradiotherapy, at a total radiation dose of ≥ 50 Gy with curative intent from 2000 to 2016 at Kindai University Hospital, and who had no distant metastasis (excluding supraclavicular lymph node). The same patient data set was re-staged according to both the 7th and 8th editions of AJCC/UICC TNM classification. RESULTS: For the 7th edition, 5-year overall survival (OS) for stages I, II, III, and IV were 58%, 52%, 22%, and 12%, respectively, which seemed to be separable into two groups (Stages I-II and III-IV). In the 8th edition, corresponding values for stages I, II, III, and IV were 65%, 44%, 34%, and 16%, respectively, which seemed to be separated into three groups (Stage I, II-III, and IV). CONCLUSIONS: The 8th edition of AJCC/UICC TNM classification is a useful predictor of OS among ESCC patients who were treated with definitive radiotherapy.
  • Okada W; Tanooka M; Sano K; Shibata M; Doi H; Miyazaki M; Nakahara R; Sueoka M; Suzuki H; Fujiwara M; Inomata T; Yamakado K
    Journal of Applied Clinical Medical Physics. 20 8 114 - 121 2019年08月 [査読有り]
     
    We sought to validate new couch modeling optimization for tomotherapy planning and delivery. We constructed simplified virtual structures just above a default setting couch through a planning support system (MIM Maestro, version 8.2, MIM Software Inc, Cleveland, OH, USA). Based on ionization chamber measurements, we performed interactive optimization and determined the most appropriate physical density of these virtual structures in a treatment planning system (TPS). To validate this couch optimization, Gamma analysis and these statistical analyses between a three-dimensional diode array QA system (ArcCHECK, Sun Nuclear, Melbourne, FL, USA) results and calculations from ionization chamber measurements were performed at 3%/2 mm criteria with a threshold of 10% in clinical QA plans. Using a virtual model consisting of a center slab density of 4.2 g/cm3 and both side slabs density of 1.9 g/cm3 , we demonstrated close agreement between measured dose and the TPS calculated dose. Agreement was within 1% for all gantry angles at the isocenter and within 2% in off-axis plans. In validation of the couch modeling in a clinical QA plan, the average gamma passing rate improved approximately 0.6%-5.1%. It was statistically significant (P < 0.05) for all treatment sites. We successfully generated an accurate couch model for a TomoTherapy TPS by interactively optimizing the physical density of the couch using a planning support system. This modeling proved to be an efficient way of correcting the dosimetric effects of the treatment couch in tomotherapy planning and delivery.
  • Doi H; Nakamatsu K; Nishimura Y
    International Journal of Clinical Oncology 24 8 899 - 909 2019年08月 [査読有り]
  • Otsuka M; Monzen H; Ishikawa K; Doi H; Matsumoto K; Tamura M; Nishimura Y
    In Vivo 33 4 1271 - 1277 2019年07月 [査読有り]
     
    Background/Aim: The parotid glands in the head and neck are organs at risks (OARs) adjacent to high dose region and dose of OARs might be increased during the course of radiotherapy. The influence factors of the dose distribution for the parotid glands were investigated in terms of weight loss and mandibular rotation for head and neck cancers treated with volumetric modulated arc therapy (VMAT). Patients and Methods: Ten oropharyngeal cancer patients (OPC) who underwent VMAT were enrolled. The dose volume histogram (DVH) parameters of the parotid glands and planning target volume (PTV) were compared between the planning computed tomography (CT) and the on board imager (OBI) at 1, 5, 10, 15, and 20 fractions. Results: The variation of dose distribution in PTV was not observed in both factors. The relationship between the mandibular rotation and dose difference for the right and left parotid glands (linear regression, r(2)=0.1577 and -0.689) showed a slighty stronger correlation with dose difference than the weight loss (linear regression, r(2)=-0.079 and -0.547). Conclusion: The mandibular rotation tends to have a large influence on dose distribution of the parotid glands for head and neck cancers treated with VMAT.
  • Hayama Y; Doi H; Hasegawa T; Minami Y; Ichimura N; Koike M; Shiomi H; Oh RJ; Oishi F
    Lower Urinary Tract Symptoms 11 2 O127 - O134 2019年04月 [査読有り]
  • Tarutani K; Tanooka M; Doi H; Fujiwara M; Miyashita M; Kagawa K; Kamikonya N; Yamakado K
    Reports of Practical Oncology and Radiotherapy 24 2 133 - 144 2019年03月 [査読有り]
  • Shimpei Anami; Hiroshi Doi; Kiyoshi Nakamatsu; Takuya Uehara; Yutaro Wada; Kohei Fukuda; Masahiro Inada; Kazuki Ishikawa; Shuichi Kanamori; Yasumasa Nishimura
    Journal of radiation research 60 2 257 - 263 2019年03月 [査読有り]
     
    This study aimed to identify factors that predict prognosis after radiotherapy for brain metastases (BMs) from small-cell lung cancer (SCLC). This study retrospectively evaluated 48 consecutive patients who underwent whole-brain radiotherapy (WBRT) for BMs from SCLC between February 2008 and December 2017. WBRT was delivered at a median dose of 30 Gy (range: 30-40 Gy) in 10 fractions (range: 10-16 fractions). Clinical factors were tested for associations with overall survival after WBRT. The median survival and 1-year overall survival rate after WBRT treatment were 232 days and 34.4%, respectively. Univariate analyses revealed that longer survival was associated with Eastern Cooperative Oncology Group performance status of 0-1, asymptomatic BMs, lactate dehydrogenase (LDH) in the normal range, Radiation Therapy Oncology Group-recursive partitioning analysis class 2, and a graded prognostic assessment score of ≥1.5 (P < 0.01, P < 0.01, P < 0.01, P < 0.01 and P < 0.05, respectively). In the multivariate analyses, longer survival was independently associated with asymptomatic BMs [hazard ratio for death (HR), 0.32; 95% confidence interval (CI), 0.12-0.79; P < 0.05] and LDH in the normal range (HR, 0.42; 95% CI, 0.21-0.83; P < 0.05). The presence of symptoms due to BMs and LDH values independently predicted prognosis after WBRT for BMs from SCLC. Elevated LDH may provide valuable information for identifying patients with BMs who could have poor survival outcomes.
  • Doi, Hiroshi; Nakamatsu, Kiyoshi; Anami, Shimpei; Fukuda, Kohei; Inada, Masahiro; Tatebe, Hitoshi; Ishikawa, Kazuki; Kanamori, Shuichi; Monzen, Hajime; Nishimura, Yasumasa
    In Vivo 33 1 195 - 201 2019年01月 [査読有り]
     
    Aim: This study aimed to identify prognostic factors for response to whole-brain radiotherapy (WBRT) in patients with brain metastases (BMs) from non-small cell lung cancer (NSCLC). Patients and Methods: This study retrospectively evaluated 100 patients who underwent WBRT for BMs from NSCLC between December 2012 and October 2017. Clinical factors were tested for associations with overall survival after WBRT. Results: The median follow-up time was 134 days (range=14-1,395 days), the median survival time was 143 days, and the 1-year survival rate was 30.4%. Univariate and multivariate analyses revealed that better survival was independently associated with expression of programmed death-ligand 1 (PD-L1), no previous treatment for BMs, no extracranial disease, and a neutrophil-to-lymphocyte ratio (NLR) of <5.0. Conclusion: A low NLR and positive PD-L1 expression independently predict better prognosis in patients with BMs from NSCLC after WBRT. These findings suggest that the potential immune response may influence survival among patients with BMs.
  • Doi H; Fujiwara M; Kitajima K; Tanooka M; Terada T; Noguchi K; Ishikura R; Kamikonya N; Yamakado K
    Nagoya Journal of Medical Science 80 4 541 - 550 2018年11月 [査読有り]
  • Tamura M; Monzen H; Matsumoto K; Kubo K; Otsuka M; Inada M; Doi H; Ishikawa K; Nakamatsu K; Sumida I; Mizuno H; Yoon DK; Nishimura Y
    Radiation Oncology 13 1 163  2018年08月 [査読有り]
     
    Background: This study clarified the mechanical performance of volumetric modulated arc therapy (VMAT) plans for prostate cancer generated with a commercial knowledge-based treatment planning (KBP) and whether KBP system could be applied clinically without any major problems with mechanical performance.Methods: Thirty consecutive prostate cancer patients who underwent VMAT using extant clinical plans were evaluated. The mechanical performance and dosimetric accuracy of the single optimized KBPs, which were trained with other 51 clinical plans, were compared with the clinical plans. The mechanical performance metrics were mean field area (MFA), mean asymmetry distance (MAD), cross-axis score (CAS), closed leaf score (CLS), small aperture score (SAS), leaf travel (LT), modulation complexity score (MCSv), and monitor unit (MU). The. passing rates were evaluated with ArcCheck and EBT3 film.Results: The mean mechanical performance metrics (clinical plan vs. KBP) were as follows: 18.28 cm(2) vs. 17.25 cm(2) (MFA), 21.08 mm vs. 20.47 mm (MAD), 0.54 vs. 0.55 (CAS), 0.040 vs. 0.051 (CLS), 0.20 vs. 0.23 (SAS5mm), 458.5 mm vs. 418.8 mm (LT), 0.27 vs. 0.27 (MCSv), and 618.2 vs. 622.1 (MU), respectively. Significant differences were observed for CLS and LT. The average. passing rates (clinical plan vs. KBP) were as follows: 99.0% vs. 99.1% (3%/3 mm) and 92.4% vs. 92.5% (2%/2 mm) with ArcCHeck, and 99.5% vs. 99.4% (3%/3 mm) and 95.2%vs. 95.4% (2%/2 mm) with EBT3 film, respectively.Conclusions: The KBP used lower multileaf collimator (MLC) travel and more closed or small MLC apertures than the clinical plan. The KBP system of VMAT for the prostate cancer was acceptable for clinical use without any major problems.
  • Katsuura T; Kitajima K; Fujiwara M; Terada T; Uwa N; Noguchi K; Doi H; Tamaki Y; Yoshida R; Tsuchitani T; Fujita M; Yamakado K
    Annals of Nuclear Medicine 32 7 453 - 462 2018年08月 [査読有り]
     
    PURPOSE: To evaluate therapeutic response to chemoradiotherapy and prediction of recurrence and death in patients with head and neck squamous cell carcinoma (HNSCC) using Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST). MATERIALS AND METHODS: Forty-two patients (mean 63.4, range 20-79 years) with nasopharyngeal (n = 10), oropharyngeal (n = 13), hypopharyngeal (n = 11), or laryngeal (n = 8) cancer underwent fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) before and approximately 3 months (mean 95.0, range 70-119 days) after undergoing concurrent chemoradiotherapy. The effect of PERCIST regarding progression-free survival (PFS) and overall survival (OS) was examined using log-rank and Cox methods. RESULTS: Complete metabolic response (CMR), partial metabolic response (PMR), stable metabolic disease (SMD), and progressive metabolic disease shown by PERCIST were seen in 30 (71.4%), 9 (21.4%), 3 (7.1%), and 0 patients, respectively. Fourteen (33.3%) developed recurrent disease (median follow-up 27.2, range 8.7-123.1 months) and 9 (21.4%) died (median follow-up 43.6, range 9.6-132.6 months). Furthermore, 4 (13.3%) of 30 patients with CMR developed recurrence, while 7 (77.8%) of 9 with PMR and all 3 (100%) with SMD developed recurrence. Two (6.7%) of 30 patients with CMR, 4 (44.4%) of 9 with PMR, and all 3 (100%) with SMD died. Patients who achieved CMR showed significantly longer PFS and OS as compared to those who did not (PMR and SMD) (both, p < 0.0001). CONCLUSION: PERCIST is useful for evaluating therapeutic response to chemoradiotherapy and predicting recurrence and death in HNSCC patients.
  • Doi H; Kuribayashi K; Kijima T
    Future Oncology 14 19 1977 - 1988 2018年08月 [査読有り]
  • Negi Y; Kuribayashi K; Doi H; Funaguchi N; Koda Y; Fujimoto E; Mikami K; Minami T; Yokoi T; Kijima T
    Molecular and Clinical Oncology 9 181 - 186 2018年06月 [査読有り]
  • Tamura M; Monzen H; Matsumoto K; Okumura M; Doi H; Nishimura Y
    In Vivo 32 3 531 - 536 2018年05月 [査読有り]
  • Doi H; Uemoto K; Masai N; Tatsumi D; Shiomi H; Oh RJ
    Acta Oto-Laryngologica 138 8 750 - 758 2018年02月 [査読有り]
  • Hiroshi Doi; Naohito Beppu; Kazuhiro Kitajima; Kozo Kuribayashi
    Anticancer Research 38 2 591 - 599 2018年02月 [査読有り]
     
    Surgical resection is the standard therapy for solitary primary or metastatic liver tumors. However, liver tumors are often unresectable at diagnosis and hepatectomy is invasive. Local therapies, such as radiofrequency ablation, are used instead, which can be challenging. Recent advances in modern radiotherapy, including stereotactic body radiation therapy (SBRT), have increased the use of radiotherapy as a curative modality. SBRT delivers ablative high doses of irradiation in small volumes. SBRT for liver tumors provided local control with potential survival benefits in patients with inoperable status. However, the following issues remain: primary vs. metastatic liver cancers SBRT-related toxicity and prevention pathological features of liver cancers and potential SBRT strategies. We summarized a literature review to summarize the effectiveness of SBRT and patient tolerance and present the current status and future perspective of SBRT for liver tumors. SBRT is a potential game changer for multimodal therapy.
  • Hitoshi Tatebe; Hiroshi Doi; Kazuki Ishikawa; Hisato Kawakami; Masaki Yokokawa; Kiyoshi Nakamatsu; Shuichi Kanamori; Toru Shibata; Mutsukazu Kitano; Yasumasa Nishimura
    Anticancer research 38 2 979 - 986 2018年02月 [査読有り]
     
    AIM: To evaluate the clinical results of two-step intensity-modulated radiation therapy (IMRT) for oropharyngeal cancer. PATIENTS AND METHODS: Eighty patients were treated with two-step IMRT between 2002 and 2014. Whole-neck radiotherapy (44.0-50.0 Gy/22-25 fractions) was delivered by IMRT, followed by boost IMRT to the high-risk clinical target volume (total dose of 70.0 Gy/35 fractions). Forty-seven patients received concurrent chemotherapy. Immunohistochemistry for human papillomavirus type 16 (HPV/p16) was performed for 64 patients. RESULTS: The 5-year overall survival and locoregional control rates for stage I, II, III, and IVA-B disease were 80.0%, 75.0%, 78.0%, and 64.0% and 100.0%, 75.0%, 92.0%, and 82.0%, respectively. Overall survival was significantly higher in HPV/p16-positive patients than in HPV/p16-negative patients (p=0.01). Xerostomia of grade 2 or more was noted in 10 patients. CONCLUSION: Favourable overall survival and locoregional control rates with excellent salivary preservation were obtained using the two-step IMRT method for oropharyngeal cancer.
  • Kenji Uemoto; Hiroshi Doi; Hiroya Shiomi; Koichi Yamada; Daisaku Tatsumi; Taku Yasumoto; Masaaki Takashina; Masahiko Koizumi; Ryoong-Jin Oh
    Anticancer Research 38 2 945 - 954 2018年02月 [査読有り]
     
    Background: This study aimed to assess the need to consider microscopic invasion in terms of treatment planning in stereotactic body radiation therapy (SBRT) for hepatocellular carcinoma and elucidate the appropriate clinical target volume (CTV) margin. Patients and Methods: A total of 121 patients (with 146 liver tumors) who underwent SBRT between July 2007 and August 2016 were analyzed, regarding overall survival and local control (LC). Results: The 2- and 5-year LC rates were 91.5% and 89.8%, respectively. Planning target volume (PTV) margin < 8 mm was associated with poor LC. Of the 77 patients with PTV margin of < 8 mm, age < 75 years was associated with poor LC, while alpha-fetoprotein (AFP) ≤20 ng/ml was associated with good LC. Conclusion: In patients with high AFP levels, there is a possibility of microscopic invasion around the tumor, suggesting that LC may be improved by adding an additional clinical target volume margin to the gross tumor volume.
  • Kazuyuki Akazawa; H. Doi; S. Ohta; T. Terada; M. Fujiwara; N. Uwa; M. Tanooka; M. Sakagami
    Journal of Laryngology and Otology 132 2 111 - 116 2018年02月 [査読有り]
     
    Objective: This study evaluated the relationship between radiation and Eustachian tube dysfunction, and examined the radiation dose required to induce otitis media with effusion. Methods: The function of 36 Eustachian tubes in 18 patients with head and neck cancer were examined sonotubometrically before, during, and 1, 2 and 3 months after, intensity-modulated radiotherapy. Patients with an increase of 5 dB or less in sound pressure level (dB) during swallowing were categorised as being in the dysfunction group. Additionally, radiation dose distributions were assessed in all Eustachian tubes using three dose-volume histogram parameters. Results: Twenty-two of 25 normally functioning Eustachian tubes before radiotherapy (88.0 per cent) shifted to the dysfunction group after therapy. All ears that developed otitis media with effusion belonged to the dysfunction group. The radiation dose threshold evaluation revealed that ears with otitis media with effusion received significantly higher doses to the Eustachian tubes. Conclusion: The results indicate a relationship between radiation dose and Eustachian tube dysfunction and otitis media with effusion.
  • Negi Y; Kuribayashi K; Funaguchi N; Doi H; Mikami K; Minami T; Takuwa T; Yokoi T; Hasegawa S; Kijima T
    In Vivo 32 1169 - 1174 2018年 [査読有り]
  • Jomoto W; Tanooka M; Doi H; Kikuchi K; Mitsuie C; Yamada Y; Suzuki T; Yamano T; Ishikura R; Kotoura N; Yamamoto S
    Cureus 10 1 e2018  2018年01月 [査読有り]
  • Doi H; Harui S; Nakajima H; Ando A; Kamino K; Fujiwara M; Nakajima T; Ikura S; Aihara T; Yamanaka N
    Cureus 9 12 e1902  2017年12月 [査読有り]
  • Kazuhiro Kitajima; Masatoyo Nakajo; Hayato Kaida; Ryogo Minamimoto; Kenji Hirata; Masakatsu Tsurusaki; Hiroshi Doi; Yoshiko Ueno; Keitaro Sofue; Yukihisa Tamaki; Koichiro Yamakado
    NAGOYA JOURNAL OF MEDICAL SCIENCE 79 4 527 - 543 2017年11月 [査読有り]
     
    Positron emission tomography/computed tomography (PET/CT) integrated with 2-[F-18] fluoro-2-deoxy-D-glucose (FDG) is a useful tool for acquisition of both glucose metabolism and anatomic imaging data, as only a single device and one diagnostic session is required, thus opening a new field in clinical oncologic imaging. FDG-PET/CT has been successfully used for initial staging, restaging, assessment of early treatment response, evaluation of metastatic disease response, and prognostication of intestinal cancer as well as various malignant tumors. We reviewed the current status and role of FDG-PET/CT for management of patients with esophageal cancer, gastric cancer, and colorectal cancer, with focus on both its usefulness and limitations.
  • Hiroshi Doi; Norihisa Masai; Kenji Uemoto; Osamu Suzuki; Hiroya Shiomi; Daisaku Tatsumi; Ryoong-Jin Oh
    Reports of Practical Oncology and Radiotherapy 22 4 303 - 309 Elsevier 2017年07月 [査読有り]
     
    Aim The purpose of this study was to determine the optimal mean liver biologically effective dose (BED) to prevent radiation-induced liver disease (RILD) in stereotactic body radiation therapy (SBRT). Background The actual mean doses appropriate for liver irradiation in modern radiotherapy techniques have not been adequately investigated, although SBRT is sometimes alternatively performed using fractionated regimens. Materials and methods SBRT treatment plans for liver tumors in 50 patients were analyzed. All distributions of the physical doses were transformed to BED2 using the linear-quadratic model. The relationship between physical doses and the BED2 for the liver were then analyzed, as was the relationship between the mean BED2 for the liver and the planning target volume (PTV). Results A significantly positive correlation was observed between the mean physical dose for the background liver and the mean BED2 for the whole liver (P <  0.0001, r = 0.9558). Using the LQ model, a mean BED2 of 73 and 16 Gy for the whole liver corresponded to the hepatic tolerable mean physical dose of 21 and 6 Gy for Child–Pugh A- and B-classified patients, respectively. Additionally, the PTV values were positively correlated with the BEDs for the whole liver (P <  0.0001, r = 0.8600), and the background liver (P <  0.0001, r = 0.7854). Conclusion A mean BED2 of 73 and 16 Gy for the whole liver appeared appropriate to prevent RILD in patients with Child–Pugh classes A and B, respectively. The mean BED2 for the liver correlated well with the PTV.
  • Hiroshi Doi; Masao Tanooka; Toshihisa Ishida; Kuniyasu Moridera; Kenji Ichimiya; Kazuo Tarutani; Kazuhiro Kitajima; Masayuki Fujiwara; Hiromitsu Kishimoto; Norihiko Kamikonya
    Reports of Practical Oncology and Radiotherapy 22 4 310 - 318 Elsevier 2017年07月 [査読有り]
     
    Aim This study aimed to assess the utility and stability of intraoral stent during intensity-modulated radiation therapy (IMRT). Background The benefits of intraoral stents in radiotherapy are unclear. Materials and methods We analyzed 386 setup errors in 12 patients who received IMRT for head and neck cancers without intraoral stents (intraoral stent [−]) and 183 setup errors in 6 patients who received IMRT with intraoral stents (intraoral stent [+]). All patients were matched according to the immobilization method (masks and boards). Setup errors were measured as the distance from the initial setup based on the marking on the skin and mask to the corrected position based on bone matching on cone beam computed tomography. Results The mean interfractional setup errors in the right–left, craniocaudal, anterior–posterior (AP), and three-dimensional (3D) directions were −0.33, 0.08, −0.25, and 2.75 mm in the intraoral stent (−) group and −0.37, 0.24, −0.63, and 2.42 mm in the intraoral stent (+) group, respectively (P = 0.50, 0.65, 0.01, and 0.02, respectively). The systematic errors for the same directions were 0.89, 1.46, 1.15, and 0.88 mm in the intraoral stent (−) group and 0.62, 1.69, 0.68, and 0.56 mm in the intraoral stents (+) group, respectively. The random errors were 1.43, 1.43, 1.44, and 1.22 mm in the intraoral stent (−) group and 1.06, 1.11, 1.05, and 0.92 mm in the intraoral stents (+) group, respectively. Conclusion Setup errors can be significantly reduced in the AP and 3D-directions by using intraoral stents.
  • Hiroshi Doi; Kenji Uemoto; Osamu Suzuki; Koichi Yamada; Norihisa Masai; Daisaku Tatsumi; Hiroya Shiomi; Ryoong-Jin Oh
    ONCOLOGY LETTERS 14 1 453 - 460 2017年07月 [査読有り]
     
    Metastatic liver tumors (MLTs) from colorectal cancer (CRC) are often treated with stereotactic body radiation therapy (SBRT). The present study aimed to examine the predictive factors for response of MLTs to SBRT. A total of 39 MLTs from 24 patients with CRC were retrospectively analyzed. Radiotherapy for MLT was typically performed with a prescribed dose equivalent to a biologically effective dose (BED) of 100 Gy. The median follow-up period was 16 months (range, 5-64 months). The median prescribed dose and total BED were 56 Gy (range, 45-72 Gy) and 97.5 Gy (range, 71.7-115.5 Gy), respectively, in a median of 8 fractions (range, 4-33 fractions). The 1- and 2-year local control rates were 67.2 and 35.9%, respectively. For patients with MLT treated with ablative SBRT (BED10 >= 100 Gy in <= 5 fractions), the 1- and 2-year local control rates were 83.3 and 62.5%, respectively. Univariate analysis showed that primary tumor location (left-sided colon), maximum tumor diameter (<= 30 mm) and ;ablative SBRT (BED10 >= 100 Gy in <= 5 fractions) were significantly associated with improved local control (P=0.0058, P=0.0059 and P=0.0268, respectively). Multivariate analysis showed that tumor diameter was significantly associated with improved local control (P=0.0314). In addition, patients who received ablative SBRT had significantly prolonged overall survival times compared with those treated with non-ablative SBRT (P=0.0261). To conclude, tumors mm that can be treated with ablative SBRT are associated with good local control rates: The primary tumor location may affect the radiosensitivity of MLTs.
  • Hiroshi Doi; Seiji Matsumoto; Soichi Odawara; Toshiyuki Shikata; Kazuhiro Kitajima; Masao Tanooka; Yasuhiro Takada; Tohru Tsujimura; Norihiko Kamikonya; Shozo Hirota
    EXPERIMENTAL AND THERAPEUTIC MEDICINE 13 5 1765 - 1772 2017年05月 [査読有り]
     
    Pravastatin is an inhibitor of 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase that has been reported to have therapeutic applications in a range of inflammatory conditions. The aim of the present study was to assess the radioprotective effects of pravastatin in an experimental animal model. Mice were divided into two groups: The control group received ionizing radiation with no prior medication, while the pravastatin group received pravastatin prior to ionizing radiation. Pravastatin was administered orally at 30 mg/kg body weight in drinking water at 24 and 4 h before irradiation. Intestinal crypt epithelial cell survival and the incidence of apoptosis in the intestine and lung were measured post-irradiation. The effect of pravastatin on intestinal DNA damage was determined by immunohistochemistry. Finally, the effect of pravastatin on tumor response to radiotherapy was examined in a mouse mesothelioma xenograft model. Pravastatin increased the number of viable intestinal crypts and this effect was statistically significant in the ileum (P<0.0001). The pravastatin group showed significantly lower apoptotic indices in all examined parts of the intestine (P<0.0001) and tended to show reduced apoptosis in the lung. Pravastatin reduced the intestinal expression of ataxia-telangiectasia mutated and gamma-H2AX after irradiation. No apparent pravastatin-related differences were observed in the response of xenograft tumors to irradiation. In conclusion, pravastatin had radioprotective effects on the intestine and lung and reduced radiation-induced DNA double-strand breaks. Pravastatin may increase the therapeutic index of radiotherapy.
  • Naohito Beppu; Ayako Kakuno; Hiroshi Doi; Norihiko Kamikonya; Nagahide Matsubara; Naohiro Tomita; Hidenori Yanagi; Naoki Yamanaka
    SURGERY 161 2 422 - 432 2017年02月 [査読有り]
     
    Background. Although preoperative chemoradiotherapy exerts a destructive effect on positive lymph nodes, microscopic examination reveals different degrees of tumor regression. The aim of the present study is to investigate the impact of the radiation-induced regression of positive nodes on survival in patients with rectal cancer treated with preoperative chemoradiotherapy. Methods. From 2001 to 2015, 229 patients with T3 rectal cancer underwent total mesorectal excision after preoperative chemoradiotherapy. The patients were classified into 3 groups according to their lymph node status: residual cancer cells in positive nodes (Group A), total regression of positive nodes after preoperative chemoradiotherapy with complete fibrosis (Group B), and the entire lymph node filled with lymph nodules and the absence of fibrosis (Group C). The survival of the 3 groups was compared, and a Cox model was used to evaluate the prognostic value of the regression of the positive nodes by preoperative chemoradiotherapy. Results. Groups A, B, and C included 57, 18, and 154 patients, respectively. Group B showed significantly better overall survival than Group A (P = .041) and similar outcomes to Group C (P = .383). Among the patients with positive lymph nodes prior to treatment (Groups A and B), the total regression of the positive nodes after preoperative chemoradiotherapy was the only independent factor to be associated with good overall survival (hazard ratio; 6.26, 95 % confidence interval; 1.28-113.0, P = .020). Conclusion. Total regression of positive nodes by preoperative chemoradiotherapy improves the prognosis of patients with rectal cancer with positive lymph nodes prior to treatment.
  • 肝定位放射線治療における鉄含有金マーカーを用いた自動照合における物理的検証.
    春井章吾; 土井啓至; 上野敬司; 杉本敦洋; 尾崎佳弘; 樽岡照知
    明和医学誌 4 94 - 99 2017年 [査読有り]
  • 土井啓至; 春井章吾; 杉本敦洋; 上野敬司; 冨士原将之; 中島隆善; 生田真一; 相原司; 山中若樹
    臨床放射線 62 9 1165 - 1171 金原出版 2017年 [査読有り]
  • Eriko Fujimoto; Takashi Kijima; Kozo Kuribayashi; Yoshiki Negi; Shingo Kanemura; Koji Mikami; Hiroshi Doi; Kazuhiro Kitajima; Takashi Nakano
    EXPERT REVIEW OF ANTICANCER THERAPY 17 9 865 - 872 2017年 [査読有り]
     
    Background: Mesothelioma of peritoneal origin has wider variation in treatment outcomes than mesothelioma of pleural origin, likely because peritoneal mesothelioma comprises borderline malignant variants and aggressive malignant peritoneal mesothelioma (MPeM). This study retrospectively evaluates the efficacy of first-line systemic pemetrexed and cisplatin chemotherapy in MPeM.Research design and methods: Twenty-four patients with histologically proven MPeM were treated with pemetrexed plus cisplatin as a first-line systemic chemotherapy. The response was evaluated radiologically according to standard Response Evaluation Criteria In Solid Tumors (RECIST) criteria. Twenty-two patients underwent F-18-fluorodeoxyglucose positron emission tomography/(FDG-PET)/computed tomography(CT) at baseline, and 13 were eligible for metabolic assessment.Results: Two complete responses and 9 partial responses were achieved. Overall response rate and disease control rate were 45.8% and 91.7%, respectively. Median progression-free survival and median overall survival were 11.0months and 15.8months, respectively. Wet- type MPeM had significantly longer survival (40.9months median) than other clinical types (15.5months) (P=0.045). The baseline maximum standardized uptake value in 22 patients was 8.93 (range, 2.5-16.77).Conclusions: Systemic pemetrexed plus cisplatin is active for MPeM. Disparity with the outcome of cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) needs to receive more emphasis, since peritoneal mesothelioma has a 5-year survival rate of 50%.
  • Beppu N; Kimura F; Aihara T; Doi H; Tomita N; Yanagi H; Yamanaka N
    Annals of surgical oncology 24 1 219 - 226 2017年01月 [査読有り]
     
    Short-course radiotherapy with delayed surgery (SRT-delay) is still under clinical investigation for its efficacy in treating low rectal cancer (ae<currency>5 cm from the anal verge). This study was designed to assess the pattern of local recurrence and oncologic outcomes in T3 low rectal cancer treated with SRT-delay. This study enrolled T3 low rectal cancer patients without distant metastasis between 2003 and 2015. All patients received total mesorectal excision following SRT-delay (25 Gy/10 fractions/5 days + S-1 radiosensitizer with a 4-week delay of surgery). The median follow-up period was 69 (range 1-149) months. A total 119 consecutive patients had low rectal cancer; 104 (87.4 %) underwent intersphincteric resection (ISR), and 15 (12.6 %) underwent abdominoperineal resection (APR). Fifty-six patients (47.1 %) were ypT-downstaged, 86 (72.2 %) were ypN0, and 10 (8.4 %) had circumferential resection margin involvement. The 5-year local recurrence-free survival, recurrence-free survival, and overall survival were 93.0, 76.2, and 80.5 %, respectively. Nine patients experienced local recurrence: lateral pelvic recurrence in six patients (5.0 %) and central pelvic recurrence in three (2.5 %). A total of 87.4 % of sphincter-preserving surgeries were performed for T3 low rectal cancer following SRT-delay. Pathological tumor downstaging, circumferential resection margin involvement, local recurrence, and oncologic outcomes were acceptable; therefore, the SRT-delay regimen may be an option for treating T3 low rectal cancer.
  • Kazuhiro Kitajima; Hiroshi Doi; Kozo Kuribayashi; Masaki Hashimoto; Tatsuya Tsuchitani; Masao Tanooka; Kazuhito Fukushima; Takashi Nakano; Seiki Hasegawa; Shozo Hirota
    European Journal of Radiology 86 176 - 183 2017年01月 [査読有り]
     
    Purpose To investigate the relationships between pretreatment volume-based quantitative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) parameters and overall survival (OS) in patients with malignant pleural mesothelioma (MPM). Materials and methods We retrospectively reviewed data from 201 MPM patients, of whom 38 underwent surgical resection, and calculated the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG), including primary tumors and nodal or distant metastatic lesions, on pretreatment 18F-FDG PET/CT. Relationships between clinicopathological factors (age, sex, performance status, European Organization for Research and Treatment of Cancer [EORTC] score, histological subtype, TNM stage, and treatment strategy), volume-based quantitative PET/CT parameters, and OS were evaluated using a Cox proportional hazards model and log-rank test. Results The median follow-up was 15 months (range, 1–96 months median, 17 months). In a univariate analysis of all patients, older age (p <  0.05), high EORTC score (p <  0.001), non-epithelioid histological subtype (p <  0.001), high T stage (p <  0.001), positive N/M status (p <  0.05, p <  0.001), advanced TNM stage (p <  0.001), non-surgical treatment (p <  0.001), and high SUVmax (p <  0.001), MTV (p <  0.001), or TLG (p <  0.001) were associated with significantly shorter OS. A multivariate analysis confirmed non-epithelioid subtype (hazard ratio [HR]: 1.69, 95% confidence interval [CI]: 1.14–2.48 p <  0.05), non-surgical treatment (HR: 0.58, 95% CI: 0.34–0.95 p <  0.05), and high TLG (HR: 1.97, 95% CI: 1.14–3.44 p <  0.05) as independent negative predictors. Conclusions Pretreatment volume-based quantitative 18F-FDG PET/CT parameters, especially TLG, could serve as potential surrogate markers for MPM prognosis.
  • Shingo Kanemura; Kozo Kuribayashi; Norihiko Funaguchi; Eisuke Shibata; Koji Mikami; Hiroshi Doi; Kazuhiro Kitajima; Seiki Hasegawa; Takashi Nakano
    EUROPEAN JOURNAL OF RADIOLOGY 86 92 - 98 2017年01月 [査読有り]
     
    Purpose: Efficient monitoring of tumor responsiveness to chemotherapy is essential to mitigate high mortality risks and cytotoxic effects of chemotherapeutics. However, there is no consensus on the most suitable diagnostic technique/parameters for assessing response to chemotherapy in malignant pleural mesothelioma (MPM). We compared the tumor responsiveness of MPM patients as assessed using modified RECIST (mRECIST) criteria and integrated 18F-FDG-PET/CT. Methods: Histologically confirmed MPM patients (N=82) who were treated with three cycles of cisplatin and pemetrexed, or carboplatin and pemetrexed, were included. mRECIST and integrated 18F-FDGPET/CT were used to evaluate MPM tumor response to chemotherapy. Metabolic non-responders were defined as those with a 25% or greater increase in SUVmax compared with the previous value. Time to progression (TTP) and overall survival (OS) were compared between metabolic-responders and non responders. Results: After three cycles of chemotherapy, 62(75.6%) of the patients were classified as having SD, 15 (18%) with partial remission (PR), and 5 (6%) with progressive disease (PD), based on mRECIST criteria. The cumulative median OS was 728.0 days (95% confidence interval [CI]: 545.9-910.1) and cumulative median TTP was 365.0 days (95% CI: 296.9-433.1). For the 82 patients, the disease control rate was 93.9%, whereas the metabolic response rate was only 71.9% (p < 0.001). All PD and PR patients were found to be metabolic responders on 18F-FDG-PET/CT; however, among the 62mRECIST SD patients, 18 (29%) were classified as metabolic non-responders. The median TTP for metabolic responders was 13.7 months, while it was 10.0 months for non-responders(p < 0.001). Metabolic responders had a trend toward longer OS, although the difference did not reach statistical significance (metabolic responders:33.9 months; non-responders: 21.6 months; p > 0.05). Conclusion: Several mRECIST-confirmed SD MPM patients may be classified as metabolic non-responders onl 8F-FDGPET/CT. Metabolic response is significantly correlated with the median TTP, suggesting it should be included in the evaluation of the response to chemotherapy in MPM patients classified as mRECIST SD, to identify non-responders. (C) 2016 Published by Elsevier Ireland Ltd.
  • Hiroshi Doi; Kazuhiro Kitajima; Masao Tanooka; Tomonori Terada; Kazuma Noguchi; Yasuhiro Takada; Masayuki Fujiwara; Reiichi Ishikura; Norihiko Kamikonya; Shozo Hirota
    European Archives of Oto-Rhino-Laryngology 273 12 4485 - 4492 2016年12月 [査読有り]
     
    The purpose of our study was to assess the feasibility of radiotherapy (RT) for locally advanced paranasal sinus carcinomas in late elderly patients (aged aeyen75 years) from a single institution in Japan. From 2000 to 2015, we retrospectively analyzed 14 patients (11 maxillary and 3 ethmoid sinus carcinoma patients) who underwent RT for pathologically confirmed paranasal sinus carcinomas. RT was performed without unexpected cessations. Two patients, however, developed Grade 3 mucositis. The median follow-up duration was 13 months (range 2-54 months). The 1- and 2-year overall survival (OS) rates were 81.8 and 54.5 %, respectively. The local response rate after the initial treatment was 85.7 %. The 1- and 2-year progression-free survival (PFS) rates were 46.2 and 24.8 %, respectively. Univariate analysis of different clinicopathological parameters was conducted to identify associations with OS and PFS. We demonstrated that intensity modulated radiation therapy (IMRT) of > 60 Gy with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy led to improved OS and PFS rates, although no statistical significance was observed. Moreover, none of the squamous cell carcinoma (SCC) patients who received 33 fractions of 66 Gy in IMRT died during the median follow-up period of 13 months (range 12-25 months). In conclusion, RT with concomitant intra-arterial (cisplatin-based) infusion chemoradiotherapy can be considered an effective, well-tolerated, and feasible treatment option for late elderly patients with paranasal sinus carcinomas. In addition, > 60 Gy of RT in IMRT led to improved survival outcomes in elderly paranasal sinus carcinoma patients.
  • Beppu N; Yoshie H; Kimura F; Aihara T; Doi H; Kamikonya N; Matsubara N; Tomita N; Yanagi H; Yamanaka N
    Surgery today 46 10 1123 - 1131 2016年10月 [査読有り]
     
    To evaluate the safety and efficacy of induction SOX (S-1 + oxaliplatin) +/- A cetuximab chemotherapy followed by short-course chemoradiotherapy and surgery in patients with poor-risk locally advanced rectal cancer. We enrolled eligible patients with poor-risk rectal cancer defined as T3 lower rectal cancer with mesorectal fascia involvement, T4a or T4b tumors or cases with lateral lymph node swelling. The primary endpoint was a pathological complete response (pCR), and the secondary endpoints were the objective response rate (ORR) and the pathological high response rate (Grade 2 plus 3). Twenty eligible patients were enrolled. The majority (75.0 %, 15/20) of the patients completed four cycles of induction chemotherapy, and all patients completed the radiotherapy (25 Gy/10 fractions/5 days). The global rate of Grade 3-4 toxicities was 30.0 % (6/20 patients). The ORRs were 85.0 % (17/20) and 95.0 % (19/20) in the patients who underwent R0 and R1 resection, respectively. The pathological high response rate was 70.0 % (14/20) and the pCR was 10.0 % (2/20). The regimen of induction SOX (S-1 + oxaliplatin) +/- A cetuximab chemotherapy followed by short-course chemoradiotherapy is safe and is associated with good tumor regression in patients with poor-risk locally advanced rectal cancer.
  • Odawara S; Doi H; Shikata T; Kitajima K; Suzuki H; Niwa Y; Kosaka K; Tarutani K; Tsujimura T; Kamikonya N; Hirota S
    Molecular and clinical oncology 5 4 377 - 381 2016年10月 [査読有り]
  • Kazuhiro Kitajima; Hiroshi Doi; Kozo Kuribayashi
    JAPANESE JOURNAL OF RADIOLOGY 34 8 537 - 547 2016年08月 [査読有り]
     
    Positron emission tomography/computed tomography (PET/CT) integrated with 2-[F-18]fluoro-2-deoxy-d-glucose (F-18-FDG) has emerged as a powerful tool for combined metabolic and anatomic evaluations in clinical oncologic imaging. This review discusses the utility of F-18-FDG PET/CT as a tool to manage patients with malignant pleural mesothelioma. We discuss different stages of patient management in malignant pleural mesothelioma, including diagnosis, initial staging, therapy planning, early treatment response assessment, re-staging, and prognosis.
  • Naohito Beppu; Hidenori Yoshie; Fumihiko Kimura; Tsukasa Aihara; Hiroshi Doi; Norihiko Kamikonya; Nagahide Matsubara; Naohiro Tomita; Hidenori Yanagi; Naoki Yamanaka
    SURGERY TODAY 46 7 852 - 859 2016年07月 [査読有り]
     
    Purpose To investigate the clinicopathological outcomes of patients with T4 lower rectal cancer treated using preoperative chemoradiotherapy with S-1 plus Irinotecan. Methods Between 2005 and 2011, 35 patients with T4M0 lower rectal cancer, diagnosed initially as T4a in 12 and as T4b in 23, were treated with 45 Gy of radiotherapy concomitantly with S-1 plus Irinotecan. The median follow-up period was 50.6 months (range 2-123 months). Results A total of 32 patients (91.4 %) completed the radiotherapy and 26 (74.3 %) completed the full chemotherapy regimen. Radical surgery was then performed in 33 (94.3 %) of the 35 patients after the exclusion of two patients, who had macroscopic residual disease. The pathological diagnosis was downstaged from T4a to ypT0-3 in all 12 of those patients (100 %) and from T4b to ypT0-4a in 20 of those 23 patients (87.0 %). The tumor regression grade of 1a/1b/2/3 (complete response) was 10/8/15/2, respectively. In terms of long-term survival, the 5-year local relapse-free survival rate was 74.8 % and the recurrence-free survival rate was 52.0 %. Conclusions This regimen may result in favorable down-staging. Moreover, in this series, pathological evidence of involvement of adjacent organs was rare following preoperative chemoradiotherapy, in the patients with disease diagnosed as T4b at the initial staging.
  • Hiroshi Doi; Hiroya Shiomi; Norihisa Masai; Daisaku Tatsumi; Takumi Igura; Yasuharu Imai; Ryoong-Jin Oh
    JOURNAL OF RADIATION RESEARCH 57 3 294 - 300 2016年06月 [査読有り]
     
    The purpose of the present study was to investigate the threshold dose for focal liver damage after stereotactic body radiation therapy (SBRT) in cirrhotic and normal livers using magnetic resonance imaging (MRI). A total of 64 patients who underwent SBRT for liver tumors, including 54 cirrhotic patients with hepatocellular carcinoma (HCC) and 10 non-cirrhotic patients with liver metastases, were analyzed. MRI was performed 3-6 months after SBRT, using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced T1-weighted sequences. All MRI datasets were merged with 3D dosimetry data. All dose distributions were corrected to the biologically effective dose using the linear-quadratic model with an assumed alpha/beta ratio of 2 Gy. The development of liver dysfunction was validly correlated with isodose distribution. The median biologically effective dose (BED2) that provoked liver dysfunction was 57.3 (30.0-227.9) and 114.0 (70.4-244.9) Gy in cirrhotic and normal livers, respectively (P = 0.0002). The BED2 associated with a >5% risk of liver dysfunction was 38.5 in cirrhotic livers and 70.4 Gy in normal livers. The threshold BED2 for liver dysfunction was not significantly different between Child-Pugh A and B patients (P = 0.0719). Moreover, the fractionation schedule was not significantly correlated with threshold BED2 for liver dysfunction in the cirrhotic liver (P = 0.1019). In the cirrhotic liver, fractionation regimen and Child -Pugh classification did not significantly influence the threshold BED2 for focal liver damage after SBRT. We suggest that the threshold BED2 for liver dysfunction after SBRT is 40 and 70 Gy in the cirrhotic and normal liver, respectively.
  • Kazuhiro Kitajima; Hiroshi Doi; Tomonori Kanda; Tomohiko Yamane; Tetsuya Tsujikawa; Hayato Kaida; Yukihisa Tamaki; Kozo Kuribayashi
    JAPANESE JOURNAL OF RADIOLOGY 34 6 387 - 399 2016年06月 [査読有り]
     
    Integrated positron emission tomography/computed tomography (PET/CT) using 2-[F-18]fluoro-2-deoxy-d-glucose (F-18-FDG) has emerged as a powerful tool for combined metabolic and anatomic evaluation in clinical oncologic imaging. This review discusses the utility of F-18-FDG PET/CT as a tool for managing patients with lung cancer. We discuss different patient management stages, including diagnosis, initial staging, therapy planning, early treatment response assessment, re-staging, and prognosis.
  • Hiroshi Doi; Kazuhiro Kitajima; Kazuhito Fukushima; Yusuke Kawanaka; Miya Mouri; Satoshi Yamamoto; Reiichi Ishikura; Tomonori Terada; Kazuma Noguchi; Shozo Hirota
    JAPANESE JOURNAL OF RADIOLOGY 34 5 349 - 355 2016年05月 [査読有り]
     
    Our aim was to determine whether the maximum standardized uptake value (SUVmax) of the primary lesion demonstrated by [F-18]-fluoro-2-deoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) is associated with the prognosis of maxillary sinus cancer. The relationships of clinicopathological factors including age, T stage, N stage, histologic type, treatment strategy, and primary tumor SUVmax with progression-free (PFS) and overall (OS) survival were evaluated using the log-rank test and Cox method in 31 patients with maxillary sinus cancer before combined superselective intra-arterial chemotherapy using high-dose cisplatin with concurrent radiotherapy, or radiotherapy alone. The median duration of follow-up was 55.4 (range 9.7-72.6) months. PFS and OS of patients exhibiting a high SUVmax (a parts per thousand yen16 and a parts per thousand yen17, respectively) for the primary tumor were significantly lower than those of patients for whom the primary tumor SUVmax was low (p = 0.0010 and p = 0.033, respectively). Multivariate analyses showed that T stage (p = 0.0049) and primary tumor SUVmax (p = 0.026) were independently prognostic of poorer PFS and that only primary tumor SUVmax (p = 0.049) was independently prognostic of poorer OS. SUVmax of the primary tumor determined by FDG-PET/CT before treatment could be a good surrogate marker for prognostication of maxillary sinus cancer.
  • Kazuhiro Kitajima; Toshiko Yamano; Kazuhito Fukushima; Yasuo Miyoshi; Seiichi Hirota; Yusuke Kawanaka; Mouri Miya; Hiroshi Doi; Koichiro Yamakado; Shozo Hirota
    EUROPEAN JOURNAL OF RADIOLOGY 85 5 943 - 949 2016年05月 [査読有り]
     
    Purpose: To correlate both primary lesion maximum standardized uptake values (SUVmax) of FDG-PET/CT, and apparent diffusion coefficient (ADC) values of diffusion-weighted imaging (DWI) with clinicopathologic prognostic factors in patients with breast carcinoma. Materials and methods: 214 patients with 216 mass -type invasive breast carcinomas underwent whole body FDG-PET/CT and 3-Tesla breast MRI including DWI before initial therapy. The primary tumor's SUVmax and ADC values were measured using FDG-PET/CT and DWI, respectively. Histologic analysis parameters included tumor size, expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67, nuclear grade, histology subtype, and axillary lymph node (LN) metastasis. The relationships among SUVmax, ADC values, and pathologic prognostic factors were evaluated. Results: The mean SUVmax and ADCmean were 5.63 +/- 3.79 (range, 1.2-24.17) and 894 +/- 204 x 10-6 mm(2/)s (range, 452-1550 x 10(-6)), respectively. There was a significant but weak inverse correlation between the SUVmax and ADCmean values (correlation coefficient r = 0.30, p < 0.0001). SUVmax was associated with numerous prognostic factors such as tumor size (p < 0.0001), expression levels of ER (p = 0.00041), PR (p = 0.00028), HER2 (p = 0.00021), and Ki-67 (p < 0.0001), nuclear grade (p < 0.0001), histology subtype (p = 0.00061), axillary LN metastasis (p < 0.0001), and TNM staging (p < 0.0001). Meanwhile, ADCmean value was associated with tumor size (p = 0.013), expression of Ki-67 (p = 0.0010), histology subtype (p = 0.00013), axillary LN metastasis (p = 0.00059), and TNM staging (p = 0.0011). Conclusions: Primary tumor SUVmax on FDG-PET/CT has a stronger relationship with known prognostic parameters and may be a more useful for predicting the prognosis of breast carcinoma than ADC values. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Yusuke Kawanaka; Kazuhiro Kitajima; Kazuhito Fukushima; Miya Mouri; Hiroshi Doi; Tsutomu Oshima; Hirotaka Niwa; Nobuaki Kaibe; Mitsuru Sasako; Toshihiko Tomita; Hiroto Miwa; Shozo Hirota
    EUROPEAN JOURNAL OF RADIOLOGY 85 5 989 - 995 2016年05月 [査読有り]
     
    Purpose: To evaluate the added clinical value of pretreatment F-18-FDG PET/CT compared with conventional contrast-enhanced multidetector-row CT (CECT) alone for staging of advanced gastric cancer Materials and methods: We studied 106 patients with locally advanced gastric cancer who underwent pretreatment CECT and 18F-FDG PET/CT. Two experienced reviewers assessed the diagnostic performance of both CECT alone and the combination of CECT and 18F-FDG PET/CT for the primary tumor, regional lymph node metastasis (N) and distant metastasis (M), rating their diagnostic confidence with a 5 -point scoring system for each location. The two methods were compared using receiver operating characteristic (ROC) curve analysis for histopathologic findings, imaging, and clinical follow-up as the reference standards. Results: Among the 106 patients, 96 primary tumors (90.6%) were detected by CECT, while 101 (95.3%) were clearly identified by F-18-FDG PET/CT (p = 0.074). Patient -based areas under the ROC curves for CECT alone versus the combination of CECT and 18F-FDG PET/CT for diagnosis of N stage, peritoneal dissemination, liver metastasis, distant lymph node metastasis, bone metastasis, metastasis at other sites and overall M stage were 0.787 vs. 0.858 (p = 0.13), 0.866 vs. 0.878 (p = 0.31), 0.998 vs. 1.0 (p = 0.36), 0.744 vs. 0.865 (p = 0.049), 0.786 vs. 0.998 (p = 0.034), 0.944 vs. 0.984 (p = 0.34), and 0.889 vs. 0.912 (p = 0.21), respectively. The diagnostic performance of primary tumor detection and NM staging was not influenced by the histologic subtype. Conclusion: Adding 18F-FDG PET/CT to CECT provides better diagnostic accuracy for detection of distant lymph node metastasis and bone metastasis in patients with untreated advanced gastric cancer. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
  • Kazuhiro Kitajima; Kazuhito Fukushima; Yasuo Miyoshi; Takayuki Katsuura; Yoko Igarashi; Yusuke Kawanaka; Miya Mouri; Kaoru Maruyama; Toshiko Yamano; Hiroshi Doi; Koichiro Yamakado; Seiichi Hirota; Shozo Hirota
    JAPANESE JOURNAL OF RADIOLOGY 34 3 220 - 228 2016年03月 [査読有り]
     
    To investigate the diagnostic and prognostic value of F-18-FDG-PET/CT for axillary lymph node (LN) staging in breast cancer patients, employing histologic evaluation as the reference. Among 196 patients with biopsy-proven breast cancer who had undergone F-18-FDG-PET/CT before mastectomy or breast-conserving surgery with sentinel LN biopsy and/or axillary LN dissection, 200 axillae were retrospectively analyzed by visual assessment and quantitatively using SUVmax. LN SUVmax as well as other clinicopathological features were assessed for their prognostic value using the log-rank test and Cox method. Metastasis was diagnosed histopathologically in 56 (28 %) axillae. The sensitivity, specificity, and accuracy of visual PET/CT for diagnosing node metastasis were 55.4, 95.8, and 84.5 %, respectively. When the optimal discriminative SUVmax cutoff was 1.5, these figures were 51.8, 97.2, and 84.5 %, respectively. Fourteen of 55 patients (25.5 %) with LN metastases suffered a recurrence during follow-up (median 39 months). Patients with a high nodal SUVmax (a parts per thousand yen1.7) had a significantly lower progression-free survival rate than those with a low SUVmax (p = 0.0499). Axillary nodal and primary tumor SUVmax as well as estrogen receptor status were significantly associated with recurrence. Axillary nodal SUVmax may be a prognostic indicator of disease recurrence in patients with axillary LN metastases.
  • Doi H; Oh RJ; Miura H; Masai N; Shiomi H; Inoue T
    Molecular and clinical oncology 4 1 83 - 88 2016年01月 [査読有り]
     
    Surgical resection is a well-established treatment option for sarcoma. However, anatomical barriers often hamper radical surgical procedures. The treatment of unresectable sarcoma, including local or distant failures following initial treatment, is challenging. The aim of the present study was to analyze the outcome of radiotherapy (RT) for refractory sarcoma, including unresectable, metastatic and recurrent disease, following radical treatment. We retrospectively reviewed a total of 67 tumors in 28 patients who were treated with RT between 2007 and 2014. Clinical target volume (CTV) was generally not defined in a preventive manner; therefore, in the majority of the cases, CTV equaled the gross tumor volume. The total delivered dose, number of fractions and biological equivalent dose were 52 (range, 40-69), 10 (range, 4-24) and 92.2 (range, 56-119.6) Gy, respectively. Only 1 patient developed local failure, with a median follow-up of 11 months (range, 1-59 months). Therefore, the 12-month progression-free survival rate for 67 sites was 96.8%. The overall survival rates at 12 and 36 months were 75.8 and 30.2%, respectively. A total of 2 patients developed grade >2 toxicities, including grade 3 mucositis and grade 4 pericardial effusion. Our results demonstrated that radical RT using modern techniques is highly feasible, achieves excellent local control, and may be an effective treatment option for refractory sarcoma.
  • Naohito Beppu; Kimura Fumihiko; Doi Hiroshi; Kamikonya Norihiko; Nagahide Matsubara; Naohiro Tomita; Hidenori Yanagi; Naoki Yamanaka
    DIGESTIVE SURGERY 33 5 431 - 438 2016年 [査読有り]
     
    Purpose: The aim of this study was to assess the functional outcomes of patients treated with intensive medications for bowel and pain control for low-lying rectal cancer who received preoperative chemoradiotherapy (CRT). Methods: The inclusion criterion was sphincter-preserving surgery following CRT for T3 middle and low rectal cancer. Postoperative defecation control was conducted using calcium polycarbophil and loperamide, and anal pain control was conducted using oxycodone hydrochloride hydrate. The functional outcomes were determined by an annual questionnaire after stoma closure. Results: Of 64 patients evaluated, 33 were reconstructed using the double stapling technique (DST) and 31 were reconstructed using the intersphincteric resection (ISR) technique. The median Visual Analogue Scale at ISR was improved from 7 to 1.5 at 1 year after surgery. The median Wexner scores were 6.0, 6.0, 5.0 and 5.0 for DST and 14.5, 12.0, 10.0 and 8.0 for ISR for the first 4 years, respectively. The only independent predictor of a poor bowel function (Wexner score > 10) according to a multivariate analyses was pelvic infection (OR 3.994, 95% CI 1.235-13.52, p = 0.021), while ISR was not a predictor. Conclusions: Anal pain following ISR can be controlled with oxycodone hydrochloride hydrate therapy. ISR is feasible following CRT for low-lying rectal cancer. (C) 2016 S. Karger AG, Basel
  • Naohito Beppu; Masayoshi Kobayashi; Nagahide Matsubara; Masashi Noda; Tomoki Yamano; Hiroshi Doi; Norihiko Kamikonya; Ayako Kakuno; Fumihiko Kimura; Naoki Yamanaka; Hidenori Yanagi; Naohiro Tomita
    INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 30 10 1339 - 1347 2015年10月 [査読有り]
     
    The aim of this study was to compare the pathological response of mesorectal positive nodes between short-course chemoradiotherapy with delayed surgery (SCRT-delay) and long-course chemoradiotherapy (LC-CRT) in patients with rectal cancer. The resected primary tumor specimens following the two different approaches were assessed utilizing the tumor regression grade (TRG 0-4), and each positive lymph node was assessed according to the lymph node regression grade (LRG 1-3), with TRG 4 and LRG 3 indicating total regression. The lymph node sizes were measured to elucidate any correlation with LRG scores. Seventy-four patients with ypN-positive rectal cancer had 220 positive lymph nodes following the SCRT-delay, and 48 patients had 141 positive lymph nodes following the LC-CRT. The distribution of LRG 1/2/3 in the two groups was 123/72/25 and 60/31/50 (p < 0.001), respectively, and the distribution of TRG 0/1/2/3/4 in the two groups was 36/19/19/0 and 12/15/20/1 (p = 0.005), respectively. The requirements of total regression of positive lymph nodes were a primary tumor degenerated to TRG 3 with a size less than 6 mm in SCRT-delay (sensitivity, 60.9 %) or a primary tumor degenerated to TRG 2-4 with a size less than 5 mm at TRG 2 (sensitivity, 57.6 %) or 6 mm at TRG 3 and 4 (sensitivity, 84.2 %) in LC-CRT as indicated by the receiver operating characteristic curve analysis. The tumor regression effect of LC-CRT on the primary tumor and positive nodes was more favorable than SCRT-delay, and LC-CRT is able to predict the LRG 3 response with a high sensitivity.
  • Doi H; Beppu N; Kato T; Noda M; Yanagi H; Tomita N; Kamikonya N; Hirota S
    Molecular and clinical oncology 3 5 1129 - 1134 2015年09月 [査読有り]
  • Naohito Beppu; Nagahide Matsubara; Masashi Noda; Tomoki Yamano; Ayako Kakuno; Hiroshi Doi; Norihiko Kamikonya; Fumihiko Kimura; Naoki Yamanaka; Hidenori Yanagi; Naohiro Tomita
    SURGERY 158 1 225 - 235 2015年07月 [査読有り]
     
    Introduction. The aim of this study was to compare the short- and long-term outcomes between short-course radiotherapy with delayed surgery (SRT-delay) and a standard conventional chemoradiotherapy (CRT) regimen. Methods. Two collaborating institutions adopted different regimens; the SRT-delay regimen was selected by Meiwa Hospital and the CRT regimen was selected by Hyogo College of Medicine. The inclusion criteria were T3 middle and low rectal cancer patients treated with radical surgery after preoperative therapy. The median follow-up period was 44 months (range, 12-85). Results. From 2007 to 2013, 104 patients were treated using the SRT-delay regimen and 61 patients were treated using the CRT regimen. The pretreatment characteristics of the 2 groups were not significantly different. The sphincter-preserving rate (93.3%, 85.2%), T downstaging (37.5%, 37.7%), ypN(-) (74.0%, 67.2%), postoperative complications and the bowel, and urinary and sexual functioning of the SRT-delay regimen were noninferior to those of the CRT regimen. The 3-year local recurrence-free survival, recurrence-free survival, and overall survival in the SRT-delay and CRT groups were 90.6% and 90.6% (P = .764), 83.8% and 78.3% (P = .687) and 96.0% and 92.8% (P = .833), respectively. Conclusion. The SRT-delay regimen was noninferior in terms of the downstaging effect, and oncologic and functional outcomes compared with the CRT regimen for T3 middle and low rectal cancer.
  • Masayuki Fujiwara; Norihiko Kamikonya; Soichi Odawara; Hitomi Suzuki; Yasue Niwa; Yasuhiro Takada; Hiroshi Doi; Tomonori Terada; Nobuhiro Uwa; Kosuke Sagawa; Shozo Hirota
    JOURNAL OF RADIATION RESEARCH 56 3 577 - 582 2015年05月 [査読有り]
     
    The purpose of the present study was to determine the risk factors for developing thyroid disorders based on a dose-volume histograms (DVHs) analysis. Data from a total of 116 consecutive patients undergoing 3D conformal radiation therapy for head and neck cancers was retrospectively evaluated. Radiation therapy was performed between April 2007 and December 2010. There were 108 males and 8 females included in the study. The median follow-up term was 24 months (range, 1-62 months). The thyroid function was evaluated by measuring thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels. The mean thyroid dose, and the volume of thyroid gland spared from doses >= 10, 20, 30 and 40 Gy (VS10, VS20, VS30 and VS40) were calculated for all patients. The thyroid dose and volume were calculated by the radiotherapy planning system (RTPS). The cumulative incidences of hypothyroidism were 21.1% and 36.4% at one year and two years, respectively, after the end of radiation therapy. In the DVH analyses, the patients who received a mean thyroid dose <30 Gy had a significantly lower incidence of hypothyroidism. The univariate analyses showed that the VS10, VS20, VS30 and VS40 were associated with the risk of hypothyroidism. Hypothyroidism was a relatively common type of late radiation-induced toxicity. A mean thyroid dose of 30 Gy may be a useful threshold for predicting the development of hypothyroidism after radiation therapy for head and neck cancers.
  • Naohito Beppu; Nagahide Matsubara; Ayako Kakuno; Hiroshi Doi; Norihiko Kamikonya; Naoki Yamanaka; Hidenori Yanagi; Naohiro Tomita
    DISEASES OF THE COLON & RECTUM 58 5 479 - 487 2015年05月 [査読有り]
     
    BACKGROUND: 5-Fluorouracil-based chemotherapy is considered to be a radiosensitizer; however, conventional short-course radiotherapy combined with chemotherapy is generally thought to not be feasible because of the prevalence of side effects. OBJECTIVE: The aim of this study was to evaluate the feasibility of modified short-course radiotherapy combined with a chemoradiosensitizer for T3 rectal cancer. DESIGN AND SETTINGS: This study was retrospective in nature and used a prospectively collected database. PATIENTS: Patients with T3 rectal cancer located below the peritoneum reflection were selected. INTERVENTIONS: A total dose of 25 Gy of radiotherapy was administered in 10 fractions of 2.5 Gy each for 5 days. Radiotherapy was performed with S-1 as a radiosensitizer from day 1 to day 10. Surgery was targeted to be performed 4 weeks after radiotherapy. MAIN OUTCOME MEASUREMENTS: The morbidity, sphincter-preserving rate, anal function, and long-term outcomes were assessed. RESULTS: All patients (n = 170) completed the radiotherapy regimen and 166 (97.6%) completed the combination regimen with chemotherapy. A total of 149 patients (87.6%) had sphincter-preserving surgery (double stapling technique (DST), 58 patients; intersphincteric resection (ISR), 91 patients), and postoperative complications were relatively mild (anastomotic leakage, 15.4%; intra-abdominal infection, 8.2%). Among those undergoing sphincter preserving surgery, the 5-year local relapse-free survival rate was 94.3% in the DST group, and 89.8% in the ISR group. With respect to the anal function, the Wexner score the first year after stoma closure for the double-stapling technique group was 6 and that for intersphincteric resection was 15; however, the score for the intersphincteric resection group was improved to 8 at 4 years after stoma closure. LIMITATIONS: This study had limitations because it was an uncontrolled, 1-arm, retrospective review with a small sample size. CONCLUSIONS: Modified short-course radiotherapy combined with chemoradiosensitizer is a feasible approach for treating T3 rectal cancer. With the use of the short-course approach, efforts to reduce the incidence of side effects by appropriately prolonging the waiting period enable the administration of combination treatment with short-course radiotherapy and chemotherapy.
  • Naohito Beppu; Nagabide Matsubara; Masashi Noda; Tomoki Yamano; Ayako Kakuno; Hiroshi Doi; Norihiko Kamikonya; Naoki Yamanaka; Hidenori Yanagi; Naohiro Tomita
    SURGERY 157 4 743 - 751 2015年04月 [査読有り]
     
    Background. The response of positive mesorectal lymph nodes to chemoradiotherapy remains largely unstudied in patients with rectal cancer. The aim of this study was to investigate the requirements of the total regression of positive nodes treated with chemoradiotherapy. Methods. The response of the primary tumor was evaluated according to the tumor regression grade (TRG 0-4) in resected specimens, and positive lymph nodes were assessed according to the lymph node regression grade (LRG 1-3), with TRG 4 and LRG 3 indicating total regression. We investigated the relationships among TRG, LRG, and the sizes of positive lymph nodes. Results. Among 178 patients, 68 (38.2%) had 200 positive lymph nodes. We first investigated the relationship of positive nodes to TRG and LRG and found that the response of the primary tumor to chemoradiotherapy correlated with the response of positive nodes. Next, we investigated the correlation between LRG and the size of positive nodes. At TRG I and 2, LRG score was not correlated with the positive node size. In contrast, at TRG 3, LRG score was correlated with the size of positive nodes. Next, our assessment of the relationship between the sizes of positive nodes and complete degeneration to LRG 3 showed that the most accurate cut-off score on receiver-operator-characteristics curve analysis was 6 mm in maximum diameter for TRG 3. Conclusion. The requirements of the total regression of positive nodes are I) degeneration of the primary tumor to TRG 3 and 2) a positive node diameter of <6 mm.
  • Masayuki Fujiwara; Satoshi Yamamoto; Hiroshi Doi; Yasuhiro Takada; Soichi Odawara; Yasue Niwa; Reiichi Ishikura; Norihiko Kamikonya; Tomonori Terada; Nobuhiro Uwa; Kosuke Sagawa; Shozo Hirota
    LARYNGOSCOPE 125 3 685 - 689 2015年03月 [査読有り]
     
    Objectives/HypothesisThe purpose of this study was to estimate the efficacy of superselective arterial chemoradiotherapy for locally advanced carcinomas of the external auditory canal and middle ear. Study DesignA retrospective study of clinical data for consecutive patients with locally advanced carcinomas of the external auditory canal and middle ear. MethodsThirteen patients with locally advanced carcinomas of the external auditory canal and middle ear (T3: one patient, T4: 12 patients) were reviewed. The median follow-up duration in the living patients was 33 months. The total dose of radiation therapy was 60 Gy using conventional fractionation. Four, five, or six courses of a superselective arterial infusion (cisplatin 50 mg) were given weekly. ResultsThe overall survival and progression-free survival rates at 2 years, calculated by the Kaplan-Meier method, were 58.7% and 53.8%, respectively. No late-phase adverse effects due to chemoradiation and no adverse effects due to catheterization were observed. ConclusionsThese results suggest that superselective arterial chemoradiation can be a treatment option for locally advanced carcinomas of the external auditory canal and middle ear.
  • Doi H; Fujiwara M; Suzuki H; Niwa Y; Nakayama M; Shikata T; Odawara S; Takada Y; Kimura T; Kamikonya N; Hirota S
    Molecular and clinical oncology 3 2 381 - 386 2015年03月 [査読有り]
     
    Polaprezinc (PZ), an antiulcer drug, has been reported to have antioxidant properties. The aim of the present study was to assess the feasibility and efficacy of administering PZ for radiation-induced mucositis in head and neck cancer patients. Patients with newly diagnosed head and neck cancer were enrolled in this prospective study. PZ was prepared as an oral rinse. The PZ oral rinse was used four times per day during the course of radiotherapy. Sequential changes in radiation mucositis were assessed during and after radiotherapy according to the Common Terminology Criteria for Adverse Events, version 3.0. Furthermore, a retrospective comparison analysis was performed to assess the efficacy of PZ for radiation-induced mucositis. A total of 32 patients were enrolled in the prospective study of the PZ oral rinse. Radiotherapy was performed up to a total dose of 60-66 Gy using a conventional schedule combined with chemotherapy. Of the 32 patients, 30 (93.8%) reported no complaints due to the PZ oral rinse. In addition, PZ was not associated with severe adverse effects. Among the patients who received PZ, grade 3 mucositis was observed in 29.0% based on the mucosal findings and in 39.3% based on the symptoms. In the patients who did not receive PZ, the incidence of grade 3 mucositis was 40.0% based on the mucosal findings and 60.7% based on the symptoms. Moreover, PZ promoted the recovery from mucositis caused by chemoradiotherapy and was not associated with reduced tumor response to radiotherapy. Therefore, the PZ oral rinse was well tolerated and proved to be efficient for the treatment of radiotherapy-induced oral mucositis.
  • Uwa N; Hao H; Tsukamoto Y; Terada T; Sagawa K; Mohri T; Daimon T; Doi H; Sotsuka Y; van Eys G; Bochaton-Piallat ML; Hirota S; Sakagami M
    International Journal of Otolaryngology and Head & Neck Surgery 4 108 - 114 2015年 [査読有り]
  • Naohito Beppu; Nagahide Matsubara; Masashi Noda; Tomoki Yamano; Hiroshi Doi; Norihiko Kamikonya; Naoki Yamanaka; Hidenori Yanagi; Naohiro Tomita
    INTERNATIONAL JOURNAL OF COLORECTAL DISEASE 29 12 1459 - 1466 2014年12月 [査読有り]
     
    The purpose of this study was to analyze the influence of variations in clinical practice regarding the timing of surgery with short-course chemoradiotherapy with delayed surgery (SCRT-delay) for lower rectal cancer. A total of 171 patients with T3 N0-2 lower rectal cancer treated with SCRT-delay (25 Gy/10 fractions/5 days (S-1); days 1-10) were retrospectively evaluated. The median waiting period of 30 days was used as a discriminator (group A: waiting period, a parts per thousand currency sign30 days; group B: waiting period, a parts per thousand yen31 days). Preoperative treatment responses and oncological outcomes were analyzed. The mean waiting periods for groups A and B were 24.4 +/- 5.3 and 41.4 +/- 12.3 days, respectively. There were no statistically significant differences between the two groups in any of the clinical variables. The clinicopathological outcomes were as follows: T downstaging (43.5 vs 37.2 %; p = 0.400), negative yp N (67.1 vs 75.6 %; p = 0.218), pCR (7.1 vs 1.2 %; p = 0.119). The 5-year local recurrence-free survival (89.3 vs 87.6 %; p = 0.956), the recurrence-free survival (82.2 vs 78.8 %; p = 0.662), and the overall survival (88.5 vs 84.4 %; p = 0.741), all of which were similar between the two groups. The longer waiting period did not increase the tumor downstaging and not improve the oncological outcomes for T3 lower rectal cancer treated with SCRT-delay. In addition, considering that the impaired leukocyte response occurred during the sub-acute period, any time after the sub-acute period (day 12) up to 30 days after radiotherapy would be a suitable waiting period.
  • Miura M; Tanooka M; Inoue H; Fujiwara M; Kosaka K; Doi H; Takada Y; Odawara S; Kamikonya N; Hirota S
    International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 3 3 117 - 124 2014年08月 [査読有り]
  • Miura M; Tanooka M; Fujiwara M; Takada Y; Doi H; Odawara S; Kosaka K; Kamikonya N; Hirota S
    International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 3 2 82 - 87 2014年05月 [査読有り]
  • Hiroshi Doi; Fumiko Ishimaru; Masao Tanooka; Hiroyuki Inoue; Soichi Odawara; Yasuhiro Takada; Yasue Niwa; Masayuki Fujiwara; Norihiko Kamikonya; Shingo Yamamoto; Shozo Hirota
    ONCOLOGY LETTERS 7 1 209 - 214 2014年01月 [査読有り]
  • Tian J; Doi H; Saar M; Santos J; Li X; Peehl DM; Knox SJ
    International journal of radiation oncology, biology, physics 87 5 1179 - 1185 2013年12月 [査読有り]
  • Hiroshi Doi; Naohito Beppu; Soichi Odawara; Masao Tanooka; Yasuhiro Takada; Yasue Niwa; Masayuki Fujiwara; Fumihiko Kimura; Hidenori Yanagi; Naoki Yamanaka; Norihiko Kamikonya; Shozo Hirota
    JOURNAL OF RADIATION RESEARCH 54 6 1118 - 1124 2013年11月 [査読有り]
     
    The purpose of this study was to examine the safety and feasibility of a novel protocol of neoadjuvant short-course hyperfractionated accelerated radiotherapy (SC-HART) combined with S-1 for locally advanced rectal cancer. A total of 56 patients with lower rectal cancer of cT3N1M0 (Stage III b) was treated with SC-HART followed by radical surgery, and were analyzed in the present study. SC-HART was performed with a dose of 2.5 Gy twice daily, with an interval of at least 6 hours between fractions, up to a total dose of 25 Gy (25 Gy in 10 fractions for 5 days) combined with S-1 for 10 days. Radical surgery was performed within three weeks following the end of the SC-HART. The median age was 64.6 (range, 39-85) years. The median follow-up term was 16.3 (range, 2-53) months. Of the 56 patients, 53 (94.4%) had no apparent adverse events before surgery; 55 (98.2%) completed the full course of neoadjuvant therapy, while one patient stopped chemotherapy because of Grade 3 gastrointestinal toxicity (CTCAE v.3). The sphincter preservation rate was 94.6%. Downstaging was observed in 45 patients (80.4%). Adjuvant chemotherapy was administered to 43 patients (76.8%). The local control rate, disease-free survival rate and disease-specific survival rate were 100%, 91.1% and 100%, respectively. To conclude, SC-HART combined with S-1 for locally advanced rectal cancer was well tolerated and produced good short-term outcomes. SC-HART therefore appeared to have a good feasibility for use in further clinical trials.
  • Masao Tanooka; Hiroshi Doi; Hideharu Miura; Hiroyuki Inoue; Yasue Niwa; Yasuhiro Takada; Masayuki Fujiwara; Toshiyuki Sakai; Kiyoshi Sakamoto; Norihiko Kamikonya; Shozo Hirota
    JOURNAL OF RADIATION RESEARCH 54 6 1153 - 1159 2013年11月 [査読有り]
     
    We validated 3D radiochromic film dosimetry for volumetric modulated arc therapy (VMAT) using a newly developed spiral water phantom. The phantom consists of a main body and an insert box, each of which has an acrylic wall thickness of 3 mm and is filled with water. The insert box includes a spiral film box used for dose-distribution measurement, and a film holder for positioning a radiochromic film. The film holder has two parallel walls whose facing inner surfaces are equipped with spiral grooves in a mirrored configuration. The film is inserted into the spiral grooves by its side edges and runs along them to be positioned on a spiral plane. Dose calculation was performed by applying clinical VMAT plans to the spiral water phantom using a commercial Monte Carlo-based treatment-planning system, Monaco, whereas dose was measured by delivering the VMAT beams to the phantom. The calculated dose distributions were resampled on the spiral plane, and the dose distributions recorded on the film were scanned. Comparisons between the calculated and measured dose distributions yielded an average gamma-index pass rate of 87.0% (range, 91.2-84.6%) in nine prostate VMAT plans under 3 mm/3% criteria with a dose-calculation grid size of 2 mm. The pass rates were increased beyond 90% (average, 91.1%; range, 90.1-92.0%) when the dose-calculation grid size was decreased to 1 mm. We have confirmed that 3D radiochromic film dosimetry using the spiral water phantom is a simple and cost-effective approach to VMAT dose verification.
  • Hideharu Miura; Masayuki Fujiwara; Masao Tanooka; Hiroshi Doi; Hiroyuki Inoue; Yasuhiro Takada; Norihiko Kamikonya; Shozo Hirota
    JOURNAL OF RADIATION RESEARCH 53 5 785 - 790 2012年09月 [査読有り]
     
    We compared the efficiency and accuracy of full-arc and half-arc volumetric-modulated arc therapy (VMAT) delivery for maxillary cancer. Plans for gantry rotation angles of 360 and 180 (full-arc and half-arc VMAT) were created for six maxillary cancer cases with the Monaco treatment planning system, and delivered using an Elekta Synergy linear accelerator. Full-arc and half-arc VMAT were compared with regard to homogeneity index (HI), conformity index (CI), mean dose to normal brain, total monitor units (MU), delivery times, root mean square (r.m.s.) gantry accelerations (degrees/s(2)), and rims. gantry angle errors (degrees). The half-arc VMAT plans achieved comparable HI and Cl to the full-arc plans. Mean doses to the normal brain and brainstem with the half-arc VMAT plans were on average 16% and 17% lower than those with the full-arc VMAT plans. For other organs at risk (OARs), no significant DVH differences were observed between plans. Half-arc VMAT resulted in 11% less total MU and 20% shorter delivery time than the full-arc VMAT, while r.m.s. gantry acceleration and rims. gantry angle error during half-arc VMAT delivery were 30% and 23% less than those during full-arc VMAT delivery, respectively. Furthermore, the half-arc VMAT plans were comparable with the full-arc plans regarding close homogeneity and conformity in maxillary cancer, and provided a statistical decrease in mean dose to OAR, total MU, delivery time and gantry angle error. Half-arc VMAT plans may be a suitable treatment option in radiotherapy for maxillary cancer.
  • Hiroshi Doi; Norihiko Kamikonya; Yasuhiro Takada; Masayuki Fujiwara; Keita Tsuboi; Hideharu Miura; Hiroyuki Inoue; Masao Tanooka; Takeshi Nakamura; Toshiyuki Shikata; Takeshi Kimura; Tohru Tsujimura; Shozo Hirota
    JOURNAL OF RADIATION RESEARCH 53 2 217 - 224 2012年03月 [査読有り]
     
    The purpose of the present study was to establish an experimental rat model for late radiation proctitis, and to examine the assessment strategy for late radiation proctitis. A total of 57 Wistar rats were used. Fourty-five of the rats were exposed to selective rectal irradiation with a single fraction of 25 Gy. These rats were sacrificed at the 4th, 12th, 24th, and 37th week following irradiation. The remaining 12 rats comprised the control group without irradiation. The rectal mucosa of each rat was evaluated macroscopically and pathologically. The number of vessels in the rectal mucosa was counted microscopically. In addition, the vascular stenosis was evaluated. In the results, the degree of clinical and macroscopic findings decreased following acute proctitis and developed later. In the pathological examination, mucosal changes and microangiopathy were followed up, as well. The absolute number of vessels in the rectum was the greatest at the 12th week following irradiation and was the lowest in the control group. The severity of the microangiopathy was also well evaluated. To conclude, we established an animal experimental model of late radiation proctitis, and also established an assessment strategy to evaluate objectively the severity of late radiation proctitis with focusing on microangiopathy using an animal experimental model. This model can be used as an animal experimental model of radiation-induced microangiopathy.
  • Doi H; Fujiwara M; Takada Y; Niwa Y; Kamikonya N; Tonooka M; Ito T; Terada T; Kakibuchi M; Hirota S
    World Journal of Surgical Medical and Radiation Oncology 1 18 91 - 96 2012年 [査読有り]
  • Doi H; Kamikonya N; Takada Y; Fujiwara M; Tsuboi K; Miura H; Inoue H; Tanooka M; Nakamura T; Shikata T; Kimura T; Tsujimura T; Hirota S
    World Journal of Oncology 3 4 173 - 181 2012年 [査読有り]
  • 井上 裕之; 田ノ岡 征雄; 土井 啓至; 三浦 英治; 中川 英雄; 酒井 敏行; 小田 雅彦; 安政 勝己; 坂本 清; 上紺屋 憲彦; 廣田 省三
    医学物理 31 1 2 - 11 (一社)日本医学物理学会 2011年08月 [査読有り]
     
    Cone-beam CTを用いた自動位置照合における治療計画用CT画像のスライス厚について検討した。被写体として、内部に球体の空気層を包含するPenta-Guideファントム、被写体辺縁での部分容積効果が大きいと思われるアクリル製球体ファントム、骨盤部の人体ファントムを使用した。スライス厚が厚い場合でも照合誤差の平均値はすべて1mm以内で、スライス厚の違いによる照合誤差は有意差を認めなかった。3種類のファントムすべてにおいてスライス厚と照合誤差の間に相関関係を認めなかった。寝台移動量別に比較しても、スライス厚と照合誤差に一定の相関関係はみられなかった。骨盤部ファントムにおいて、誤差方向による有意差を認めた。臨床例では、10mmスライス厚画像を用いた場合に、2mmスライス厚との照合結果に1mm以上の差を生じる症例があったが、ほかのスライス厚では平均0.2〜0.4mmの差であった。
  • Hiroshi Doi; Norihiko Kamikonya; Yasuhiro Takada; Masayuki Fujiwara; Keita Tsuboi; Hiroyuki Inoue; Masao Tanooka; Takeshi Nakamura; Toshiyuki Shikata; Tohru Tsujimura; Shozo Hirota
    International journal of radiation oncology, biology, physics 80 3 877 - 884 2011年07月 [査読有り]
     
    Purpose: The purpose of the present study was to standardize the experimental rat model of radiation proctitis and to examine the efficacy of polaprezinc on radiation proctitis. Methods and Materials: A total of 54 female Wistar rats (5 weeks old) were used. The rats were divided into three groups: those treated with polaprezinc (PZ+), those treated with base alone, exclusive of polaprezinc (PZ-), and those treated without any medication (control). All the rats were irradiated to the rectum. Polaprezinc was prepared as an ointment. The ointment was administered rectally each day after irradiation. All rats were killed on the 10th day after irradiation. The mucosal changes were evaluated endoscopically and pathologically. The results were graded from 0 to 4 and compared according to milder or more severe status, as applicable. Results: According to the endoscopic findings, the proportion of mild changes in the PZ+, PZ-, and control group was 71.4%, 25.0%, and 14.3% respectively. On pathologic examination, the proportion of low-grade findings in the PZ+, PZ-, and control group was 80.0%, 58.3%, and 42.9% for mucosa! damage, 85.0%, 41.7%, and 42.9% for a mild degree of inflammation, and 50.0%, 33.3%, and 4.8% for a shallow depth of inflammation, respectively. The PZ+ group tended to have milder mucosal damage than the other groups, according to all criteria used. In addition, significant differences were observed between the PZ+ and control groups regarding the endoscopic findings, degree of inflammation, and depth of inflammation. Conclusions: This model was confirmed to be a useful experimental rat model for radiation proctitis. The results of the present study have demonstrated the efficacy of polaprezinc against acute radiation-induced rectal disorders using the rat model. (c) 2011 Elsevier Inc.

書籍

  • Hiroshi Doi; Kozo Kuribayashi (担当:分担執筆範囲:Definitive radiotherapy for locally advanced non-small cell lung cancer: current status and future perspectives.)IntechOpen 2021年06月 ISBN: 9781789855760 Online first
  • 別冊日本臨牀 領域別症候群シリーズ No.14 肝・胆道系症候群（第３版）−その他の肝・胆道系疾患を含めて−肝臓編（下）
    土井啓至 (担当:分担執筆範囲:XIV その他 8.放射線肝炎)日本臨牀社 2021年02月 363-366
  • Kazuhiro Kitajima; Hiroshi Doi; Kozo Kuribayashi (担当:分担執筆範囲:18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Malignant Pleural Mesothelioma: What Is the Role in Mesothelioma Detection and Treatment Response Assessment?)Springer 2021年 ISBN: 9789811591570 352 207-221
  • 肺癌診療 虎の巻 WJOG 肺がんグループのプラクティス 初版
    土井啓至 (担当:分担執筆範囲:Ⅳ 肺癌の放射線治療 2 緩和照射.)クリニコ出版 2020年09月
  • Oral Science in Japan 2018
    Kazuhiro Kitajima; Kazuma Noguchi; Tatsuya Tsuchitani; Hiroshi Doi; Shuji Kanda; Kuniyasu Moridera; Kazuki Takaoka; Koichiro Yamakado; Hiromitsu Kishimoto (担当:分担執筆範囲:Usefulness of quantitative bone SPECT/CT for evaluating response to antibiotics therapy in patients with osteomyelitis of mandible)Japanese Stomatological Society 2019年
  • Management of Chronic Liver Diseases - Recent Advances
    Hiroshi Doi; Hiroya Shiomi; Ryoong-Jin Oh (担当:分担執筆範囲:Stereotactic body radiation therapy for hepatocellular carcinoma.)InTech 2018年07月 ISBN: 9781789234619

講演・口頭発表等

  • 進行肺癌に対するIMRT.  [招待講演]
    土井啓至
    第5回兵庫の放射線治療の未来をかたる会 2024年01月 口頭発表（招待・特別）
  • 局所進行肺癌に対する放射線治療の現状と実践  [招待講演]
    土井啓至
    Unresectable NSCLC Academy 2023年12月 その他
  • PACIFIC試験時代におけるⅢ期NSCLC根治照射の適応と治療計画.  [招待講演]
    土井啓至
    肺癌放射線治療を考える会 in 和歌山 2023年12月 その他
  • 転移性脳腫瘍の集学的治療 2) 放射線治療科の立場から  [招待講演]
    土井啓至
    転移性脳腫瘍マネジメントセミナー 2023年08月
  • 切除可能、切除不能NSCLCにおける放射線治療の役割  [招待講演]
    土井啓至
    Scientific Exchange Meeting 2023 2023年07月
  • 局所進行肺癌の放射線治療計画：IMRTを中心に  [招待講演]
    土井啓至
    第333回日本医学放射線学会関西地方会（第405回レントゲンアーベント） 2023年02月 口頭発表（招待・特別） 大阪
  • Ⅲ期非小細胞肺癌への放射線治療－近畿大学病院でのプラクティス－  [招待講演]
    土井啓至
    第12回がん放射線療法研修会. 2022年12月 公開講演，セミナー，チュートリアル，講習，講義等
  • 大腸がんの放射線療法  [招待講演]
    土井啓至
    ともに生きる会 公開セカンドオピニオン. 2022年08月 公開講演，セミナー，チュートリアル，講習，講義等
  • 切除不能Ⅲ期非小細胞肺癌治療のアップデート  [招待講演]
    土井啓至
    関西 TPS Live Seminar. 2022年06月
  • 肝がんへの定位放射線治療の役割  [招待講演]
    土井啓至
    第8回関西高精度放射線治療計画研究会 2022年02月
  • 令和時代に求められるIII期肺がんの放射線治療  [招待講演]
    土井啓至
    照射計画セミナーin関西~Ⅲ期非小細胞肺癌の根治を目指して~ 2021年04月 口頭発表（招待・特別）
  • 局所進行肺癌に対する放射線治療の現状と実践  [招待講演]
    土井啓至
    胸部放射線治療Expert Meeting in Wakayama 2020年12月
  • 免疫チェックポイント阻害剤時代におけるIII期肺癌に対する放射線治療の現状  [招待講演]
    土井啓至
    放射線治療セミナー〜局所進行非小細胞肺癌治療を考える〜 2019年11月 松山
  • III期非小細胞肺癌に対する根治的化学放射線療法  [招待講演]
    土井啓至
    肺癌治療講演会inはびきの 2019年09月 羽曳野
  • 肝臓癌に対する放射線治療の現状と役割.  [招待講演]
    土井 啓至
    第10回四国放射線治療研究ネットワークセミナー 2019年06月 口頭発表（招待・特別） 三好
  • がん診療における放射線治療の役割と近年の話題.  [招待講演]
    土井 啓至
    第74回ともに生きる会. 2019年02月 公開講演，セミナー，チュートリアル，講習，講義等 大阪狭山
  • 肝腫瘍への放射線治療の5W1H〜when, where, who, what, why, and how〜  [招待講演]
    土井 啓至
    第138回放射線治療かたろう会 2018年12月 口頭発表（招待・特別） 西宮
  • 教育講演基礎編 前立腺癌  [招待講演]
    土井 啓至
    日本放射線腫瘍学会第30回学術大会 2017年11月 大阪
  • がん診療における放射線治療の役割  [招待講演]
    土井 啓至
    医療講座「診て癒す！医療放射線の進歩」 2017年05月 西宮
  • 放射線治療の全て〜ステージIからIVまで  [招待講演]
    土井 啓至
    第17回Single Topic Seminar in 鳴尾 2016年09月 公開講演，セミナー，チュートリアル，講習，講義等 西宮
  • 放射線治療の有害事象低減を目指して-亜鉛製剤の有効性を中心に-  [招待講演]
    土井 啓至
    第49回兵庫県放射線医会総会 2014年10月 口頭発表（基調） 神戸
  • 増感剤ダリナパルシンの基礎と臨床試験の現状  [招待講演]
    土井 啓至
    第20回癌治療増感研究会 2014年06月 口頭発表（招待・特別） 高知
  • スタンフォード大学留学体験談  [招待講演]
    土井 啓至
    第5回中・四国放射線治療夏季セミナー 2013年08月 口頭発表（招待・特別） 神石郡

MISC

  • 【肝胆膵癌に対する放射線治療:2023 Update】膵癌 膵NENに対するペプチド受容体放射性核種療法(PRRT)
    細野 眞; 李 在俊; 立野 沙織; 福田 隼己; 石田 奈緒子; 植原 拓也; 稲田 正浩; 松浦 知弘; 土井 啓至; 中松 清志; 門前 一; 松尾 幸憲 肝胆膵 87 (1) 79 -84 2023年07月
  • 植原拓也; 西村恭昌; 石川一樹; 稲田正浩; 土井啓至; 松本賢治; 門前一 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 36th 2023年
  • 放射線治療とオーラルマネジメント－頭頸部放射線治療と口腔周囲有害事象を中心に－.
    土井啓至; 岸本裕充 歯界展望 136 (3) 473 -376 2020年09月 [招待有り]
  • 前立腺癌根治的切除後に行った救済的照射の治療成績
    中松 清志; 稲田 正浩; 福田 浩平; 建部 仁志; 土井 啓至; 石川 一樹; 金森 修一; 西村 恭昌 Japanese Journal of Radiology 38 (Suppl.) 34 -34 2020年02月
  • 局所進行原発性肺癌に対する化学放射線治療で重篤な合併症をきたした1例
    和田 祐太郎; 中松 清志; 植原 拓也; 阿南 慎平; 稲田 正浩; 福田 浩平; 石川 一樹; 土井 啓至; 金森 修一; 西村 恭昌 Japanese Journal of Radiology 38 (Suppl.) 44 -44 2020年02月
  • 上咽頭癌の化学放射線療法後に右内頸動脈瘤破裂を来した一例
    石川 一樹; 立野 沙織; 井上 恵理; 稲田 正浩; 土井 啓至; 中松 清志; 金森 修一; 西村 恭昌 日本癌治療学会学術集会抄録集 57回 P4 -6 2019年10月
  • 肝腫瘍への放射線治療の5W1H～when, where, who, what, why, and how～.
    土井 啓至 放射線治療かたろう会会誌 (24) 164 -174 2019年05月 [招待有り]
  • 稲田 正浩; 中松 清志; 福田 浩平; 建部 仁志; 石川 一樹; 土井 啓至; 金森 修一; 西村 恭昌 Japanese Journal of Radiology 37 (Suppl.) 43 -43 2019年02月
  • 稲田正浩; 石川一樹; 中松清志; 植原拓也; 和田祐太郎; 福田浩平; 阿南慎平; 土井啓至; 金森修一; 西村恭昌 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 32nd 56 2019年
  • weekly CBCTとDIRを用いた中咽頭癌患者のIMRTにおける解剖学的変化と線量変化
    石川 一樹; 稲田 正浩; 福田 浩平; 土井 啓至; 中松 清志; 金森 修一; 西村 恭昌 日本癌治療学会学術集会抄録集 56回 P64 -2 2018年10月
  • 慢性活動性EBウイルス感染症(CAEBV)に対し放射線治療を行った1例
    加藤 貴; 高田 康弘; 冨士原 将之; 鈴木 公美; 土井 啓至; 上紺屋 憲彦; 廣田 省三; 岡田 昌也; 小川 啓恭 Japanese Journal of Radiology 36 (Suppl.) 36 -36 2018年02月
  • 冨士原将之; 田ノ岡征雄; 石田敏久; 若山司; 小坂賢吾; 樽谷和雄; 鈴木公美; 加藤貴; 高田康弘; 土井啓至; 土井啓至; 上紺屋憲彦; 廣田省三 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 30th 62 2017年
  • 土井啓至; 土井啓至; 田ノ岡征雄; 石田敏久; 森寺邦康; 一宮賢治; 樽谷和雄; 中島浩樹; 春井章吾; 安藤新; 上野敬司; 北島一宏; 若山司; 酒井敏行; 高田康弘; 冨士原将之; 上紺屋憲彦; 岸本裕充; 廣田省三 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 30th 47 2017年
  • 肝腫瘍に対する体幹部定位放射線治療の現状と展望
    土井 啓至 明和医学誌 4 5 -20 2017年 [査読有り]
  • H. Doi; S. Matsumoto; S. Odawara; T. Shikata; M. Tanooka; K. Kitajima; Y. Takada; M. Fujiwara; T. Tsujimura; N. Kamikonya; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 96 (2) E560 -E561 2016年10月
  • 遊走脾の1例
    高田 恵広; 興津 茂行; 河 相吉; 土井 啓至; 上野 敬司 明和医学誌 3 50 -54 2016年10月 [査読有り]
  • 前立腺癌に対するVMATの有用性
    安藤 新; 春井 章吾; 中島 浩樹; 土井 啓至; 樽岡 照知 明和医学誌 3 99 -104 2016年10月 [査読有り]
  • 術前放射線化学療法にてEf3を得たが、1年以内に再発をきたした肺癌2例の検討
    中道 徹; 橋本 昌樹; 黒田 鮎美; 多久和 輝尚; 松本 成司; 近藤 展行; 長谷川 誠紀; 塚本 吉胤; 土井 啓至; 富山 憲一 肺癌 56 (2) 142 -143 2016年04月
  • H. Doi; S. Odawara; T. Shikata; H. Suzuki; Y. Niwa; M. Tanooka; K. Kosaka; K. Tarutani; Y. Takada; M. Fujiwara; N. Kamikonya; T. Tsujimura; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 93 (3) E532 -E532 2015年11月
  • 寺田 友紀; 宇和 伸浩; 佐川 公介; 毛利 武士; 野口 一馬; 冨士原 将之; 土井 啓至; 阪上 雅史 日本耳鼻咽喉科学会会報 118 (4) 560 -560 2015年04月
  • S. Odawara; H. Doi; T. Tsujimura; T. Shikata; H. Suzuki; K. Kosaka; H. Inoue; M. Tanooka; Y. Takada; Y. Niwa; M. Fujiwara; N. Kamikonya; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 90 S782 -S782 2014年09月
  • 直腸癌に対する化学療法併用短期加速過分割放射線治療の短期成績
    土井 啓至; 別府 直仁; 柳 秀憲; 上紺屋 憲彦; 廣田 省三 臨床放射線 59 (9) 1196 -1202 2014年09月 [招待有り]
  • 鼻腔原発悪性腫瘍の臨床的検討
    宇和 伸浩; 寺田 友紀; 佐川 公介; 毛利 武士; 貴田 紘太; 土井 啓至; 冨士原 将之; 石蔵 礼一; 阪上 雅史 頭頸部癌 40 (2) 246 -246 2014年05月
  • 木村 文彦; 柳 秀憲; 後野 礼; 竹中 雄也; 堀尾 勇規; 北濱 誠一; 小野 朋二郎; 友松 宗史; 別府 直仁; 飯田 洋也; 生田 真一; 岸本 昌浩; 相原 司; 土井 啓至; 上紺屋 憲彦; 山中 若樹 臨床外科 69 (3) 299 -306 2014年03月
  • Naohito Beppu; Hidenori Yanagi; Naoki Yamanaka; Hiroshi Doi; Norihiko Kamikonya; Masafumi Noda; Naohiro Tomita JOURNAL OF CLINICAL ONCOLOGY 32 (3) 2014年01月
  • 木村 文彦; 柳 秀憲; 後野 礼; 竹中 雄也; 堀尾 勇規; 北濱 誠一; 小野 朋二郎; 友松 宗史; 別府 直仁; 飯田 洋也; 生田 真一; 岸本 昌浩; 相原 司; 土井 啓至; 上紺屋 憲彦; 山中 若樹 癌の臨床 59 (6) 681 -686 2013年12月
  • 頭頸部癌放射線治療に伴う甲状腺機能低下に関する検討
    冨士原 将之; 上紺屋 憲彦; 小田原 聡一; 土井 啓至; 高田 康弘; 寺田 友紀; 宇和 伸浩; 佐川 公介; 廣田 省三 日本癌治療学会誌 48 (3) 1533 -1533 2013年09月
  • 前立腺癌に対するMonaco-VMATの初期経験
    冨士原 将之; 上紺屋 憲彦; 土井 啓至; 田ノ岡 征雄; 井上 裕之; 三浦 英治; 高田 康弘; 廣田 省三; 中川 英雄; 酒井 敏行; 石丸 芙美子; 小田 雅彦 Japanese Journal of Radiology 31 (Suppl.I) 46 -46 2013年02月
  • 低用量アスピリンは放射線粘膜障害を増悪するか? 動物実験モデルでの検討
    土井 啓至; 上紺屋 憲彦; 高田 康弘; 冨士原 将之; 井上 裕之; 田ノ岡 征雄; 三浦 英治; 廣田 省三; 中村 豪志; 志方 敏幸; 木村 健; 辻村 亨 Japanese Journal of Radiology 31 (Suppl.I) 52 -52 2013年02月
  • 骨悪性腫瘍に対する術中体外照射法を用いた自家骨移植の検討
    高田 康弘; 小田原 聡一; 土井 啓至; 丹羽 康江; 冨士原 将之; 三浦 英治; 井上 裕之; 坪井 慶太; 上紺屋 憲彦; 廣田 省三 日本医学放射線学会学術集会抄録集 72回 S401 -S402 2013年02月
  • テープ材によるビルドアップ効果と相反する皮膚反応を呈した臨床経験の報告
    丹羽 康江; 田ノ岡 征雄; 小田原 聡一; 土井 啓至; 高田 康宏; 冨士原 将之; 酒井 敏行; 和泉 正幸; 上紺屋 憲彦; 廣田 省三 日本医学放射線学会学術集会抄録集 72回 S408 -S408 2013年02月
  • M. Tanooka; H. Inoue; H. Doi; H. Miura; Y. Takada; M. Fujiwara; F. Ishimaru; K. Sakamoto; N. Kamikonya; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 84 (3) S747 -S748 2012年11月
  • M. Fujiwara; N. Kamikonya; M. Tanooka; H. Miura; H. Doi; Y. Takada; T. Terada; N. Uwa; K. Sagawa; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 84 (3) S520 -S520 2012年11月
  • 頭頸部癌に対する放射線治療後の甲状腺機能障害に関する検討
    冨士原 将之; 上紺屋 憲彦; 土井 啓至; 高田 康弘; 寺田 友紀; 宇和 伸浩; 佐川 公介; 廣田 省三 頭頸部癌 38 (2) 188 -188 2012年05月
  • 三浦英治; 冨士原将之; 田ノ岡征雄; 土井啓至; 井上裕之; 高田康弘; 上紺屋憲彦; 廣田省三 医学物理 Supplement 32 (1) 151 2012年04月
  • 頭頸部放射線治療の補助療法としての亜鉛含嗽液の有用性
    冨士原 将之; 上紺屋 憲彦; 土井 啓至; 高田 康弘; 田ノ岡 征雄; 井上 裕之; 廣田 省三; 志方 敏幸; 中山 雅裕; 木村 健 Japanese Journal of Radiology 30 (Suppl.I) 51 -51 2012年02月
  • 当院における前立腺癌放射線治療後の直腸障害に関する検討
    高田 康弘; 土井 啓至; 冨士原 将之; 田ノ岡 正雄; 井上 裕之; 三浦 英治; 坪井 慶太; 和泉 正幸; 上紺屋 憲彦; 廣田 省三 日本医学放射線学会学術集会抄録集 71回 S335 -S335 2012年02月
  • 放射線腫瘍学と私.
    土井啓至 JASTRO Newsletter 106 38 -39 2012年 [招待有り]
  • H. Inoue; M. Tanooka; E. Miura; H. Doi; Y. Takada; M. Fujiwara; K. Yasumasa; K. Sakamoto; N. Kamikonya; S. Hirota EUROPEAN JOURNAL OF CANCER 47 S193 -S193 2011年09月
  • 高田 康弘; 土井 啓至; 冨士原 将之; 田ノ岡 征雄; 井上 裕之; 坪井 慶太; 上紺屋 憲彦; 廣田 省三; 上田 康生; 山本 新吾 臨床放射線 56 (7) 878 -883 2011年07月 [査読有り]
  • 当院における骨転移に対する緩和放射線治療の傾向と分析
    高田 康弘; 土井 啓至; 冨士原 将之; 田ノ岡 征雄; 井上 裕之; 三浦 英治; 坪井 慶太; 上紺屋 憲彦; 廣田 省三; 村川 和重 日本緩和医療学会学術大会プログラム・抄録集 16回 266 -266 2011年06月
  • 上紺屋 憲彦; 土井 啓至; 冨士原 将之 口腔・咽頭科 24 (1) 29 -34 2011年03月 [招待有り]
  • 直腸への選択的放射線照射ラットの長期自然経過とその病理組織学的検討
    土井 啓至; 井上 裕之; 田ノ岡 征雄; 三浦 英治; 上紺屋 憲彦; 高田 康弘; 冨士原 将之; 中村 豪志; 辻村 亨; 廣田 省三 日本医学放射線学会学術集会抄録集 70回 S349 -S349 2011年02月
  • 当院における前立腺癌全摘術後の救済放射線治療に関する検討
    高田 康弘; 土井 啓至; 冨士原 将之; 田ノ岡 征雄; 井上 裕之; 坪井 慶太; 和泉 正幸; 上紺屋 憲彦; 廣田 省三; 山本 新吾 日本医学放射線学会学術集会抄録集 70回 S367 -S368 2011年02月
  • H. Inoue; M. Tanooka; H. Doi; E. Miura; Y. Takada; M. Fujiwara; K. Yasumasa; K. Sakamoto; N. Kamikonya; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 81 (2) S774 -S775 2011年
  • 当院における前立腺癌I-125密封小線源治療の経験と現状
    高田 康弘; 土井 啓至; 冨士原 将之; 上紺屋 憲彦; 廣田 省三; 上田 康生; 樋口 喜秀; 山本 新吾; 島 博基 Japanese Journal of Radiology 29 (Suppl.I) 43 -43 2011年01月
  • 放射線性直腸炎に対する亜鉛製剤経直腸投与が有効であった症例
    土井 啓至; 井上 裕之; 田ノ岡 征雄; 上紺屋 憲彦; 高田 康弘; 冨士原 将之; 坪井 慶太; 廣田 省三; 志方 敏幸; 濱口 常男; 門林 宗男 Japanese Journal of Radiology 29 (Suppl.I) 48 -48 2011年01月
  • 呼吸同期ヘリカルスキャンにおけるヘッドマウントディスプレイを用いた呼吸ナビゲーションシステムの開発
    田ノ岡 征雄; 井上 裕之; 酒井 敏行; 中川 英雄; 小田 雅彦; 平山 伸一; 安政 勝己; 坂本 清; 土井 啓至; 高田 康弘; 冨士原 将之; 上紺屋 憲彦 日本放射線技術学会近畿部会雑誌 16 (2) 37 -39 2010年10月
  • 志方 敏幸; 中村 豪志; 日笠 真一; 濱口 常男; 土井 啓至; 上紺屋 憲彦; 門林 宗男; 木村 健 医療薬学 36 (8) 549 -556 2010年08月 [査読有り]
  • 聴器癌に対する超選択的動注化学療法併用放射線治療の治療成績
    冨士原 将之; 山本 聡; 土井 啓至; 高田 康弘; 石藏 礼一; 上紺屋 憲彦; 寺田 友紀; 佐伯 暢生; 宇和 伸浩; 廣田 省三 頭頸部癌 36 (2) 173 -173 2010年05月
  • Hiroshi Doi; N. Kamikonya; Y. Takada; M. Fujiwara; K. Tsuboi; H. Inoue; M. Tanooka; S. Hirota; T. Nakamura; T. Shikata; T. Hamaguchi Japanese Journal of Clinical Radiology 55 443 -449 2010年03月
  • 土井 啓至; 上紺屋 憲彦; 高田 康弘; 冨士原 将之; 坪井 慶太; 井上 裕之; 田ノ岡 征雄; 中村 豪志; 志方 敏幸; 濱口 常男; 廣田 省三 臨床放射線 55 (3) 443 -449 2010年03月 [査読有り]
  • 動物実験モデルでの急性期放射線性直腸炎への亜鉛製剤の有効性
    土井 啓至; 井上 裕之; 田ノ岡 征雄; 上紺屋 憲彦; 高田 康弘; 冨士原 将之; 中村 豪志; 志方 敏幸; 山本 泰子; 廣田 省三 日本医学放射線学会学術集会抄録集 69回 S191 -S191 2010年02月
  • 当院におけるハイリスク膀胱癌症例に対する動注化学療法併用放射線治療の現状と検討
    高田 康弘; 土井 啓至; 冨士原 将之; 田ノ岡 征雄; 井上 裕之; 坪井 慶太; 和泉 正幸; 谷口 緑; 上紺屋 憲彦; 廣田 省三 日本医学放射線学会学術集会抄録集 69回 S194 -S194 2010年02月
  • H. Doi; N. Kamikonya; Y. Takada; M. Fujiwara; H. Inoue; M. Tanooka; T. Nakamura; T. Shikata; T. Tsujimura; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 78 (3) S635 -S636 2010年
  • M. Tanooka; T. Sakai; H. Inoue; H. Doi; Y. Takada; M. Fujiwara; K. Yasumasa; K. Sakamoto; N. Kamikonya; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 78 (3) S769 -S769 2010年
  • H. Inoue; M. Tanooka; H. Doi; M. Oda; Y. Takada; M. Fujiwara; K. Yasumasa; K. Sakamoto; N. Kamikonya; S. Hirota INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS 78 (3) S765 -S765 2010年
  • 冨士原 将之; 山本 聡; 土井 啓至; 高田 康弘; 石藏 礼一; 上紺屋 憲彦; 寺田 友紀; 佐伯 暢生; 宇和 伸浩; 廣田 省三 頭頸部癌 36 (4) 473 -477 2010年
  • 土井 啓至; 上紺屋 憲彦; 高田 康弘; 冨士原 将之; 井上 裕之; 田ノ岡 征雄; 坪井 慶太; 志方 敏幸; 濱口 常男; 門林 宗男; 廣田 省三 日本放射線腫瘍学会誌 21 (3-4) 149 -154 2009年12月
  • 志方 敏幸; 中村 豪志; 日笠 真一; 濱口 常男; 門林 宗男; 土井 啓至; 上紺屋 憲彦 日本医療薬学会年会講演要旨集 19 424 -424 2009年09月
  • 上紺屋憲彦; 土井啓至; 田ノ岡征雄; 井上裕之; 高田康弘; 冨士原将之; 廣田省三 日本癌治療学会誌 44 (2) 332 2009年09月
  • 冨士原将之; 山本聡; 野口一馬; 森寺邦康; 土井啓至; 高田康弘; 石藏礼一; 上紺屋憲彦; 浦出雅裕; 廣田省三 日本放射線腫瘍学会誌 21 (Supplement 1) 217 2009年08月
  • 土井啓至; 井上裕之; 田ノ岡征雄; 上紺屋憲彦; 高田康弘; 冨士原将之; 志方敏幸; 濱口常男; 門林宗男; 廣田省三 日本放射線腫瘍学会誌 21 (Supplement 1) 127 2009年08月
  • 高田康弘; 土井啓至; 冨士原将之; 田ノ岡征雄; 井上裕之; 坪井慶太; 和泉正幸; 小田雅彦; 上紺屋憲彦; 廣田省三 日本放射線腫瘍学会誌 21 (Supplement 1) 196 2009年08月
  • Image Analysis Software Next Advances 次世代の画像解析ソフトウェア ポータルイメージ-DRR自動照合ソフトウェアの開発
    井上 裕之; 田ノ岡 征雄; 中川 英雄; 酒井 敏行; 小田 雅彦; 平山 伸一; 安政 勝己; 坂本 清; 土井 啓至; 冨士原 将之; 高田 康弘; 上紺屋 憲彦; 廣田 省三 INNERVISION 24 (6付録) 22 -23 2009年05月
  • 頭頸部癌に対する動注化学療法併用放射線療法における局所効果の差
    冨士原 将之; 山本 聡; 土井 啓至; 高田 康弘; 石藏 礼一; 上紺屋 憲彦; 廣田 省三; 森寺 邦康; 野口 一馬; 寺田 友紀 頭頸部癌 35 (2) 102 -102 2009年05月
  • 前立腺癌小線源治療における線源確認のためのMIP画像の有用性
    高田 康弘; 田ノ岡 征雄; 土井 啓至; 井上 裕之; 冨士原 将之; 上紺屋 憲彦; 坪井 慶太; 和泉 正幸; 中川 英雄; 廣田 省三 日本医学放射線学会学術集会抄録集 68回 S223 -S223 2009年02月
  • 放射線性直腸粘膜障害評価用の動物実験モデル作成と亜鉛製剤投与
    土井 啓至; 井上 裕之; 上紺屋 憲彦; 高田 康弘; 冨士原 将之; 入江 美和; 小田 雅彦; 濱口 常男; 門林 宗男; 廣田 省三 日本医学放射線学会学術集会抄録集 68回 S314 -S314 2009年02月
  • 次世代の画像解析ソフトウェア ポータルイメージ-DRR 自動照合ソフトウェアの開発
    井上 裕之; 田ノ岡 征雄; 中川 英雄; 酒井 敏行; 小田 雅彦; 平山 伸一; 安政 勝己; 坂本 清; 土井 啓至; 冨士原 将之; 高田 康弘; 上紺屋 憲彦; 廣田 省三 INNERVISION 24 (2) 106 -107 2009年01月
  • 土井啓至; 井上裕之; 上紺屋憲彦; 高田康弘; 冨士原将之; 坪井慶太; 田ノ岡征雄; 中川英雄; 小田雅彦; 廣田省三 日本放射線腫瘍学会誌 20 (Supplement 1) 183 2008年09月
  • 高田康弘; 田ノ岡征雄; 土井啓至; 井上裕之; 冨士原将之; 上紺屋憲彦; 坪井慶太; 和泉正幸; 小田雅彦; 廣田省三 日本放射線腫瘍学会誌 20 (Supplement 1) 195 2008年09月
  • 冨士原将之; 土井啓至; 井上裕之; 中川英雄; 田ノ岡征雄; 小田雅彦; 平山伸一; 高田康弘; 上紺屋憲彦; 廣田省三 日本放射線腫瘍学会誌 20 (Supplement 1) 174 2008年09月
  • 田ノ岡征雄; 酒井敏行; 中川英雄; 小田雅彦; 平山伸一; 井上裕之; 土井啓至; 高田康弘; 冨士原将之; 上紺屋憲彦 日本放射線腫瘍学会誌 20 (Supplement 1) 258 2008年09月
  • 井上裕之; 田ノ岡征雄; 土井啓至; 中川英雄; 小田雅彦; 平山伸一; 高田康弘; 冨士原将之; 上紺屋憲彦; 廣田省三 日本放射線腫瘍学会誌 20 (Supplement 1) 260 2008年09月
  • 中村 豪志; 辰見 明俊; 久保田 明花; 多河 典子; 小林 吉晴; 井上 千亜紀; 田中 邦佳; 日笠 真一; 濱口 常男; 上紺屋 憲彦; 土井 啓至; 廣田 省三; 門林 宗男 日本医療薬学会年会講演要旨集 18 437 -437 2008年09月

受賞

  • 2022年07月 近畿大学医学会 近畿大学医学会賞
     Escalated Maximum Dose in the Planning Target Volume Improves Local Control in Stereotactic Body Radiation Therapy for T1-2 Lung Cancer. Cancers (Basel). 14(4):933, 2022 
    受賞者: 土井啓至
  • 2020年07月 近畿大学医学会 近畿大学医学会賞
     Stereotactic body radiotherapy in patients with chronic obstructive pulmonary disease and interstitial pneumonia: a review. Int J Clin Oncol, 24(8):899-909, 2019 
    受賞者: 土井 啓至
  • 2020年02月 The 3rd International Cancer Research Symposium Best Performance Award
     
    受賞者: 土井 啓至
  • 2018年02月 International Institute of Anticancer Research 'Exceptional Quality Paper'
     Stereotactic Body Radiation Therapy for Liver Tumors: Current Status and Perspectives 
    受賞者: 土井 啓至
  • 2018年01月 医療法人明和病院 明和医学誌最優秀論文賞
     肝腫瘍に対する体幹部定位放射線治療の現状と展望. 
    受賞者: 土井 啓至
  • 2011年11月 日本放射線腫瘍学会 優秀演題賞
     低用量アスピリンの放射線直腸炎への影響－動物実験モデルにおける検討－ 
    受賞者: 土井 啓至
  • 2008年10月 日本放射線腫瘍学会 ポスター賞
     動物実験モデルによる放射線直腸障害に対する亜鉛製剤の有効性の検討 
    受賞者: 土井 啓至

共同研究・競争的資金等の研究課題

  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2024年04月 -2027年03月 
    代表者 : 土井 啓至; 南 俊行; 立野 沙織
  • 日本学術振興会：科学研究費助成事業
    研究期間 : 2023年04月 -2026年03月 
    代表者 : 門前 一; 土井 啓至; 久保 和輝
  • 臨床的グリオーマ実験モデルを用いた放射線脳壊死関連マクロファージの機能解析
    日本学術振興会
    研究期間 : 2022年04月 -2025年03月 
    代表者 : 中松 清志; 土井 啓至: 李 在俊; 藤田 貢
  • 間質性肺炎合併放射線肺臓炎モデルの確立と吸入ステロイド薬の放射線防護効果の証明
    日本学術振興会：
    研究期間 : 2022年04月 -2025年03月 
    代表者 : 立野 沙織; 土井 啓至
  • 深層学習の手法を用いた肺癌に対する新規強度変調放射線治療計画システムの開発
    日本学術振興会：基盤研究(C)
    研究期間 : 2020年04月 -2023年03月 
    代表者 : 土井 啓至; 門前 一
  • 臨床的グリオーマ実験モデルを使用した放射線脳壊死への免疫応答の解明
    日本学術振興会：基盤研究(C)
    研究期間 : 2019年04月 -2022年03月 
    代表者 : 中松 清志; 土井 啓至; 藤田 貢
  • 鉛を含まない放射線遮蔽材を用いた新規放射線治療法の開発
    日本学術振興会：基盤研究(C)
    研究期間 : 2019年04月 -2022年03月 
    代表者 : 門前 一; 吉田 謙; 松本 賢治; 土井 啓至; 田村 命; 花岡 宏平; 秋山 広徳
  • 早期非小細胞肺癌に対する体幹部定位放射線治療量増加ランダム化比較試験
    日本医療研究開発機構（AMED）：革新的がん医療実用化研究事業
    研究期間 : 2017年12月 -2020年03月 
    代表者 : 永田 靖
  • 放射線治療後再発に対する再照射実験モデルの確立−放射線感受性と生体応答の検証−
    日本学術振興会：若手研究（B）
    研究期間 : 2017年04月 -2020年03月 
    代表者 : 土井 啓至
  • 悪性胸膜中皮腫の癌幹細胞を標的としたStat3阻害治療(START)に関する研究
    日本学術振興会：基盤研究(C)
    研究期間 : 2016年04月 -2019年03月 
    代表者 : 松本 成司; 長谷川 誠紀; 近藤 展行; 多久和 輝尚; 土井 啓至
  • 細胞周期を標的としたCDK阻害剤による分子標的治療法の開発
    日本学術振興会：基盤研究(C)
    研究期間 : 2015年04月 -2018年03月 
    代表者 : 橋本 昌樹; 長谷川 誠紀; 近藤 展行; 松本 成司; 多久和 輝尚; 黒田 鮎美; 中道 徹; 土井 啓至
  • 放射線増感剤・防護剤併用による放射線直腸粘膜障害の予防−酸素と亜鉛の功罪解明−
    日本学術振興会：基盤研究(C)
    研究期間 : 2015年04月 -2018年03月 
    代表者 : 上紺屋 憲彦; 土井 啓至; 丹羽 康江; 高木 治行; 高田 康弘; 冨士原 将之; 廣田 省三
  • ポリマーゲル線量計を用いた放射線治療における金属の影響解析
    日本学術振興会：基盤研究(C)
    研究期間 : 2015年04月 -2018年03月 
    代表者 : 冨士原 将之; 上紺屋 憲彦; 高田 康弘; 土井 啓至; 丹羽 康江; 廣田 省三
  • 頭頸部放射線治療における口腔内装置の開発と有効性の評価
    公益財団法人兵庫県健康財団：がん研究奨励賞
    研究期間 : 2016年04月 -2017年03月 
    代表者 : 土井 啓至
  • 新規放射線防護材としてのスタチンの可能性と肥満が及ぼす影響
    日本学術振興会：若手研究(B)
    研究期間 : 2013年04月 -2016年03月 
    代表者 : 土井 啓至
  • Polaprezinc Reduces Radiation Induced Apoptosis in Normal Intestine and the Severity of Radiation Dermatitis in Mice（米国放射線腫瘍学会（ASTRO)第57回年次会）
    学校法人兵庫医科大学：若手研究者海外発表助成
    研究期間 : 2015年10月 
    代表者 : 土井 啓至
  • ハイリスク放射線治療患者での直腸粘膜障害の予防と治療ー亜鉛製剤の設計と評価ー
    日本学術振興会：基盤研究(C)
    研究期間 : 2012年04月 -2015年03月 
    代表者 : 上紺屋 憲彦; 冨士原 将之; 高田 康弘; 土井 啓至; 前田 弘彰; 廣田 省三; 丹羽 康江
  • 日本学術振興会：基盤研究(C)
    研究期間 : 2009年04月 -2012年03月 
    代表者 : 上紺屋 憲彦; 冨士原 将之; 高田 康弘; 廣田 省三; 前田 弘彰; 小林 薫; 山本 聡; 土井 啓至
     
    現在までの成果は、放射線直腸障害動物実験モデルの確立と亜鉛製剤の作成・評価がなされた。実験動物よる放射線直腸障害モデルは、麻酔下ラットに陽性造影剤注腸し倒立位にて腸管の下垂と直腸照射範囲の設定を確認でき、外科的処置を行うことなく、直腸に選択的に照射可能とした。照射後変化は内視鏡にて経時的に評価可能である。亜鉛化合物の設計、製剤化は、亜鉛化合物として亜鉛-Lカルノシン錯化合物、透視にて拡散・付着性の検討、白色ワセリン・ラノリン基剤とした軟膏とし、注射器にて肛門より無麻酔下にて確実に投与可能となった。

委員歴

  • 2021年05月 - 現在   Oncology Letters   Editorial Board
  • 2020年02月 - 現在   日本癌治療学会   編集委員会, 専門委員
  • 2020年02月 - 現在   International Journal of Clinical Oncology   Deputy Editor
  • 2019年04月 - 現在   Journal of Thoracic Disease   Editorial Board Member
  • 2018年01月 - 現在   World Journal of Gastrointestinal Oncology   Editorial Board

その他

  • 2019年04月 - 2020年03月  放射線治療後再発に対する再照射の実験モデルの確立と生体応答の解明 
    近畿大学学内研究助成金 研究種目:奨励研究助成金 課題番号:SR11 研究内容:放射線照射部位への再照射の実験モデルを確立させ、生体応答の検証を行った。

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