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• Deterioration of Performance Status during Palliative Radiotherapy Suggests a Significant Short Survival Duration: Indicating the Necessities for Considering Radiotherapy Discontinuation

  Maemoto, H; Kushi, K; Owan, I; Ariga, T; Heianna, J; Nishie, A

  CURRENT ONCOLOGY ( Current Oncology )  31 ( 4 ) 1752 - 1761   2024.04 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  Discontinuation of palliative radiotherapy due to a patient's declining general condition poses a clinical dilemma for palliative care physicians. This study aimed to investigate the survival duration of patients whose performance status (PS) deteriorated during palliative radiotherapy and inform decisions regarding early treatment discontinuation. We retrospectively analyzed data from patients referred from our institute's palliative care department who underwent ≥10 fractions of palliative radiotherapy between March 2017 and December 2021. PS was assessed using the Eastern Cooperative Oncology Group (ECOG) scale. Survival duration was calculated from the final day of palliative radiotherapy to death using the Kaplan-Meier method. A total of 35 patients underwent palliative radiotherapy. Seven (20%) experienced deterioration in ECOG PS during treatment. Their median survival duration was significantly shorter at 22 days (95% confidence interval: 1-94 days) compared to 125 days (95% confidence interval: 82-150 days) for the 28 patients whose PS remained stable (p = 0.0007). Deterioration in ECOG PS during palliative radiotherapy signifies a markedly shorter survival duration. Careful assessment of a patient's condition throughout treatment is crucial, and early discontinuation should be considered if their general health worsens rather than strictly adhering to the initial schedule.

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• Definitive radiotherapy consisting of external beam radiotherapy without central shielding and 3D image-guided brachytherapy for patients with cervical cancer: feasibility for Japanese patients and dose-response analyses for local control in the low-dose range

  Toita Takafumi, Wada Kentaro, Sutani Shinya, Umezawa Rei, Maemoto Hitoshi, Ii Noriko, Kawamura Tomoko, Ikushima Hitoshi, Takenaka Ryosuke, Konishi Koji, Yorozu Atsunori, Jingu Keiichi, Ariga Takuro, Nomoto Yoshihito, Yamashita Hideomi

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY ( Japanese Journal of Clinical Oncology )  53 ( 6 ) 480 - 488   2023.06 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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• Therapeutic efficacy of selective intraarterial chemoradiotherapy with docetaxel and nedaplatin for human papilloma virus-negative oropharyngeal cancer.

  Heianna J, Makino W, Hirakawa H, Agena S, Tomita H, Ariga T, Ishikawa K, Takehara S, Kusada T, Maemoto H, Maeda H, Murayama S

  Auris, nasus, larynx ( Auris Nasus Larynx )  49 ( 3 ) 468 - 476   2022.06 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  OBJECTIVE: Human papilloma virus-negative oropharyngeal cancer has not achieved satisfactory outcomes compared with those of human papilloma virus-positive oropharyngeal cancer. This study evaluated the therapeutic efficacy of selective intraarterial chemoradiotherapy with the docetaxel and nedaplatin regimen for human papilloma virus-negative oropharyngeal cancer. METHODS: Twenty-two consecutive patients with human papilloma virus-negative oropharyngeal cancer who had undergone selective intraarterial chemoradiotherapy were retrospectively analyzed. The primary tumor and whole neck were irradiated (50 Gy). Subsequently, the primary site and metastatic lymph nodes were boosted by 20 Gy. The intraarterial chemotherapy regimen comprised a combination of nedaplatin (80 mg/m2) and docetaxel (60 mg/m2), which was initially administered at the start of radiotherapy and was given every 4 weeks for three sessions. Each intraarterial dose of an anticancer agent was determined according to the percentage of the tumor volume supplied by the target artery to the total tumor volume, which was intraoperatively measured via cone-beam computed tomography. The outcome measures were locoregional control, disease-free survival, and overall survival rates and adverse events. Statistical analyses were performed using the Kaplan-Meier method. RESULTS: The median follow-up period was 59 (range, 15-103) months. The T stage was T1/T2 in 5 patients (23%), T3 in 5 patients (23%), and T4 in 12 patients (54%). Cervical lymph node metastasis was staged as ≥N2c in 7 (32%) patients. Complete response was achieved in all patients at the first imaging examination after intraarterial chemoradiotherapy. The 5-year locoregional control, disease-free survival, and overall survival rates were 96% (95% confidence interval, 0.72-0.99), 91% (95% confidence interval, 0.68-0.98), and 100% (95% confidence interval, not available), respectively. Regarding serious acute adverse events, grade 4 laryngeal edema and leukopenia were observed in 1 (5%) and 11 patients (50%), respectively. No other serious acute adverse events were observed. CONCLUSION: Selective intraarterial chemoradiotherapy with docetaxel and nedaplatin has the potential to achieve favorable locoregional control, disease-free survival, and overall survival rates in human papilloma virus-negative oropharyngeal cancer.

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• Small dose of oral gastrografin for computed tomography-based image-guided brachytherapy in patients with uterine cervical cancer.

  Maemoto H, Ogura T, Toita T, Ariga T, Hashimoto S, Kawakami Y, Ishikawa K, Takehara S, Heianna J, Kudaka W, Aoki Y, Nishie A

  Journal of radiation research ( Oxford University Press (OUP) )  63 ( 1 ) 107 - 114   2022.01 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  <title>Abstract</title> Oral administration of a water-soluble iodine contrast agent (gastrografin) was reported to assist in the appropriate contouring of the small intestine on computed tomography (CT)-based radiotherapy (RT) planning. The efficacy and optimal dose of gastrografin in CT-based image-guided brachytherapy (IGBT) for cervical cancer remain unknown. This study aimed to investigate the efficacy of pretreatment oral administration of gastrografin at a small dose of 50 ml in CT-based IGBT for cervical cancer. A total of 422 sessions in 137 patients who underwent CT-based IGBT with 50 ml of oral gastrografin (concentration, 3% or 4%) were analyzed. Preparation of gastrografin was judged as effective when the small intestine was contrast-enhanced at the area where the small intestine was in contact with the uterus/adnexa. About 287 out of 422 sessions (68%) were judged as effective with gastrografin preparation. The 135 ineffective sessions were considered as follows: (i) the contrast enhancement of the small intestine was not confirmed (n = 36), (ii) the small intestine was not in contact with the uterus/adnexa despite the confirmation of the contrast enhancement of the small intestine (n = 34), and (iii) gastrografin was absent in the small intestine at the area in contact with the uterus/adnexa, even when gastrografin was observed in the small intestine at the area not in contact with the uterus/adnexa (n = 65). In conclusion, pretreatment oral administration of a small dose gastrografin achieved moderate efficacy for accurate contouring of the small intestine close to the uterus/adnexa in CT-based IGBT for cervical cancer.

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• Patterns of recurrence after low-dose postoperative radiotherapy for head and neck squamous cell carcinoma.

  Makino W, Heianna J, Ishikawa K, Kusada T, Maemoto H, Ariga T, Matayoshi A, Nakasone T, Hirakawa H, Agena S, Yamashita Y, Maeda H, Murayama S

  Journal of the Egyptian National Cancer Institute ( Journal of the Egyptian National Cancer Institute )  33 ( 1 ) 40   2021.12 [ Peer Review Accepted ]

  Type of publication: Research paper (scientific journal)

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  <title>Abstract</title><sec> <title>Background</title> Postoperative chemoradiotherapy is recommended for patients with head and neck squamous cell carcinoma with positive margins or extracapsular extension at high risk of recurrence. However, high-dose radiotherapy in the head and neck region often causes severe acute and late radiation-related adversities. In our institution, the radiation dose has been relatively lower than that used in Western countries to reduce radiation-related toxicities. Therefore, in this study, we examined the treatment outcomes of low-dose postoperative chemoradiotherapy. </sec><sec> <title>Methods</title> The outcomes of 90 consecutive head and neck squamous cell carcinoma patients who received postoperative radiotherapy between June 2009 and December 2016 were retrospectively analyzed. All patients received postoperative three-dimensional conformal radiotherapy with or without concurrent systemic chemotherapy. The median patient age was 65 years. Concurrent chemoradiotherapy was administered at a total dose of 50.4 Gy in 28 fractions (daily fraction, 1.8 Gy). High-risk patients received 10.8 Gy of boost irradiation in six fractions. For radiotherapy alone, the irradiation dose was up to 54 Gy in 30 fractions and 64.8 Gy in 36 fractions for high-risk patients to increase the treatment intensity. </sec><sec> <title>Results</title> The median follow-up period was 40.5 months. The 3-year locoregional control and overall survival rates were 67.5% and 82.7%, respectively. A significantly higher proportion of patients with oral cavity carcinoma experienced locoregional failure (<italic>p</italic> = 0.004). The acute adverse events were mild, and the only late adverse event was grade 3 dysphagia (<italic>n</italic> = 3). </sec><sec> <title>Conclusion</title> This study suggests that de-escalation of the postoperative radiation dose can potentially reduce the severe adverse events of irradiation in patients while ensuring its effectiveness. In patients with oral cavity carcinoma, it might be necessary to increase the radiation dose. </sec>

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• 頭頸・口腔 頭頸部がんに対する治療戦略 進行副鼻腔癌に対する超選択的動注化学放射線療法の初期治療経験

  平安名 常一, 戸板 孝文, 有賀 拓郎, 前本 均, 安座間 喜明, 伊良波 裕子, 村山 貞之, 真栄田 裕之, 安慶名 信也, 上原 貴行, 山下 懐, 鈴木 幹男

  日本癌治療学会学術集会抄録集 ( (一社)日本癌治療学会 )  54回   WS80 - 6   2016.10

   

• 進行副鼻腔癌に対する超選択的動注化学放射線療法の初期治療経験

  平安名 常一, 安座間 喜明, 伊良波 裕子, 有賀 拓郎, 前本 均, 橋本 成司, 戸板 孝文, 村山 貞之, 真栄田 裕行, 上原 貴行, 山下 懐, 鈴木 幹男

  IVR: Interventional Radiology ( (一社)日本インターベンショナルラジオロジー学会 )  31 ( Suppl. ) 129 - 129   2016.04

   

Grant-in-Aid for Scientific Research 【 display / non-display 】

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• Grant-in-Aid for Scientific Research(C)

  Project Year: 2019.04  -  2023.03 

  Direct: 3,300,000 (YEN)  Overheads: 4,290,000 (YEN)  Total: 990,000 (YEN)

• Development of optimal radiotherapy protocols for cervical cancer patients with highly precise radiotherapy

  Grant-in-Aid for Scientific Research(C)

  Project Year: 2016.04  -  2019.03 

  Investigator(s): Toita Takafumi 

  Direct: 3,600,000 (YEN)  Overheads: 4,680,000 (YEN)  Total: 1,080,000 (YEN)

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  We investigated interfraction uterine motion using treatment planning CT and cone beam CT (CBCT) to determined the predictive factors affecting uterine movement during external beam RT for patients with cervical cancer treated with definitive RT. We evaluated the oncologic outcomes and complications of cervical cancer patients in terms of CT-based 3D-image-guided brachytherapy parameters. We performed national survey and demonstrated present status of 3D-IGBT for cervical cancer in Japan. We achieved final results of a prospective clinical study of definitive RT consisting of 3D-CRT with no CS and 3D-IGBT for 40 patients with cervical cancer.