白石 悠 (シライシ ユタカ)

Shiraishi, Yutaka

写真a

所属(所属キャンパス)

医学部 放射線科学教室(治療) (信濃町)

職名

専任講師(有期)

経歴 【 表示 / 非表示

  • 2004年05月
    -
    2006年04月

    国立病院機構東京医療センター, 初期臨床研修医

  • 2006年05月
    -
    2008年03月

    慶應義塾大学医学部, 放射線科学, 専修医

  • 2008年04月
    -
    2009年09月

    国立病院機構東京医療センター, 放射線科, レジデント

  • 2009年10月
    -
    2011年03月

    国立病院機構東京医療センター, 放射線科, 医員

  • 2011年04月
    -
    継続中

    慶應義塾大学医学部, 放射線治療科, 助教

学歴 【 表示 / 非表示

  • 1998年04月
    -
    2004年03月

    慶應義塾大学, 医学部

    大学, 卒業

学位 【 表示 / 非表示

  • 博士(医学), 慶應義塾大学, 論文, 2013年12月

 
 

論文 【 表示 / 非表示

  • Severe lymphopenia during neoadjuvant chemoradiation for esophageal cancer: A propensity matched analysis of the relative risk of proton versus photon-based radiation therapy

    Shiraishi Y., Fang P., Xu C., Song J., Krishnan S., Koay E., Mehran R., Hofstetter W., Blum-Murphy M., Ajani J., Komaki R., Minsky B., Mohan R., Hsu C., Hobbs B., Lin S.

    Radiotherapy and Oncology (Radiotherapy and Oncology)  128 ( 1 ) 154 - 160 2018年07月

    ISSN  01678140

     概要を見る

    © 2017 Elsevier B.V. Background and purpose: Circulating lymphocytes are exquisitely sensitive to radiation exposure, even to low scattered doses which can vary drastically between radiation modalities. We compared the relative risk of radiation-induced lymphopenia between intensity modulated radiation therapy (IMRT) or proton beam therapy (PBT) in esophageal cancer (EC) patients undergoing neoadjuvant chemoradiation therapy (nCRT). Material and methods: EC patients treated with IMRT and PBT were propensity matched based on key clinical variables. Treatment-associated lymphopenia was graded using CTCAE v.4.0. Using matched cohorts, univariate and multivariable multiple logistic regression was used to identify factors associated with increased risk of grade 4 lymphopenia as well as characterize their relative contributions. Results: Among the 480 patients treated with nCRT, 136 IMRT patients were propensity score matched with 136 PBT patients. In the matched groups, a greater proportion of the IMRT patients (55/136, 40.4%) developed grade 4 lymphopenia during nCRT compared with the PBT patients (24/136, 17.6%, P < 0.0001). On multivariable analysis, PBT was significantly associated with a reduction in grade 4 lymphopenia risk (odds ratio, 0.29; 95% confidence interval, 0.16–0.52; P < 0.0001). Conclusion: PBT is associated with significant risk reduction in grade 4 lymphopenia during nCRT in esophageal cancer.

  • Long-term results of concurrent chemoradiotherapy with daily-low-dose continuous infusion of 5-fluorouracil and cisplatin (LDFP) for Stage I-II esophageal carcinoma

    Kumabe A., Fukada J., Kota R., Koike N., Shiraishi Y., Seki S., Yoshida K., Kitagawa Y., Shigematsu N.

    Diseases of the Esophagus (Diseases of the Esophagus)  31 ( 4 )  2018年04月

    ISSN  1120-8694

     概要を見る

    © The Author(s) 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. We investigated long-term treatment outcomes and the feasibility of chemoradiotherapy consisting of daily-low-dose 5-fluorouracil and cisplatin (LDFP) chemotherapy plus radiotherapy for Stage I-II squamous cell esophageal cancer. Treatment records from the 2000 through 2008 period were reviewed retrospectively. Fractionated radiotherapy was performed with a total dose of 60 Gy delivered in 2 Gy per fraction. LDFP chemotherapy, as continuous infusion of 200 mg/m 2 5-fluorouracil combined with one hour infusion of 4 mg/m 2 cisplatin, was administered on the same days as radiotherapy. Survival was calculated by the Kaplan-Meier method. Survival, responses, failure patterns, and toxicities were evaluated. Seventy-six (47 stage I and 29 stage II) patients were analyzed with a median follow-up of 93.6 months. The 8-year overall survival (OS), progression-free survival (PFS) and cause-specific survival (CSS) rates were 63.4%, 49.8%, and 76.7%, respectively. The 8-year OS, PFS, and CSS for stage I and stage II patients were 71.0%/56.1%/82.9% and 45.2%/40.2%/66.6%, respectively. Sixty-eight patients (89.5%) completed the treatment regimen. A complete response (CR) was achieved in 68 patients (89.5%). Twenty-five patients (36.8%) experienced recurrence after CR. The failure patterns were (overlap included): local failure (n = 12), nodal metastasis (n = 12), distant metastasis (n = 3), details unknown (n = 2). Salvage therapy was performed for local failure; endoscopic therapy (n = 7) or surgery (n = 2). Six patients remain alive without relapse after salvage endoscopic therapy. Major Grade 3 or higher acute adverse events were leukopenia (22%), anorexia (17%), and esophagitis (11%). Major late toxicities (Grade 3 or 4) involved pericardial effusion (12%), pleural effusion (4%), and esophageal stenosis (3%). Chemoradiotherapy with LDFP provided favorable long-term survival with acceptable toxicity for Stage I-II squamous cell esophageal cancer. The tumor response was excellent, but close endoscopic follow-up is essential for detecting and treating local recurrence.

  • Predictive factors of long-term rectal toxicity following permanent iodine-125 prostate brachytherapy with or without supplemental external beam radiation therapy in 2216 patients

    Tanaka T., Yorozu A., Sutani S., Yagi Y., Nishiyama T., Shiraishi Y., Ohashi T., Hanada T., Saito S., Toya K., Shigematsu N.

    Brachytherapy (Brachytherapy)  17 ( 5 ) 799 - 807 2018年01月

    ISSN  1538-4721

     概要を見る

    © 2018 American Brachytherapy Society Purpose: We analyzed factors associated with rectal toxicity after iodine-125 prostate brachytherapy (BT) with or without external beam radiation therapy (EBRT). Methods and Materials: In total, 2216 prostate cancer patients underwent iodine-125 BT with or without EBRT between 2003 and 2013. The median followup was 6.9 years. Cox proportional hazards modeling was used for univariate and multivariate analyses to assess clinical and dosimetric factors associated with rectal toxicity. Dosimetric parameters from 1 day after implantation (Day 1) and 1 month after implantation (Day 30) were included in the analyses. Results: The 7-year cumulative incidence of Grade 2 or higher rectal toxicity was 5.7% in all patients. The multivariate analysis revealed that antiplatelet or anticoagulant therapy, neoadjuvant androgen deprivation therapy, treatment modality, Day 1 rectal volume receiving 100% of the prescribed dose (RV 100 ), and the Day 30 minimal percent of the prescribed dose delivered to 30% of the rectum (RD 30 ) were associated with rectal toxicity. Day 1 RV 100 was a common predictor in both BT-alone and the BT + EBRT groups. The 5-year cumulative incidence of Grade 2 or higher rectal toxicity was 12.6%, 5.9%, and 1.7% for BT + 3-dimensional conformal radiation therapy, BT + intensity-modulated radiation therapy, and the BT-alone groups, respectively (p < 0.001). Conclusions: Rectal dosimetric parameters in BT were associated with late rectal toxicity. Although the risk of rectal toxicity was higher when EBRT was combined with BT, with proper and achievable rectal dose constraints intensity-modulated radiation therapy yielded less toxicity than 3-dimensional conformal radiation therapy.

  • Definitive Chemoradiation Therapy for Esophageal Cancer in the Elderly

    Xu Cai, Xi Mian, Moreno Amy, Shiraishi Yutaka, Hobbs Brian P., Huang Meilin, Komaki Ritsuko, Lin Steven H.

    International Journal of Radiation Oncology Biology Physics 98 ( 4 ) 811 - 819 2017年07月

    ISSN  0360-3016

     概要を見る

    <p>Purpose The optimal treatment approach for patients ≥80 years (“elderly”) with esophageal cancer is not well established. We assessed the clinical outcomes in elderly patients treated with definitive chemoradiation therapy (CCRT) at our institution. Methods and Materials 56 consecutive patients ≥80 years with esophageal cancer treated with conventional CCRT between 2001 and 2016 were propensity score matched 1:2 to generate 2 younger patient cohorts treated with CCRT without surgery: “intermediate” (65-79 years, n=112) and “younger” (&lt;65 years, n=112). Treatment related toxicity was assessed using the Common Terminology Criteria for Adverse Events version 4.0. The rates of overall survival (OS) and recurrence-free survival (RFS) were calculated with the Kaplan-Meier method. Results The median ages of the 3 cohorts were 81 years (elderly, 80-92 years), 71 years (intermediate, 65-79 years), and 58 years (younger, 20-64 years). The elderly cohort was more likely to have cardiac comorbidities. Although the clinical complete response (cCR) rate deviated significantly among the 3 cohorts, (78%, 72%, and 56%; P=.004), the data failed to identify statistically significant differences among RFS, 2-year, and 5-year OS, or in median survival, which was 15.5 months, 23.6 months, and 20.2 months (P=.468), respectively. The overall severe toxicity rates were 38%, 32%, and 30%, respectively (P=.644), including comparable rate of radiation pneumonitis (P&gt;.05). The elderly cohort, however, did show statistically significant evidence of an increased rate of severe radiation pneumonitis (grade ≥3) which was observed to be 11% versus 4% and 0%, respectively (P=.003). Conclusions The studied elderly population showed evidence of similar long-term clinical efficacy after definitive CCRT when compared with cohorts of younger patients with similar prognostic status. An increased rate of pulmonary toxicity was identified, without evidence of differences for nonpulmonary severe adverse events. Understanding the prognostic risk factors of pulmonary toxicity after CCRT may effectuate improved long-term outcomes for elderly population.</p>

  • Severe lymphopenia during neoadjuvant chemoradiation for esophageal cancer

    Shiraishi Yutaka, Fang Penny, Xu Cai, Song Juhee, Krishnan Sunil, Koay Eugene J., Mehran Reza J., Hofstetter Wayne L., Blum-Murphy Mariela, Ajani Jaffer A., Komaki Ritsuko, Minsky Bruce, Mohan Radhe, Hsu Charles C., Hobbs Brian P., Lin Steven H.

    Radiotherapy and Oncology 2017年01月

    ISSN  0167-8140

     概要を見る

    <p>Background and purpose: Circulating lymphocytes are exquisitely sensitive to radiation exposure, even to low scattered doses which can vary drastically between radiation modalities. We compared the relative risk of radiation-induced lymphopenia between intensity modulated radiation therapy (IMRT) or proton beam therapy (PBT) in esophageal cancer (EC) patients undergoing neoadjuvant chemoradiation therapy (nCRT). Material and methods: EC patients treated with IMRT and PBT were propensity matched based on key clinical variables. Treatment-associated lymphopenia was graded using CTCAE v.4.0. Using matched cohorts, univariate and multivariable multiple logistic regression was used to identify factors associated with increased risk of grade 4 lymphopenia as well as characterize their relative contributions. Results: Among the 480 patients treated with nCRT, 136 IMRT patients were propensity score matched with 136 PBT patients. In the matched groups, a greater proportion of the IMRT patients (55/136, 40.4%) developed grade 4 lymphopenia during nCRT compared with the PBT patients (24/136, 17.6%, P &lt; 0.0001). On multivariable analysis, PBT was significantly associated with a reduction in grade 4 lymphopenia risk (odds ratio, 0.29; 95% confidence interval, 0.16-0.52; P &lt; 0.0001). Conclusion: PBT is associated with significant risk reduction in grade 4 lymphopenia during nCRT in esophageal cancer.</p>

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研究発表 【 表示 / 非表示

  • 外照射併用療法を考える―小線源療法適応拡大に向けてのステップ― 外照射併用療法の治療計画と実際「GIを中心とした注意事項について」

    白石 悠

    第十二回前立腺癌密封小線源永久挿入治療研究会, 2016年, シンポジウム・ワークショップ パネル(指名)

  • 外部放射線併用療法総論

    白石 悠

    第17回ヨウ素125シード線源永久挿入による前立腺癌密封小線源療法技術講習会 (東京) , 2015年, 公開講演,セミナー,チュートリアル,講習,講義等

  • Normal Tissue Complication Probability (NTCP) Modeling of Late Rectal Bleeding Following Iodine-125 Prostate Brachytherapy Combined With External Beam Radiation Therapy.

    白石 悠

    The 57th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (San Antonio) , 2015年, ポスター(一般)

  • Transperineal Mapping Biopsy Results following Continuous PSA Rises in Patients Treated with Iodine-125 Prostate Brachytherapy

    白石 悠

    15th International Congress of Radiation Research (Kyoto) , 2015年, ポスター(一般)

  • Brachytherapy with or without External Beam Radiotherapy. Outcomes and Toxicities at Tokyo Medical Center.

    白石 悠

    Dr. Grimm Online Workshop (Tokyo) , 2015年, 公開講演,セミナー,チュートリアル,講習,講義等

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競争的資金等の研究課題 【 表示 / 非表示

  • ニューラルネットワークを用いた前立腺癌小線源治療の予後予測モデルの構築

    2018年04月
    -
    2021年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 白石 悠, 基盤研究(C), 補助金,  代表

 

担当授業科目 【 表示 / 非表示

  • 放射線医学講義

    2020年度

  • 放射線医学講義

    2019年度

担当経験のある授業科目 【 表示 / 非表示

  • 系統講義

    慶應義塾, 2015年度

  • 臨床実習

    慶應義塾, 2015年度, 通年, 専門科目, 実習・実験