武田　篤也 （タケダ　アツヤ）

Takeda, Atsuya

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

教授
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  • Real-World Results of Stereotactic Body Radiotherapy for 399 Medically Operable Patients with Stage I Histology-Proven Non-Small Cell Lung Cancer

    Onishi H., Shioyama Y., Matsumoto Y., Matsuo Y., Miyakawa A., Yamashita H., Matsushita H., Aoki M., Nihei K., Kimura T., Ishiyama H., Murakami N., Nakata K., Takeda A., Uno T., Nomiya T., Taguchi H., Seo Y., Komiyama T., Marino K., Aoki S., Matsuda M., Akita T., Saito M.

    Cancers （MDPI）  15 （ 17 ） 4382 2023年09月

    研究論文（学術雑誌）, 共著, 査読有り

  • Local control correlates with overall survival in radiotherapy for early-stage non-small cell lung cancer: A systematic review

    Sanuki N., Takeda A., Eriguchi T., Tsurugai Y., Tateishi Y., Kibe Y., Akiba T., Fukuzawa T., Horita N.

    Radiotherapy and Oncology （Radiotherapy and Oncology）  183 2023年06月

    ISSN  01678140

    　概要を見る

    Purpose: Local control (LC) is an important outcome of local cancer therapy, besides overall survival (OS). We conducted a comprehensive literature search to investigate whether a high LC rate contributes to good OS in radiotherapy for early-stage non-small cell lung cancer (ES-NSCLC). Materials and methods: Studies in patients receiving radiotherapy for peripheral ES-NSCLC, mainly staged as T1-2N0M0 were included for a systematic review. Relevant information was collected including, dose fractionation, T stage, median age, 3-year LC, cancer-specific survival (CSS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and OS. Correlations between outcomes and clinical variables were evaluated. Results: After screening, 101 data points from 87 studies including 13,435 patients were selected for the quantitative synthesis. Univariate meta-regression analysis revealed that the coefficients between the 3-year LC and 3-year DFS, DMFS, CSS, and OS were 0.753 (95% confidence interval (CI): 0.307–1.199; p < 0.001), 0.360 (95% CI: 0.128–0.593; p = 0.002), 0.766 (95% CI: 0.489–1.044; p < 0.001), and 0.574 (95% CI: 0.275–0.822; p < 0.001), respectively. Multivariate analysis revealed that the 3-year LC (coefficient, 0.561; 95% CI: 0.254–0.830; p < 0.001) and T1 proportion (coefficient, 0.207; 95% CI: 0.030–0.385; p = 0.012) were significantly associated with the 3-year OS and CSS (coefficient for 3-year LC, 0.720; 95% CI: 0.468–0.972; p < 0.001 and T1 proportion, 0.002; 95% CI: 0.000–0.003; p = 0.012). Toxicities ≥ grade 3 were low (3.4%). Conclusions: Three-year LC was correlated with three-year OS in patients receiving radiotherapy for ES-NSCLC. A 5% increase in 3-year LC is expected to improve the 3-year CSS and OS rates by 3.8% and 2.8%, respectively.

  • Clinical Practice Guidelines for Hepatocellular Carcinoma: The Japan Society of Hepatology 2021 version (5th JSH-HCC Guidelines)

    Hasegawa K., Takemura N., Yamashita T., Watadani T., Kaibori M., Kubo S., Shimada M., Nagano H., Hatano E., Aikata H., Iijima H., Ueshima K., Ohkawa K., Genda T., Tsuchiya K., Torimura T., Ikeda M., Furuse J., Akahane M., Kobayashi S., Sakurai H., Takeda A., Murakami T., Motosugi U., Matsuyama Y., Kudo M., Tateishi R.

    Hepatology Research （Hepatology Research）  53 （ 5 ） 383 - 390 2023年05月

    ISSN  13866346

    　概要を見る

    The fifth version of the Clinical Practice Guidelines for Hepatocellular Carcinoma was revised by the Japan Society of Hepatology, according to the methodology of evidence-based medicine and partly to the Grading of Recommendations Assessment, Development and Evaluation system, which was published in October 2021 in Japanese. In addition to surveillance–diagnostic and treatment algorithms, a new algorithm for systemic therapy has been created, as multiple drugs for hepatocellular carcinoma can be currently selected. Here, new or revised algorithms and evidence on which the recommendations are based are described.

  • Role of stereotactic body radiotherapy in multidisciplinary management of liver metastases in patients with colorectal cancer

    Sanuki N., Takeda A., Tsurugai Y., Eriguchi T.

    Japanese Journal of Radiology （Japanese Journal of Radiology）  40 （ 10 ） 1009 - 1016 2022年10月

    ISSN  18671071

    　概要を見る

    In the treatment of colorectal cancer patients with distant metastases, the development of new anticancer agents has considerably prolonged progression-free survival. Such survival benefits attributed to chemotherapy have increased the relative significance of local therapy in patients with limited metastases. The liver is recognized as the most common site of metastasis of colorectal cancer because of the intestinal mesenteric drainage to the portal veins. Hepatic resection of isolated liver metastases of colorectal cancer is the only option for a potential cure. However, hepatic metastases are resectable in only approximately 20% of the patients. For remaining patients with high-risk resectable liver metastases or those who are unfit for surgery, less invasive, local therapies including radiation therapy (stereotactic body radiation therapy, SBRT) may have a potential role in treatment. Although the local control rate of SBRT for colorectal liver metastases has room for improvement, its less-invasive nature and broad indications deserve consideration. Future research should include SBRT dose escalation or the selection of patients who benefit from local ablative therapies. SBRT may offer an alternative, non-invasive approach for the treatment of colorectal liver metastases in a multidisciplinary treatment strategy.

  • Relationship between Dose Prescription Methods and Local Control Rate in Stereotactic Body Radiotherapy for Early Stage Non-Small-Cell Lung Cancer: Systematic Review and Meta-Analysis

    Eriguchi T., Takeda A., Nemoto T., Tsurugai Y., Sanuki N., Tateishi Y., Kibe Y., Akiba T., Inoue M., Nagashima K., Horita N.

    Cancers （Cancers）  14 （ 15 ）  2022年08月

    ISSN  2072-6694

    　概要を見る

    Variations in dose prescription methods in stereotactic body radiotherapy (SBRT) for early stage non-small-cell lung cancer (ES-NSCLC) make it difficult to properly compare the outcomes of published studies. We conducted a comprehensive search of the published literature to summarize the outcomes by discerning the relationship between local control (LC) and dose prescription sites. We systematically searched PubMed to identify observational studies reporting LC after SBRT for peripheral ES-NSCLC. The correlations between LC and four types of biologically effective doses (BED) were evaluated, which were calculated from nominal, central, and peripheral prescription points and, from those, the average BED. To evaluate information on SBRT for peripheral ES-NSCLC, 188 studies were analyzed. The number of relevant articles increased over time. The use of an inhomogeneity correction was mentioned in less than half of the articles, even among the most recent. To evaluate the relationship between the four BEDs and LC, 33 studies were analyzed. Univariate meta-regression revealed that only the central BED significantly correlated with the 3-year LC of SBRT for ES-NSCLC (p = 0.03). As a limitation, tumor volume, which might affect the results of this study, could not be considered due to a lack of data. In conclusion, the central dose prescription is appropriate for evaluating the correlation between the dose and LC of SBRT for ES-NSCLC. The standardization of SBRT dose prescriptions is desirable.

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  • 【定位照射の実際こうすればできる】肝臓腫瘍に対するSBRTの心得

    武田 篤也

    Rad Fan （(株)メディカルアイ）  21 （ 13 ） 24 - 28 2023年11月

    ISSN  1348-3498

    　概要を見る

    肝臓に対する体幹部定位放射線治療は大きく肝細胞癌と肝転移に分けられる。肝細胞癌の背景にある慢性肝炎、肝硬変はそれ自体が進行性疾患であり、肝内再発も高率であるため、腫瘍制御と肝機能温存の両立が必要である。肝転移では大腸癌原発の放射線感受性が低いため高線量投与が必要である。今後は免疫療法との併用による治療も期待される。(著者抄録)

  • 【進行・再発肝細胞癌に対する集学的治療update】進行・再発・肝外転移性肝細胞癌に対する放射線治療

    武田 篤也

    肝臓クリニカルアップデート （医学図書出版(株)）  9 （ 2 ） 126 - 133 2023年10月

    ISSN  2189-4469

    　概要を見る

    放射線治療の技術進歩は著しい。無痛・無血,外来通院治療が可能であり,標的腫瘍への到達が容易である。肝細胞癌に対する治療線量では血管・胆管に対する毒性が小さく,高い局所制御率を有する。放射線治療は肝細胞癌治療の一翼を担う。とくに体幹部定位放射線治療の適応は広い。局所再発に対する救済治療,門脈腫瘍塞栓,オリゴメタスタシスへの治療,緩和治療などがある。本特集では,BCLCステージングに即して放射線治療の役割を示す。(著者抄録)

  • 【肝胆膵癌に対する放射線治療:2023 Update】肝細胞癌　肝細胞癌に対する体幹部定位放射線治療の適応と成績

    武田 篤也

    肝胆膵 （(株)アークメディア）  87 （ 1 ） 15 - 24 2023年07月

    ISSN  0389-4991

  • 【Oligometastasesの最新知見2023】Oligometastasesの最新知見　海外の動向も含めて

    木部 優一, 武田 篤也

    臨床放射線 （金原出版(株)）  68 （ 3 ） 209 - 226 2023年03月

    ISSN  0009-9252

  • 肝癌診療ガイドライン2021年版の改訂点

    竹村 信行, 建石 良介, 山下 竜也, 渡谷 岳行, 海堀 昌樹, 久保 正二, 島田 光生, 永野 浩昭, 波多野 悦朗, 相方 浩, 飯島 尋子, 上嶋 一臣, 大川 和良, 玄田 拓哉, 土谷 薫, 鳥村 拓司, 池田 公史, 古瀬 純司, 赤羽 正章, 小林 聡, 櫻井 英幸, 武田 篤也, 村上 卓道, 本杉 宇太郎, 松山 裕, 工藤 正俊, 長谷川 潔

    肝臓 （(一社)日本肝臓学会）  64 （ 3 ） 109 - 121 2023年03月

    ISSN  0451-4203

    　概要を見る

    2021年に肝癌診療ガイドラインの改訂が行われた.肝細胞癌の診断にEOB-MRIが多く用いられるようになったため,サーベイランスアルゴリズムにおいて超音波で結節が検出された後にまずEOB-MRIを撮像するアルゴリズムが追加された.治療アルゴリズムにおいては,3cm以内の単発肝細胞癌に対する治療推奨が切除と焼灼療法が同等に推奨されることになり,また,脈管侵襲陽性肝細胞癌に対しては,まず切除が推奨され,切除不能例に対して薬物療法,次いで肝動注化学療法ならびにTACEが推奨されることとなった.前回の改訂後に,肝細胞癌に対する薬物療法の選択肢が大幅に増えたため,従来の治療アルゴリズムを補完する形で,新たに薬物療法アルゴリズムが作成された.また,前版では弱く推奨されないとされていた薬物療法とTACEの併用療法が,今回の改訂で行うことを考慮しても良いとの弱い推奨に変更がなされた.(著者抄録)

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