Sanuki, Naoko

写真a

Affiliation

School of Medicine, Department of Radiology (Radiation Oncology) Radiation Oncology Department (Shinanomachi)

Position

Associate Professor

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Research Areas 【 Display / hide 】

  • Life Science / Tumor diagnostics and therapeutics (Radiation Oncology)

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Books 【 Display / hide 】

  • Ablative Radiation Therapy for Early Hepatocellular Carcinoma

    Sanuki N., Takeda A., Tsurugai Y., Radiotherapy of Liver Cancer, 2021.01

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    Ablative radiation therapy, also known as stereotactic body radiation therapy (SBRT) or stereotactic ablative body radiotherapy (SABR), has an evolving role in the treatment of hepatocellular carcinoma (HCC), owing to recent advances in technology. SBRT is primarily used when other local therapies are not feasible. Although evidence is limited, SBRT has been demonstrated to be an effective treatment with excellent local control. In this chapter, we discuss the role of SBRT as a curative local therapy for patients with early HCC.

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Papers 【 Display / hide 】

  • Annual report of National Clinical Database-Breast Cancer Registry in 2021: characteristics categorized by body mass index and menopause status

    Konishi T., Kumamaru H., Niikura N., Sagara Y., Miyashita M., Iwamoto T., Sanuki N., Tanakura K., Nagahashi M., Yoshida M., Kawashima M., Kinoshita T., Sasada S., Kinukawa N., Saji S., Ishida T., Taira N.

    Breast Cancer 32 ( 4 ) 621 - 629 2025.07

    ISSN  13406868

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    The Japanese Breast Cancer Society initiated the breast cancer registry in 1975 and migrated the registry to the National Clinical Database-Breast Cancer Registry (NCD-BCR) in 2012. This annual report presents 2021 data on the NCD-BCR. We analyzed data from 98,540 breast cancer (BC) cases registered in 2021. In 2021, 99.4% of BC cases were females with a median age of 61. Most (57.5%) were diagnosed at early stages (Stage 0 or I). Breast-conserving surgery was performed in 42.8% of cases. Sentinel lymph node biopsy was performed in 67.8%, followed by radiotherapy in 71.0% of those post-conserving surgery. Regarding postoperative systemic therapy, 63.1% received endocrine therapy, 28.2% received chemotherapy, and 14.9% received molecular-targeted therapy. ER positivity was observed in 75.2%, HER2 in 13.6%, and Ki67 ≥30% in 29.1% of cases. The median age of premenopausal cases was 46 (interquartile range, 42–49) years and the median BMI was 21.5 (19.7–24.2) kg/m<sup>2</sup> whereas the median age of postmenopausal cases was 69 (61–76) years and the median BMI was 23.0 (20.6–25.9) kg/m<sup>2</sup>. In premenopausal cases, cases with normal BMI were more likely to be found at checkups without subjective symptoms and in the early stage than those with high BMI. The tendency of ER, PgR, HER2, and Ki67 status on BMI differed by menopause status; premenopausal cases with a lower BMI showed higher proportions of ER- and PgR-positive cancer and lower proportions of cancer with high Ki67. These nationwide descriptive statistics would help clinical explanation and further research on breast cancer.

  • Clinicopathological analysis of the absence of seminal vesicle invasion in prostate cancer patients without radiological evidence on magnetic resonance imaging

    Saihara K., Sanuki N., Hashimoto Y., Tochigi K., Hayakawa A., Tomioka S., Nara Y., Maruyama K.

    Reports of Practical Oncology and Radiotherapy 30 ( 2 ) 216 - 222 2025.04

    ISSN  15071367

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    Background: In definitive radiotherapy for localized prostate cancer, the seminal vesicle is included in the target volume for intermediate- and high-risk cases, though this increases the risk of toxicity to the bowel and rectum. This study retrospectively examined clinicopathological data to assess the absence of seminal vesicle invasion (SVI) in prostate cancer patients without radiological evidence of SVI using preoperative magnetic resonance imaging (MRI). Materials and methods: Patients with cT1c–cT3a prostate cancer who underwent radical prostatectomy between March 2010 and February 2024 were retrospectively selected, excluding those with distant metastasis, missing MRI data, preoperative systemic therapy, or delayed surgery post-biopsy. Preoperative risk factors [age, initial prostate-specific antigen (PSA), grade group (GG), clinical T stage, positive core ratio] and postoperative pathology were analyzed to assess SVI risk. The impact of GG changes between biopsy and postoperative pathology on risk classification and SVI treatment intensity in radiotherapy was also examined. Results: Of 368 patients, 308 met the inclusion criteria. SVI was observed in 26 patients (8.4%). Significant predictors of SVI included GG, initial PSA ≥ 8.6, and positive core ratio, with a positive core ratio < 0.5 and GG ≤ 3 indicating an SVI risk under 10%. GG discrepancies between biopsy and surgery were noted in 182 cases (59.1%), but had minimal impact on risk classification and SVI risk. Conclusions: Patients with a positive core ratio <0.5 had a low risk of SVI. GG discrepancies did not significantly underestimate prostate cancer risk, minimizing the risk of failing to treat true SVI.

  • Final Results of a Multicenter Prospective Study of Stereotactic Body Radiation Therapy for Previously Untreated Solitary Primary Hepatocellular Carcinoma (The STRSPH Study)

    Sanuki N., Kimura T., Takeda A., Ariyoshi K., Oyamada S., Yamaguchi T., Tsurugai Y., Doi Y., Kokubo M., Imagumbai T., Katoh N., Eriguchi T., Ishikura S.

    International Journal of Radiation Oncology Biology Physics 121 ( 4 ) 942 - 950 2025.03

    ISSN  03603016

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    Purpose: To report final results of a prospective study of stereotactic body radiation therapy (SBRT) in patients with previously untreated solitary primary hepatocellular carcinoma (HCC). Methods and Materials: This prospective, single-arm, multicenter phase 2 trial recruited patients with HCC who were unsuitable for, or refused, surgery and radiofrequency ablation, with 3-year overall survival rates as the primary endpoint and survival outcomes and adverse events as secondary endpoints. The prescribed SBRT dose was 40 Gy in 5 fractions. The final data were analyzed in November 2022. Results: Between 2014 and 2018, 36 patients (median age, 73.5 years) were registered; enrollment was closed before full recruitment due to slow accrual. Overall, 34 patients were analyzed for efficacy evaluation after excluding 2 patients. The median tumor size was 2.3 cm. The median follow-up times for all patients and for survivors were 49 and 56 months, respectively. The 3-year overall survival rate was 82% (95% confidence interval, 65%-92%). The 3-year local control rate was 93% (95% confidence interval, 76%-98%). Grade 3 or higher SBRT-related nonlaboratory toxicities were observed in 4 patients (11%). No grade 5 adverse events were observed. Conclusions: Final results of this phase 2 trial suggest the efficacy and safety of SBRT for newly diagnosed early-stage HCC that is unfit for other local therapies. Although this study was underpowered by the small number of registrations, the excellent results indicate that SBRT may be an alternative option for the management of early-stage HCC.

  • Breast cancer statistics for Japan in 2022: annual report of the national clinical database-breast cancer registry—clinical implications including chemosensitivity of breast cancer with low estrogen receptor expression

    Nagahashi M., Kumamaru H., Kinukawa N., Iwamoto T., Kawashima M., Kinoshita T., Konishi T., Sagara Y., Sasada S., Saji S., Sanuki N., Tanakura K., Niikura N., Miyashita M., Yoshida M., Ishida T., Taira N.

    Breast Cancer 32 ( 2 ) 217 - 226 2025.03

    ISSN  13406868

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    This is an annual report by the Japanese Breast Cancer Society, which provides statistics on the clinical data on breast cancer in Japan, extracted from the National Clinical Database-Breast Cancer Registry (NCD-BCR). This report includes an update of 102,453 breast cancer cases at 1339 institutions registered in the NCD-BCR in 2022. Among the 101,793 female patients, the median age at cancer diagnosis was 62 years (interquartile range, 50–73 years), and 29.4% of the patients were premenopausal. Of these patients, 15,437 (15.2%) and 42,936 (42.2%) were diagnosed with stage 0 and I disease, respectively. Estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 (HER2) were positive in 78.7%, 69.4%, and 12.8% of the patients, respectively. Of the 97,154 patients without distant metastasis, 40,521 (41.7%) underwent breast-conserving surgery, and 5780 (5.9%) patients underwent some form of breast reconstruction procedures at the time of mastectomy. A total of 66,894 (68.9%) patients were treated with sentinel lymph node biopsy and 7155 (7.4%) patients were treated with sentinel lymph node biopsy followed by axillary node dissection. In the group of patients treated with breast-conserving surgery (n = 40,521), 29,500 (72.8%) received whole-breast irradiation. In the group of patients who underwent mastectomy (n = 54,476), 6226 (11.4%) received radiation therapy to the chest wall. Of the 13,950 patients receiving preoperative chemotherapy with or without molecular targeted therapy, 4308 (30.9%) achieved a pathological complete response, with the highest rate of 60.5% in patients with the hormone receptor-negative/HER2-positive subtype.

  • The Japanese breast cancer society clinical practice guidelines for radiation treatment of breast cancer, 2022 edition

    Yoshimura M., Yamauchi C., Sanuki N., Hamamoto Y., Hirata K., Kawamori J., Kawamura M., Ogita M., Yamamoto Y., Iwata H., Saji S.

    Breast Cancer 31 ( 3 ) 347 - 357 2024.05

    ISSN  13406868

    　View Summary

    The Breast Cancer Clinical Practice Guidelines, organized by the Japanese Breast Cancer Society (JBCS), were published in 2022. We present the English version of the Radiation Therapy (RT) section of the guidelines. The JBCS formed a task force to update the 2018 version of the JBCS Clinical Practice Guidelines. The Background Questions (BQs) contain the standard treatments for breast cancer in clinical practice, whereas the Clinical Questions (CQs) address daily clinical questions that remain controversial. Future Research Questions (FRQs) explore the subjects that are considered important issues, despite there being insufficient data for inclusion as CQs. The task force selected the 12 BQs, 8 CQs, and 6 FRQs for the RT section. For each CQ, systematic literature reviews and meta-analyses were conducted according to the Minds Manual for Guideline Development 2020, version 3.0. The recommendations, strength of recommendation, and strength of evidence for each CQ were determined based on systematic reviews and meta-analyses, and finalized by voting at the recommendation decision meeting.

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Reviews, Commentaries, etc. 【 Display / hide 】

  • In Regard to Lee et al.

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

    International Journal of Radiation Oncology Biology Physics 111 ( 4 ) 1088 - 1089 2021.11

    ISSN  03603016

  • Correction to: The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2018 edition (Breast Cancer, (2020), 27, 1, (9-16), 10.1007/s12282-019-01019-5)

    Yamauchi C., Yoshimura M., Sekiguchi K., Hamamoto Y., Nakajima N., Sanuki N., Ogo E., Oguchi M., Saji S., Iwata H.

    Breast Cancer 28 ( 4 )  2021.07

    ISSN  13406868

    　View Summary

    The article “The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2018 edition”, written by Chikako Yamauchi, Michio Yoshimura, Kenji Sekiguchi, Yasushi Hamamoto, Naomi Nakajima, Naoko Sanuki, Etsuyo Ogo, Masahiko Oguchi, Shigehira Saji, Hiroji Iwata, was originally published electronically on the publisher’s internet portal on 28 October 2019 without open access. After publication in volume 27, issue 1, page 9–16, the author decided to opt for Open Choice and to make the article an Open Access publication. Therefore, the copyright of the article has been changed to © The Author(s) and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4. 0/. The original article has been updated.

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Courses Taught 【 Display / hide 】

  • LECTURE SERIES, RADIOLOGY

    2025

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