Details of a Researcher - Sanuki, Naoko

Papers - Sanuki, Naoko

Division display >> ／ All the affair displays 1 - 93 of about 93

Postmastectomy radiation therapy for autologous breast reconstruction: a systematic review and meta-analysis for the 2022 Japanese Breast Cancer Society Clinical Practice Guideline

Ogita M., Sawayanagi S., Jinnouchi H., Yoshimura M., Yamauchi C., Sanuki N., Hamamoto Y., Hirata K., Kawamura M., Yamamoto Y., Saji S., Toyama T.

Breast Cancer 33 ( 1 ) 1 - 9 2026.01

ISSN 13406868

Background: The safety of postmastectomy radiation therapy (PMRT) after autologous breast reconstruction remains unclear. Therefore, we conducted a systematic review and meta-analysis to investigate the effects of PMRT on patients with breast cancer who underwent autologous breast reconstruction. Methods: A comprehensive literature search of English and Japanese articles until March 2021 was performed using PubMed/MEDLINE, the Cochrane Library, and Ichushi-Web. We included studies that compared the outcomes of patients with breast cancer who underwent immediate autologous breast reconstruction with and without PMRT. Outcomes including major complications, fat necrosis, and cosmetic results were assessed. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random effects model. Results: Ten studies (two retrospective case-controlled and eight retrospective cohort studies) comprising 3,123 cases were included. The rate of major complications was slightly higher in the PMRT group compared to the no PMRT group, but the difference was not statistically significant (13.2% vs. 12.2%, OR 1.58, 95% CI 0.93–2.68, P = 0.09). In contrast, the rate of fat necrosis was significantly increased in the PMRT group (17.2% vs. 8.1%, OR 2.71, 95% CI 1.58–4.65, P = 0.0003). Data on cosmetic outcomes were limited and not pooled for the meta-analysis. Conclusions: PMRT following autologous breast reconstruction was associated with a higher risk of fat necrosis, but not with a significantly increased rate of major complications. With careful patient selection and monitoring, PMRT after autologous breast reconstruction can be considered a safe and acceptable treatment option.

Access to Document (DOI)

Postmastectomy radiation therapy for implant-based breast reconstruction: a systematic review and meta-analysis for the 2022 Japanese Breast Cancer Society Clinical Practice Guideline

Ogita M., Sawayanagi S., Jinnouchi H., Yoshimura M., Yamauchi C., Sanuki N., Hamamoto Y., Hirata K., Kawamura M., Yamamoto Y., Saji S., Toyama T.

Breast Cancer Tokyo Japan 32 ( 6 ) 1169 - 1179 2025.11

ISSN 1340-6868

BACKGROUND: Implant-based breast reconstruction is the most commonly performed reconstructive technique following mastectomy. With an increasing number of patients undergoing implant-based breast reconstruction, concerns have arisen regarding the safety of postmastectomy radiation therapy (PMRT) in reconstructed breasts. This study aimed to investigate the safety of PMRT in implant-based breast reconstruction. METHODS: A comprehensive literature search was conducted for articles published up to March 2021. Eligible studies included clinical trials and observational studies comparing outcomes between patients with breast cancer undergoing immediate implant-based breast reconstruction with PMRT and those without PMRT. The primary outcomes included major complications, reconstruction failure, capsular contracture, and cosmetic outcomes. Pooled odds ratio (OR) with 95% confidence interval (CI) were calculated using a random-effects model. RESULTS: A total of 23 studies were identified, comprising one case-control study, one prospective cohort study, and 21 retrospective cohort studies. PMRT was significantly associated with increased rates of major complications (OR 2.62, 95% CI 1.82-3.77, P < 0.00001), reconstruction failure (OR 2.53, 95% CI 2.00-3.20, P < 0.00001), and capsular contracture (OR 9.63, 95% CI 5.77-16.06, P < 0.00001). Furthermore, cosmetic outcomes were significantly poorer in patients undergoing PMRT compared with those not receiving PMRT (OR 3.55, 95% CI 1.80-6.98, P < 0.003). CONCLUSIONS: This meta-analysis demonstrated that PMRT in implant-based breast reconstruction is associated with a significantly increased risk of adverse outcomes. Given these risks, treatment decisions should involve through discussions with patients to ensure that they are fully informed of the potential benefits and complications.

Access to Document (DOI)

Timing of postmastectomy radiation therapy in two-stage expander/implant-based breast reconstruction: a systematic review and meta-analysis for the 2022 Japanese breast cancer society clinical practice guideline

Ogita M., Sawayanagi S., Jinnouchi H., Yoshimura M., Yamauchi C., Sanuki N., Hamamoto Y., Hirata K., Kawamura M., Yamamoto Y., Saji S., Toyama T.

Breast Cancer 32 ( 6 ) 1159 - 1168 2025.11

ISSN 13406868

Background: In immediate expander/implant reconstruction, postmastectomy radiation therapy (PMRT) can be administered at two different time points: during tissue expander insertion or after exchange with an implant. The optimal timing for PMRT remains unclear. We conducted a systematic review and meta-analysis to evaluate the impact of PMRT timing on the outcomes of patients with breast cancer undergoing two-stage expander/implant breast reconstruction. Methods: A literature review of articles in English and Japanese up to March 2021 was performed using PubMed/MEDLINE, the Cochrane Library, and Ichushi-Web. Studies comparing the timing of PMRT in patients with breast cancer undergoing immediate two-stage expander/implant breast reconstructions and PMRT were included. The assessed outcomes included major complications, reconstruction failure, cosmesis, capsular contractures, and local recurrence. Results: Eleven studies encompassing 1,628 cases were identified. These included one prospective cohort study, one prospective case–control study, and nine retrospective cohort studies. No significant differences were observed in major complications between PMRT to expander and PMRT to implant (odds ratio [OR] 1.11, 95% confidence intervals [CI] 0.72–1.73, P = 0.64). Reconstruction failure was more prevalent in the expander group (OR 2.33, 95% CI 1.43–3.82, P = 0.0007), while severe capsular contractures occurred less frequently in the expander group (OR 0.33, 95% CI 0.12–0.92, P = 0.03). Conclusions: PMRT to expander was associated with higher reconstruction failure and lower severe capsular contracture rates, with no significant differences in major complications by timing. There is insufficient evidence to favor one approach over the other.

Access to Document (DOI)

【Radiation Therapy Today 2025　定位放射線治療の現状と未来】肝細胞がんに対する体幹部定位放射線治療

佐貫直子, 武田篤也

INNERVISION ((株)インナービジョン) 40 ( 11 ) 14 - 17 2025.10

ISSN 0913-8919

肝細胞がん(hepatocellular carcinoma:HCC)は,世界的に主要ながん死因の一つであり,日本においても依然として死亡率の高い疾患である。特に,C型肝炎ウイルス(HCV)やB型肝炎ウイルス(HBV)などの感染に伴う肝硬変を背景として発症することが多いが,近年では飲酒や脂肪肝による慢性肝障害もがん化の原因として増加しており,高齢化とともに治療選択の幅の重要性は増加している。HCCの局所治療は,切除,局所療法[ラジオ波焼灼療法(RFA)やマイクロ波凝固療法(MWA)],肝動脈化学塞栓療法(TACE)など多岐にわたるが,これらが非適応の症例に対する治療として,放射線治療(radiotherapy),特に体幹部定位放射線治療(stereotactic body radiation therapy:SBRT)が注目されている。SBRTは,短期間で高線量を腫瘍に集中的に照射する技術であり,非侵襲性と高い制御率が特徴である。本稿では,HCCに対するSBRTの現状とエビデンス,および今後の展望について論じる。(著者抄録)

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

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/m2 whereas the median age of postmenopausal cases was 69 (61–76) years and the median BMI was 23.0 (20.6–25.9) kg/m2. 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.

Access to Document (DOI)

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

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.

Access to Document (DOI)

A Case of a 12-cm Huge Hepatocellular Carcinoma Treated Successfully With Two-Stage CyberKnife Stereotactic Body Radiation Therapy.

Nishimura S, Takeda A, Sanuki N, Kawase T, Tsukamoto N

Cureus 17 ( 4 ) e83094 2025.04

ISSN 2168-8184

Access to Document (DOI)

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

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.

Access to Document (DOI)

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

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.

Access to Document (DOI)

Design Paper: A Prospective, Multicenter, Single-arm, Phase II Trial of Tailored Axillary Surgery in Patients with Clinically Node-positive Breast Cancer in the Upfront Surgery Setting

Sagara, Y; Terata, K; Sakai, T; Takayama, S; Kitagawa, D; Iwatani, T; Tsukioki, T; Ogita, M; Sanuki, N; Yoshida, M; Tsuda, H; Yamamoto, S; Iwata, H; Shien, T

JMA JOURNAL 8 ( 1 ) 264 - 269 2025.01

ISSN 2433-328X

Access to Document (DOI)

高齢者に発症し,放射線治療が奏効した前額部脂腺癌の1例

水野彩加, 渡邊清未, 津田憲志郎, 小幡康範, 佐貫直子, 奈良佳治

日本皮膚科学会雑誌 ((公社)日本皮膚科学会) 135 ( 1 ) 128 - 128 2025.01

ISSN 0021-499X

【薬物療法の進歩における肝細胞癌の診断と治療Update】薬物療法の進歩における放射線治療の役割

佐貫直子, 木村智樹, 斉原和志, 武田篤也

肝臓クリニカルアップデート (医学図書出版(株)) 10 ( 2 ) 186 - 192 2024.10

ISSN 2189-4469

近年の高精度放射線治療技術の進歩により,病変に高線量を照射しつつ肝実質への線量を低減することが可能となった。肝細胞癌のさまざまなステージで有効で安全な治療成績が報告されている。肝細胞癌にはさまざまな治療法があるが,放射線治療はとくに各治療の適応境界において一定の役割を果たし得る。複合免疫療法をはじめとした薬物療法が進歩したいま,改めて放射線治療を含めた局所治療の意義が問われるであろう。(著者抄録)

Tailored Axillary Surgery (TAS) in Patients with Clinically Node-Positive Breast Cancer in the Upfront Surgery Setting: A Prospective, Single-Arm, Multicenter Trial

Terata, K; Sagara, Y; Shien, T; Sakai, T; Takayama, S; Kitagawa, D; Iwatani, T; Tsukioki, T; Ogita, M; Sanuki, N; Yoshida, M; Tsuda, H; Yamamoto, S; Iwata, H

CANCER RESEARCH 84 ( 9 ) 2024.05

ISSN 0008-5472

Access to Document (DOI)

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

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.

Access to Document (DOI)

2020 Annual Report of National Clinical Database-Breast Cancer Registry: 10-year mortality of elderly breast cancer patients in Japan

Sagara Y., Kumamaru H., Niikura N., Miyashita M., Konishi T., Iwamoto T., Sanuki N., Tanakura K., Nagahashi M., Hayashi N., Yoshida M., Kinukawa N., Watanabe C., Toi M., Saji S.

Breast Cancer 31 ( 2 ) 179 - 184 2024.03

ISSN 13406868

The Japanese Breast Cancer Society initiated the breast cancer registry in 1975, which transitioned to the National Clinical Database-Breast Cancer Registry in 2012. This annual report presents data from 2020 and analyzes the ten-year mortality rates for those aged 65 and older. We analyzed data from 93,784 breast cancer (BC) cases registered in 2020 and assessed 10-year mortality rates for 36,279 elderly patients diagnosed between 2008 and 2012. In 2020, 99.4% of BC cases were females with a median age of 61. Most (65%) were diagnosed at early stages (Stage 0 or I). Breast-conserving surgery rates varied with stages: 58.5% at cStage I, 30.8% at cStage II, and 13.1% at cStage III. Sentinel lymph node biopsy was done in 73.6% of cases, followed by radiotherapy in 70% of those post-conserving surgery and chemotherapy in 21.1% post-surgery. Pathology showed that 63.4% had tumors under 2.0 cm, 11.7% had pTis tumors, and 77.3% had no axillary lymph node metastasis. ER positivity was seen in 75.1%, HER2 in 14.3%, and 30% had a Ki67 positivity rate above 30%. Across all stages and subtypes, there was a trend where the 10-year mortality rates increased for individuals older than 65 years. In Stage I, many deaths were not directly linked to BC and, for those with HER2-type and triple-negative BC, breast cancer-related deaths increased with age. Within Stage II, patients older than 70 years with luminal-type BC often experienced deaths not directly linked to BC, whereas patients below 80 years with HER2-type and triple-negative BC, likely had breast cancer-related deaths. In Stage III, breast cancer-related deaths were more common, particularly in HER2 and triple-negative BC. Our prognostic analysis underscores distinct mortality patterns by stage, subtype, and age in elderly BC patients. It highlights the importance of personalized treatment strategies, considering subtype-specific aggressiveness, age-related factors, and comorbidities.

Access to Document (DOI)

Survival trends and patient characteristics between 2004 and 2016 for breast cancer in Japan based on the National Clinical Database-Breast Cancer Registry

Iwamoto T., Kumamaru H., Niikura N., Sagara Y., Miyashita M., Konishi T., Sanuki N., Tanakura K., Nagahashi M., Hayashi N., Yoshida M., Watanabe C., Kinukawa N., Toi M., Saji S.

Breast Cancer 31 ( 2 ) 185 - 194 2024.03

ISSN 13406868

This is a prognostic report by the Japanese Breast Cancer Society on breast cancer extracted from the National Clinical Database-Breast Cancer Registry of Japan. Here, we present a summary of 457,878 breast cancer cases registered between 2004 and 2016. The median follow-up duration was 5.6 years. The median age at the start of treatment was 59 years (5–95%: 38–82 years) and increased from 57 years between 2004 and 2008 to 60 years between 2013 and 2016. The proportion of patients with Stage 0–II disease increased from 74.5% to 78.3%. The number of cases with estrogen and progesterone receptor positivity increased from 74.8% to 77.9% and 60.5% to 68.1%, respectively. Regarding (neo-)adjuvant chemotherapy, the taxane (T) or taxane-cyclophosphamide (C) regimen increased by 2.4% to 8.2%, but the (fluorouracil (F)) adriamycin (A)-C-T/(F) epirubicin (E)C-T and (F)AC/(F)EC regimens decreased by 18.6% to 15.2% and 13.5% to 5.0%, respectively. Regarding (neo-)adjuvant anti-human epidermal growth factor-2 (HER2)-targeted therapy, the use of trastuzumab increased from 4.6% to 10.5%. The rate of sentinel lymph node biopsy increased from 37.1% to 60.7%, while that of axillary dissection decreased from 54.5% to 22.6%. Improvements in disease-free and overall survival were observed in patients with HER2-positive breast cancer, but there was no apparent trend in patients with hormone receptor-positive, HER2-negative, or triple-negative breast cancers.

Access to Document (DOI)

Multinational Association of Supportive Care in Cancer (MASCC) clinical practice guidance for the prevention of breast cancer-related arm lymphoedema (BCRAL): international Delphi consensus-based recommendations

Wong H.C.Y., Wallen M.P., Chan A.W., Dick N., Bonomo P., Bareham M., Wolf J.R., van den Hurk C., Fitch M., Chow E., Chan R.J., AlKhaifi M., Alvarez B.A., Banerjee S., Bloomquist K., Borman P., Borthwick Y., Chan D., Chan S.M., Chan Y., Jean Cheng N.S., Choi J.I., Choy Y.P., Corbin K., Dylke E., Hammond P., Hirakawa S., Hirata K., Lee S.F., Holt M., Johnstone P., Kikawa Y., Kirk D., Kotani H., Kwok C., Lai J., Lim M.Y., Lock M., Lorden B., Mack P., Magno S., Meattini I., Marta G.N., McNeely M., Mondry T., Lopez Montoya L.E., Ogita M., Osaka M., Phan S., Poortmans P., Rafn B.S., Recht A., Rembielak A., Río-González A., Robijns J., Sanuki N., Simone C.B., Spałek M., Tane K., Nevola Teixeira L.F., Terada M., Trombetta M., Wong K.H., Yoshidome K.

Eclinicalmedicine 68 2024.02

ISSN 2589-5370

Background: Developing strategies to prevent breast cancer-related arm lymphoedema (BCRAL) is a critical unmet need because there are no effective interventions to eradicate it once it reaches a chronic state. Certain strategies such as prospective surveillance programs and prophylactic lymphatic reconstruction have been reported to be effective in clinical trials. However, a large variation exists in practice based on clinician preference, organizational standards, and local resources. Methods: A two-round international Delphi consensus process was performed from February 27, 2023 to May 25, 2023 to compile opinions of 55 experts involved in the care and research of breast cancer and lymphoedema on such interventions. Findings: Axillary lymph node dissection, use of post-operative radiotherapy, relative within-arm volume increase one month after surgery, greater number of lymph nodes dissected, and high body mass index were recommended as the most important risk factors to guide selection of patients for interventions to prevent BCRAL. The panel recommended that prospective surveillance programs should be implemented to screen for and reduce risks of BCRAL where feasible and resources allow. Prophylactic compression sleeves, axillary reverse mapping and prophylactic lymphatic reconstruction should be offered for patients who are at risk for developing BCRAL as options where expertise is available and resources allow. Recommendations on axillary management in clinical T1–2, node negative breast cancer patients with 1–2 positive sentinel lymph nodes were also provided by the expert panel. Routine axillary lymph node dissection should not be offered in these patients who receive breast conservation therapy. Axillary radiation instead of axillary lymph node dissection should be considered in the same group of patients undergoing mastectomy. Interpretation: An individualised approach based on patients' preferences, risk factors for BCRAL, availability of treatment options and expertise of the healthcare team is paramount to ensure patients at risk receive preventive interventions for BCRAL, regardless of where they are receiving care. Funding: This study was not supported by any funding. RJC received investigator grant support from the Australian National Health and Medical Research Council (APP1194051).

Access to Document (DOI)

Annual report of the Japanese Breast Cancer Registry for 2019

Miyashita M., Kumamaru H., Niikura N., Sagara Y., Konishi T., Iwamoto T., Sanuki N., Tanakura K., Nagahashi M., Hayashi N., Yoshida M., Watanabe C., Kinukawa N., Toi M., Saji S.

Breast Cancer 31 ( 1 ) 16 - 23 2024.01

ISSN 13406868

This is an annual report by the Japanese Breast Cancer Society regarding the clinical data on breast cancer extracted from the National Clinical Database-Breast Cancer Registry (NCD-BCR) of Japan. Here, we present an updated summary of 98,300 breast cancer cases registered in 2019. The median age at cancer diagnosis was 61 years (interquartile range 49–72 years), and 30.6% of the breast cancer patients were premenopausal. Of the 93,840 patients without distant metastases, 14,118 (15.0%) and 42,047 (44.8%) were diagnosed with stage 0 and I disease, respectively. Breast-conserving surgery was performed in 42,080 (44.8%) patients. Regarding axillary procedures, 62,677 (66.8%) and 7371 (7.9%) patients underwent sentinel node biopsy and axillary node dissection after biopsy, respectively. Whole breast irradiation was administered to 29,795 (70.8%) of the 42,080 patients undergoing breast-conserving surgery. Chest wall irradiation was administered to 5524 (11.1%) of the 49,637 patients who underwent mastectomy. Of the 6912 clinically lymph node-negative patients who received preoperative therapy, 5250 (76.0%) and 427 (6.2%) underwent sentinel node biopsy and axillary node dissection after biopsy, respectively; however, 602 (8.7%) patients initially underwent axillary node dissection without biopsy.

Access to Document (DOI)

Toxicity profile and clinical outcomes of stereotactic body radiotherapy with a focal boost without fiducials or perirectal hydrogel spacer for localized prostate cancer

Tsurugai Y., Takeda A., Sanuki N., Aoki Y., Kimura Y., Oku Y., Eriguchi T., Yamanaka H., Machida M., Matsushita T., Saito S.

Strahlentherapie Und Onkologie 201 ( 8 ) 779 - 787 2024

ISSN 01797158

Purpose: Whole-prostate dose escalation in stereotactic body radiotherapy (SBRT) for localized prostate cancer (PCa) can improve oncological outcomes, albeit at the cost of increased toxicity. A focal boost to the dominant intraprostatic lesion (DIL) is gaining interest as an alternative approach. Herein, we investigate the safety and efficacy of this approach. Methods: This retrospective study enrolled patients with localized PCa who underwent five-fraction SBRT with a focal boost to the DIL at our institution between May 2016 and August 2021. The prescription doses to the whole prostate were 35 and 36.25 Gy for low- to favorable intermediate-risk PCa and unfavorable intermediate- to high-risk PCa, respectively. The focal boost to the DIL was up to 115–140% of the prescribed dose. None of the patients underwent pretreatment fiducial or perirectal hydrogel spacer placement. Acute and late genitourinary (GU) and gastrointestinal (GI) toxicities and oncological outcomes were assessed. Results: Among the 520 patients, 44% were categorized as patients with high-risk PCa. The median follow-up period was 42.9 months. No acute or late grade ≥3 toxicities were observed. Acute and late grade 2 GU toxicities were observed in 22.3 and 6.1%, respectively, while GI toxicities were observed in 2.1 and 0.8% of the patients. The 4‑year relapse-free survival rate was 94.8% among all patients. Conclusion: Our results indicate that SBRT with a focal boost without fiducials or perirectal hydrogel spacer for localized PCa has a promising toxicity profile and oncological outcomes. Longer follow-up studies are necessary to adequately evaluate late toxicities and efficacy.

Access to Document (DOI)

A Case of Treatment-resistant Extensive-disease Small-cell Lung Cancer with Multiple Liver Metastases Shrunk by Whole Liver Radiotherapy

Kodama S., Yoshida M., Miki H., Goto H., Masuda K., Fujiwara A., Nanpei Y., Sanuki N., Goto D., Tsuruga T.

Japanese Journal of Lung Cancer 63 ( 7 ) 959 - 964 2023.12

ISSN 03869628

Background. Liver metastases are common in patients with small-cell lung cancer (SCLC) and are associated with a poor prognosis. Recent reports, mainly from abroad, have demonstrated the efficacy of palliative radiotherapy for liver metastases, but this therapy has not been widely used or reported in Japan. Case. Since late June, 20XX−1, a 76-year-old man had been treated with carboplatin, etoposide, and durvalumab for extensive-disease SCLC. After completing six treatment cycles, the patient was undergoing maintenance therapy with durvalumab. Owing to worsening of the primary lesion, liver metastases, and para-aortic lymph node metastases, the patient was admitted to our hospital on late February, 20XX, for treatment modification. Since more than 90 days had passed since the last dose of etoposide, a sensitive relapse was considered, and carboplatin plus etoposide therapy was initiated. However, back pain and jaundice appeared and became severe, requiring the initiation of regular opioid therapy. The symptoms were suggestive of capsular extension due to the rapid growth of multiple liver metastases, prompting whole liver radiotherapy (21 Gy/7 fr) to alleviate pain. There was a temporary increase in pain due to a flare reaction, requiring a temporary increase in opioid and steroid doses, but the symptoms rapidly resolved, and the patient was discharged with independent gait. The patient was subsequently readmitted and switched to amrubicin therapy. Approximately one month after whole liver radiotherapy, all symptoms and multiple liver metastases were under control. Conclusion. SCLC is radiosensitive and responds well to low-dose radiotherapy. Radiation-induced liver disease is unlikely to occur at low doses, and whole liver radiotherapy is considered effective even in patients with treatment-resistant SCLC.

Access to Document (DOI)

全肝照射により多発肝転移が縮小した治療抵抗性の進展型小細胞肺癌の1例

児玉秀治, 吉田正道, 三木寛登, 後藤広樹, 増田和記, 藤原篤司, 南平結衣, 佐貫直子, 後藤大基, 鶴賀龍樹

肺癌 ((NPO)日本肺癌学会) 63 ( 7 ) 959 - 964 2023.12

ISSN 0386-9628

背景.肝転移は小細胞肺癌で発生頻度が高く予後不良因子である.近年,海外を中心に肝臓への緩和照射の有用性が報告されているが,国内で報告例は少なく普及していない.症例.76歳男性.進展型小細胞肺癌に対し20XX-1年6月下旬からカルボプラチン+エトポシド+デュルバルマブ療法を開始,6コース完遂後にデュルバルマブ維持療法中だった.原発巣,肝転移,傍大動脈リンパ節転移の増大のため20XX年2月下旬に治療変更目的に入院した.Sensitive relapseと考えカルボプラチン+エトポシド療法を行ったが,背部痛と黄疸が出現し増強,オピオイドを開始した.多発肝転移増大に伴う被膜伸展症状であり疼痛緩和目的の全肝照射(21Gy/7fr)を行った.フレア現象で一過性疼痛増強がありオピオイドやステロイドを一時増量したが速やかに症状は軽快し独歩退院した.再入院しアムルビシン療法へ変更,全肝照射終了から約1ヵ月時点で症状は軽快し多発肝転移も縮小している.結論.小細胞肺癌は放射線感受性が高く,低線量照射で効果が得られた.低線量では放射線肝障害が起こりにくく全肝照射は治療抵抗性の小細胞肺癌でも有用と考える.(著者抄録)

Tailored axillary surgery (TAS) in patients with clinically node-positive breast cancer in the upfront surgery setting: A prospective, single-arm, multicenter trial

Terata, K; Sagara, Y; Shien, T; Sakai, T; Takayama, S; Kitagawa, D; Iwatani, T; Tsukioki, T; Ogita, M; Sanuki, N; Yoshida, M; Tsuda, H; Yamamoto, S; Iwata, H

JOURNAL OF CLINICAL ONCOLOGY 41 ( 16 ) 2023.06

ISSN 0732-183X

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 183 109664 2023.06

ISSN 01678140

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.

Access to Document (DOI)

Symptom palliation with QUAD Shot radiation therapy to penile metastasis derived from descending colon cancer: a case report

Yamamoto, A; Ieki, H; Shimamura, M; Tsujiura, M; Yokoe, T; Sanuki, N; Ojima, E; Uchida, K; Mohri, Y

International Cancer Conference Journal 12 ( 3 ) 210 - 215 2023.03

ISSN 2192-3183

Access to Document (DOI)

【Oligometastasesの最新知見2023】肝oligometastasesに対する定位放射線治療　case based review

佐貫直子, 武田篤也, 江里口貴久, 鶴貝雄一郎

臨床放射線 (金原出版(株)) 68 ( 3 ) 257 - 265 2023.03

ISSN 0009-9252

放射線治療によりリンパ浮腫が改善し一時退院が可能となった肺扁平上皮がん後腹膜リンパ節転移の1例

児玉秀治, 佐貫直子, 酒井美紀子, 山川智一, 宮本翔子, 藤井稚奈, 秦いづみ, 北山智美, 今出雅博, 吉田正道

Palliative Care Research ((NPO)日本緩和医療学会) 18 ( 2 ) 111 - 116 2023

症例は73歳女性.肺扁平上皮がん(cT3N3M0-Stage IIIC)に対し当科治療中.2022年6月より肺がん進行に伴い後腹膜リンパ節転移による腰背部痛が増強した.疼痛以外に両下肢浮腫による体動困難もあり7月8日に緊急入院し,後腹膜リンパ節転移に対して放射線治療(30Gy/10fr)を行った.タペンタドール200mg/日で疼痛管理を行っていたが入院中にフェンタニル貼付剤1200μg/日へ変更し腰背部痛は軽減した.また浮腫の原因疾患を鑑別し,理学所見・検査所見や病歴から,後腹膜リンパ節転移に関連したリンパ浮腫と診断した.入院31日目に浮腫は改善し,ベッド周囲のADLが向上し一時退院可能となった.リンパ節転移に関連したリンパ浮腫の治療方法は確立されておらず,放射線治療の有効性が報告されている.リンパ浮腫の診断に至るまでに他の病態を鑑別し,放射線治療によりリンパ浮腫が改善した1例を報告する.(著者抄録)

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 40 ( 10 ) 1009 - 1016 2022.10

ISSN 18671071

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.

Access to Document (DOI)

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 14 ( 15 ) 2022.08

ISSN 2072-6694

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.

Access to Document (DOI)

Applying Artificial Neural Networks to Develop a Decision Support Tool for Tis-4N0M0 Non-Small-Cell Lung Cancer Treated With Stereotactic Body Radiotherapy

Nemoto T., Takeda A., Matsuo Y., Kishi N., Eriguchi T., Kunieda E., Kimura R., Sanuki N., Tsurugai Y., Yagi M., Aoki Y., Oku Y., Kimura Y., Han C., Shigematsu N.

JCO Clinical Cancer Informatics 6 e2100176 2022.06

ISSN 2473-4276

PURPOSE: Clear evidence indicating whether surgery or stereotactic body radiation therapy (SBRT) is best for non-small-cell lung cancer (NSCLC) is lacking. SBRT has many advantages. We used artificial neural networks (NNs) to predict treatment outcomes for patients with NSCLC receiving SBRT, aiming to aid in decision making. PATIENTS AND METHODS: Among consecutive patients receiving SBRT between 2005 and 2019 in our institution, we retrospectively identified those with Tis-T4N0M0 NSCLC. We constructed two NNs for prediction of overall survival (OS) and cancer progression in the first 5 years after SBRT, which were tested using an internal and an external test data set. We performed risk group stratification, wherein 5-year OS and cancer progression were stratified into three groups. RESULTS: In total, 692 patients in our institution and 100 patients randomly chosen in the external institution were enrolled. The NNs resulted in concordance indexes for OS of 0.76 (95% CI, 0.73 to 0.79), 0.68 (95% CI, 0.60 to 0.75), and 0.69 (95% CI, 0.61 to 0.76) and area under the curve for cancer progression of 0.80 (95% CI, 0.75 to 0.84), 0.72 (95% CI, 0.60 to 0.83), and 0.70 (95% CI, 0.57 to 0.81) in the training, internal test, and external test data sets, respectively. The survival and cumulative incidence curves were significantly stratified. NNs selected low-risk cancer progression groups of 5.6%, 6.9%, and 7.0% in the training, internal test, and external test data sets, respectively, suggesting that 48% of patients with peripheral Tis-4N0M0 NSCLC can be at low-risk for cancer progression. CONCLUSION: Predictions of SBRT outcomes using NNs were useful for Tis-4N0M0 NSCLC. Our results are anticipated to open new avenues for NN predictions and provide decision-making guidance for patients and physicians.

Access to Document (DOI)

Radiation Therapy for Malignant Lumbosacral Plexopathy: A Case Series

Sanuki, N; Kodama, S; Seta, H; Sakai, M; Watanabe, H

Cureus 14 ( 1 ) e20939 2022.01

ISSN 2168-8184

Access to Document (DOI)

【改訂:肝癌診療ガイドライン】肝細胞癌に対する放射線療法

木部優一, 佐貫直子, 江里口貴久, 竹中亮介, 渋谷圭, 井垣浩, 水本斉志, 武田篤也, 櫻井英幸

消化器・肝臓内科 ((有)科学評論社) 11 ( 1 ) 117 - 125 2022.01

ISSN 2432-3446

Dynamic conformal arc radiotherapy for locally advanced lung cancer: a comparison with static-beam conformal radiotherapy

Goto M., Sanuki N., Kasae M., Terabayashi R., Nishiwaki Y., Ogita Y., Tone J., Seta H.

Reports of Practical Oncology and Radiotherapy 27 ( 5 ) 897 - 904 2022

ISSN 15071367

Background: This study investigated whether the dose distribution of lung cancer can be improved by dynamic arc conformal radiotherapy (dynamic CRT) compared with static multiple-beam radiotherapy (static CRT). Materials and methods: A dummy study of static CRT and dynamic CRT was performed, designed to meet the predetermined dose constraints. A dose of 60 Gy in 30 fractions was administered using two dose prescription methods: dose prescribed to the isocenter (IC prescription), and dose prescribed to > 50% of the planning target volume (D50 prescription). Dose–volume parameters were compared between the plans. Results: Among 20 patients with locally advanced lung cancer, dose conformity was significantly better with dynamic CRT than static CRT (median conformity index: 1.3 vs. 2.2; p < 0.01). As for the lung dose, compared with static CRT, dynamic CRT did not increase the percentage lung volume receiving ≥ 20 Gy (18.9% vs. 19.3%, p = 0.09). The maximum spinal cord dose was significantly reduced by dynamic CRT (static vs. dynamic CRT: 44.1 vs. 25.2 Gy, p < 0.001). With the change from IC to D50 prescription, the 95% isodose volume increased by 18.3 cc in static CRT and by 4.1 cc in dynamic CRT, while doses to the lung and spinal cord remained within the acceptable ranges. Conclusion: The dynamic CRT technique showed better target coverage and lower doses to the spinal cord in exchange for increased low-dose lung area, compared with static CRT. Dynamic CRT with D50 prescription instead of prescription to the isocenter has excellent dose distribution profiles without compromising doses to organs at risk for lung cancer at favorable locations.

Access to Document (DOI)

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 0360-3016

Access to Document (DOI)

Three Cases of Hepatocellular Carcinoma With Massive Macrovascular Invasion Successfully Treated With Radiotherapy

Tsurugai, Y; Takeda, A; Sanuki, N; Eriguchi, T; Ueno, M

Cureus 13 ( 10 ) e18624 2021.10

ISSN 2168-8184

Access to Document (DOI)

Stereotactic Body Radiation Therapy With a High Maximum Dose Improves Local Control, Cancer-Specific Death, and Overall Survival in Peripheral Early-Stage Non-Small Cell Lung Cancer

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

International Journal of Radiation Oncology Biology Physics 111 ( 1 ) 143 - 151 2021.09

ISSN 03603016

Purpose: We investigated whether delivery of a high biologically effective dose (BED) to primary tumors affects systemic outcomes of cancer-specific death (CSD) and overall survival (OS) rates after stereotactic body radiation therapy (SBRT) in patients with early-stage non-small cell lung cancer (ES-NSCLC). Methods and Materials: Among consecutive ES-NSCLC patients treated with SBRT between 2005 and 2019, we retrospectively identified patients who received a prescription of 50 to 60 Gy in 5 fractions with maximum doses of 62.5 to 100 Gy. Patients were categorized by maximum BED within the planning target volume with a threshold dose of 200 Gy. Outcomes were analyzed in all and matched patients. Results: Overall, 433 patients were eligible, and 262 and 171 patients were categorized into HighBED and LowBED groups, respectively. After propensity score matching, pairs of 154 patients were selected. Median follow-up times for the HighBED and LowBED groups were 52.3 months (range, 0.8-107.2 months) and 121.6 months (range, 3.0-162.8 months), respectively. The local recurrence rate in the HighBED group was significantly lower than that in the LowBED group (5-year rate, 1.3% and 7.2%; hazard ratio [HR], 0.15; 95% confidence interval [CI], 0.03-0.65; P = .011). Rates of any recurrence and CSD in the HighBED group were significantly lower (5-year any recurrence: 18.1% and 32.1%; HR, 0.52; 95% CI, 0.33-0.83; P = .0058; 5-year CSD: 9.5% and 21.8%; HR, 0.38; 95% CI, 0.20-0.70; P = .002), and OS in the HighBED group was significantly better compared with the LowBED group (5-year rate: 61.7% and 51.8%; HR, 0.71; 95% CI, 0.50-1.00; P = .047). Conclusion: In patients with peripheral ES-NSCLC, SBRT with a high maximum dose may improve not only local control, but also any recurrence, CSD, and OS rates without increased toxicity. Further trials designed to evaluate whether higher intensity SBRT increases local control rates and contributes to improved CSD and OS outcomes are anticipated.

Access to Document (DOI)

Comparison of stereotactic body radiotherapy and radiofrequency ablation for hepatocellular carcinoma: Systematic review and meta-analysis of propensity score studies

Eriguchi T., Takeda A., Tateishi Y., Tsurugai Y., Sanuki N., Ebinuma H., Horita N.

Hepatology Research 51 ( 7 ) 813 - 822 2021.07

ISSN 13866346

Aim: Stereotactic body radiotherapy (SBRT) is an emerging treatment for hepatocellular carcinoma (HCC) and has shown excellent local control (LC), as has radiofrequency ablation (RFA). As no randomized controlled trial has compared SBRT and RFA for HCC, data from a propensity score matched study (PSMS) are valuable. However, the results varied greatly and depended on composing factors of Barcelona Clinic Liver Cancer staging (BCLC-factors) adjusted. Therefore, we undertook a systematic review and meta-analyses of the studies focusing on BCLC-factors matching. Methods: We systematically searched PubMed, the Cochrane database, EMBASE, and Web of Science to identify studies comparing RFA and SBRT using propensity scores. The hazard ratios (HRs) of overall survival (OS) and LC from BCLC-factor-matched and -unmatched PSMS were pooled. Heterogeneity between the data from these studies was assessed. Results: Three BCLC-factor-matched studies were identified. Stereotactic body radiotherapy led to comparable OS (HR, 0.89; 95% CI, 0.74–1.08; p = 0.24; I2 = 0%; p for heterogeneity, 0.56) and significantly better LC (HR, 0.39; 95% CI, 0.30–0.51; p < 0.001; I2 = 0%; p for heterogeneity, 0.67). We also identified three additional BCLC-factor-unmatched studies (HR of OS, 1.41; 95% CI, 1.21–1.65; p < 0.0001; I2 = 0%; p for heterogeneity, 0.63). However, considerable heterogeneity was observed for HR of OS between BCLC-factor-matched and -unmatched studies (I2 = 92.6%; p for heterogeneity, 0.0002). Conclusions: When BCLC-factors were properly adjusted, the results of the meta-analysis revealed equivalent OS and better LC for SBRT compared with RFA. Stereotactic body radiotherapy could be an alternative treatment option for HCC.

Access to Document (DOI)

Correction to: The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2018 edition

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

Breast Cancer 28 ( 4 ) 988 - 988 2021.07

ISSN 1340-6868

Access to Document (DOI)

Multicenter prospective study of stereotactic body radiotherapy for previously untreated solitary primary hepatocellular carcinoma: The STRSPH study

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

Hepatology Research 51 ( 4 ) 461 - 471 2021.04

ISSN 13866346

Aim: To prospectively evaluate the efficacy and safety of stereotactic body radiotherapy (SBRT) for patients with previously untreated solitary primary hepatocellular carcinoma (HCC). Methods: The main eligibility criteria included the following: (1) primary solitary HCC; (2) no prior treatment for HCC; (3) Child–Turcotte–Pugh score of seven or less; and (4) unsuitability for or refusal of surgery and radiofrequency ablation (RFA). The prescribed dose of SBRT was 40 Gy in five fractions. The primary endpoint was 3-year overall survival (OS); the secondary endpoints included local progression-free survival (LPFS), local control (LC), and adverse events. The accrual target was 60 patients, expecting a 3-year OS of 70% with a 50% threshold. Results: Between 2014 and 2018, 36 patients were enrolled; enrollment was closed early because of slow accrual. The median tumor size was 2.3 cm. The median follow-up at the time of evaluation was 20.8 months. The 3-year OS was 78% (95% confidence interval [CI]: 53%–90%). The 3-year LPFS and LC proportion were 73% (95% CI: 48%–87%) and 90% (95% CI: 65%–97%), respectively. Grade 3 or higher SBRT-related toxicities were observed in four patients (11%), and grade five toxicities were not observed. Conclusions: This study showed acceptably low incidence of SBRT-related toxicities. LC and OS after SBRT were comparable for previously untreated solitary HCC for patients unfit for resection and RFA. Although a definitive conclusion cannot be drawn by this study, the promising results indicate that SBRT may be an alternative option in the management of early HCC.

Access to Document (DOI)

Hypofractionated radiotherapy for hepatocellular carcinomas adjacent to the gastrointestinal tract

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

Hepatology Research 51 ( 3 ) 294 - 302 2021.03

ISSN 13866346

Aim: Decisions regarding therapeutic plans for inoperable patients with hepatocellular carcinoma (HCC) adjacent to the gastrointestinal (GI) tract are challenging because radiofrequency ablation has the potential risk of thermal injury. Moreover, the response rate of transcatheter arterial chemoembolization is relatively low and stereotactic body radiotherapy (SBRT) is believed to be too toxic. We have applied hypofractionated radiotherapy (HFRT) for such lesions. This study investigated the outcomes and toxicities of this treatment. Methods: Among consecutive HCC patients treated with radiotherapy with curative intent at our institution between 2015 and 2019, we retrospectively extracted those outside of the indication for SBRT due to exceeding the constraint of the GI tract and who were treated using HFRT with a prescription dose of 42 Gy in 14 fractions and prophylactic proton pump inhibitor administration for 6 months. The oncological outcomes and toxicities were investigated. Results: A total of 66 patients with 73 lesions were eligible. The median follow-up period was 24.0 months. The local recurrence, intrahepatic recurrence, liver-related death, and overall survival rates at 2 years were 11.3%, 50.6%, 15.9%, and 60.4%, respectively. Six (9.1%) patients experienced Child–Pugh score deterioration ≥2 within 6 months following treatment. Two and one patient developed grades 2 and 3 gastroduodenal bleeding, respectively. Conclusions: HFRT can achieve good local control in patients with HCC adjacent to the GI tract, with low GI toxicity incidence. Our study demonstrated that HFRT can be a potentially curative treatment option for lesions.

Access to Document (DOI)

The Japanese Breast Cancer Society Clinical Practice Guideline for radiation treatment of breast cancer, 2018 edition

Breast Cancer 2020.01

ISSN 1340-6868

<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Purpose</jats:title>
<jats:p>The Japanese Breast Cancer Society (JBCS) Clinical Practice Guideline was revised in 2018. This article describes the revise points in the section on radiation therapy (RT).</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods and materials</jats:title>
<jats:p>The JBCS formed task force to update the JBCS Clinical Practice Guideline 2015 edition. Background questions (BQs) deal with standard treatments of breast cancer in clinical practice. Clinical questions (CQs) highlight the important treatments in which controversy remains. The task force for RT section addressed the 10 BQs, the 10 CQs, and the 4 Future reseach questions (FQs). For each CQ, systematic literature reviews and meta-analyses were conducted, and recommendations, strength of recommendation and strength of evidence were determined according to the protocol in Morizane et al. (Minds Handbook for Clinical Practice Guideline Development, 2014).</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>The recommendations, the strength of recommendation and the strength of evidence were determined based on the systematic literature reviews and the meta-analyses for each CQ.</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>The JBCS updated the Clinical Practice Guideline. RT represents a significant portion of the breast cancer treatment, and these recommendations regarding RT will be useful in individualized, shared decision making between physicians and patients.</jats:p>
</jats:sec>

Access to Document (DOI)

Stereotactic body radiotherapy for primary non-small cell lung cancer patients with clinical T3-4N0M0 (UICC 8th edition): outcomes and patterns of failure

Atsuya Narita and Atsuya Takeda and Takahisa Eriguchi and Yusuke Saigusa and Naoko Sanuki and Yuichiro Tsurugai and Tatsuji Enomoto and Hidehiko Kuribayashi and Tomikazu Mizuno and Kae Yashiro and Yu Hara and Takeshi Kaneko

Journal of Radiation Research (Oxford University Press ({OUP})) 60 ( 5 ) 639 - 649 2019.10

Access to Document (DOI)

Cutaneous metastasis of prostate carcinoma treated with electron radiotherapy

IJU Case Reports 2019.07

ISSN 2577-171X

<jats:sec><jats:title>Introduction</jats:title><jats:p>Prostate carcinoma is typically diagnosed and treated, and it rarely manifests as cutaneous metastases. We herein report electron radiotherapy for the treatment of cutaneous metastases causing cellulitis, with a durable clinical response achieved.</jats:p></jats:sec><jats:sec><jats:title>Case presentation</jats:title><jats:p>A 70‐year‐old male patient with scrotal cutaneous metastasis of prostate carcinoma was undergoing treatment with docetaxel chemotherapy due to recurring cellulitis originating from the scrotum, and his treatment was interrupted. We administered electron radiotherapy to the scrotal cutaneous metastasis lesions, as irradiation was difficult, and obtained a good clinical effect. Subsequently, he continued chemotherapy, and the scrotal lesions remained clear and dry with no recurring cellulitis for 1 year.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Electron radiotherapy is one of the safe and effective treatment options for controlling cutaneous metastasis of prostate carcinoma.</jats:p></jats:sec>

Access to Document (DOI)

Questionnaire survey comparing surgery and stereotactic body radiotherapy for lung cancer: lessons from patients with experience of both modalities

Journal of Thoracic Disease 2019.06

ISSN 2072-1439

Access to Document (DOI)

Stereotactic body radiotherapy for patients with non-small-cell lung cancer using RapidArc delivery and a steep dose gradient: prescription of 60% isodose line of maximum dose fitting to the planning target volume

Journal of Radiation Research 2019.05

ISSN 0449-3060

Access to Document (DOI)

Pleural contact decreases survival in clinical T1N0M0 lung cancer patients undergoing SBRT

Radiotherapy and Oncology 2019.05

ISSN 0167-8140

Access to Document (DOI)

Toward consensus reporting of radiation-induced liver toxicity in the treatment of primary liver malignancies: defining clinically relevant endpoints: In Regard to Chapman et al

Sanuki, N.

Practical Radiation Oncology 8 ( 4 ) e187 - e188 2018

ISSN 18798500

Access to Document (DOI)

Phase 2 study of stereotactic body radiotherapy and optional transarterial chemoembolization for solitary hepatocellular carcinoma not amenable to resection and radiofrequency ablation

Cancer 2016.07

ISSN 0008-543X

<jats:sec><jats:title>BACKGROUND</jats:title><jats:p>Curative treatment options for patients with early stage hepatocellular carcinoma (HCC) include resection, liver transplantation, and percutaneous ablation therapy. However, even patients with solitary HCC are not always amenable to these treatments. The authors prospectively investigated the clinical outcomes of patients who received stereotactic body radiotherapy (SBRT) for solitary HCC.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>A phase 2 study involving SBRT and optional transarterial chemoembolization (TACE) was conducted in patients with Child‐Pugh grade A or B and underlying, solitary HCC (greatest tumor dimension, ≤4 cm) who were unsuitable candidates for resection and radiofrequency ablation. The prescription dose was 35 to 40 grays in 5 fractions. The primary endpoint was 3‐year local tumor control.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>From 2007 to 2012, 101 patients were enrolled, and 90 were evaluable with a median follow‐up of 41.7 months (range, 6.8‐96.2 months). Thirty‐two patients were treatment‐naïve, 20 were treated for newly diagnosed intrahepatic failure, and 38 were treated for residual or recurrent HCC as salvage therapy. Thirty‐two patients did not receive TACE, 48 received insufficient TACE, and 10 attained full lipiodol accumulation. The 3‐year local control rate was 96.3%, the 3‐year liver‐related cause‐specific survival rate was 72.5%, and the overall survival rate was 66.7%. Grade 3 laboratory abnormalities were observed in 6 patients, and 8 patients had Child‐Pugh scores that worsened by 2 points.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>SBRT achieved high local control and overall survival with feasible toxicities for patients with solitary HCC, despite rather stringent conditions. SBRT can be effective against solitary HCC in treatment‐naive, intrahepatic failure, residual disease, and recurrent settings, taking advantage of its distinctive characteristics. <jats:bold><jats:italic>Cancer</jats:italic> 2016;122:2041–9</jats:bold>. © <jats:italic>2016 American Cancer Society</jats:italic>.</jats:p></jats:sec>

Access to Document (DOI)

Stereotactic body radiotherapy for chronic obstructive pulmonary disease patients undergoing or eligible for long-term domiciliary oxygen therapy

Journal of Radiation Research 2016.01

ISSN 0449-3060

Access to Document (DOI)

Dose-Escalated Stereotactic Body Radiotherapy (SBRT) as a Salvage Treatment for Two Cases with Relapsed Peripheral Lung Cancer After Initial SBRT

Journal of Thoracic Oncology 2015.08

ISSN 1556-0864

Access to Document (DOI)

Feasibility study of stereotactic body radiotherapy for peripheral lung tumors with a maximum dose of 100 Gy in five fractions and a heterogeneous dose distribution in the planning target volume

Journal of Radiation Research 2014.09

ISSN 0449-3060

Access to Document (DOI)

Toxicities of Organs at Risk in the Mediastinal and Hilar Regions Following Stereotactic Body Radiotherapy for Centrally Located Lung Tumors

Journal of Thoracic Oncology 2014.09

ISSN 1556-0864

Access to Document (DOI)

Stereotactic ablative body radiotherapy for previously untreated solitary hepatocellular carcinoma

Journal of Gastroenterology and Hepatology 2014.02

ISSN 0815-9319

<jats:title>Abstract</jats:title><jats:sec><jats:title>Background and Aims</jats:title><jats:p>Stereotactic ablative body radiotherapy (<jats:styled-content style="fixed-case">SABR</jats:styled-content>) is a relatively new treatment for hepatocellular carcinoma (<jats:styled-content style="fixed-case">HCC</jats:styled-content>). The outcomes of <jats:styled-content style="fixed-case">SABR</jats:styled-content> for previously untreated solitary <jats:styled-content style="fixed-case">HCC</jats:styled-content> unfit for ablation and surgical resection were evaluated.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Untreated solitary <jats:styled-content style="fixed-case">HCC</jats:styled-content> patients treated with <jats:styled-content style="fixed-case">SABR</jats:styled-content> were retrospectively studied. Between 2005 and 2012, 221 <jats:styled-content style="fixed-case">HCC</jats:styled-content> patients underwent <jats:styled-content style="fixed-case">SABR</jats:styled-content>. Among them, patients with untreated solitary <jats:styled-content style="fixed-case">HCC</jats:styled-content>, treated with only <jats:styled-content style="fixed-case">SABR</jats:styled-content> or <jats:styled-content style="fixed-case">SABR</jats:styled-content> preceded by transarterial chemoembolization, were eligible. Based on baseline liver function and liver volume receiving ≥ 20 <jats:styled-content style="fixed-case">G</jats:styled-content>y, 35–40 <jats:styled-content style="fixed-case">G</jats:styled-content>y in five fractions was prescribed to the planning target volume surface.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Sixty‐three patients were eligible, with a median follow‐up duration of 31.1 (range 12.0–88.1) months. No patients were lost to follow‐up. Twenty patients were treated with only <jats:styled-content style="fixed-case">SABR</jats:styled-content>. In 43 patients treated with <jats:styled-content style="fixed-case">SABR</jats:styled-content> preceded by transarterial chemoembolization, accumulation of lipiodol in the tumor remained complete in five, a partial defect in 38 on pre‐<jats:styled-content style="fixed-case">SABR</jats:styled-content> computed tomography. The 1‐, 2‐, and 3‐year local control rates were 100%, 95%, and 92%, respectively; the intrahepatic recurrence‐free rates were 76%, 55%, and 36%, respectively; and the overall survival rates were 100%, 87%, and 73%, respectively. Grade 3 laboratory toxicities in the acute, subacute, and chronic phases were observed in 10, 9, and 13 patients, respectively, and ascites occurred in one patient.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Local control and overall survival after <jats:styled-content style="fixed-case">SABR</jats:styled-content> for untreated solitary <jats:styled-content style="fixed-case">HCC</jats:styled-content> were excellent despite the candidates being unfit for resection and ablation. <jats:styled-content style="fixed-case">SABR</jats:styled-content> is safe and might be an alternative to resection and ablation.</jats:p></jats:sec>

Access to Document (DOI)

Threshold Doses for Focal Liver Reaction After Stereotactic Ablative Body Radiation Therapy for Small Hepatocellular Carcinoma Depend on Liver Function: Evaluation on Magnetic Resonance Imaging With Gd-EOB-DTPA

International Journal of Radiation Oncology*Biology*Physics 2014.02

ISSN 0360-3016

Access to Document (DOI)

Maximum Standardized Uptake Value on FDG-PET Is a Strong Predictor of Overall and Disease-Free Survival for Non–Small-Cell Lung Cancer Patients after Stereotactic Body Radiotherapy

Journal of Thoracic Oncology 2014.01

ISSN 1556-0864

Access to Document (DOI)

Subclinical interstitial lung disease: Is it a risk factor for fatal radiation pneumonitis following stereotactic body radiotherapy?

Lung Cancer 2014.01

Access to Document (DOI)

Stereotactic ablative body radiation therapy with dynamic conformal multiple arc therapy for liver tumors: Optimal isodose line fitting to the planning target volume

Oku, Y. and Takeda, A. and Sanuki, N. and Sudo, Y. and Oooka, Y. and Aoki, Y. and Shimouchi, Y. and Nishina, R. and Nomura, K. and Eriguchi, T. and Kunieda, E.

Practical Radiation Oncology 4 ( 1 ) e7 2014

ISSN 18798500

Access to Document (DOI)

Tumor Response on CT Following Hypofractionated Stereotactic Ablative Body Radiotherapy for Small Hypervascular Hepatocellular Carcinoma With Cirrhosis

American Journal of Roentgenology 2013.12

ISSN 0361-803X

Access to Document (DOI)

Salvage Stereotactic Ablative Irradiation for Isolated Postsurgical Local Recurrence of Lung Cancer.

2013.08

Access to Document (DOI)

Stereotactic body radiotherapy for small hepatocellular carcinoma: A retrospective outcome analysis in 185 patients.

2013.08

Evaluation of microscopic tumor extension in early-stage cervical cancer: quantifying subclinical uncertainties by pathological and magnetic resonance imaging findings.

2013.07

Access to Document (DOI)

Stereotactic ablative body radiation therapy for octogenarians with non-small cell lung cancer.

2013.06

Access to Document (DOI)

Acceptable toxicity after stereotactic body radiation therapy for liver tumors adjacent to the central biliary system.

2013.03

Access to Document (DOI)

Evaluation for local failure by 18F-FDG PET/CT in comparison with CT findings after stereotactic body radiotherapy (SBRT) for localized non-small-cell lung cancer.

2013.03

Access to Document (DOI)

Outcomes of Clinically Node-Negative Breast Cancer Without Axillary Dissection: Can Preserved Axilla Be Safely Treated With Radiation After a Positive Sentinel Node Biopsy?

Clinical Breast Cancer 2013.02

ISSN 1526-8209

Access to Document (DOI)

Reassessment of declines in pulmonary function ≥1 year after stereotactic body radiotherapy.

2013.01

Access to Document (DOI)

Axillary Irradiation with High Tangent Fields for Clinically Node-Negative Breast Cancer: Can 3-D Conformal Radiotherapy with a Field-in-Field Technique Better Control the Axilla?

Breast Care 2013

ISSN 1661-3791

<jats:p>Background: The target volume for postoperative breast irradiation is the remaining breast tissue, and the axillary region is not an intentional target volume. Patients and Methods: Between 2001 and 2009, eligible women with pT1-2cN0/pN0(sn) breast cancer underwent breast-conserving therapy without axillary dissection. Treatment outcomes between 2 radiotherapy planning groups, high tangent fields with 2-dimensional (2-D) simulation-based planning and 3-dimensional (3-D) computed tomography-based planning with a field-in-field technique, were compared. The correlating factors for axillary failure were also calculated. Results: In total, 678 patients were eligible. As of May 2009, the median follow-up times for the 2-D (n = 346) and 3-D (n = 332) groups were 94 and 52 months, respectively. Patient characteristics were balanced, except for a younger population in the 2-D group and more lymphovascular invasion in the 3-D group. On multivariate analysis, 2-D planning was the only risk factor for axillary failure. In the 2-D and 3-D groups, the 5-year cumulative incidences of axillary failure were 8 (3.1%) and 1 (0.3%) (log-rank p = 0.009), respectively. The respective 5-year overall survival rates were 97.4 and 98.4% (p = 0.4). Conclusion: High tangent irradiation with 3-D planning improved axillary control compared to that with 2-D planning, suggesting that optimizing axillary dose distribution may impact outcomes.</jats:p>

Access to Document (DOI)

Multi-institutional comparison of treatment planning using stereotactic ablative body radiotherapy for hepatocellular carcinoma - benchmark for a prospective multi-institutional study.

2013

Access to Document (DOI)

Pitfalls in stereotactic body radiation therapy for heptocellular carcinoma

Sanuki, N. and Takeda, A. and Oku, Y. and Eriguchi, T. and Kunieda, E.

Japanese Journal of Clinical Radiology 58 ( 5 ) 682 - 690 2013

ISSN 00099252

Dose volume histogram analysis of focal liver reaction in follow-up multiphasic CT following stereotactic body radiotherapy for small hepatocellular carcinoma.

2012.09

Access to Document (DOI)

Stereotactic body radiotherapy (SBRT) for solitary pulmonary nodules clinically diagnosed as lung cancer with no pathological confirmation: comparison with non-small-cell lung cancer.

2012.07

Access to Document (DOI)

Comparison of clinical, tumour-related and dosimetric factors in grade 0–1, grade 2 and grade 3 radiation pneumonitis after stereotactic body radiotherapy for lung tumours

The British Journal of Radiology 2012.05

ISSN 0007-1285

Access to Document (DOI)

Radiotherapy quality assurance review for a multi-center randomized trial of locally advanced esophageal cancer: the Japan Clinical Oncology Group (JCOG) trial 0303.

2012.04

Access to Document (DOI)

Association of computed tomography-detected pulmonary interstitial changes with severe radiation pneumonitis for patients treated with thoracic radiotherapy.

2012

Access to Document (DOI)

The maximum standardized uptake value (SUVmax) on FDG-PET is a strong predictor of local recurrence for localized non-small-cell lung cancer after stereotactic body radiotherapy (SBRT)

Radiotherapy and Oncology 2011.11

ISSN 0167-8140

Access to Document (DOI)

CT evaluations of focal liver reactions following stereotactic body radiotherapy for small hepatocellular carcinoma with cirrhosis: relationship between imaging appearance and baseline liver function

The British Journal of Radiology 2010.12

ISSN 0007-1285

Access to Document (DOI)

Early graphical appearance of radiation pneumonitis correlates with the severity of radiation pneumonitis after stereotactic body radiotherapy (SBRT) in patients with lung tumors.

2010.07

Access to Document (DOI)

Dose distribution analysis in stereotactic body radiotherapy using dynamic conformal multiple arc therapy.

2009.06

Access to Document (DOI)

Relation between elective nodal failure and irradiated volume in non-small-cell lung cancer (NSCLC) treated with radiotherapy using conventional fields and doses

Radiotherapy and Oncology 2009.06

ISSN 0167-8140

Access to Document (DOI)

Stereotactic body radiotherapy for primary lung cancer at a dose of 50 Gy total in five fractions to the periphery of the planning target volume calculated using a superposition algorithm.

2009.02

Access to Document (DOI)

[Discrepancy between the intended isocenter and that from orthogonal linacgrams in the treatment of CT-guided stereotactic body radiotherapy(SBRT)].

2009.01

Dose distribution analysis of axillary lymph nodes for three-dimensional conformal radiotherapy with a field-in-field technique for breast cancer.

2009.01

Access to Document (DOI)

Discrepancy between the intended isocenter and that from orthogonal linacgrams in the treatment of CT-guided stereotactic body radiotherapy(SBRT)

Oooka, Y. and Takeda, A. and Sudo, Y. and Iwashita, H. and Aoki, Y. and Katayose, T. and Sasajima, N. and Sanuki, N. and Oohashi, T. and Kunieda, E. and Nagaoka, T.

Nippon Hoshasen Gijutsu Gakkai zasshi 65 ( 1 ) 41 - 49 2009

ISSN 03694305

Access to Document (DOI)

Future strategies in chemoradiotherapy for stage III non-small cell lung cancer

Ishikura, S. and Sanuki, N. and Ito, Y. and Nihei, K.

Japanese Journal of Clinical Radiology 54 ( 7 ) 851 - 856 2009

ISSN 00099252

Acute exacerbation of subclinical idiopathic pulmonary fibrosis triggered by hypofractionated stereotactic body radiotherapy in a patient with primary lung cancer and slightly focal honeycombing.

2008.10

Access to Document (DOI)

Pattern of tumor recurrence in initially nonmetastatic breast cancer patients

Cancer 2008.08

ISSN 0008-543X

<jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND.</jats:title><jats:p>Breast cancer is likely to have systemic involvement. However, to the authors' knowledge there are few reports to date regarding clinically detected patterns of metastasis, meticulously studied in regard to the natural history of breast cancer, including unusual sites of metastasis.</jats:p></jats:sec><jats:sec><jats:title>METHODS.</jats:title><jats:p>Patients treated for invasive breast cancer from April 1983 to May 2007 were retrospectively analyzed. Patterns of clinically apparent tumor recurrence, focusing especially on unusual metastases, were studied as well as possible risk factors for unusual metastases and their influence on survival.</jats:p></jats:sec><jats:sec><jats:title>RESULTS.</jats:title><jats:p>Overall, 3783 patients were eligible for the current analysis. The median duration of follow‐up was 5.0 years (range, 0.6 years–20.4 years). Cumulative 5‐year and 10‐year survival rates were 89.7% and 81.5%, respectively. “Unusual metastasis” was defined as systemic failure with a frequency of ≤1%; in the current series; it was observed in 85 (2.2%) patients %. Of those, 70 (82%) had preceding metastasis in the usual sites. The median duration until the development of usual and unusual metastasis was 2.3 years and 3.6 years, respectively (<jats:italic>P</jats:italic> < .0001). Among764 patients with distant metastasis, the 5‐year cumulative overall survival rate in those with or without unusual metastasis was 53.5% and 53.4 years, respectively (<jats:italic>P</jats:italic> = .33). No risk factors for unusual metastasis were identified.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS.</jats:title><jats:p>This retrospective study examined the frequency of unusual metastases in a large number of Japanese patients with initially nonmetastatic breast cancer. The prognosis of patients with unusual metastases was found to be similar to that of patients with metastasis only at more usual sites. Cancer 2008. © 2008 American Cancer Society.</jats:p></jats:sec>

Access to Document (DOI)

Possible misinterpretation of demarcated solid patterns of radiation fibrosis on CT scans as tumor recurrence in patients receiving hypofractionated stereotactic radiotherapy for lung cancer.

2008.03

Access to Document (DOI)

Hypofractionated stereotactic radiotherapy with and without transarterial chemoembolization for small hepatocellular carcinoma not eligible for other ablation therapies: Preliminary results for efficacy and toxicity.

2008.01

Access to Document (DOI)

Radiation therapy after breast-conserving surgery.

2006.06

Access to Document (DOI)

Evaluation of acute intestinal toxicity in relation to the volume of irradiated small bowel in patients treated with concurrent weekly gemcitabine and radiotherapy for locally advanced pancreatic cancer

Ito, Y. and Okusaka, T. and Kagami, Y. and Ueno, H. and Ikeda, M. and Sumi, M. and Imai, A. and Fujimoto, N. and Ikeda, H.

Anticancer Research 26 ( 5 B ) 3755 - 3759 2006

Pro‐gastrin–releasing peptide as a factor predicting the incidence of brain metastasis in patients with small cell lung carcinoma with limited disease receiving prophylactic cranial irradiation

Cancer 2005.08

ISSN 0008-543X

<jats:title>Abstract</jats:title><jats:sec><jats:title>BACKGROUND</jats:title><jats:p>Prophylactic cranial irradiation (PCI) reduces the incidence of brain metastasis with an effect on overall survival in patients with small cell lung carcinoma (SCLC). In spite of multidisciplinary intensive treatment approaches, many patients still experience brain metastasis. The authors retrospectively analyzed the characteristics of the first failure event due to brain metastasis (FBM) in patients treated with PCI.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>Between January 1990 and April 2004, 71 patients with limited disease SCLC were treated with PCI after completing systemic treatment at the National Cancer Center Hospital (Tokyo, Japan). Univariate and multivariate analyses were used to identify factors related to FBM and survival.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>The FBM and overall incidence of brain metastasis (OBM) were 16.9 % (12 of 71) and 26.8% (19 of 71), respectively. Median time to progressive disease and median survival were 8.4 months and 21.6 months, respectively. Elevation of pro‐gastrin–releasing peptide (Pro GRP) level before PCI was found to be a significant predictive and prognostic factor for FBM, OBM, and survival on multivariate analysis (<jats:italic>P</jats:italic> = 0.007, <jats:italic>P</jats:italic> = 0.025, and <jats:italic>P</jats:italic> = 0.009, respectively).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>An elevated Pro GRP level before PCI was found to be significantly related to FBM and survival, and should be considered before PCI is performed. Cancer 2005. © 2005 American Cancer Society.</jats:p></jats:sec>

Access to Document (DOI)

Benefits of axillary radiotherapy unclear in women with early stage breast cancer undergoing conservative breast surgery without axillary dissection

Sanuki-Fujimoto, N.

Cancer Treatment Reviews 31 ( 6 ) 496 - 500 2005

Access to Document (DOI)

Treatment of breast carcinoma in patients with clinically negative axillary lymph nodes using radiotherapy versus axillary dissection

Fujimoto, N. and Amemiya, A. and Kondo, M. and Takeda, A. and Shigematsu, N.

Cancer 101 ( 10 ) 2155 - 2163 2004

Access to Document (DOI)

A new bisphosphonate treatment option for giant cell tumors

Oncology Reports 2001.05

ISSN 1021-335X

Access to Document (DOI)

　 Previous page - Next page 　