基本情報
研究分野
1経歴
2論文
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European heart journal. Cardiovascular Imaging 2023年9月28日
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In Vivo 37(5) 2320-2326 2023年9月Background/Aim: Accelerated hyperfractionation (AHF) is used in head and neck cancer to improve the local control (LC) rate, but reports of outcomes for early-stage GC are limited. The outcomes of radiotherapy (RT) for stage 1 glottic carcinoma (GC) were retrospectively analyzed, comparing AHF and once-daily fractionation (ODF) using 2.0-2.4 Gy. Patients and Methods: A total of 102 patients with stage 1 GC underwent RT alone between 2007 and 2021, with 43 in the AHF group and 59 in the ODF group. A p-value less than 0.05 was considered to indicate a significant difference. Results: The 5-year LC rate was 98% in the AHF group and 91% in the ODF group (p=0.19). During RT, significantly more patients in the AHF group required opioids due to mucositis than in the ODF group (74% vs. 25%, p<0.001), and the rate of aspiration pneumonia tended to be higher in the AHF group than in the ODF group (7% vs. 0%, p=0.072). Conclusion: There was no difference in the LC rate between AHF and ODF for stage 1 GC. Moreover, the AHF group required opioids at a higher rate and tended to have a higher risk of developing aspiration pneumonia.
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In Vivo 37(5) 2320-2326 2023年8月31日
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Cancer reports (Hoboken, N.J.) 6(7) e1825 2023年7月BACKGROUND: Carbon-ion radiotherapy (C-ion RT) is effective for head and neck mucosal melanoma (HN-MM), including radioresistant mucosal melanoma. Melanoma also responds effectively to immune checkpoint inhibitors (ICIs). Data on the efficacy and safety of ICIs for HN-MM are insufficient. AIMS: To analyze the efficacy and safety of ICI salvage therapy in patients with HN-MM recurrence after C-ion RT. METHODS AND RESULTS: This retrospective study analyzed the medical records of 52 patients with HN-MM treated with C-ion RT between 2012 and 2020. A dose of 57.6 or 64.0 Gy (relative biological effectiveness) was provided in 16 fractions. The primary endpoint was 3-year overall survival (OS) rate. The median follow-up time was 26.8 months for all patients. A total of 29 patients had local recurrence or distant metastasis, and 16 patients who received ICI therapy. The 3-year OS rate in the ICI group (n = 16) and best supportive care group (n = 13) were 53.8% and 0.0%, respectively (p = 0.837); the difference was not statistically significant. There were no deaths after 1 year among patients who underwent ICI therapy. No adverse events associated with C-ion RT were related to or exacerbated by ICI. CONCLUSION: ICI salvage therapy is effective and safe for patients with HN-MM recurrence after C-ion RT.
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Case reports in oncology 16(1) 218-226 2023年QUAD SHOT is an ultra-hypofractionated radiotherapy (RT) technique that prescribes 14.0-14.8 Gy over 2 days. Although this technique has already gained some status as an effective palliative treatment for inoperable head and neck cancer (HNC), its application in other situations has not been given much consideration. Herein, we report a case of a 62-year-old woman who received preoperative QUAD SHOT therapy for poorly differentiated parotid carcinoma. In this case, after two courses of QUAD SHOT plus a standard chemotherapy regimen with pembrolizumab, the patient's inoperable, bulky tumor shrank dramatically and became operable. Best of all, while adequate therapeutic effects were achieved, the patient's time commitment and physical exertion were limited. RT during this period consisted of only eight fractions over 4 days. According to previous reports, the response rate for QUAD SHOT is sufficiently high, and the rate of serious adverse events is quite low. This case asks the question of whether the indications for QUAD SHOT irradiation can be expanded as one of the preoperative interventions undertaken by HNC surgeons to achieve conversion surgery.
MISC
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歯科放射線 in press(1) 15-18 2018年Introduction: Temporomandibular joint luxation has various causes, such as bruising and external force, as well as excessive opening of the mouth during eating, yawning, dental treatment, or oral intubation procedures for general anesthesia. Due to its sudden onset, it can have a significant psychological impact on patients, and early and appropriate treatment is necessary. We report a case in which temporomandibular joint luxation occurred during computed tomographic planning for postoperative chemoradiotherapy for oral cancer. <br>Case presentation: The patient was a 74-year-old female with squamous cell carcinoma of the right mandibular gingiva （cT4aN2bM0, stage Ⅳ, World Health Organization grade 1, INF-b）. We performed right mandibular segmental resection, right radical neck dissection, a free rectus abdominis muscle dermal flap transfer and wrap-around reconstruction, and tracheotomy with a reconstruction plate for right mandible squamous cell carcinoma. Two months after the surgery, temporomandibular joint luxation was detected during computed tomographic planning （with a mouthpiece） for postoperative chemoradiotherapy. The left mandibular condyle had deviated forward from the glenoid cavity. However, when we subsequently performed computed tomographic treatment planning without a mouthpiece the jaw dislocation could not be confirmed, and the left mandibular condyle was present in the glenoid cavity. There was no recurrence of the temporomandibular joint luxation, and the subsequent radiotherapy （60Gy/30fr） was effective.<br>Conclusion: It is considered that thorough anatomical confirmation during postoperative computed tomographic treatment planning is important in oral cancer cases, especially those involving mandibular segmental resection.
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