研究者業績
基本情報
- 所属
- 藤田医科大学 医学部 医学科 放射線腫瘍学講座 講師
- 学位
- 博士(医学）
- J-GLOBAL ID
- 201501004347822720
- researchmap会員ID
- 7000012869
英国王立医学協会 海外会員（FRSM; Fellow of Royal Society of Medicine）
論文
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International journal of surgery case reports 116 109302-109302 2024年2月1日 査読有り筆頭著者責任著者INTRODUCTION: Radiotherapy is a treatment option in the management of patients with metastatic liver disease. The aim in this case was to evaluate radiation-induced dysfunctional liver lesions using 99mTc-GSA-SPECT, Gd-EOB-DTPA-enhanced MRI, and radiation dose distribution in a patient after radiation therapy. PRESENTATION OF CASE: After sigmoid colon resection, three liver metastases were treated with radiotherapy at the same time. Liver function after radiotherapy was determined to be A according to the Child-Turcott-Pugh classification. 99mTc-GSA-SPECT showed a wider reduction in uptake than Gd-EOB-DTPA MRI at all three sites. HH15 showed decreased liver function. DISCUSSION: In the 99mTc-GSA-SPECT and Gd-EOB-DTPA MRI hepatocyte phases, residual signals of normal hepatocytes were observed despite irradiation at three sites. Additional treatment could be considered for the two recurrent lesions because there was no deterioration of liver function in post-irradiation imaging findings and blood sampling. CONCLUSION: 99mTc-GSA-SPECT and EOB-MRI showed characteristic findings for evaluation of liver function after radiotherapy for multiple liver metastases, suggesting the need for both imaging evaluations. It is now possible to choose whether to perform local additional treatment (additional radiation, RFA) or other chemotherapy for liver metastases after recurrence.
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Pediatric reports 15(2) 333-340 2023年5月26日 査読有りCentral nervous system (CNS) involvement in anaplastic large cell lymphoma (ALCL) at diagnosis is rare and leads to poor prognosis with the use of the standard ALCL99 protocol alone. CNS-directed intensive chemotherapy, such as an increased dose of intravenous MTX, increased dose of dexamethasone, intensified intrathecal therapy, and high-dose cytarabine, followed by cranial irradiation, has been shown to improve survival in this population. In this paper, the authors describe a 14-year-old male with an intracranial ALCL mass at onset who received CNS-directed chemotherapy followed by 23.4 Gy of whole-brain irradiation. After the first systemic relapse, the CNS-penetrating ALK inhibitor, alectinib, was applied; it has successfully maintained remission for 18 months without any adverse events. CNS-penetrating ALK inhibitor therapy might prevent CNS relapse in pediatric ALK-positive ALCL. Next-generation ALK inhibitors could be introduced as a promising treatment option, even for primary ALCL with CNS involvement, which could lead to the omission of cranial irradiation and avoid radiation-induced sequalae. Further evidence of CNS-penetrating ALK inhibitor combined therapy for primary ALK-positive ALCL is warranted to reduce radiation-induced sequalae in future treatments.
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Nagoya journal of medical science 84(1) 111-119 2022年2月 査読有り筆頭著者責任著者The purpose of this study was to determine the most appropriate seed arrangement by comparing two different methods (linked seeds and loose seeds). A total of sixty-one patients (28 linked seed brachytherapy cases and 33 loose seed brachytherapy cases) with clinically localized prostate cancer were treated with I-125 permanent prostate brachytherapy. Modified peripheral loading was the method used for seed placement. The parameters evaluated were as follows: prostate D90, V100, and V150; urethral D90, D10, and D5; and rectal V100 (RV100) and D2 (RD2). Coefficient parameters (r and r2) were assessed by regression analysis. Prostate V150, urethral D90, urethral D10, urethral D5, and RD2 showed significant correlations between both methods in all patients. Urethral D90, urethral D10, urethral D5, and RD2 showed significant correlations in patients who received linked seed brachytherapy. Prostate V150, urethral D90, urethral D10, urethral D5, RV100, and RD2 showed significant correlations in patients who received loose seed brachytherapy. Urethral D90, urethral D10, urethral D5, and RD2 showed significant correlations in the linked seed and loose seed brachytherapy analyses. In contrast, prostate D90 and prostate V100 showed no correlation. Parameters of normal organ damage showed good correlations between intraplan and postplan parameters. These parameters may be useful to determine normal organ damage during guided brachytherapy with two different methods (linked seeds and loose seeds).
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European Journal of Gynaecological Oncology 2022年 査読有り筆頭著者責任著者Although concurrent chemoradiotherapy (CCRT) is an effective treatment for advanced cervical cancer, its use in advanced cervical cancer with a pedunculated cervical leiomyoma remains challenging. The prognosis of recurrent cervical cancer is poor, with a low possibility of complete response (CR). In this present study, after completion of external beam radiotherapy (EBRT) and chemotherapy (weekly cisplatin), we performed the resection of a pedunculated cervical leiomyoma. No malignant cells were identified in the pathological specimen. After the myoma resection, no cervical tumor was observed on follow-up magnetic resonance imaging (MRI). High-dose-rate intracavitary brachytherapy (HDR-ICBT) was also performed. Local control of the cervical tumor was achieved after 30 months of treatment. After CCRT, rectal hemorrhage was observed but was effectively controlled via local intervention. Twenty-four months after CCRT, the patient was given salvage chemotherapy (paclitaxel plus carboplatin) due to lymph node metastasis observed at the outside range of EBRT. Thirty months after CCRT, computed tomography showed that the metastatic lymph nodes had disappeared, and the patient achieved CR. Thus, for advanced cervical cancer with a pedunculated cervical leiomyoma, CCRT could be completed following myoma resection. In addition, salvage chemotherapy for lymph node metastasis might result in CR. In this present case, a gastrointestinal adverse event was observed after radiotherapy and salvage chemotherapy with paclitaxel plus carboplatin achieved CR.
MISC
34-
RADIATION ONCOLOGY 8 56 2013年3月Background: Radiation pneumonitis (RP) and organizing pneumonia (OP) are the two main types of lung damage that can occur after lung irradiation. The goal of this study was to evaluate the relationship between RP and OP after irradiation for breast cancer. Methods: Four hundred and twenty-eight patients who underwent radiotherapy for breast cancer were identified. The whole breast was irradiated with two tangential photon beams. Chest computed tomography (CT) scan were performed when patients showed any symptoms that were suspicious for pneumonitis. Results: Five patients (1.2%) were diagnosed with OP. All five patients showed ground glass opacities and consolidation of the border of the lesion of RP in the radiation fields. Infiltration of OP spread from the site of RP to the hilum of the ipsilateral lung. Between RP and OP, a free region space (FRS) could be detected. Conclusions: OP is closely related to RP. All OP lesions developed near the site of RP.
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日本泌尿器科学会雑誌 102(2) 498 2011年
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ANNALS OF NUCLEAR MEDICINE 24(3) 163-169 2010年4月The transition of microglia from the normal resting state to the activated state is associated with an increased expression of peripheral benzodiazepine receptors (PBR). The extent of PBR expression is dependent on the level of microglial activation. A PBR ligand, [C-11]PK11195, has been used for imaging of the activation of microglia in vivo. We evaluated whether [C-11]PK11195 PET can indicate differences of microglial activation between no treatment and lipopolysaccharide (LPS) treatment in a rat artificial injury model of brain inflammation. On day 1, a small aliquot of absolute ethanol was injected into the rat right striatum (ST) to produce artificial brain injury. On day 3, MRI scans were performed to evaluate and select rats showing a similar degree of brain injury. Then LPS or vehicle was administered intraperitoneally. On day 4, PET scans were performed after a bolus injection of [C-11]PK11195. Eleven rats (7 LPS administered rats, 4 LPS non-administered rats) were evaluated. We used uptake ratios of the integral of right and left striatum from 0 to 60 min as an estimate of PBR distribution volume (V (60)). The number of activated microglia and mRNA expression of inflammatory cytokines (TNF alpha, IL-1 beta) were assessed by isolectin-B4 staining and RT-PCR, respectively. Right/left ST V (60) ratios of LPS group were significantly higher than those of non-LPS group (P < 0.03). Although there were no significant differences in the number of activated microglia between the two groups, LPS group showed higher expression of inflammatory cytokines (TNF alpha, IL-1 beta) than the non-treated group indicating that further activation was induced by LPS treatment. The results suggest that intensity of PBR signals in [C-11]PK11195 PET may be related to the level of microglial activation rather than the number in activated microglia at least in an artificial brain injury model.
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日本放射線腫瘍学会雑誌 21(3) 165-168 2009年9月【目的】早期前立腺がんに対するI-125を用いた永久挿入治療においては脱落線源の紛失による環境汚染が問題となっている．本研究では，挿入後から一時管理区域病室退院までの間の脱落線源を確実に捕捉しうる方策を検討する．【方法】2006年 7 月から2007年12月までの期間で，密封小線源挿入療法を施行した121例(7718個)を対象とした．挿入直後から退院までの脱落線源の発見事例における発見場所ならびに発見時期を検討し，脱落の場所，時期を推定した．【結果】退院までに総計43個発見され，頻度は43/7718(0.56%)であった．挿入後手術室にて 4 個，一時管理区域病室では膀胱内留置カテーテル抜去前が 2 個，そして，膀胱内留置カテーテル抜去後，一時管理区域病室退院時のサーベイで32個発見された．膀胱鏡にて，膀胱内より取り除いたのは 5 個であった．別に，退院後自宅で脱落したとして持参したのが 5 個であった．【結語】脱落線源を紛失しないためには，管理病室への入退室者の注意深いモニターと慎重なサーベイが必要と考えられた．
講演・口頭発表等
20教育内容・方法の工夫（授業評価等を含む）
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件名放射線腫瘍学に関し、医学部4年、医療科学部2年生に講義している。開始年月日2009終了年月日2012概要定位放射線治療、密封小線源治療、RI療法を実診療、国家試験内容に則した内容で講義している。