Biomedical subjects

Hiromichi Ishiyama

Publications and source records attributed to Hiromichi Ishiyama.

11 recordsLinked to original sources

PubMed2006

Quality of life after brachytherapy or radical prostatectomy for localized prostate cancer: a prospective longitudinal study.

OBJECTIVES: To investigate health-related quality of life (HRQOL) in Japanese men with localized prostate cancer who underwent prostate brachytherapy (BT) or retropubic radical prostatectomy (RRP). METHODS: A total of 70 patients who underwent BT and 67 who underwent RRP were enrolled in our study. The Medical Outcomes Study 36-Item Short Form (SF-36), University of California, Los Angeles, Prostate Cancer Index, and the International Prostate Symptom Score were administered before and 1, 3, 6, and 12 months after treatment. No patients received neoadjuvant or adjuvant therapy. RESULTS: The RRP group reported significantly lower scores in several domains of the SF-36 at 1 month (P <0.05), but these domains returned to baseline within 6 months. The BT patients reported no significant changes in any of the general HRQOL domains throughout the follow-up period. The RRP group reported a lower posttreatment urinary function score, which reflected leakage, than the BT group. However, the BT patients experienced a significantly delayed recovery of the urinary bother score. The data from the International Prostate Symptom Score showed adverse effects from BT on voiding symptoms for the initial 6 months after treatment. No differences were found in bowel symptoms. RRP was associated with worse sexual function than BT, although nerve-sparing surgery minimized the difference. CONCLUSIONS: The results of this study have indicated that BT and RRP have meaningfully different profiles in the recovery of general QOL. The differences in the recovery of disease-specific HRQOL were pronounced during the first 12 months after treatment.

Aged↗

PubMed2006

Difference in rectal dosimetry between pre-plan and post-implant analysis in transperineal interstitial brachytherapy for prostate cancer.

BACKGROUND AND PURPOSE: To investigate differences in rectal dosimetry between pre-plan ultrasonography (US) and post-implant computed tomography (CT). PATIENTS AND METHODS: Subjects comprised 49 patients who underwent prostate brachytherapy using (125)I seed implants. Prescribed dose was 145Gy to the periphery of the prostate. Differences in rectal dosimetry between pre-plan US and post-implant CT analysis were evaluated. In addition, patients were divided into two groups according to timing of pre-planning (pre-plan group, n=28; intraoperative pre-plan group, n=21), and differences in rectal dosimetry between groups were assessed. RESULTS: The average of volume differences between pre-plan and post-implant analysis (pre-plan minus post-implant analysis) for all patients were follows: -0.08 cm(3) in V60 (volume of rectal wall receiving 60% of prescribed dose); -0.05 cm(3) in V70; -0.16 cm(3) in V80; -0.38 cm(3) in V90; -0.40 cm(3) in V100; -0.32 cm(3) in V110; -0.22 cm(3) in V120; -0.15 cm(3) in V130; -0.10 cm(3) in V140; -0.07 cm(3) in V150; and -0.05 cm(3) in V160. Apparent differences between pre-plan US and post-implant CT in rectal dosimetry were small. However, considering the steep curve of the relationship between tolerable volume and dose, a large actual difference should be assumed. No advantage was identified for the intraoperative pre-plan group. Safe volume to avoid proctitis tended to be smaller on ultrasonography than on CT at 1 month. CONCLUSIONS: The present work shows that direct comparison of CT analysis and pre-plan US is unfavorable due to large differences in these modalities and overestimation of tolerable volume. However, by comprehending the degree of difference, comparison of data from CT analysis with a US pre-plan may be feasible and useful for providing feedback between these modalities.

Brachytherapy↗

PubMed2006

Results of a questionnaire survey for symptom of late complications caused by radiotherapy in breast conserving therapy.

PURPOSE: The present study aimed to determine the prevalence of subjective symptoms of late complications mainly caused by radiotherapy in breast-conserving therapy (BCT), and to identify patients and treatment factors that may predict such complications. MATERIALS AND METHODS: A cross-sectional survey was conducted on 247 patients who had had early breast cancer and who were free of recurrence after BCT. Self-administered questionnaires were mailed to the 247 patients. Patient and treatment factors were analyzed. RESULTS: Responses were received from 193 of the 247 patients. Common perceptions of late complications included shrinking in size (85%), pain (73%), firmness (65%), thickening of the arm (34%), and changes in skin color (19%). However, high-grade toxicity (above Grade 2) was perceived in only 0.52-7.8% of patients. In multivariate models, shrinking in size was associated with age (P=0.020), pain was associated with additional boost irradiation (P=0.015), and firmness was associated with time after surgery (P=0.004). CONCLUSIONS: Late complications as perceived by the patient herself after BCT are common, but tend to be of minimal severity. Most predictive factors are inevitably associated with late complications. However, the boost irradiation may not be indicated for every patient from a QOL perspective.

Adult↗

PubMed2006

[Cranial nerve palsies due to skull base metastases in patients with prostate cancer: a report of two cases].

Two patients with prostate cancer showed cranial nerve palsies due to skull base metastases. Case 1: A 64-year-old man had prostate cancer (T4 N0 M1, Gleason score 7, prostate-specific antigen [PSA] level 372 ng/mL) with multiple bone metastases. Seventy-seven months after initiation of therapy, he had an articulation disorder and palsy of the left side of the tongue, with 12th cranial nerve palsy. Case 2: A 75-year-old man had a prostate cancer (T3b N0 M1, Gleason score 7, PSA level 177 ng/mL) with multiple bone metastases. Sixty-six months after initiation of therapy, he had hearing loss, noise in the right ear, and dizziness, with 8th cranial nerve deficits. Magnetic resonance imaging showed low intensity in the clivus in both cases, and all over the skull in case 2. The first patient was treated with radiation therapy and intravenous steroids at an early date. His symptoms improved.

Adenocarcinoma↗

PubMed2005

[Sudden death after 125I brachytherapy in prostate cancer patient: a case report].

A management of 125I isotope is defined by medical guideline from Ministry of Health, Labour and Welfare in Japan. According to this, when the patient died within one year after 125I interstitial permanent prostate brachytherapy, we have to do autopsy and collect all implanted isotopes as soon as possible. We report here, a 70-year-old man who underwent 125I interstitial permanent prostate brachytherapy for localized prostate cancer and one month after brachytherapy the patient died of acute cerebral hemorrhage, which was unrelated to the 125I brachytherapy. Autopsy was performed and collection of migrated isotopes was extremely difficult in technically. In addition, the cost of autopsy and distance from our hospital were also problems in this case. Treatment of prostate cancer with brachytherapy has increased in Japan, and we should establish management manual for sudden death case after 125I brachytherapy.

Adenocarcinoma↗

PubMed2005

Geometrical verification system using Adobe Photoshop in radiotherapy.

PURPOSE: Adobe Photoshop is used worldwide and is useful for comparing portal films with simulation films. It is possible to scan images and then view them simultaneously with this software. The purpose of this study was to assess the accuracy of a geometrical verification system using Adobe Photoshop. MATERIALS AND METHODS: We prepared the following two conditions for verification. Under one condition, films were hanged on light boxes, and examiners measured distances between the isocenter on simulation films and that on portal films by adjusting the bony structures. Under the other condition, films were scanned into a computer and displayed using Adobe Photoshop, and examiners measured distances between the isocenter on simulation films and those on portal films by adjusting the bony structures. To obtain control data, lead balls were used as a fiducial point for matching the films accurately. The errors, defined as the differences between the control data and the measurement data, were assessed. RESULTS: Errors of the data obtained using Adobe Photoshop were significantly smaller than those of the data obtained from films on light boxes (p < 0.007). CONCLUSION: The geometrical verification system using Adobe Photoshop is available on any PC with this software and is useful for improving the accuracy of verification.

Head and Neck Neoplasms↗

PubMed2005

Simple technique to visualize random set-up displacements using a commercially available radiotherapy planning system.

PURPOSE: To visualize random set-up displacements in isodose distribution images, we introduce a simple technique using a commercially available radiotherapy planning system (RTP). MATERIALS AND METHODS: A distribution of set-up displacement is known to be compatible with that of a Gaussian distribution. Based on that assumption, 41 intentionally misaligned beams with 1-mm intervals were planned in the respective weights according to Gaussian distribution. "Modified" isodose distributions were then visualized using a commercially available RTP. In the next step, only two beams misaligned with one standard deviation (SD) of the Gaussian distribution were used in place of 41 beams, as a large number of beams increases the workload and is unsuitable for clinical use. Differences between the two versions of isodose distribution images were assessed visually. RESULTS: In modified dose distribution images, the edge of distribution was dull compared to normal images. These images show that the larger SD of set-up displacement dulls the edge of dose distribution. Images from two beams were not significantly different to those from 41 beams. CONCLUSION: Using this technique, the impact of random set-up displacements was effectively reflected in isodose distribution images.

Humans↗

PubMed2004

Relationship between morphine and radiotherapy for management of symptomatic bone metastases from lung cancer.

To determine whether radiotherapy is effective for reducing morphine dose in patients with bone metastasis from lung cancer, a retrospective study was undertaken of 58 patients who had undergone palliative radiotherapy. Mean dose of radiotherapy was 20.26 (range 8-60) Gy. Daily morphine dose after start of radiotherapy was significantly greater than before radiotherapy, and dose of morphine did not significantly decrease. Radiotherapy appears ineffective for reducing morphine dose in patients with bone metastasis from lung cancer.

Adult↗

PubMed2004

[Usefulness of 3D conformal radiation therapy for reduction of radiation-induced white matter injury].

PURPOSE: The usefulness of three-dimensional conformal radiation therapy(3DCRT) in decreasing radiation-induced white matter changes(WMC) was assessed. MATERIAL AND METHODS: Thirty-seven patients(age 5-77 years, mean 42 years; male/female = 11/26) with primary intracranial tumors received 40 Gy or more, and were followed up with MRI for more than one year. Thirty-four patients underwent chemotherapy(with a platinum drug, 16; without a platinum drug, 18). Nineteen were treated with 3DCRT (radiation dose, range 60-64 Gy, mean 60.2 Gy; maximum width of radiation field, range 7-16 cm, mean 12.5 cm) and 18 were treated with non-3DCRT (radiation dose, range 40-62.4 Gy, mean 53.4 Gy; maximum width of radiation field, range 4-19 cm, mean 12.3 cm). RESULTS: WMC occurred in 37% of the 3DCRT group and 50% of the non-3DCRT group. Among the patients with WMC, Karnofsky performance scale(KPS) deteriorated in none of the 3DCRT group, whereas KPS deteriorated in 3 of 9 in the non-3DCRT group. All the patients with deterioration of KPS were at least 50 years of age. KPS did not strictly correlate with the severity of white matter changes on MRI. Chemotherapy with a platinum drug increased the incidence of WMC. Age(< 50 years vs. > or = 50 years), gender, radiation technique(3DCRT vs. non-3DCRT), radiation dose(< 60 Gy vs. > or = 60 Gy), maximum field-size(< 12 cm vs. > or = 12 cm), and maximum boost-field size(< 10 cm vs. > or = 10 cm) were not relevant to the incidence and severity of WMC. CONCLUSION: Though 3DCRT did not decrease the incidence and severity of white matter change on MRI, it may be useful to preserve the KPS, especially for older patients.

Adolescent↗

PubMedDate not supplied

Impact of pretreatment cholinesterase level on survival of inoperable intrahepatic or hepatic-hilar carcinomas treated with three-dimensional conformal radiotherapy.

PURPOSE: Prognostic factors for inoperable hepatocellular carcinomas (HCC), intrahepatic cholangiocellular carcinomas (IHCC), and hepatic-hilar cholangiocellular carcinomas (HHCC) treated with three-dimensional conformal radiotherapy (3DCRT) were evaluated. MATERIALS AND METHODS: Thirty-five consecutive patients were treated with 3DCRT (HCC, 14; IHCC, 11; HHCC, 10). Doses of 3DCRT ranged from 30-70 Gy (mean, 51.5 Gy). The follow-up time of the 12 living patients was 5-39 (median, 11) months. RESULTS: Two-year overall survival rates of HCC, IHCC, and HHCC were 19%, 26%, and 39%, respectively. On univariate analysis, 3DCRT dose (<50 Gy vs. 50-54 Gy vs. > or =60 Gy) (p<0.01) and pre-3DCRT cholinesterase value (p<0.01) were statistically significant factors for survival. Two-year overall survival rates of the patients treated with <50 Gy, 50-54 Gy, and > or =60 Gy were 0%, 50%, and 17%, respectively. The difference in survival between patients given 50-54 Gy and > or =60 Gy was not statistically significant (p=0.13). Two-year overall survival rates of patients with higher and lower cholinesterase values were 43% and 0%, respectively. On multivariate analysis, the independent variable most predictive of survival was pre-3DCRT cholinesterase value (p<0.01). CONCLUSION: Pre-3DCRT cholinesterase value was a significant independent prognostic indicator for survival. Benefit of dose escalation above 60 Gy could not be demonstrated.

Aged↗

PubMedDate not supplied

Successful treatment of concurrent chemoradiotherapy for stage I nasal NK/T cell lymphoma: a report of two cases.

Nasal natural killer/T cell (NK/T cell) lymphoma is a rare subtype of lymphomas, being a subtype of non-Hodgkin's lymphoma with a much worse prognosis than other subtypes. One reason for this worse prognosis is that nasal NK/T cell lymphoma is resistant to standard sequential chemoradiotherapy. Thus, we adopted concurrent chemoradiotherapy using a CHOP-like regimen for treating stage I nasal NK/T cell lymphoma. Case 1 was treated with concurrent chemoradiotherapy using 41-Gy irradiation with 12 cycles of the CHOP-like regimen (THP-CVP). Case 2 was treated with concurrent chemoradiotherapy using 50-Gy irradiation with 10 cycles of THP-CVP. In both Case I and Case 2, the tumors disappeared after chemoradiotherapy. The Case 1 patient is still alive with 45 months free of relapse. The Case 2 patient is also still alive with 39 months free of relapse. These results suggest that concurrent chemoradiotherapy using a CHOP-like regimen for stage I nasal NK/T cell lymphoma provided sufficient dose intensity and may be a useful treatment option.

Adult↗