Biomedical subjects

Masamichi Nishio

Publications and source records attributed to Masamichi Nishio.

8 recordsLinked to original sources

PubMed2006

Analyses of dose-response in radiotherapy for patients with mature T/NK-cell lymphomas according to the WHO classification.

BACKGROUND AND PURPOSE: This study was conducted to analyze the influence of radiotherapy doses and chemotherapy doses and clinical parameters on in-field disease control in order to assess the optimal radiation doses for treatment of mature T/NK-cell lymphomas according to the newly proposed WHO classification. PATIENTS AND METHODS: Subjects consisted of 62 patients with mature T/NK-cell lymphomas treated with radiotherapy at four Japanese institutions between 1983 and 2002. We reevaluated all histopathological specimens of non-Hodgkin's lymphomas (NHL), using the WHO classification. Radiation therapy was usually delivered to the involved field. The majority of patients also received adriamycin-based chemotherapy such as CHOP, modified CHOP, or more intensive chemotherapy. RESULTS: There were no significant differences in radiosensitivity among subtypes of mature T/NK-cell lymphomas, at least between extranodal NK/T-cell lymphomas, nasal type and peripheral T-cell lymphomas, unspecified. There was a radiation dose-response in non-bulky mature T/NK-cell lymphomas, indicating that radiation doses of more than 52 Gy may be required to obtain in-field control. However, it was difficult to obtain local control of bulky T-cell lymphomas, even with high doses of irradiation. CONCLUSIONS: Mature T/NK-cell lymphomas were more radioresistant than B-cell lymphomas such as diffuse large B-cell lymphomas (DLBCL). The chemotherapy including adriamycin did not improve the in-field control of mature T/NK-cell lymphomas. These results were obtained by using non-randomized data and the significance of these results is limited by bias in data. However, our results suggest that the treatment strategy which is usually used for DLBCL, that is, a combined modality of CHOP and around 40 Gy of radiotherapy, may not be sufficiently effective for mature T/NK-cell lymphomas.

Adult↗

PubMed2006

[Altered fractionation].

For improving radiotherapy treatment results, altered fractionation (AF) is one of the most important biological factors to modify the conventional fractionation schedule. AF is classified into two categories. One is decreasing in dose-per-fraction and increasing in total dose, so-called hyperfractionation (HF), which expands the difference in radio-sensitivity between tumor and normal tissue. On the other hand, shortening of overall treatment time, so-called accelerated hyperfractionation (AHF), prevents accelerated repopulation of tumor cells during radiotherapy. AF is rarely recognized as a standard therapy despite many reports about its efficacy against various cancers, totally. This is often used for head and neck cancer. However, the problem is that they usually improve local-control, but do not always improve survival. Although AHF is recognized as one of a standard treatment for small cell lung cancer, it is still objectionable and disputable. Besides these, efficacy of AF against non-small cell lung cancer, bladder cancer and malignant glioma, has been reported. However, AF is not considered as a standard treatment. Accompanied with spread out of stereotactic irradiation, dose-fractionation-time relationship becomes to be more important subject, especially hypofractionation, to clarify the new aspect of AF.

Dose Fractionation, Radiation↗

PubMed2005

Results of radiation monotherapy for primary central nervous system lymphoma in the 1990s.

PURPOSE: Results of radiation therapy for primary central nervous system lymphoma (PCNSL) were poor in the 1970-1980s, with most reported 5-year survival rates being less than 10%. To investigate whether the prognosis of PCNSL patients treated by radiation alone remains still poor, we investigated the results of radiation monotherapy in the 1990s. METHODS AND MATERIALS: We collected data on 132 patients with histologically proven PCNSL treated by radiation alone in the 1990s from three nationwide or regional multiinstitutional studies conducted by the Japanese Society for Therapeutic Radiology and Oncology (JASTRO) Lymphoma Study Group or the Chubu Radiation Oncology Group. Follow-up data were updated as far as possible. Eleven patients who did not complete planned radiotherapy were included. The data were analyzed in relation to patient and tumor characteristics. The median patient age was 63 years, and the World Health Organization performance status (PS) was 3 or 4 in 40% of the patients. Multiple tumors were seen in 34%. Whole-brain irradiation with or without focal boost was used in 92%. The median radiation dose to the tumor site was 50 Gy (range, 8-74 Gy). RESULTS: For all 132 patients, the median survival time was 18 months and the 5-year survival rate was 18.0%. For 62 patients with PS 0-3 and aged 16-65 years (i.e., those eligible for the European Organization for Research and Treatment of Cancer 20962 study), the median survival was 26 months and 5-year survival was 24%. The 5-year survival was 25% for patients 63 years old or younger, and 9.8% for those older than 63 years (p = 0.0005). The 5-year survival was 22% for patients with PS 0-2 and 13% for those with PS 3 or 4 (p = 0.0040). Multivariate analysis confirmed the negative influence of higher age on patient prognosis. CONCLUSIONS: The results of radiation monotherapy for PCNSL appear to have improved as compared with those reported previously. The results of new treatment should be evaluated in light of this finding. Since most prospective studies on the combined treatment exclude poor PS and high-age patients, the 5-year survival rate of 30% may not be regarded as a marked improvement over radiation alone.

Adolescent↗

PubMed2005

[General remarks on brachytherapy].

Brachytherapy has long been used because its therapeutic gain factor is high. The high-dose-rate remote after loading system (RALS) that enables therapists to treat patients without any radiation exposure recently has become the mainstream method and has been used in preference to low-dose-rate brachytherapy. 192Ir fine seeds were developed to expand the number of diseases treated and to increase the precision of treatment through computerization. However, because of new adaptations of brachytherapy and its use with external irradiation and other techniques, new issues have been generated as a result of the technological advances in external beam radiotherapy. The current status of brachytherapy is summarized, and information on the cautions and future views for developments and problems in brachytherapy are given in this report.

Brachytherapy↗

PubMed2005

[A multicenter study to determine the efficacy and safety of strontium (89Sr) chloride for palliation of painful bony metastases in cancer patients].

PURPOSE: A multicenter study was conducted to evaluate the efficacy of strontium chloride (89SrCl2) for palliation of painful bony metastases using the Visual Analogue Scale (VAS), Brief Pain Inventory (BPI) and Functional Assessment for Cancer Therapy-General (FACT-G). METHODS: Ninety patients received a single injection of 2.0 MBq/kg and were classified as responders if VAS scores decreased without increased use of analgesics or if analgesic consumption decreased without an increase in the VAS. RESULTS: In the 69 subjects that could be evaluated, mean VAS values decreased significantly from 48.0 +/- 20.8 mm at baseline to 24.1 +/- 22.3 mm at last visit(Week 12) (p < 0.0001). VAS decreased more than 10 mm in 58.0% of these subjects, and analgesic consumption was reduced more than 10% in 39.1% of subjects. The response rates were 46.4% (95% confidence interval (CI) 34.3-58.8%) in the 69 subjects that could be evaluated and 43.3% (95% CI 32.9-54.2%) in all subjects. The scoring in BPI for interference in daily life improved together with improvement in its pain scores. Total FACT-G score showed significant improvement, as did its score in the subsection of physical well-being. Both platelets and leucocytes decreased by 22% at nadir (week 8), and such profiles of myelosuppression by 89SrCl2 were similar to those in the previous clinical studies. CONCLUSION: These results suggest the clinical utility of 89SrCl2 for pain palliation, which leads to QOL improvement in patients with painful generalized bone metastases.

Adult↗

PubMed2004

[Radiotherapy for head and neck cancer].

Radiotherapy plays an important role in therapy for head and neck cancers from the aspect of functional and cosmetic conservation. In 2001, 130,000 patients underwent radiotherapy for the first time, and those with head and neck cancer accounted for 12.5% of this population. However, we cannot consider the management of head and neck cancer without understanding the similarities and differences among the primary sub-sites, because there is a significant difference in the natural history of cancer among these sub-sites. Treatment results are improving with the popularization of stereotactic radiotherapy and concurrent chemotherapy, in addition to traditional brachytherapy. Trends in radiotherapy for head and neck cancer are summarized in this article by discussing the specificities and similarities among sub-sites.

Chemotherapy, Adjuvant↗

PubMed2002

A prospective, randomized trial comparing neoadjuvant chemotherapy with radiotherapy alone in patients with advanced nasopharyngeal carcinoma.

BACKGROUND: A prospective, randomized study was performed to determine the efficacy of neoadjuvant chemotherapy over radiotherapy alone in patients with locally advanced nasopharyngeal carcinoma. METHODS: From January 1991 to December 1998, 80 patients were enrolled in this study. Patients with locoregional carcinoma of the nasopharynx were randomized to receive two courses of chemotherapy, consisting of cisplatin and 5-fluorouracil (CDDP-5FU), that were administered before radiation therapy (CT arm) or radiotherapy alone. The patients who received neoadjuvant chemotherapy were treated with radiation therapy, which was scheduled to commence 2 weeks after the second course chemotherapy. RESULTS: With a median follow-up of 49 months, a trend toward improved overall survival or disease free survival favoring the CT arm was observed (5-year overall survival rate, 60% vs. 48%; 5-year disease free survival rate, 55% vs. 43%), although this difference was not significant. There were no differences in locoregional failure free survival between the two arms. However, metastasis free survival favored the CT arm, although this difference was not significant. The results also demonstrated that most patients in the CT arm who experienced recurrent disease developed locoregional recurrences before distant metastases, suggesting that improvements in locoregional control may lead to improved disease free survival. CONCLUSIONS: The use of CDDP-5FU chemotherapy prior to radiotherapy in patients with nasopharyngeal carcinoma did not result in a significant improvement in disease free survival or overall survival. However, there was a positive tendency in favor of the CT arm for distant metastasis free survival, although there was no improvement in the locoregional recurrence free survival rate.

Adolescent↗

PubMedDate not supplied

Results of radiation therapy for superficial esophageal cancer using the standard radiotherapy method recommended by the Japanese Society of Therapeutic Radiology and Oncology (JASTRO) Study Group.

BACKGROUND: Superficial esophageal cancer (SEC) is defined as esophageal cancer limited to the submucosal layers, including mucosal cancer and submucosal cancer, and is squamous cell carcinoma in most patients. In 2000, the Japanese Society of Therapeutic Radiology and Oncology (JASTRO) Study Group for SEC published a consensus guideline of standard radiotherapy methods. In this study, the interim treatment outcomes of SEC patients, who had received radiation therapy following the standard radiotherapy methods, were investigated. PATIENTS AND METHODS: From 2000 to 2003, a total of 141 SEC patients were treated in 24 institutions in Japan. RESULTS: The 1-, 2- and 3-year survival rates were 95%, 90% and 90%, respectively, for patients with mucosal cancer and 90%, 81% and 70%, respectively, for patients with submucosal cancer. The overall survival was better in patients who had undergone chemotherapy than in patients who had received radiation therapy alone, though the difference was not statistically significant. The clinical target volume (CTV) did not influence overall survival and intracavitary irradiation did not influence the local control rate in either patients with mucosal or submucosal cancer. Radiation-induced esophageal ulcer was not observed in this series. CONCLUSION: The standard radiotherapy methods are safe and effective for treating SEC. However, the usefulness of chemotherapy and intracavitary irradiation and the optimal setting of the CTV should be clarified by future randomized trials.

Aged↗