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Clinical benefit of radiation therapy and metallic stenting for unresectable hilar cholangiocarcinoma

World Journal of Gastroenterology 2012年第19期18卷 2364-2370页

作者： Hiroyuki Isayama Takeshi Tsujino Yousuke Nakai Takashi Sasaki keiichi nakagawa Hideomi Yamashita Taku Aoki Kazuhiko Koike Department of Gastroenterology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Department of Radiology Graduate School of MedicineThe University of TokyoTokyo 113-8655Japan Division of Hepato-Biliary-Pancreatic and Transplantation Surgery Department of SurgeryGraduate School of MedicineUniversity of TokyoTokyo 113-8655Japan

AIM:To determine the efficacy of external beam radiotherapy(EBRT),with or without intraluminal brachytherapy(ILBT),in patients with non-resected locally advanced hilar cholangiocarcinoma.METHODS:We analyzed 64 patients with locally advanced hilar cholangiocarcinoma,including 25 who underwent resection(17 curative and 8 non-curative),28 treated with radiotherapy,and 11 who received best supportive care(BSC).The radiotherapy group received EBRT(50 Gy,30 fractions),with 11 receiving an additional 24 Gy(4 fractions) ILBT by iridium-192 with remote after loading.ILBT was performed using percutaneous transhepatic biliary drainage(PTBD) route.Uncovered metallic stents(UMS) were inserted into nonresected patients with obstructive jaundice,with the exception of four patients who received percutaneous transhepatic biliary drainage only.UMS were placed endoscopically or percutaneously,depending on the initial drainage procedure.The primary endpoints were patient death or stent occlusion.Survival time of patients in the radiotherapy group was compared with that of patients in the resection and BSC groups.Stent patency was compared in the radiotherapy and BSC groups.RESULTS:No statistically significant differences in patient characteristics were found among the resection,radiotherapy,and BSC groups.Three patients in the radiotherapy group and one in the BSC group did not receive UMS insertion but received PTBD alone;cholangitis occurred after endoscopic stenting,and patients were treated with PTBD.A total of 16 patients were administered additional systemic chemotherapy(5-fluorouracil-based regimen in 9,S-1 in 6,and gemcitabine in 1).Overall survival varied significantly among groups,with median survival times of 48.7 mo in the surgery group,22.1 mo in the radiotherapy group,and 5.7 mo in the BSC group.Patients who underwent curative resection survived significantly longer than those who were not candidates for surgery(P = 0.0076).Cumulative survival in the radiotherapy group was significantly longer than in the BSC group(P =

关键词：金属支架放射治疗手术切除胆管平均存活时间肝临床癌

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Extended cancer-free survival after palliative chemoradiation for metastatic esophageal cancer

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World Journal of Gastrointestinal Oncology 2014年第2期6卷 52-54页

作者： Hideomi Yamashita Kae Okuma Akihiro Nomoto Mami Yamashita Hiroshi Igaki keiichi nakagawa Departments of Radiology University of Tokyo Hospital Departments of Palliative Care Unit University of Tokyo Hospital

We report on a patient who remained cancer-free for an extended time after palliative radiotherapy(RT) and chemotherapy(nedaplatin plus 5-fluorouracil) treatment for stage Ⅳ(cT3N3M1) esophageal squamous cell carcinoma. Although multiple lymph nodes outside the RT field recurred, the local primary tumor within the RT field did not recur, even 17 mo after palliative RT of 30 Gy in 10 fractions. In this case, acute toxicity, such as myelosuppression or esophagitis, was not enhanced by increasing the fraction dose from 1.8-2.0 Gy to 3.0 Gy. Because 30 Gy in 10 fractions can be completed within a shorter time and is less expensive than 50.4 Gy in 28 fractions, we think that 30 Gy without oblique beams is a more favorable RT method for patients.

关键词： Radiotherapy Chemotherapy Esophageal cancer Esophageal stenosis Metastatic esophageal cancer

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Case Report: Anaplastic Astrocytoma Treated with Postoperative Radiotherapy Using Flattening Filter-Free Volumetric Arc Therapy (FFF-VMAT) during Pregnancy—Acceptable Fetal Dosimetry

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Journal of Cancer Therapy 2020年第11期11卷 738-744页

作者： Tomoyuki Noyama Wataru Takahashi Yuki Nozawa Kanabu Nawa Hideomi Yamashita Osamu Abe keiichi nakagawa Department of Radiology The University of Tokyo Hospital Bunkyo-ku Tokyo Japan

Background: Postoperative irradiation for brain tumor in pregnant women is a matter of concern. Aim: We aimed to assess the safety of radiotherapy for brain tumors in pregnancy. We here report a successful treatment for anaplastic astrocytoma during pregnancy: surgery + postoperative irradiation. We wish to emphasize how we devised irradiation procedure to achieve both therapeutic effectiveness and safety to the fetus/infant. Case Presentation: A 34-year-old pregnant woman suffered with brain anaplastic astrocytoma. Tumor resection under craniotomy was performed with success. We decided to conduct postoperative radiotherapy at 25 weeks of gestation to reduce the risk of recurrence. We used a flattening filter-free volumetric arc therapy (FFF-VMAT) technique, which can achieve lower out-of-field dose than VMAT with a flattening filter or helical tomotherapy. We prescribed 60 Gy over 30 fractions. During actual beam delivery, surface and rectal dose to the patient (mother) were measured. The total fetal dose was estimated at 0.006 - 0.018 Gy, which is under the threshold set by the ICRP. A male healthy infant was born vaginally at the 37th week of pregnancy. The patient (mother) and the infant are healthy at the time of writing. Conclusion: FFF-VMAT is a good choice for brain tumors during pregnancy.

关键词： Pregnancy Radiotherapy Flattening Filter-Free Volumetric Arc Therapy An-aplastic Astrocytoma Fetal Dose

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Radiation therapy for portal venous invasion by hepatocellular carcinoma

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World Journal of Gastroenterology 2005年第46期11卷 7237-7241页

作者： keiichi nakagawa Hideomi Yamashita Kenshiro Shiraishi Naoki Nakamura Masao Tago Hiroshi Igaki Yoshio Hosoi Shuichiro Shiina Masao Omata Masatoshi Makuuchi Kuni Ohtomo Department of RadiologyUniversity of Tokyo 7-3-1 Hongo Bunkyo-kuTokyo 113-0033Japan Department of GastroenterologyUniversity of Tokyo 7-3-1 Hongo Bunkyo-kuTokyo 113-0033Japan Department of Hepatobiliary SurgeryUniversity of Tokyo 7-3-1 Hongo Bunkyo-kuTokyo 113-0033Japan

AIM: To clarify the efficacy and safety of three-dimensional conformal radiotherapy (3-D CRT) for this disease and to specify patient subgroups suitable for this treatment.METHODS: Fifty-two patients with HCC received PVI-targeted radiation therapy from January 1995 through December 2003. Portal venous invasion (PVI) was found in the second or lower order branches of the portal vein in 6 patients, in the first branch in 24 patients and in the main trunk in 22 patients. Child classifications of liver function before radiation therapy were A, B, and C for 19, 24 and 2 patients, respectively. All patients received three-dimensional conformal radiotherapy with a total dose ranging from 39 to 60 Gy (57.0 Gy in average).RESULTS: Overall survival rates at 1, 2, 3, 4, and 5 years were 45.1%, 25.3%, 15.2%, 10.1%, and 5.1%, respectively. Univariate analysis revealed that Child status, the number of tumor foci, tumor type,transcatheter arterial embolization (TAE) after radiation therapy were statistically significant prognostic factors.Multivariate analysis showed that the number of tumor foci and TAE after radiation therapy were statistically significant.CONCLUSION: The results of this study strongly suggest the efficacy of 3-D CRT as treatment for PVI in HCC. 3-D CRT is recommended in combination with postradiation TAE for PVI of HCC with 5 tumor foci or less in the liver and with Child A liver function.

关键词：肝细胞癌放射治疗病理机制临床表现

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A Half-Arc Multiple Deep-Inspiration Breath-Hold Volumetric Modulated Arc Therapy for a Lung Tumor with 10 MV Flattening-Filter-Free Beams and an Image Sensor Measuring a Distance Map to Thorax Surface: An Initial Clinical Experience

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第1期6卷 31-35页

作者： keiichi nakagawa Kanabu Nawa Masatoshi Hashimoto Shuri Aoki Yoshihiro Kaneko Hideomi Yamashita Akihiro Haga Department of Radiology University of Tokyo Hospital Tokyo Japan Department of Radiation Oncology The Cancer Institute Hospital of Japanese Foundation for Cancer Research Tokyo Japan

A technique for multiple deep-inspiration breath-hold (DIBH) volumetric modulated arc therapy (VMAT) for a lung tumor has been proposed with 10 MV flattening-filter-free beams and an image sensor measuring a distance map to thorax surface. Planning CT images were acquired under a DIBH condition and a clinical target volume (CTV) was contoured. This procedure was repeated five times and an internal target volume (ITV) among the multiple DIBHs was created by integrating the five CTVs. A planning target volume (PTV) was defined by adding an isotropic margin of 5 mm to the ITV. Immediately before treatment, a 30-second half-arc cone-beam computer tomography (CBCT) imaging was performed under another DIBH condition, and the couch was repositioned so that tumor may be located inside the PTV contours. An infrared distance measurement device having laser diodes and an image sensor was attached to the couch, and a distance map to the patient thorax surface was recorded as a reference during still another DIBH condition. A half-arc segmented VMAT beams with two beam interrupts were delivered to the patient under multiple DIBHs, where the delivery time of each of the three segmented beams was 30 seconds. During the beam delivery, the distance map was monitored in real time to confirm that the distance to the thorax surface remained unchanged. In-treatment CBCT images suggested that the tumor position at the time of tumor registration was accurately reproduced during the DIBH VMAT delivery.

关键词： Deep Inspiration Breath-Hold DIBH FFF VMAT Kinect Lung

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Radiation pneumonitis after stereotactic radiation therapy for lung cancer

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World Journal of Radiology 2014年第9期6卷 708-715页

作者： Hideomi Yamashita Wataru Takahashi Akihiro Haga keiichi nakagawa Department of Radiology University of Tokyo Hospital

Stereotactic body radiation therapy(SBRT)has a locacontrol rate of 95%at 2 years for non-small cell lungcancer(NSCLC)and should improve the prognosis oinoperable patients,elderly patients,and patients withsignificant comorbidities who have early-stage NSCLCThe safety of SBRT is being confirmed in internationalmulti-institutional PhaseⅡtrials for peripheral lungcancer in both inoperable and operable patients,bureports so far have found that SBRT is a safe and effective treatment for early-stage NSCLC and early metastatic lung cancer.Radiation pneumonitis(RP)is oneof the most common toxicities of SBRT.Although mospost-treatment RP is Grade 1 or 2 and either asymptomatic or manageable,a few cases are severe,symptomatic,and there is a risk for mortality.The reportedrates of symptomatic RP after SBRT range from 9%to28%.Being able to predict the risk of RP after SBRT isextremely useful in treatment planning.A dose-effecrelationship has been demonstrated,but suggesteddose-volume factors like mean lung dose,lung V20and/or lung V2.5 differed among the reports.We foundthat patients who present with an interstitial pneumo-nitis shadow on computed tomography scan and high levels of serum Krebs von den Lungen-6 and surfactant protein D have a high rate of severe radiation pneumo-nitis after SBRT.At our institution,lung cancer patients with these risk factors have not received SBRT since 2006,and our rate of severe RP after SBRT has de-creased significantly since then.

关键词： Radiation pneumonitis Stereotactic radia-tion therapy Dose-volume factors Krebs von den Lun-gen-6 Surfactant protein D Computed tomography changes

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EVALUATION OF NEUTRON NUCLEAR DATA OF NATURAL SILVER AND ITS ISOTOPES

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中国核科技报告 1991年第S2期 197-213页

作者： Liu Tingjin(CHINESE NUCLEAR DATA CENTER, IAE)keiichi SHIBATA and Tsuneo nakagawa(NUCLEAR DATA CENTER, DEPARTMENT OF PHYSICS, JAERI)

Neutron nuclear data of natural sliver and its isotopes(Ag andAg)have been evaluated in the energy range of 10eV～20 MeV.Evaluated quan-tities are the total,elastic and inelastic scattering,capture,(n,2n),(n,3n),(n,p)... 详细信息

关键词： Ag EVALUATION OF NEUTRON NUCLEAR DATA OF NATURAL SILVER AND ITS ISOTOPES ENDF ITS

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Reductive Conversion of Biomass-Derived Furancarboxylic Acids with Retention of Carboxylic Acid Moiety

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Transactions of Tianjin University 2021年第3期27卷 165-179页

作者： Yoshinao nakagawa Mizuho Yabushita keiichi Tomishige Department of Applied Chemistry School of EngineeringTohoku University6-6-07 AobaAramakiAoba-kuSendai 980-8579Japan Research Center for Rare Metal and Green Innovation Tohoku University468-1AobaAramakiAoba-kuSendai 980-0845Japan

Catalytic reduction systems of 2-furancarboxylic acid(FCA)and 2,5-furandicarboxylic acid(FDCA)with H 2 without reduction of the carboxyl groups are reviewed.FCA and FDCA are produced from furfural and 5-hydroxymethylfurfural which are important platform chemicals in biomass conversions.Furan ring hydrogenation to tetrahydrofuran-2-carboxylic acid(THFCA)and tetrahydrofuran-2,5-dicarboxylic acid(THFDCA)easily proceeds over Pd catalysts.Hydrogenolysis of one C–O bond in the furan ring produces 5-hydroxyvaleric acid(5-HVA)and 2-hydroxyadipic acid.2-Hydroxyvaleric acid is not produced in the reported systems.5-HVA can be produced as the lactone form(δ-valerolactone;DVL)or as the esters depending on the solvent.These reactions proceed over Pt catalysts with good yields(~70%)at optimized conditions.Hydrogenolysis of two C–O bonds in the furan ring produces valeric acid and adipic acid,the latter of which is a very important chemical in industry and its production from biomass is of high importance.Adipic acid from FDCA can be produced directly over Pt-MoO_(x) catalyst,indirectly via hydrogenation and hydrodeoxygenation as one-pot reaction using the combination of Pt and acid catalysts such as Pt/niobium oxide,or indirectly via two-step reaction composed of hydrogenation catalyzed by Pd and hydrodeoxygenation catalyzed by iodide ion in acidic conditions.Only the two-step method can give good yield of adipic acid at present.

关键词： Biomass Hydrogenolysis Furanic compound Carboxylic acid

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Taming heterogeneous rhenium catalysis for the production of biomass-derived chemicals

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Chinese Chemical Letters 2020年第5期31卷 1071-1077页

作者： keiichi Tomishige Yoshinao nakagawa Masazumi Tamura Department of Applied Chemistry School of EngineeringTohoku UniversityMiyagi 980-857Japan

Rhenium is one of important components for heterogeneous catalysts,which has been recently used for the catalytic reactions related to the production of biomass-derived chemicals such as deoxydehydration of vicinal OH groups,C-O hydrogenolysis,and hydrogenation of carboxylic acids,and so on.Suitable oxidation state of Re as a catalytic active species is strongly dependent on the catalytic reactions.The control of the oxidation state of Re species on the catalysts is crucial on the catalyst development.

关键词： Rhenium Oxidation state Deoxydehydration Hydrogenolysis Hydrogenation

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用于水蒸气重整生物质热解焦油的镍基催化剂的发展(英文)

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催化学报 2012年第4期33卷 583-594页

作者： Dalin LI Yoshinao nakagawa keiichi TOMISHIGE Department of Applied Chemistry School of Engineering Tohoku University Sendai 980-8579 Japan National Engineering Research Center of Chemical Fertilizer Catalyst Fuzhou University Fuzhou 350002 Fujian China

Nickel catalysts are effective for the steam reforming of tar derived from biomass pyrolysis,but the improvement is needed in terms of activity,stability,suppression of coke deposition and aggregation,and regeneration.Our recent development of Ni-based catalysts for the steam reforming of tar is reviewed including the modification with CeO2(or MnO),trace Pt,and MgO.The role of additives such as CeO2,MnO,Pt,and MgO is also discussed.

关键词：化学催化高压高温

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