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Modified simultaneous integrated boost radiotherapy for an unresectable huge refractory pelvic tumor diagnosed as a rectal adenocarcinoma

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World Journal of Gastroenterology 2014年第48期20卷 18480-18486页

作者： Takuma Nomiya Hiroko Akamatsu Mayumi Harada Ibuki Ota Yasuhito Hagiwara Mayumi Ichikawa Misako Miwa Shouhei Kawashiro Motohisa Hagiwara Masahiro Chin Eiji Hashizume kenji nemoto Department of Radiation Oncology National Institute of Radiological Sciences Chiba 263-8555 Japan Department of Radiation Oncology Yamagata University Hospital Yamagata 990-8560 Japan Department of Surgery Nihonkai General Hospital Yamagata 990-8560 Japan

A clinical trial of radiotherapy with modified simultaneous integrated boost(SIB)technique against huge tumors was conducted.A 58-year-old male patient who had a huge pelvic tumor diagnosed as a rectal adenocarcinoma due to familial adenomatous polyposis was enrolled in this *** total dose of 77 Gy(equivalent dose in 2Gy/fraction)and 64.5 Gy was delivered to the center of the tumor and the surrounding area respectively,andapproximately 20%dose escalation was achieved with the modified SIB *** tumor with an initial maximum size of 15 cm disappeared 120 d after the start of the *** status of the patient improved from 4 to *** with modified SIB may be effective for patients with a huge tumor in terms of tumor shrinkage/disappearance,improvement of QOL,and prolongation of survival.

关键词： Clinical trial Image-guided radiotherapy Rectal neoplasms Quality of life Neoplasm recurrence

Effect of pulmonary rehabilitation on oxidative stress in patients with pulmonary diseases

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Advances in Bioscience and Biotechnology 2012年第7期3卷 1028-1036页

作者： Masayuki Itoh kenji nemoto Takao Tsuji Hiroyuki Nakamura Kazutetsu Aoshiba Department of Respiratory Medicine Tokyo Medical University Ibaraki Medical Center Ibaraki Japan

Exercise-training-based pulmonary rehabilitation has been confirmed to be effective in improving the activities of daily living (ADL) and relieving the dyspnea of chronic obstructive pulmonary disease (COPD) patients. Exercise training increases the antioxidant capacity of COPD patients, but since strenuous exercise and acute exercise loading have the opposite effect and increase oxidative stress, it is important to establish exercise training conditions that efficiently raise antioxidant capacity without increasing oxidative stress. Research on oxidative stress during exercise training by COPD patients has been pursued from that standpoint, but in recent years the targets of research on respirator diseases other than COPD have been expanding. In this article we will therefore review the results of research that has been conducted thus far on the effect of pulmonary rehabilitation on oxidative stress, including the results obtained at our own institution.

关键词： Pulmonary Rehabilitation Exercise Oxidative Stress Antioxidants Chronic Obstructive Pulmonary Disease

Experience of a Videoconference System with Medical Information Desktop Sharing for Radiation Therapy and Evaluation of Its Usefulness

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2014年第1期3卷 20-24页

作者： Shohei Kawashiro Yasuhito Hagiwara Ibuki Ota Mayumi Ichikawa Misako Miwa Yuuki Kuroda kenji nemoto Department of Radiation Oncology Yamagata Uni-versity Faculty of Medicine Yamagata Japan

Purpose: To present our videoconference system with medical information desktop sharing for radiation therapy and report initial experience using the system and its usefulness. Materials and Methods: A videoconference system for radiation therapy enables radiation oncologists sent to affiliated hospitals to consult a more experienced board-certified doctor at our institution while sharing the same display showing a patient’s information, radiology information system (RIS), and radiation therapy planning (RTP) system. We evaluated cases discussed in videoconferences to determine the influence of the system on treatment policies and radiation therapy plans. Results: From December 2012 to March 2013, treatment policies for 56 cases and radiation therapy plans for 50 cases were discussed in videoconferences. As for treatment policies, no change was made in treatment policy for 33 cases (59%), and minor and major changes were made for 16 (29%) cases and 7 (12%) cases, respectively. Radiation therapy plans for 50 cases were checked. No change was needed for 32 cases (64%), and minor and major changes were needed for 17 (34%) cases and 1 (2%) case, respectively. Conclusion: The videoconference system can be effective for improving the quality of radiation therapy.

关键词： Radiation Therapy Shortage of Radiation Oncologists Videoconference Desktop Sharing Telemedicine

Bladder-Sparing Approach with Radiotherapy in Patients with Small Cell Carcinoma of the Bladder

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Journal of Cancer Therapy 2014年第8期5卷 797-805页

作者： Hiroko Akamatsu Takuma Nomiya Mayumi Harada Ibuki Oota Mayumi Ichikawa Misako Miwa Yuuki Kuroda kenji Takai Akira Anbai Hideo Kawaguchi Yoshihiro Takai kenji nemoto Department of Radiation Oncology School of Medicine Akita University Akita Japan Department of Radiation Oncology School of Medicine Yamagata University Yamagata Japan Department of Radiation Oncology Yamagata City Hospital Saiseikan Yamagata Japan Department of Radiology School of Medicine Hirosaki University Hirosaki Japan

Small cell carcinoma (SCCB) of the bladder is rare and has a poor prognosis. Because of its rarity, gold standard care has not been established. The purpose of this study was to analyze the feasibility of a bladder-sparing approach. Data for treatments and outcomes in patients with a diagnosis of SCCB who received bladder-sparing treatment in our facility in the period from February 2007 to August 2012 were retrospectively analyzed. Six eligible patients received definitive radiotherapy in the cancer network of Tohoku region. Mean age of the patients was 69.5 years (range: 44 - 83 years), and median follow-up period was 29.2 months (range: 4.1 - 54.5 months). The mean dose was 60 Gy (range: 60 to 63 Gy), and 1.2 - 2.0 Gy was given per fraction. The initial CTV was the whole pelvis or the small pelvis, and it was shrunk to the bladder or tumor as a boost. The 1-year and 3-year overall survival rates were 83.3% and 55.6%, respectively. The 1-year and 3-year local control rates were both 80.0%. Only one patient had local failure. Recurrence or metastasis in sites other than the brain occurred in three (50%) of the patients after primary treatment. Two of those patients did not receive any chemotherapy. None of the patients had serious toxicities, and the bladder could be preserved in all patients. In this study, radiotherapy was effective for patients with SCCB. There was no recurrence in the bladder, and it was possible to preserve the bladder in all patients. Distant metastases were observed frequently, and chemotherapy was considered to be essential. Local treatment with radiotherapy has an important role from the point of view of the patient’s QOL.

关键词： Small Cell Carcinoma of the Bladder Radiotherapy Cystectomy