2023/03/20 更新

写真a

タカセ　ユウキ
髙瀬　裕樹
TAKASE Yuki
所属
医学部附属病院 放射線科 病院助教
職名
病院助教

学位 1

  1. 博士(医学) （ 2021年3月   名古屋大学 ） 

学位の先頭へ▲

研究分野 1

  1. ライフサイエンス / 腫瘍診断、治療学

研究分野の先頭へ▲

現在の研究課題とSDGs 2

  1. 頭蓋内悪性腫瘍の放射線治療

  2. 他施設での放射線治療データ共有の円滑化

現在の研究課題とSDGsの先頭へ▲

経歴 1

  1. 名古屋大学   病院助教

経歴の先頭へ▲

学歴 1

  1. 名古屋大学

学歴の先頭へ▲

所属学協会 2

  1. 日本放射線腫瘍学会

  2. 日本医学放射線学会

所属学協会の先頭へ▲

委員歴 5

  1. 強度変調放射s年治療システム試用策定委員  

  2. 薬事委員  

  3. マスタ委員  

  4. カルテ監査委員  

  5. 移動型投資用エックス線装置仕様策定委員  

委員歴の先頭へ▲
 

論文 15

  1. Stereotactic body radiation therapy for prostate cancer: a study comparing 3-year genitourinary toxicity between CyberKnife and volumetric-modulated arc therapy by propensity score analysis.

    Ito M, Yoshioka Y, Takase Y, Suzuki J, Takahashi H, Minami Y, Sakuragi A, Oshima Y, Okuda T, Suzuki K

    Radiation oncology (London, England)   18 巻 ( 1 ) 頁： 39   2023年2月

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    記述言語：英語   出版者・発行元：Radiation Oncology  

    Background: To investigate whether the rate of stereotactic body radiation therapy-related (SBRT-related) genitourinary (GU) toxicity is lower in patients with prostate cancer treated with CyberKnife. Methods: We retrospectively reviewed the medical records of patients with nonmetastatic prostate cancer at two institutions between 2017 and 2020. We analyzed 70 patients who were extracted by propensity score matching based on age, pre-treatment International Prostate Symptom Score (IPSS), and prostate volume. The patients were treated with SBRT, with a total dose of 36.25 Gy in five fractions over five consecutive weekdays, using CyberKnife or volumetric-modulated arc therapy (VMAT). Results: The low-, medium-, and high-risk patients were 2, 19, and 14, respectively, in the CyberKnife group and 4, 17, and 14, respectively, in the VMAT group. The median follow-up time in both groups was 3 years. One patient with CyberKnife died of unrelated causes. No biochemical or clinical recurrence, distant metastases, or death from prostate cancer was observed. The peak values of IPSS in the acute phase (< 3 months) were significantly lower in the CyberKnife than in the VMAT group (CyberKnife:16.2 vs VMAT:20.2, p = 0.025). In multiple regression analyses, the treatment modality (p = 0.03), age (p = 0.01), bladder medication pre-irradiation (p = 0.03), and neoadjuvant androgen deprivation therapy (p = 0.04) contributed to the peak value of the acute-phase IPSS. The incidence of treatment-related grade 2 acute GU toxicity tended to be lower in the CyberKnife than the VMAT group (CyberKnife: 22.9% vs. VMAT: 45.7%, p = 0.077). No difference was noted between the groups with regard to late IPSS or GU toxicity and gastrointestinal toxicity in all phases. Toxicities of grade ≥ 3 have not been observed to date. Conclusions: Regardless of treatment modality, SBRT is effective in treating prostate cancer without serious toxicity. However, CyberKnife has an advantage over VMAT in terms of acute prostate symptoms.

    DOI： 10.1186/s13014-023-02233-4

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    PubMed

  2. Poor local control of ulcerative T1 glottic cancer treated with 2.25-Gy per fraction radiotherapy

    Oie Yumi, Itoh Yoshiyuki, Kawamura Mariko, Takase Yuuki, Murao Takayuki, Ishihara Shunichi, Nomoto Yoshihito, Hirasawa Naoki, Asano Akiko, Yamakawa Kouji, Ito Junji, Kinoshita Fumie, Naganawa Shinji

    NAGOYA JOURNAL OF MEDICAL SCIENCE   83 巻 ( 4 ) 頁： 811 - 825   2021年11月

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    記述言語：英語   出版者・発行元：Nagoya Journal of Medical Science  

    The Tokai Study Group for Therapeutic Radiology and Oncology (TOSTRO) started managing T1 glottic cancer using 2.25 Gy/fraction radiotherapy in 2011. The aim was to evaluate the local control (LC) rate and toxicity with 2.25-Gy radiotherapy in clinical practice and identify prognostic factors.The eligibility criteria were T1 glottic squamous cell carcinoma patients with age ≥20 years, treated with 2.25 Gy/fraction without chemotherapy between 2011 and 2017. LC rates were evaluated based on age, performance status, sex, T-category, tumor type (ulcerative or non-ulcerative), presence of anterior commissure invasion, tumor size, X-ray beam energy, and overall treatment time. Acute and late adverse events were evaluated using CTCAE version 4.0. A total of 202 patients were enrolled. The median follow-up period was 34.2 months. The 2 and 4-year LC rates were 93.8% and 93.1%, respectively. There was a significant difference in the LC rate between non-ulcerative type and ulcerative type (95.2% vs. 74.1% at 2 years, 94.4% vs. 74.1% at 4 years; p = 0.01). On univariate analysis, only tumor type was significantly correlated with a poor LC rate (hazard ratio 4.3; 95% confidence interval 1.2–15.4; p = 0.03). Acute grade 3 adverse events occurred in 17 patients. However, no late adverse events of grade 3 or higher have occurred to date. T1 glottic cancer treatment outcomes using hypofractionated radiotherapy with 2.25 Gy/fraction in clinical practice were comparable to previously reported results. However, ulcerative type tumor was associated with a poor LC rate.

    DOI： 10.18999/nagjms.83.4.811

    Web of Science

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  3. The importance of choosing the right strategy to treat small cell carcinoma of the cervix: a comparative analysis of treatments

    Kawamura Mariko, Koide Yutaro, Murai Taro, Ishihara Shunichi, Takase Yuuki, Murao Takayuki, Okazaki Dai, Yamaguchi Takahiro, Uchiyama Kaoru, Itoh Yoshiyuki, Kodaira Takeshi, Shibamoto Yuta, Mizuno Mika, Kikkawa Fumitaka, Naganawa Shinji

    BMC CANCER   21 巻 ( 1 ) 頁： 1046   2021年9月

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    記述言語：英語   出版者・発行元：BMC Cancer  

    Background: Standard treatments for small cell carcinoma of the cervix (SCCC) have not been established. In this study, we aimed to estimate the optimal treatment strategy for SCCC. Methods: This was a multicenter retrospective study. Medical records of patients with pathologically proven SCCC treated between 2003 and 2016 were retrospectively analyzed. Overall survival (OS) was plotted using the Kaplan-Meier method. Log-rank tests and Cox regression analysis were used to assess the differences in survival according to stage, treatment strategy, and chemotherapy regimen. Results: Data of 78 patients were collected, and after excluding patients without immunohistopathological staining, 65 patients were evaluated. The median age of the included patients was 47 (range: 24–83) years. The numbers of patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stages I-IIA, IIB-IVA, IVB were 23 (35%), 34 (52%), and 8 (12%), respectively. Of 53 patients who had undergone chemotherapy, 35 and 18 received SCCC and non-SCCC regimens as their first-line chemotherapy regimen, respectively. The 5-year OS for all patients was 49%, while for patients with FIGO stages I-IIA, IIB-IVA, IVB, it was 60, 50, and 0%, respectively. The 5-year OS rates for patients who underwent treatment with SCCC versus non-SCCC regimens were 59 and 13% (p < 0.01), respectively. This trend was pronounced in locally advanced stages. Multivariate analysis showed that FIGO IVB at initial diagnosis was a significant prognostic factor in all patients. Among the 53 patients who received chemotherapy, the SCCC regimen was associated with significantly better 5-year OS in both the uni- and multivariate analyses. Conclusion: Our results suggest that the application of an SCCC regimen such as EP or IP as first-line chemotherapy for patients with locally advanced SCCC may play a key role in OS. These findings need to be validated in future nationwide, prospective clinical studies.

    DOI： 10.1186/s12885-021-08772-x

    Web of Science

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  4. Stereotactic body radiation therapy for Japanese patients with localized prostate cancer: 2-year results and predictive factors for acute genitourinary toxicities

    Ito Makoto, Yoshioka Yasuo, Takase Yuuki, Suzuki Junji, Matsunaga Takuma, Takahashi Hironori, Takeuchi Arisa, Adachi Sou, Abe Souichirou, Oshima Yukihiko, Ohtakara Kazuhiro, Suzuki Kojiro, Okuda Takahito

    JAPANESE JOURNAL OF CLINICAL ONCOLOGY   51 巻 ( 8 ) 頁： 1253 - 1260   2021年8月

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    記述言語：英語   出版者・発行元：Japanese Journal of Clinical Oncology  

    Objective: We aimed to report the 2-year results of stereotactic body radiation therapy for prostate cancer and identify the clinical and dosimetric factors that predict acute genitourinary toxicities. Methods: We retrospectively reviewed the medical records of patients with non-metastatic prostate cancer treated at Toyota Memorial Hospital between 2017 and 2020. The patients were treated with stereotactic body radiation therapy with a total dose of 36.25 Gy in five fractions on consecutive weekdays. While low-risk patients received radiotherapy alone, intermediate- to high-risk patients also received androgen deprivation therapy. Results: We analysed a total of 104 patients, including 10, 60 and 34 low-, intermediate- and high-risk patients, respectively. The median follow-up duration was 2 years. We did not observe biochemical/clinical recurrence, distant metastasis or death from prostate cancer. One patient died of another cause. Grade 2 acute genitourinary toxicity was observed in 40 (38%) patients. Age (P = 0.021), genitourinary toxicity of grade ≥1 at baseline (P = 0.023) and bladder mean dose (P = 0.047) were significantly associated with the incidence of grade 2 acute genitourinary toxicity. The cut-off value of 65 years for age and 10.3 Gy for the bladder mean dose were considered the most appropriate. Grade 2 acute gastrointestinal toxicity was observed in five (5%) patients. None of the patients experienced grade ≥3 acute or late toxicity. Conclusions: Stereotactic body radiation therapy is feasible for Japanese patients with prostate cancer, with acceptable acute toxicity. Age, genitourinary toxicity at baseline and bladder mean dose predict grade 2 acute genitourinary toxicity.

    DOI： 10.1093/jjco/hyab094

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  5. Can we safely lower the RT dose with the use of high dose PF for advanced cervical cancer?

    Kawamura M., Nakahara R., Ishihara S., Oie Y., Takase Y., Okumura M., Ito J., Ono T., Itoh Y., Naganawa S.

    RADIOTHERAPY AND ONCOLOGY   161 巻   頁： S1064 - S1065   2021年8月

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    記述言語：日本語  

    Web of Science

  6. SBRT for Japanese patients with prostate cancer: prediction of acute genitourinary toxicities

    Ito M., Takase Y., Suzuki J., Matsunaga T., Takahashi H., Takeuchi A., Adachi S., Abe S., Oshima Y., Ohtakara K., Yoshioka Y., Suzuki K., Okuda T.

    RADIOTHERAPY AND ONCOLOGY   161 巻   頁： S1101 - S1101   2021年8月

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    記述言語：日本語  

    Web of Science

  7. Dosimetric impacts of beam-hardening filter removal for the CyberKnife system

    Kamomae Takeshi, Matsunaga Takuma, Suzuki Junji, Okudaira Kuniyasu, Kawabata Fumitaka, Kato Yutaka, Oguchi Hiroshi, Shimizu Morihito, Sasaki Motoharu, Takase Yuki, Kawamura Mariko, Ohtakara Kazuhiro, Itoh Yoshiyuki, Naganawa Shinji

    PHYSICA MEDICA-EUROPEAN JOURNAL OF MEDICAL PHYSICS   86 巻   頁： 98 - 105   2021年6月

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    記述言語：英語   出版者・発行元：Physica Medica  

    Purpose: Equipment refurbishment was performed to remove the beam-hardening filter (BHF) from the CyberKnife system (CK). This study aimed to confirm the change in the beam characteristics between the conventional CK (present-BHF CK) and CK after the BHF was removed (absent-BHF CK) and evaluate the impact of BHF removal on the beam quality correction factors kQ. Methods: The experimental measurements of the beam characteristics of the present- and absent-BHF CKs were compared. The CKs were modeled using Monte Carlo simulations (MCs). The energy fluence spectra were calculated using MCs. Finally, kQ were estimated by combining the MC results and analytic calculations based on the TRS-398 and TRS-483 approaches. Results: All gamma values for percent depth doses and beam profiles between each CK were less than 0.5 following the 3%/1 mm criteria. The percentage differences for tissue-phantom ratios at depths of 20 and 10 cm and percentage depth doses at 10 cm between each CK were −1.20% and −0.97%, respectively. The MC results demonstrated that the photon energy fluence spectrum of the absent-BHF CK was softer than that of the present-BHF CK. The kQ values for the absent-BHF CK were in agreement within 0.02% with those for the present-BHF CK. Conclusions: The photon energy fluence spectrum was softened by the removal of BHF. However, no remarkable impact was observed for the measured beam characteristics and kQ. Therefore, the previous findings of the kQ values for the present-BHF CK can be directly used for the absent-BHF CK.

    DOI： 10.1016/j.ejmp.2021.05.011

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  8. Early glottic cancer treatment with concurrent chemoradiotherapy with once-daily orally administered S-1

    Takase Yuuki, Itoh Yoshiyuki, Ohtakara Kazuhiro, Kawamura Mariko, Ito Junji, Oie Yumi, Ono Tamami, Sasaki Yutaro, Nishida Ayumi, Naganawa Shinji

    NAGOYA JOURNAL OF MEDICAL SCIENCE   83 巻 ( 2 ) 頁： 251 - 258   2021年5月

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    記述言語：英語   出版者・発行元：Nagoya Journal of Medical Science  

    Glottic carcinoma is the most common laryngeal cancer. The outcomes for T1 bulky Glottic carcinoma and T2N0 Glottic carcinoma after radiation therapy alone are unsatisfactory. This study was conducted to evaluate the efficacy and safety of unique concurrent chemoradiotherapy regimen using S-1 for early glottic cancer. Concurrent chemoradiotherapy consisted of 60 Gy in 30 fractions with once-daily, orally administered S-1 exclusively within three to six hours prior to each irradiation. Twenty-one consecutive patients treated with this regimen were retrospectively reviewed. Initial complete remission was achieved in all patients without any subsequent local and/or regional recurrences to the last follow-up. The 4-year local control, overall survival, and disease-free survival rates were all 100%. No significant toxicities were observed, except for three cases with Grade 3 acute dermatitis. This regimen is highly effective and well-tolerated, and these results encourage further research to long-term efficacy and functional preservation.

    DOI： 10.18999/nagjms.83.2.251

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  9. Comparison of Physician-recorded Toxicities and Patient-reported Outcomes of Five Different Radiotherapy Methods for Prostate Cancer

    Ito Makoto, Sasamura Kazuma, Takase Yuuki, Kotsuma Tadayuki, Oshima Yukihiko, Minami Yoshitaka, Suzuki Junji, Tanaka Eiichi, Ohashi Wataru, Oguchi Masahiko, Okuda Takahito, Suzuki Kojiro, Yoshioka Yasuo

    ANTICANCER RESEARCH   41 巻 ( 5 ) 頁： 2523 - 2531   2021年5月

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    記述言語：英語   出版者・発行元：Anticancer Research  

    Background/Aim: To compare five radiotherapy methods for prostate cancer. Patients and Methods: During 2005-2018, the data of patients with non-metastatic prostate cancer were retrospectively analysed. Patients were treated with high-dose-rate brachytherapy (HDR-BT); low-dose-rate brachytherapy (LDR-BT); or external-beam radiotherapy (EBRT), including conventionally fractionated radiotherapy (CFRT), moderate-hypofractionated radiotherapy (MHRT), and ultra-hypofractionated radiotherapy (UHRT). Results: In total, 496 patients (149, HDR-BT; 100, LDR-BT; 100, CFRT; 97, MHRT, and 50, UHRT) with a median follow-up of 4.3 years were enrolled. The incidence of grade 2 acute genitourinary toxicities was significantly lower with HDRBT (p0.001) than with any other radiotherapy. The cumulative incidence of late grade 2 genitourinary toxicities was the highest with UHRT and significantly higher (p=0.005) with UHRT than with HDR-BT. Higher symptom score peaks were noted 4 weeks after therapy for LDR-BT than for EBRT. Conclusion: Physician-recorded toxicities were slightly lower with HDR-BT and patientreported outcomes tended to be worse with LDR-BT.

    DOI： 10.21873/anticanres.15030

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  10. 大量化学療法後早期に再燃し胸膜播種を来した神経芽腫の一例 査読有り

    前村 遼, 山下 大紀, 佐治木 大知, 坂口 大俊, 吉田 奈央, 千馬 耕亮, 村瀬 成彦, 髙瀬 裕樹, 山田 哲也, 吉川 佳苗, 伊藤 藍, 伊藤 雅文, 岩本 彰太郎, 濱 麻人

    日本小児血液・がん学会雑誌   58 巻 ( 2 ) 頁： 171 - 174   2021年

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    記述言語：日本語   出版者・発行元：日本小児血液・がん学会  

    <p>Image-defined risk factor陽性の左後腹膜原発<i>MYCN</i>増幅3期神経芽腫を発症した初診時1歳2か月の男児に対して，寛解導入療法5コースを施行し，部分奏功を維持したまま，静注ブスルファンとメルファランによる自家骨髄移植併用大量化学療法を施行した．移植後72日目に腹腔鏡下腫瘍部分切除術を施行し，組織診にてviabilityの高い神経芽腫細胞を認め，77日目にCTで原発巣の増大を認めた．救援化学療法を施行したが100日目のCTでは多発胸膜転移も認めた．化学療法に加えて，30.6 Gy/17分割の原発巣局所照射および15 Gy/10分割の全肺照射を施行したが，腹膜播種を来し，207日目に死亡した．剖検後の解析にて，初発および剖検検体でのALK高発現を認めた．<i>MYCN</i>増幅およびALK高発現の神経芽腫では急速な増悪を示す可能性があり，ALK阻害剤など新規薬剤の導入が望まれる．</p>

    DOI： 10.11412/jspho.58.171

    CiNii Research

  11. Comparison of Physician-Recorded Toxicities and Patient-Reported Outcomes Among 5 Different Radiotherapy Methods for Prostate Cancer

    Ito M., Takase Y., Sasamura K., Kotsuma T., Ooshima Y., Minami Y., Suzuki J., Tanaka E., Oguchi M., Okuda T., Suzuki K., Yoshioka Y.

    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS   108 巻 ( 3 ) 頁： E912 - E913   2020年11月

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    記述言語：日本語  

    Web of Science

  12. Clinical Results of T1 Glottic Cancer Treated with Radiotherapy Using 2.25 Gy per Fractions: A Multicenter Survey in Clinical Practice

    Oie Y., Itoh Y., Kawamura M., Takase Y., Murao T., Ishihara S., Nomoto Y., Hirasawa N., Asano A., Yamakawa K., Ito J., Naganawa S.

    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS   105 巻 ( 1 ) 頁： E366 - E367   2019年9月

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    記述言語：日本語  

    Web of Science

  13. Should Small Cell Carcinoma of the Cervix be Treated As Localized Small Cell Cancer or Advanced Cervical Cancer: A Retrospective Multi-Institutional Cohort Study

    Kawamura M., Koide Y., Murai T., Ishihara S., Takase Y., Murao T., Okazaki D., Yamaguchi T., Uchiyama K., Itoh Y., Kodaira T., Shibamoto Y., Mizuno M., Kikkawa F., Naganawa S.

    INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS   105 巻 ( 1 ) 頁： E324 - E325   2019年9月

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    記述言語：日本語  

    Web of Science

  14. Study Protocol: Prospective Study of Concurrent Chemoradiotherapy with S-1 and Hypofractionated Radiotherapy for Outpatients with Early Glottic Squamous Cell Carcinomas.

    Kimura K, Itoh Y, Okada T, Kubota S, Kawamura M, Nakahara R, Oie Y, Kozai Y, Takase Y, Tsuzuki H, Nishio N, Hiramatsu M, Fujimoto Y, Mizutani T, Hirakawa A, Naganawa S

    Asian Pacific journal of cancer prevention : APJCP   19 巻 ( 5 ) 頁： 1195 - 1199   2018年5月

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    記述言語：英語   出版者・発行元：Asian Pacific Journal of Cancer Prevention  

    Background: The recommended treatment strategies for early glottic carcinoma with intent of larynx preservation are primarily radiotherapy. However, the outcomes of radiotherapy for bulky T1 or T2 glottic carcinoma are unsatisfactory. We designed a protocol consisting of concurrent chemoradiotherapy using S-1 as the radiosensitizer. We have performed this protocol in patients with favorable T2 lesions and demonstrated its efficacy and safety. In contrast, we have treated non-bulky T1 glottic carcinomas with 2.25 Gy per fraction, for a total of 25-28 fractions, starting in 2011 to improve efficacy and shorten the treatment period. Since this treatment strategy was implemented for T1 disease, no local failure has occurred to date, and it appears to be almost as safe as radiotherapy using 2.0 Gy per fraction. With the aim of improving the local control rate and shortening the treatment period primarily for favorable T2 disease, we changed the dose of radiation in our protocol from 2.0 Gy to 2.25 Gy per fraction, for a total of 25 fractions (from 30 fractions). The present study aims to evaluate the efficacy and safety of this new protocol. Methods: This study will be conducted as a clinical, prospective, single-armed, non-randomized trial. Patients are to receive S-1 (55.3 mg /m2 /day, once daily) and radiotherapy (2.25 Gy per fraction, for a total of 25 fractions). S-1 and radiotherapy are started on the same day that radiotherapy is performed, 3-6 hours after oral administration of S-1. The primary study aim is the 3-year local control rate. The secondary study aims are overall survival, voice-preservation survival, disease-free survival, complete response rate, completion rate, and toxicity. Result and conclusion: This is the first single-center, non-randomized, prospective study of concurrent chemoradiotherapy with S-1 and hypofractionated radiotherapy to be conducted. The trial will evaluate the efficacy and safety of our protocol.

    DOI： 10.22034/APJCP.2018.19.5.1195

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  15. Optimized treatment strategy of radiotherapy for early glottic squamous cell carcinomas: An initial analysis

    Kimura Kana, Itoh Yoshiyuki, Okada Tohru, Kubota Seiji, Kawamura Mariko, Nakahara Rie, Oie Yumi, Kozai Yuka, Takase Yuuki, Tsuzuki Hidenori, Nishio Naoki, Hiramatsu Mariko, Fujimoto Yasushi, Mizutani Takefumi, Naganawa Shinji

    NAGOYA JOURNAL OF MEDICAL SCIENCE   79 巻 ( 3 ) 頁： 331 - 338   2017年8月

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    記述言語：英語   出版者・発行元：Nagoya Journal of Medical Science  

    The purpose of this study was to evaluate the clinical outcomes of radiotherapy for patients with T1/T2 glottic carcinoma. Patients with T1/T2 glottic carcinoma histopathologically diagnosed with squamous cell carcinoma and treated at our hospital between 2007 and 2015 were analyzed retrospectively. Our strategy for T1/T2 glottic carcinoma was as follows: radiotherapy alone with 2.25 Gy per fraction to a total of 25-28 fractions for patients with non-bulky T1 glottic carcinoma; concurrent chemoradiotherapy with oral S-1 and radiotherapy with 2 Gy per fraction to a total of 30 fractions for patients with T1 bulky/T2 favorable glottic carcinoma; or chemoradiotherapy with high-dose cisplatin and radiotherapy with 2 Gy per fraction to a total of 35 fractions for T2 unfavorable glottic carcinoma. Forty-eight patients were eligible. The median follow-up period among surviving patients was 38 months (range, 11-107). The disease was T1a in 23%, T1b in 13%, and T2 in 65% of patients. The 3-year local control rate in all patients, T1a, T1b, and T2 was 96.7%, 100%, 100%, and 96.0%, respectively. Of the 46 patients, one with T2 glottic carcinoma developed recurrent disease at the primary site, and one with T2 glottic carcinoma had lymph node recurrences in the neck. Acute Grade 3 dermatitis occurred in 8 (17%) patients and late Grade 2 hypothyroidism occurred in 2 (4%) patients. This retrospective study shows that our optimized treatment strategy of radiotherapy depending on the stage of early glottic carcinoma is not only effective but also well-tolerated.

    DOI： 10.18999/nagjms.79.3.331

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▼全件表示

論文の先頭へ▲

書籍等出版物 1

  1. 肺癌の体幹部定位放射線治療

    高瀬裕樹、佐貫直子、石原俊一（ 担当： 共著 ,  範囲: 筆頭著者）

    科学論評者  2022年2月 

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    総ページ数：6   担当ページ：6   記述言語：日本語 著書種別：学術書

書籍等出版物の先頭へ▲

講演・口頭発表等 1

  1. Malignant 国際会議

    Takase Y., Kawamura M., Nakahara R., Itoh J., Oie Y., Okumura M., Kamomae T., Itoh Y., Ono T., Naganawa S.

    RADIOTHERAPY AND ONCOLOGY  2021年8月 

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    記述言語：英語   会議種別：ポスター発表  

講演・口頭発表等の先頭へ▲

科研費 1

  1. 悪性神経膠腫放射線治療における高精度/高再現性標的体積決定法の開発

    研究課題/研究課題番号：20K16756  2020年4月 - 2024年3月

    科学研究費助成事業  若手研究

    高瀬 裕樹

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    担当区分：研究代表者 

    配分額：3770000円 （ 直接経費：2900000円 、 間接経費：870000円 ）

    放射線治療は悪性神経膠腫の主な治療法の1つである。悪性神経膠腫は広がりやすい特徴があるため、画像で分かる腫瘍から大きくマージンを広げた範囲を標的として放射線治療が行われる。脳内は腫瘍が浸潤しにくい脳室などの構造が複雑に存在するため、マージンをどのように広げるか決定することは非常に難しく定まった方法がない。今後より標的に絞った放射線治療が行える時代が来る。それに向けより合理的で計画者間で誤差が少ないマージン付加モデルを考案した。本研究では深層学習を交えながら、モデルの安全性、有効性の検討および改良を行っていく。
    複数の計画者の間で、諸国の放射線腫瘍学会のガイドラインで記載されているような15㎜のマージンを付加してから解剖学的な境界を考慮して手動でトリミングする手法で定義したＣＴＶを比較検討する研究を行った。計画者間でのＣＴＶは全体としての一致度は良好で、差異は小さいという結果となった。しかしながら脳梁のような左右の脳実質を細い構造でつなぐよう橋渡しをする部位を超えた部分に注目すると、一致度は不良で計画者間の差異が大きいことが判明した。神経膠腫は発症時点で数cm以上の大きな浮腫を伴っていることが多く、橋渡し構造の近傍まで腫瘤が接近することも日常臨床でもしばしば経験される。本研究によって橋渡し部位の近傍における計画者間の差異を小さくすることが計画者間の放射線治療の不均一性を低減する可能性が示唆された。2021年8月にスペインマドリードで開催された欧州放射線腫瘍学会の学術発表会(ESTRO2021)にて上記研究結果の報告を行った。
    また多段階の拡張を行う上ですべての解剖学的境界を定義する手法は手間が多く、放射線治療の計画時間を極端に増加させるため臨床使用を考える上では現実的ではない。そのためより簡便に多段階な領域拡張を行うアルゴリズムの作成に着手し、脳実質と数個の橋渡し構造の情報のみ自動で多段階に指定した距離の領域を拡張するシステムの開発に至った。このシステムを用いることで、小さい手間で多段階領域拡張を行うことができ、今後の複数計画者間の差異を低減するかどうかの研究を行うことが可能となった。
    COVID-19ウィルス流行に伴う臨床的、社会的な負担の増加のため下記の遅れが生じている。
    多段階領域拡張法で作成したＣＴＶをこれまでの既治療例に適応して実際の臨床で用いられたＣＴＶとの比較を行い多段階領域拡張法の妥当性の検討が必要であるが、臨床情報を収集する段階へ移行できていない。
    今後は本年度開発した低負担、短時間で多段階領域拡張法を実現するシステムを使用して、このシステムが複数計画者間の差異を低減するかどうか検討する。
    また既治療例について、このシステムにおいて作成したCTVと実際の治療時のCTVを比較したうえで、これまでの治療例での傾向や、その後の再発とCTVが関連していたかどうかを調査し、多段階領域拡張法の臨床実用性を検討していく。

科研費の先頭へ▲
 

担当経験のある科目 (本学) 1

  1. 放射線腫瘍学特論

    2021

担当経験のある科目 (本学)の先頭へ▲