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Anticancer Res ; 40(1): 379-386, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892590


BACKGROUND/AIM: We evaluated the efficacy and safety of carbon-ion radiotherapy (CIRT) alone for Stage III non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Data of 65 patients (median age=73 years) with Stage III NSCLC who underwent CIRT alone in the QST Hospital, Chiba, Japan, between 1997 and 2015 were retrospectively analysed. The median dose was 72.0 Gy (relative biological effectiveness). RESULTS: The median follow-up was 27.6 months (range=1.6-207.7 months). Two-year local control, progression-free survival (PFS), and overall survival (OS) rates were 73.9%, 38.6%, and 54.9%, respectively. Overall, 1 (2%), 4 (6%), and 1 (2%) patient developed Grade 4 (mediastinal haemorrhage), Grade 3 (radiation pneumonitis), and Grade 3 (bronchial fistula) toxicities, respectively. On univariate analysis, clinical T and N stage and CIRT timing were significant predictors of PFS and OS; clinical target volume was a significant predictor of PFS. CONCLUSION: CIRT alone is effective with acceptable toxicity for Stage III NSCLC.

Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Radioterapia com Íons Pesados/efeitos adversos , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Resultado do Tratamento
Radiat Oncol ; 12(1): 144, 2017 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-28865463


BACKGROUND: Lung cancer is frequently complicated by interstitial lung disease (ILD). Treatment protocols for lung cancer patients with ILD have not been established; surgery, chemotherapy, and radiotherapy can all cause acute exacerbation of ILD. This study evaluated the toxicity and efficacy of carbon ion radiotherapy (CIRT) in patients with non-small cell lung cancer (NSCLC) and ILD. METHODS: Between June 2004 and November 2014, 29 patients diagnosed with NSCLC and ILD were treated with CIRT. No patient was eligible for curative surgery or conventional radiotherapy secondary to ILD. Owing to prior symptomology, radiation pneumonitis (RP) and symptom progression pre- and post-treatment were evaluated. The relationships between RP and clinical factors were investigated. RESULTS: Twenty-eight men and one woman, aged 62 to 90 years old, were followed for 2.7-77.1 months (median: 22.8 months). Single-grade symptomatic progression (grade 2-3) was observed in 4 patients, while 1 patient experiencedtwo-grade progression. Two patients experienced radiation-induced acute exacerbation. Local control at 3 years was 63.3% (72.2% for stage I disease); survival at 3 years was 46.3% (57.2% for stage I disease). Eighteen patients had died by the time of this writing, 10 of lung cancer progression. Radiation pneumonitis post-treatment progression correlated with dosimetric factors of the lungs (V5, V10) and a low pre-treatment serum surfactant protein-D. CONCLUSIONS: We found that CIRT may be useful as a low-risk, curative option for NSCLC patients with ILD, a population that is typically ineligible for conventional therapy. The DVH analysis showed that minimizing the low-dose region is important for reducing the risk of severe RP. TRIAL REGISTRATION: NIRS-9404 . Registered 1 March 1994.

Carcinoma Pulmonar de Células não Pequenas/radioterapia , Radioterapia com Íons Pesados/métodos , Doenças Pulmonares Intersticiais/complicações , Neoplasias Pulmonares/radioterapia , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/complicações , Feminino , Radioterapia com Íons Pesados/efeitos adversos , Humanos , Neoplasias Pulmonares/complicações , Masculino , Pessoa de Meia-Idade , Pneumonite por Radiação/epidemiologia , Estudos Retrospectivos
Int J Gynecol Cancer ; 24(1): 141-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24362719


OBJECTIVES: This study aimed to evaluate the effectiveness and feasibility of reirradiation using high-dose-rate interstitial brachytherapy (HDR-ISBT) in patients with recurrent cervical cancer. METHODS: The records of 52 consecutive women with central pelvic recurrence who were salvaged with HDR-ISBT-based reirradiation were retrospectively reviewed. Data regarding the primary disease, follow-up findings, recurrence, the treatment outcome, and toxicities were collected. Multivariate analysis was performed using the Cox proportional hazards regression model to identify predictors of the response to HDR-ISBT. Survival rate was calculated using the Kaplan-Meier method and compared using the log-rank test. RESULTS: A total of 52 patients who had been treated with HDR-ISBT-based reirradiation were included in our database. The local control rate was 76.9% (40/52), and the median postrecurrence survival period was 32 months. Grade 3 or 4 late toxicities were observed in 13 patients (25%). Multivariate analysis revealed that tumor size and the treatment-free interval were significant poor prognostic factors of postrecurrence survival. In a comparison between the patients who were salvaged with HDR-ISBT-based reirradiation (ISBT group) and those who were treated with palliative therapy alone (palliative group), we found that among the patients who displayed 0 or 1 poor prognostic factors, the patients in the ISBT group survived significantly longer than those in the palliative group. In contrast, similar survival rates were seen in both groups among the patients with 2 or more poor prognostic factors. CONCLUSIONS: Reirradiation using HDR-ISBT is effective and feasible in patients with recurrent cervical cancer. Our 2-clinical variable prognostic model might enable physicians to identify patients who would not derive clinical benefit from HDR-ISBT and offer them the opportunity to receive other types of treatment.

Adenocarcinoma/radioterapia , Braquiterapia/métodos , Carcinoma de Células Escamosas/radioterapia , Recidiva Local de Neoplasia/radioterapia , Neoplasias do Colo do Útero/radioterapia , Adenocarcinoma/mortalidade , Adulto , Idoso , Carcinoma de Células Escamosas/mortalidade , Feminino , Humanos , Japão/epidemiologia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Cuidados Paliativos , Estudos Retrospectivos , Resultado do Tratamento , Neoplasias do Colo do Útero/mortalidade
Intern Med ; 50(20): 2351-6, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22001464


Idiopathic basal ganglia calcification (IBGC) is a syndrome in which bilateral cerebral calcification occurs despite the absence of abnormal calcium metabolism. A 17-year-old Japanese female was admitted for investigation of intermittent proteinuria from the age of 12 years. On admission, her blood pressure was 126/60 mmHg and her serum creatinine was 0.8 mg/dL. Although computed tomography revealed bilateral striopallidodentate calcinosis, her level of intelligence and neurological findings were normal, as were the results of endocrine tests including parathyroid hormone. Asymptomatic IBGC was diagnosed. Renal biopsy showed membranoproliferative glomerulonephritis. Peritoneal dialysis was started for end-stage renal failure when she was 24 years old. Pyramidal and extrapyramidal signs started to develop at the age of 27 years and progressed, resulting in death from aspiration pneumonia at the age of 32 years. Post-mortem revealed bilateral calcification of the basal ganglia, dentate nucleus, thalamus, and centrum semiovale. On light microscopy, there was circumferential calcification of the media and intima of affected vessels in the brain, including small arteries, small veins, and capillaries, and luminal narrowing was seen. On electron microscopy, layers of differing electron density were arranged in concentric laminae. This is the first report of IBGC with bilateral and symmetrical cerebral calcification accompanied by membranoproliferative glomerulonephritis resulting in end-stage renal failure.

Encefalopatias/complicações , Calcinose/complicações , Glomerulonefrite Membranoproliferativa/complicações , Doenças Neurodegenerativas/complicações , Adulto , Doenças dos Gânglios da Base , Encefalopatias/diagnóstico , Calcinose/diagnóstico , Criança , Diagnóstico Diferencial , Evolução Fatal , Feminino , Seguimentos , Glomerulonefrite Membranoproliferativa/diagnóstico , Humanos , Doenças Neurodegenerativas/diagnóstico
Nihon Kokyuki Gakkai Zasshi ; 49(8): 619-22, 2011 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-21894780


We present a case of pulmonary varices in a 44-year-old man. The patient's chest X-ray films revealed well-delineated shadows in the right lower lung field. An enhanced chest CT scan with three-dimensional volumetric imaging demonstrated a vascular malformation in the right lower lobe. Both the arterial and parenchymal phases of digital subtraction of the right pulmonary angiography were normal. However, the venous phase showed serpiginous right lower pulmonary veins draining into the left atrium, and a delayed pooling of contrast in dilated pulmonary veins confirmed a diagnosis of pulmonary varices. No echocardiographic findings of valvular disease were recognized. He remained asymptomatic and returned to work, but radiological follow-up was continued annually.

Pulmão/irrigação sanguínea , Tomografia Computadorizada por Raios X , Varizes/diagnóstico por imagem , Humanos , Imagem Tridimensional , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade