Department of Radiation Oncology

Hiroshi Igaki, Yuko Nakayama, Kae Okuma, Tomoya Kaneda, Koji Inaba, Kana Takahashi, Tairo Kashihara, Ayaka Nagao, Madoka Sakuramachi

Introduction

The role of our department is to provide state-of-the-art radiation therapy to all patients who need it, to educate and develop the expertise of radiation oncologists, radiation technologists, and medical physicists, and to lead new developments in radiation oncology in Japan as well as worldwide. All departmental activities are dedicated to cancer patients. A linear accelerator-based neutron irradiation system for boron neutron capture therapy (BNCT) has been installed in the hospital; an epithermal neutron beam was obtained and a clinical trial of BNCT for cutaneous angiosarcoma is ongoing. Additionally, an MR-guided radiation therapy system, MRIdian®, has been introduced for the first time in Japan in our department. After strict acceptance and commissioning procedures, MRIdian is used mainly for on-line adaptive radiation therapy.

The Team and What We Do

Our department treats the largest number of radiation oncology patients in Japan. Four linear accelerators, CyberKnife, MRIdian, a brachytherapy system, four XCT-simulators, and 15 treatment planning computers are working together in online networks to provide state-of-the-art high-precision external beam radiation therapy. In addition to the conventional X-ray and electron therapies, stereotactic irradiations of brain and body tumors and intensity-modulated radiation therapy (IMRT) are routinely performed. Stereotactic brain irradiation is performed with CyberKnife in the treatment of metastatic as well as primary brain tumors. Stereotactic body radiation therapies are performed for lung and liver tumors under respiratory gating in linear accelerators, MRIdian or CyberKnife. All linear accelerators have on-board kilovoltage CT imagers, which help to precisely align patient and tumor coordinates. These image-guided radiation therapy (IGRT) facilities enable the precise delivery of IMRT in head and neck cancers, brain tumors, prostate cancers, postoperative cervical cancers, and other cancers. Gold marker fiducials have been implanted to improve the geometric precision of radiation field reproducibility. MRIdian, which is a fusion of MRI and a radiation therapy machine, is used mainly for pancreatic cancer and other upper abdominal cancers. Brachytherapy is also intensively performed to improve local control, and many patients are referred to us from all over Japan. For brachytherapy, the following modalities are being employed: an Ir-192 high dose rate (HDR) after-loading system including dedicated CT simulator and fluoroscopy; low dose rate (LDR) brachytherapy using Au-198 grains and Ru-106 eye plaques. The number of patients undergoing HDR brachytherapy continues to rise. HDR interstitial irradiation is performed mainly in gynecological, genitourinary, and head and neck tumors. Additionally, there are two beds in the shielded ward on Floor 13B. Ru-106 mold therapy is performed in collaboration with ophthalmologists to treat retinoblastomas and choroidal melanomas. LDR interstitial implants are carried out using Au-198 grains for the management of head and neck tumors and gynecological malignancies. The number of patients treated in our department is shown in following Tables.

No. of New Patients according to the Primary Site	2019	2020	2021	2022	2023
All patients undergoing radiation therapy	2,824	2,693	2,615	2,529	2,610
1．CNS	64	56	56	51	60
2．Head and Neck	224	222	252	233	198
3．Esophagus	119	114	117	129	120
4．Intrathoracic	376	362	368	329	367
4-a．Lung	325	327	334	295	347
5．Breast	288	233	196	211	193
6．Liver/Bile Duct/Pancreas	72	65	57	52	63
7．Digestive Tracts	96	75	118	164	135
8．GYN	148	138	111	99	105
9．GU	136	130	118	118	142
9-a．Prostate	90	82	71	85	96
10．Hematopoietic/Lymphatic	106	97	99	92	106
11．Cutaneous/Bone/Soft Tissue	146	146	137	148	122
12．Other Malignancies	33	25	24	21	27
13．Benign	1	0	1	1	0
14．Children aged less than 15 years	32	28	33	28	20

	2019	2020	2021	2022	2023
1．Brain metastasis	453	461	394	346	389
2．Bone metastasis	584	523	506	433	522

	2019	2020	2021	2022	2023
All patients undergoing total body irradiation	38	55	48	55	55
All patients undergoing stereotactic brain radiation	325	324	257	258	354
All patients undergoing stereotactic body radiation	76	90	158	273	287
All patients undergoing intensity-modulated radiation therapy	596	706	755	1,002	648
Brachytherapy	202	192	116	79	51

 

Research activities

Clinical research is an indispensable part of the daily activities of our department. The primary interests of the research activities of the department are as follows: (1) on-line adaptive radiation therapy using an MR-guided radiotherapy system; (2) clinical applications of accelerator-based boron neutron capture therapy for cutaneous angiosarcoma; (3) image-guided brachytherapy for genitourinary and gynecologic cancers; (4) development of new medical devices for radiotherapy; (5) hypofractionated stereotactic irradiation of brain and body tumors; (6) an optimal fractionation regimen for pain palliation of bone metastasis.

Clinical trials

• Many clinical trials are ongoing, as shown below.
• JCOG studies for lung cancers, head and neck cancers, brain tumors, gynecological cancer, and esophageal cancers
• International NRG studies for breast cancer and meningioma
• International Study of Ophthalmic Radiation Therapy Toxicity
• Phase II clinical trial of BNCT for cutaneous angiosarcoma
• Development of an Adaptive Radiation Therapy System
• Multi-institutional phase I/II trial of hybrid brachytherapy for cervical cancer
• Many other multi- or single-institutional clinical trials are also ongoing or in preparation.

Education

One resident has been trained in all fields of radiation oncology. Seminars on biology, physics, and clinical radiation oncology are regularly held during the evening.

Future prospects

With the expanding indications of radiation therapy, additional manpower will be required and research perspectives will be considerably broadened. Radiation oncology is one of the most promising disciplines in oncology.

List of papers published

Journal

2023

1. Eguchi K, Omura G, Shimoi T, Kageyama D, Igaki H, Abe Y, Watanabe T, Aihara Y, Sakai A, Matsumoto Y, Sakai T, Yonemori K, Mori T, Yoshida A, Yoshimoto S. BCOR-CCNB3 sarcoma arising in the pharynx. Auris Nasus Larynx. 2023 Aug;50(4):618-22. PubMed PMID: 35545465. Epub 20220508. eng.
2. Matsumura A, Asano T, Hirose K, Igaki H, Kawabata S, Kumada H. Initiatives Toward Clinical Boron Neutron Capture Therapy in Japan. Cancer Biother Radiopharm. 2023 Apr;38(3):201-7. PubMed PMID: 36374236. Pubmed Central PMCID: PMC10122211. Epub 20221114. eng.
3. Nakaichi T, Okamoto H, Kon M, Takaso K, Aikawa A, Nakamura S, Ijima K, Chiba T, Nakayama H, Takemori M, Mikasa S, Fujii K, Urago Y, Goka T, Shimizu Y, Igaki H. Commissioning and performance evaluation of commercially available mobile imager for image guided total body irradiation. J Appl Clin Med Phys. 2023 Apr;24(4):e13865. PubMed PMID: 36573258. Pubmed Central PMCID: PMC10113699. Epub 20221226. eng.
4. Murakami N, Watanabe M, Uno T, Sekii S, Tsujino K, Kasamatsu T, Machitori Y, Aoshika T, Kato S, Hirowatari H, Kaneyasu Y, Nakagawa T, Ikushima H, Ando K, Murata M, Yoshida K, Yoshioka H, Murata K, Ohno T, Okonogi N, Saito AI, Ichikawa M, Okuda T, Tsuchida K, Sakurai H, Yoshimura R, Yoshioka Y, Yorozu A, Kunitake N, Okamoto H, Inaba K, Kato T, Igaki H, Itami J. Phase I/II prospective clinical trial for the hybrid of intracavitary and interstitial brachytherapy for locally advanced uterine cervical cancer. J Gynecol Oncol. 2023 May;34(3):e24. PubMed PMID: 36603849. Pubmed Central PMCID: PMC10157336. Epub 20221221. eng.
5. Murakami N, Masui K, Yoshida K, Noda SE, Watanabe M, Takenaka T, Ii N, Atsumi K, Umezawa R, Inaba K, Iijima K, Kubo A, Igaki H, Shikama N, Ikushima H. Hands-on seminar for image-guided adaptive brachytherapy and intracavitary/interstitial brachytherapy for uterine cervical cancer. Jpn J Clin Oncol. 2023 Jun 1;53(6):508-13. PubMed PMID: 36810684. eng.
6. Nakayama H, Okamoto H, Nakamura S, Iijima K, Chiba T, Takemori M, Nakaichi T, Mikasa S, Fujii K, Sakasai T, Kuwahara J, Miura Y, Fujiyama D, Tsunoda Y, Hanzawa T, Igaki H, Chang W. Film measurement and analytical approach for assessing treatment accuracy and latency in a magnetic resonance-guided radiotherapy system. J Appl Clin Med Phys. 2023 May;24(5):e13915. PubMed PMID: 36934441. Pubmed Central PMCID: PMC10161048. Epub 20230319. eng.
7. Okamoto H, Murakami N, Isohashi F, Kasamatsu T, Hasumi Y, Kobayashi H, Ishikawa M, Nakamura M, Nishio T, Igaki H, Ishikura S, Yaegashi N, Mizowaki T, Nishimura Y, Toita T. Plan quality association between dummy run and individual case review in a prospective multi-institutional clinical trial of postoperative cervical cancer patients treated with intensity-modulated radiotherapy: Japan clinical Oncology Group study (JCOG1402). Radiother Oncol. 2023 Jun;183:109630. PubMed PMID: 36934892. Epub 20230318. eng.
8. Yoshida K, Kotsuma T, Takaoka Y, Tamenaga S, Yamazaki H, Nose T, Murakami N, Inaba K, Akiyama H, Masui K, Takenaka T, Kubota H, Tselis N, Masuda N, Yasojima H, Takeda M, Mano M, Nakamura S, Utsunomiya K, Tanigawa N, Tanaka E. HDR-brachytherapy for accelerated partial breast irradiation: Long-term experience from a Japanese institution. J Contemp Brachytherapy. 2023 Feb;15(1):1-8. PubMed PMID: 36970436. Pubmed Central PMCID: PMC10034731. Epub 20230228.
9. Doi Y, Nagata Y, Matsumoto Y, Numata K, Sasaki R, Yamada T, Igaki H, Imagumbai T, Katoh N, Yoshitake T, Shimizuguchi T, Fujioka D, Inoue M, Koide Y, Kimura T, Ito Y. Multicenter retrospective study of stereotactic body radiotherapy for patients with previously untreated initial small hepatocellular carcinoma. Hepatol Res. 2023 Aug;53(8):749-60. PubMed PMID: 37036153. Epub 20230425. eng.
10. Nakamura M, Zhou D, Minemura T, Kito S, Okamoto H, Tohyama N, Kurooka M, Kumazaki Y, Ishikawa M, Clark CH, Miles E, Lehmann J, Andratschke N, Kry S, Ishikura S, Mizowaki T, Nishio T. A virtual audit system for intensity-modulated radiation therapy credentialing in Japan Clinical Oncology Group clinical trials: A pilot study. J Appl Clin Med Phys. 2023 Jun;24(6):e14040. PubMed PMID: 37191875. Pubmed Central PMCID: PMC10243313. Epub 20230516.
11. Yoshioka Y, Sasamura K, Ito M, Kaneko M, Takahashi T, Anno W, Shimoyachi N, Suzuki J, Okuda T, Kashihara T, Inaba K, Igaki H, Itami J. Treatment planning comparison of high-dose-rate brachytherapy vs. robotic and conventional stereotactic body radiotherapy for ultrahypofractionated treatment of prostate cancer. Phys Imaging Radiat Oncol. 2023 Apr;26:100445. PubMed PMID: 37197153. Pubmed Central PMCID: PMC10183665. Epub 20230504. eng.
12. Imaizumi J, Shida D, Boku N, Igaki H, Itami J, Miyakita Y, Narita Y, Takashima A, Kanemitsu Y. Prognostic factors associated with the transition in treatment methods for brain metastases from colorectal cancer. Int J Clin Oncol. 2023 Aug;28(8):1043-53. PubMed PMID: 37208499. Pubmed Central PMCID: PMC10390364. Epub 20230519. eng.
13. Nakamura S, Imamichi S, Shimada K, Takemori M, Kanai Y, Iijima K, Chiba T, Nakayama H, Nakaichi T, Mikasa S, Urago Y, Kashihara T, Takahashi K, Nishio T, Okamoto H, Itami J, Ishiai M, Suzuki M, Igaki H, Masutani M. Relative biological effectiveness for epithermal neutron beam contaminated with fast neutrons in the linear accelerator-based boron neutron capture therapy system coupled to a solid-state lithium target. J Radiat Res. 2023 Jul 18;64(4):661-7. PubMed PMID: 37295954. Pubmed Central PMCID: PMC10354855. eng.
14. Murakami N, Nakatani F, Takahashi K, Nakamura S, Igaki H, Shikama N. Salvage high-dose rate brachytherapy for myxofibrosarcoma of the brachium: a technical report. J Radiat Res. 2023 Jul 18;64(4):746-9. PubMed PMID: 37301983. Pubmed Central PMCID: PMC10354856. eng.
15. Kishigami Y, Nakamura M, Nakao M, Okamoto H, Takahashi A, Igaki H. Three-dimensional assessment of interfractional cervical and uterine motions using daily magnetic resonance images to determine margins and timing of replanning. J Appl Clin Med Phys. 2023 Oct;24(10):e14073. PubMed PMID: 37317937. Pubmed Central PMCID: PMC10562032. Epub 20230615. eng.
16. Adachi M, Matsumoto Y, Furuse H, Uchimura K, Imabayashi T, Yotsukura M, Yoshida Y, Nakagawa K, Igaki H, Watanabe SI, Tsuchida T. Utility of the endobronchial Watanabe spigot for intractable cancer-related pneumothorax: a retrospective observational study. Jpn J Clin Oncol. 2023 Aug 30;53(9):829-36. PubMed PMID: 37340759. Pubmed Central PMCID: PMC10473273. eng.
17. Eguchi K, Omura G, Murakami N, Honma Y, Yokoyama K, Watanabe T, Aihara Y, Sakai A, Matsumoto Y, Sakai T, Kobayashi K, Igaki H, Yoshimoto S. Comparison of Survival Outcomes Between Larynx-Preserving Open Partial Pharyngectomy and Radiotherapy or Chemoradiotherapy in Patients with Hypopharyngeal Squamous Cell Carcinoma: A Single-Center Retrospective Analysis with Inverse Probability of Treatment Weighting Adjustments. Ann Surg Oncol. 2023 Oct;30(11):6867-74. PubMed PMID: 37452169. Epub 20230714. eng.
18. Kawauchi D, Ohno M, Miyakita Y, Takahashi M, Yanagisawa S, Omura T, Yoshida A, Kubo Y, Igaki H, Ichimura K, Narita Y. Consulting a neurosurgeon upon initial medical assessment reduces the time to the first surgery and potentially contributes to improved prognosis for glioblastoma patients. Jpn J Clin Oncol. 2023 Nov 5;53(11):1027-33. PubMed PMID: 37534529. eng.
19. Murakami N, Kojima K, Okuma K, Kashihara T, Nakamura S, Shimizu W, Suda R, Igaki H, Shikama N. Non-operative management involving chemoradiation therapy combined with high-dose-rate brachytherapy for T3 rectal cancer using a vaginal shielded cylindrical applicator: a technical report. Jpn J Clin Oncol. 2023 Nov 5;53(11):1082-6. PubMed PMID: 37554048. eng.
20. Egashira M, Arimura H, Kobayashi K, Moriyama K, Kodama T, Tokuda T, Ninomiya K, Okamoto H, Igaki H. Magnetic resonance-based imaging biopsy with signatures including topological Betti number features for prediction of primary brain metastatic sites. Phys Eng Sci Med. 2023 Dec;46(4):1411-26. PubMed PMID: 37603131. Epub 20230821. eng.
21. Tohyama N, Okamoto H, Shimomura K, Kurooka M, Kawamorita R, Ota S, Kojima T, Hayashi N, Okumura M, Nakamura M, Nakamura M, Myojoyama A, Onishi H. A national survey on the medical physics workload of external beam radiotherapy in Japandagger. J Radiat Res. 2023 Nov 21;64(6):911-25. PubMed PMID: 37816672. Pubmed Central PMCID: PMC10665301.
22. Nagao A, Okamoto H, Nakayama H, Chiba T, Fujiyama D, Kuwahara J, Sakasai T, Kashihara T, Kaneda T, Inaba K, Okuma K, Murakami N, Igaki H. Assessment of intrafractional motion of the cervix-uterus by MR-guided radiotherapy system†. J Radiat Res. 2023 Nov 21;64(6):967-72. PubMed PMID: 37816679. Pubmed Central PMCID: PMC10665310. eng.
23. Kashihara T, Mori T, Nakaichi T, Nakamura S, Ito K, Kurihara H, Kusumoto M, Itami J, Yoshimoto S, Igaki H. Correlation between L-amino acid transporter 1 expression and 4-borono-2-(18) F-fluoro-phenylalanine accumulation in humans. Cancer Med. 2023 Nov;12(21):20564-72. PubMed PMID: 37881128. Pubmed Central PMCID: PMC10660410. Epub 20231025. eng.
24. Igaki H, Nakamura S, Yamazaki N, Kaneda T, Takemori M, Kashihara T, Murakami N, Namikawa K, Nakaichi T, Okamoto H, Iijima K, Chiba T, Nakayama H, Nagao A, Sakuramachi M, Takahashi K, Inaba K, Okuma K, Nakayama Y, Shimada K, Nakagama H, Itami J. Acral cutaneous malignant melanoma treated with linear accelerator-based boron neutron capture therapy system: a case report of first patient. Front Oncol. 2023;13時12分72507. PubMed PMID: 37901311. Pubmed Central PMCID: PMC10613025. Epub 20231013. eng.
25. Kishigami Y, Nakamura M, Okamoto H, Takahashi A, Iramina H, Sasaki M, Kawata K, Igaki H. Organ-contour-driven auto-matching algorithm in image-guided radiotherapy. J Appl Clin Med Phys. 2024 Jan;25(1):e14220. PubMed PMID: 37994694. Pubmed Central PMCID: PMC10795436. Epub 20231123. eng.
26. Nakahara M, Murakami N, Chiba T, Nagao A, Okuma K, Kashihara T, Kaneda T, Takahashi K, Inaba K, Nakayama Y, Kato T, Igaki H. Gynecological technical notes for appropriate spacer injections. Brachytherapy. 2024 Jan-Feb;23(1):45-51. PubMed PMID: 38040606. Epub 20231130. eng.
27. Wada S, Ogata D, Kashihara T, Okuma K, Eto H, Nakano E, Takahashi A, Namikawa K, Igaki H, Yamazaki N. A single-center retrospective analysis of prognoses in patients with melanoma brain metastases and effectiveness of treatment in Japan. Cancer Med. 2023 Dec;12(24):21933-43. PubMed PMID: 38083908. Pubmed Central PMCID: PMC10757137. Epub 20231211. eng.
28. Kobayashi K, Gu L, Hataya R, Mizuno T, Miyake M, Watanabe H, Takahashi M, Takamizawa Y, Yoshida Y, Nakamura S, Kouno N, Bolatkan A, Kurose Y, Harada T, Hamamoto R. Sketch-based semantic retrieval of medical images. Med Image Anal. 2024 Feb;92:103060. PubMed PMID: 38104401. Epub 20231208.
29. Nakao M, Ozawa S, Miura H, Yamada K, Hayata M, Hayashi K, Kawahara D, Nakashima T, Ochi Y, Okumura T, Kunimoto H, Kawakubo A, Kusaba H, Nozaki H, Habara K, Tohyama N, Nishio T, Nakamura M, Minemura T, Okamoto H, Ishikawa M, Kurooka M, Shimizu H, Hotta K, Saito M, Nakano M, Tsuneda M, Nagata Y. CT number calibration audit in photon radiation therapy. Med Phys. 2024 Mar;51(3):1571-82. PubMed PMID: 38112216. Epub 20231219.
30. Kito S, Suda Y, Tanabe S, Takizawa T, Nagahata T, Tohyama N, Okamoto H, Kodama T, Fujita Y, Miyashita H, Shinoda K, Kurooka M, Shimizu H, Ohno T, Sakamoto M. Radiological imaging protection: a study on imaging dose used while planning computed tomography for external radiotherapy in Japan. J Radiat Res. 2024 Mar 22;65(2):159-67. PubMed PMID: 38151953. Pubmed Central PMCID: PMC10959444.
31. Sakuramachi M, Murakami N, Nagao A, Kojima K, Miyata Y, Kashihara T, Kaneda T, Takahashi K, Inaba K, Okuma K, Nakayama Y, Okamoto H, Ishikawa M, Igaki H. Hydrogel spacer injection to the meso-sigmoid to protect the sigmoid colon in cervical cancer brachytherapy: A technical report. J Contemp Brachytherapy. 2023 Dec;15(6):465-9. PubMed PMID: 38230404. Pubmed Central PMCID: PMC10789158. Epub 20231229. eng.
32. Murakami Y, Kawahara D, Soyano T, Kozuka T, Takahashi Y, Miyake K, Kashihara K, Kashihara T, Kamima T, Oguchi M, Murakami Y, Yoshioka Y, Nagata Y. Dosiomics for intensity-modulated radiotherapy in patients with prostate cancer: survival analysis stratified by baseline prostate-specific antigen and Gleason grade group in a 2-institutional retrospective study. Br J Radiol. 2024 Jan 23;97(1153):142-9. PubMed PMID: 38263831.
33. Cho H, Abe S, Nonaka S, Suzuki H, Yoshinaga S, Okuma K, Yamamoto S, Daiko H, Kato K, Sekine S, Boku N, Saito Y. Long-term outcomes after non-curative endoscopic resection for esophageal squamous cell carcinoma followed by additional chemoradiotherapy. Dis Esophagus. 2024 Jan 23. PubMed PMID: 38266034. Epub 20240123.
34. Okamoto H, Wakita A, Tani K, Kito S, Kurooka M, Kodama T, Tohyama N, Fujita Y, Nakamura S, Iijima K, Chiba T, Nakayama H, Murata M, Goka T, Igaki H. Plan complexity metrics for head and neck VMAT competition plans. Med Dosim. 2024 Feb 16. PubMed PMID: 38368182. Epub 20240216. eng.
35. Nishioka S, Okamoto H, Chiba T, Kito S, Ishihara Y, Isono M, Ono T, Mizoguchi A, Mizuno N, Tohyama N, Kurooka M, Ota S, Shimizu D. Technical note: A universal worksheet for failure mode and effects analysis-A project of the Japanese College of Medical Physics. Med Phys. 2024 Mar 20. PubMed PMID: 38507277. Epub 20240320.

Before 2022
1. Nakamura S, Murakami N, Suzuki S, Ito K, Takemori M, Nakayama H, Kaga K, Chiba T, Iijima K, Takahashi K, Goka T, Itami J, Okamoto H, Igaki H. Monte Carlo simulation of tilted contact plaque brachytherapy placement for juxtapapillary retinoblastoma. Radiation oncology (London, England), 17時16分, 2022

2. Kashihara T, Ishiki H, Kato K. Definitive Chemoradiotherapy for Older Patients With Esophageal Cancer. JAMA oncology, 8時30分4-305, 2022

3. Imamichi S, Chen L, Ito T, Tong Y, Onodera T, Sasaki Y, Nakamura S, Mauri P, Sanada Y, Igaki H, Murakami Y, Suzuki M, Itami J, Masunaga S, Masutani M. Extracellular Release of HMGB1 as an Early Potential Biomarker for the Therapeutic Response in a Xenograft Model of Boron Neutron Capture Therapy. Biology, 11時20分22

4. Igaki H, Murakami N, Nakamura S, Yamazaki N, Kashihara T, Takahashi A, Namikawa K, Takemori M, Okamoto H, Iijima K, Chiba T, Nakayama H, Takahashi A, Kaneda T, Takahashi K, Inaba K, Okuma K, Nakayama Y, Shimada K, Nakagama H, Itami J. Scalp angiosarcoma treated with linear accelerator-based boron neutron capture therapy: A report of two patients. Clinical and translational radiation oncology, 33:128-133, 2022

5. Murakami N, Okuma K, Okamoto H, Nakamura S, Kashihara T, Kaneda T, Takahashi K, Inaba K, Igaki H, Masui K, Yoshida K, Kato T, Itami J. Bevacizumab increases late toxicity in re-irradiation with image-guided high-dose-rate brachytherapy for gynecologic malignancies. Journal of contemporary brachytherapy, 14時52分-59, 2022

6. Murakami N, Kuno I, Yoshida H, Shiraishi K, Kato T, Igaki H. How should we appropriately classify low-risk uterine cervical cancer patients suitable for de-intensified treatment? Journal of radiation research, 63:312-313, 2022

7. Akiyama H, Yoshida K, Takenaka T, Kotsuma T, Masui K, Monzen H, Sumida I, Tsujimoto Y, Miyao M, Okumura H, Shimbo T, Takegawa H, Murakami N, Inaba K, Kashihara T, Takácsi-Nagy Z, Tselis N, Yamazaki H, Tanaka E, Nihei K, Ariji Y . Effect of a lead block on alveolar bone protection in image-guided high-dose-rate interstitial brachytherapy for tongue cancer: using model-based dose calculation algorithms to correct for inhomogeneity. Journal of contemporary brachytherapy, 14:87-95, 2022

8. Murakami N, Ohno T, Toita T, Ando K, Ii N, Okamoto H, Kojima T, Tsujino K, Masui K, Yoshida K, Ikushima H. Japanese Society for Radiation Oncology Consensus Guidelines of combined intracavitary and interstitial brachytherapy for gynecological cancers. Journal of radiation research, 63:402-411, 2022

9. Murakami N, Ando K, Murata M, Murata K, Ohno T, Aoshika T, Kato S, Okonogi N, Saito AI, Kim JY, Yoshioka Y, Sekii S, Tsujino K, Lowanichkiattikul C, Pattaranutaporn P, Kaneyasu Y, Nakagawa T, Watanabe M, Uno T, Umezawa R, Jingu K, Kanemoto A, Wakatsuki M, Shirai K, Igaki H, Itami J. An Asian multi-national multi-institutional retrospective study comparing intracavitary versus the hybrid of intracavitary and interstitial brachytherapy for locally advanced uterine cervical carcinoma. Journal of radiation research, 63:412-427, 2022

10. Murakami N, Watanabe M, Uno T, Sekii S, Tsujino K, Kasamatsu T, Machitori Y, Aoshika T, Kato S, Hirowatari H, Kaneyasu Y, Nakagawa T, Ikushima H, Ando K, Murata M, Yoshida K, Yoshioka H, Murata K, Ohno T, Okonogi N, Saito A, Ichikawa M, Okuda T, Tsuchida K, Sakurai H, Yoshimura R, Yoshioka Y, Yorozu A, Okamoto H, Inaba K, Kato T, Igaki H, Itami J. Large volume was associated with increased risk of acute non-hematologic adverse events in the hybrid of intracavitary and interstitial brachytherapy for locally advanced uterine cervical cancer: preliminary results of prospective phase I/II clinical trial. Japanese journal of clinical oncology, 2022

11. Okamoto H, Okuma K, Nakayama H, Nakamura S, Iijima K, Chiba T, Takemori M, Fujii K, Mikasa S, Nakaichi T, Aikawa A, Katsuta S, Igaki H. In vivo dosimetry for testicular and scalp shielding in total skin electron therapy using a radiophotoluminescence glass dosimeter. Journal of radiation research, 63:51-54, 2022

12. Okamoto H, Iijima K, Chiba T, Takemori M, Nakayama H, Fujii K, Kon M, Mikasa S, Nakaichi T, Urago Y, Aikawa A, Katsuta S, Nakamura S, Igaki H. Technical note: Analysis of brachytherapy source movement by high-speed camera. Medical physics, 2022

13. Tamura Y, Demachi K, Igaki H, Okamoto H, Nakano M. A Real-Time Four-Dimensional Reconstruction Algorithm of Cine-Magnetic Resonance Imaging (Cine-MRI) Using Deep Learning. Cureus, 14:e22826, 2022

14. Kashihara T, Igaki H, Ogata D, Nakayama H, Nakamura S, Okuma K, Mori T, Yamakawa K, Takahashi A, Namikawa K, Takahashi A, Takahashi K, Kaneda T, Inaba K, Murakami N, Nakayama Y, Okamoto H, Yamazaki N, Itami J. Prognostic factor analysis of definitive radiotherapy using intensity-modulated radiation therapy and volumetric modulated arc therapy with boluses for scalp angiosarcomas. Scientific reports, 12時43分55, 2022

15. Kobayashi R, Murakami N, Chiba T, Okuma K, Inaba K, Takahashi K, Kaneda T, Kashihara T, Takahashi A, Shimizu Y, Nakayama Y, Kato T, Ito Y, Igaki H . Effect of Hyaluronate Acid Injection on Dose-Volume Parameters in Brachytherapy for Cervical Cancer. Advances in radiation oncology, 7時10分0918, 2022

16. Yonezawa H, Ohno M, Igaki H, Miyakita Y, Takahashi M, Tamura Y, Shima S, Matsushita Y, Ichimura K, Narita Y. Outcomes of salvage fractionated re-irradiation combined with bevacizumab for recurrent high-grade gliomas that progressed after bevacizumab treatment*. Japanese journal of clinical oncology, 51:1028-1035, 2021

17. Kashihara T, Nakamura S, Murakami N, Ito K, Matsumoto Y, Kobayashi K, Omura G, Mori T, Honma Y, Kubo Y, Okamoto H, Takahashi K, Inaba K, Okuma K, Igaki H, Nakayama Y, Kato K, Matsumoto F, Yoshimoto S, Itami J. Initial Experience of Intentional Internal High-Dose Policy Volumetric Modulated Arc Therapy of Neck Lymph Node Metastases ≥ 2 cm in Patients With Head and Neck Squamous Cell Carcinoma. Frontiers in oncology, 11:651409, 2021

18. Inaba K, Tsuchida K, Kashihara T, Umezawa R, Takahashi K, Okuma K, Murakami N, Ito Y, Igaki H, Sumi M, Nakayama Y, Shinoda Y, Hara T, Matsui Y, Komiyama M, Fujimoto H, Itami J. Treatment results of radiotherapy to both the prostate and metastatic sites in patients with bone metastatic prostate cancer. Journal of radiation research, 62:511-516, 2021

19. Murakami N, Asami Y, Yoshida H, Takayanagi D, Hirose S, Kuno I, Takahashi K, Matsuda M, Shimada Y, Yamano S, Sunami K, Honda T, Nakahara T, Watanabe T, Okuma K, Kuroda T, Kohno T, Kato T, Shiraishi K, Itami J. Distribution of genetic alterations in high-risk early-stage cervical cancer patients treated with postoperative radiation therapy. Scientific reports, 11時10分567, 2021

20. Chen L, Imamichi S, Tong Y, Sasaki Y, Onodera T, Nakamura S, Igaki H, Itami J, Masutani M. A Combination of GM-CSF and Released Factors from Gamma-Irradiated Tumor Cells Enhances the Differentiation of Macrophages from Bone Marrow Cells and Their Antigen-Presenting Function and Polarization to Type 1. Medicines (Basel, Switzerland), 8時20分21

21. Itami J, Murakami N, Watanabe M, Sekii S, Kasamatsu T, Kato S, Hirowatari H, Ikushima H, Ando K, Ohno T, Okamoto H, Okuma K, Igaki H. Combined Interstitial and Intracavitary High-Dose Rate Brachytherapy of Cervical Cancer. Frontiers in oncology, 11:809825, 2021

22. Murakami N, Nakamura S, Kashihara T, Inaba K, Kaneda T, Takahashi K, Okuma K, Igaki H, Itami J. Increased number of prostate cancer patients selecting high dose-rate interstitial brachytherapy during the COVID-19 pandemic. Radiotherapy and oncology: journal of the European Society for Therapeutic Radiology and Oncology, 154:274-275, 2021

23. Murakami N, Omura G, Yatsuoka W, Okamoto H, Yoshimoto S, Ueno T, Itami J. Hybrid Intracavitary-Interstitial brachytherapy in a case of nasal vestibule cancer penetrating the hard palate. BJR case reports, 7時20分200178, 2021

24. Yokoyama K, Murakami N, Takahashi A, Kobayashi K, Igaki H, Itami J. Radiotherapy-Induced Autoeczematization. Pract Radiat Oncol, 11:E447-E448, 2021

25. Umezawa R, Wakita A, Katsuta Y, Ito Y, Nakamura S, Okamoto H, Kadoya N, Takahashi K, Inaba K, Murakami N, Igaki H, Jingu K, Itami J. A Pilot Study of Synchronization of Respiration-Induced Motions in the Duodenum and Stomach for the Primary Tumor in Radiation Therapy for Pancreatic Cancer Using 4-Dimensional Computed Tomography. Advances in radiation oncology, 6時10分0730, 2021

26.  Murakami N, Ando K, Murata M, Murata K, Ohno T, Aoshika T, Kato S, Okonogi N, Saito AI, Kim JY, Kumai Y, Yoshioka Y, Sekii S, Tsujino K, Lowanichkiattikul C, Pattaranutaporn P, Kaneyasu Y, Nakagawa T, Watanabe M, Uno T, Umezawa R, Jingu K, Kanemoto A, Wakatsuki M, Shirai K, Igaki H, Itami J. Why not de-intensification for uterine cervical cancer? Gynecologic oncology, 163:105-109, 2021

27. Murakami N, Honma Y, Yoshimoto S, Shima S, Kashihara T, Takahashi K, Kaneda T, Inaba K, Okuma K, Masui K, Yoshida K, Igaki H, Itami J. Gel spacer to protect carotid artery and reconstructed jejunum in image-guided interstitial brachytherapy for recurrent hypopharyngeal cancer: a technical report. Journal of contemporary brachytherapy, 13時58分3-587, 2021

28. Kuno I, Takayanagi D, Asami Y, Murakami N, Matsuda M, Shimada Y, Hirose S, Kato MK, Komatsu M, Hamamoto R, Okuma K, Kohno T, Itami J, Yoshida H, Shiraishi K, Kato T. TP53 mutants and non-HPV16/18 genotypes are poor prognostic factors for concurrent chemoradiotherapy in locally advanced cervical cancer. Scientific reports, 11時19分261, 2021

29. Nakamura S, Igaki H, Ito M, Imamichi S, Kashihara T, Okamoto H, Nishioka S, Iijima K, Chiba T, Nakayama H, Takemori M, Abe Y, Kaneda T, Takahashi K, Inaba K, Okuma K, Murakami N, Nakayama Y, Masutani M, Nishio T, Itami J. Neutron flux evaluation model provided in the accelerator-based boron neutron capture therapy system employing a solid-state lithium target. Scientific reports, 11:8090, 2021

30. Takada M, Nunomiya T, Masuda A, Matsumoto T, Tanaka H, Nakamura S, Endo S, Nakamura M, Aoyama K, Ueda O, Narita M, Nakamura T. Development of a real-time neutron beam detector for boron neutron capture therapy using a thin silicon sensor. Applied radiation and isotopes: including data, instrumentation and methods for use in agriculture, industry and medicine, 176:109856, 2021

31.  Urago Y, Okamoto H, Kaneda T, Murakami N, Kashihara T, Takemori M, Nakayama H, Iijima K, Chiba T, Kuwahara J, Katsuta S, Nakamura S, Chang W, Saitoh H, Igaki H. Evaluation of auto-segmentation accuracy of cloud-based artificial intelligence and atlas-based models. Radiation oncology (London, England), 16時17分5, 2021

32. Nakayama H, Nakamura S, Iijima K, Chiba T, Takemori M, Kashihara T, Okuma K, Igaki H, Saitoh H, Chang W, Okamoto H. Efficacy of tangential irradiation with volumetric modulated arc therapy on scalp angiosarcoma using medical linac. Physica medica: PM: an international journal devoted to the applications of physics to medicine and biology: official journal of the Italian Association of Biomedical Physics (AIFB), 91:105-116, 2021

33. Iijima K, Okamoto H, Nishioka S, Sakasai T, Nakamura S, Chiba T, Kaga K, Takemori M, Nakayama H, Miura Y, Fujiyama D, Tsunoda Y, Igaki H, Katsuta S, Itami J. Performance of a newly designed end-to-end phantom compatible with magnetic resonance-guided radiotherapy systems. Medical physics, 48:7541-7551, 2021

34. Ishiyama H, Tsumura H, Nagano H, Watanabe M, Mizuno E, Taka M, Kobayashi H, Eriguchi T, Imada H, Inaba K, Nakamura K. Multi-institutional retrospective analysis of ultrahypofractionated radiotherapy for Japanese prostate cancer patients. Scientific reports, 11時13分194, 2021

35. Kitaguchi M, Yamashita H, Takenaka R, Okuma K, Nawa K, Nakagawa K. Helical Skin Radiation Therapy Including Total Skin Radiation Therapy Using Tomotherapy for Primary Cutaneous Lymphoma With Bone Marrow Suppression as a Related Adverse Event. Practical radiation oncology, 11:e308-e321, 2021

36. Shimizu Y, Murakami N, Chiba T, Kaneda T, Okamoto H, Nakamura S, Takahashi A, Kashihara T, Takahashi K, Inaba K, Okuma K, Nakayama Y, Itami J, Igaki H. High-Dose-Rate Interstitial Brachytherapy for Deeply Situated Gynecologic Tumors Guided by Combination of Transrectal and Transabdominal Ultrasonography: A Technical Note. Frontiers in oncology, 11:808721, 2021

37. Kashihara T, Kashihara K. Radiotherapy with genomic-adjusted radiation dose. The Lancet. Oncology, 22:e468, 2021

38. Kashihara T, Kashihara K. Lutetium-177-PSMA-617 for Prostate Cancer. The New England journal of medicine, 385:2494-2495, 2021

39. Murakami N, Mori T, Machida R, Kodaira T, Ito Y, Shikama N, Konishi K, Matsumoto Y, Murakami Y, Nakamura N, Yamashita H, Yorozu A, Yoshimura M, Inoue K, Nozaki M, Ishikura S, Itami J, Nishimura Y, Kagami Y. Prognostic Value of Epithelial Cell Adhesion Molecules in T1-2N0M0 Glottic Cancer. The Laryngoscope, 131:1522-1527, 2021

40. Kobayashi K, Murakami N, Takahashi K, Inaba K, Igaki H, Hamamoto R, Itami J. Tensor Regression-based Model to Investigate Heterogeneous Spatial Radiosensitivity After I-125 Seed Implantation for Prostate Cancer. In vivo (Athens, Greece), 35:489-497, 2021

41. Takayanagi D, Hirose S, Kuno I, Asami Y, Murakami N, Matsuda M, Shimada Y, Sunami K, Komatsu M, Hamamoto R, Kato MK, Matsumoto K, Kohno T, Kato T, Shiraishi K, Yoshida H. Comparative Analysis of Genetic Alterations, HPV-Status, and PD-L1 Expression in Neuroendocrine Carcinomas of the Cervix. Cancers, 13時20分21

42.  Watase C, Shiino S, Shimoi T, Noguchi E, Kaneda T, Yamamoto Y, Yonemori K, Takayama S, Suto A. Breast Cancer Brain Metastasis-Overview of Disease State, Treatment Options and Future Perspectives. Cancers, 13時20分21