Annual Report 2023
Department of Radiation Oncology
Hiroshi Igaki, Yuko Nakayama, Kae Okuma, Tomoya Kaneda, Koichi 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 and globally. 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.
The Team and What We Do
Our department treats the largest number of patients requiring radiation therapy in Japan. Four linear accelerators, CyberKnife, MRIdian, a brachytherapy system, four XCT-simulators, and 19 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 for metastatic and primary brain tumor treatment. Stereotactic body radiation therapies are performed for lung and liver tumors under respiratory gating in linear accelerators or CyberKnife. All linear accelerators have on-board kilovoltage CT imagers, which assist in precisely aligning patient and tumor coordinates. These image-guided radiation therapy (IGRT) equipment enables the precise delivery of IMRT in head and neck cancers, brain tumors, prostate cancers, postoperative cervical cancers, and other cancers. MR linear accelerator system, MRIdian®, is primarily used for abdominal and thoracic tumors with respiratory motions. Brachytherapy is also performed to improve local control, with the following modalities: an Ir-192 high dose rate (HDR) after-loading system, including a dedicated CT simulator and fluoroscopy, and other low dose rate (LDR) brachytherapy systems using Au-198 grains and Ru-106 eye plaques. 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 conducted 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 Table 1.
Research Activities
Clinical research is an essential component of the daily activities of our department. The primary interests of the research activities of the department are as follows: (1) clinical applications of accelerator-based boron neutron capture therapy for skin and other tumors; (2) on-line adaptive radiation therapy using an MR linear accelerator system; (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, esophageal cancers, and others.
International NRG studies for breast cancer and meningioma
International Study of Ophthalmic Radiation Therapy Toxicity
Multi-institutional phase II clinical trial of on-line adaptive stereotactic body radiotherapy for prostate cancer using MR linear accelerators
Phase II clinical trial of BNCT for skin angiosarcoma
Development of an Adaptive Radiation Therapy System
Many other multi- or single-institutional clinical trials are also ongoing or in preparation.
Education
Residents are trained in all fields of radiation oncology in our department. Seminars on biology, physics, and clinical radiation oncology are regularly held in the evening.
Future Prospects
With the expanding of radiation therapy indications, 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 in 2023
Journal
1. 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. Medical image analysis, 92:103060, 2024
2. 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. Journal of applied clinical medical physics, 25:e14220, 2024
3. 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, 23:45-51, 2024
4. 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. Medical physics, 51:1571-1582, 2024
5. 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. Journal of radiation research, 65:159-167, 2024
6. 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. The British journal of radiology, 97:142-149, 2024
7. 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. Diseases of the esophagus, 37:doae004, 2024
8. 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. Medical dosimetry, S0958-3947(24)00009-8, 2024
9. 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. Medical physics, 51:3658-3664, 2024
10. 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. International journal of clinical oncology, 28:1043-1053, 2023
11. 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. Japanese journal of clinical oncology, 53:1027-1033, 2023
12. 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, 50:618-622, 2023
13. 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. Annals of surgical oncology, 30:6867-6874, 2023
14. 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. Japanese journal of clinical oncology, 53:829-836, 2023
15. 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. Journal of contemporary brachytherapy, 15:465-469, 2023
16. 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. Frontiers in oncology, 13:1272507, 2023
17. 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 medicine, 12:21933-21943, 2023
18. 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 medicine, 12:20564-20572, 2023
19. Matsumura A, Asano T, Hirose K, Igaki H, Kawabata S, Kumada H. Initiatives Toward Clinical Boron Neutron Capture Therapy in Japan. Cancer biotherapy & radiopharmaceuticals, 38:201-207, 2023
20. 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. Journal of applied clinical medical physics, 24:e13865, 2023
21. 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. Journal of gynecologic oncology, 34:e24, 2023
22. 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. Japanese journal of clinical oncology, 53:508-513, 2023
23. 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. Journal of applied clinical medical physics, 24:e13915, 2023
24. 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). Radiotherapy and oncology, 183:109630, 2023
25. 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. Journal of contemporary brachytherapy, 15:1-8, 2023
26. 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. Hepatology research, 53:749-760, 2023
27. 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. Journal of applied clinical medical physics, 24:e14040, 2023
28. 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. Physics and imaging in radiation oncology, 26:100445, 2023
29. 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. Journal of radiation research, 64:661-667, 2023
30. 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. Journal of radiation research, 64:746-749, 2023
31. 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. Journal of applied clinical medical physics, 24:e14073, 2023
32. 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. Japanese journal of clinical oncology, 53:1082-1086, 2023
33. 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. Physical and engineering sciences in medicine, 46:1411-1426, 2023
34. 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 Japan†. Journal of radiation research, 64:911-925, 2023
35. 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†. Journal of radiation research, 64:967-972, 2023
Book
1. Okamoto H, Chiba T, Kuwahara J, Igaki H. ViewRay MR-Linac. In: Nagata Y (ed), Stereotactic Body Radiation Therapy: Principles and Practices, 2nd Edition, Springer , Singapore, pp 285-295, 2023
2. Nakamura S. Therapy method, irradiation method, and immobilization and positioning (skin). In: Shirai T, Nishio T, Sato K (ed), Advances in Accelerators and Medical Physics, Academic Press, United Kingdom, pp 251-256, 2023
3. Igaki H, Nakamura S, Nakamura M, Itami J. Accelerator-Based Neutron Irradiation System With a Lithium Target in the National Cancer Center Hospital, Japan. In: Advances in Boron Neutron Capture Therapy, International Atomic Energy Agency, Austria, pp 307-312, 2023