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RISS 인기검색어
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- 저자 : Naoto Endo (검색결과 2 건)
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Naoki Nakamura,Osamu Takahashi,Minobu Kamo,Shogo Hatanaka,Haruna Endo,Norifumi Mizuno,Naoto Shikama,Mami Ogita,Kenji Sekiguchi 한국유방암학회 2014 Journal of breast cancer Vol.17 No.2
Purpose: The purpose of this study was to quantify the targetcoverage, homogeneity, and robustness of the dose distributionsagainst geometrical uncertainties associated with fourwhole breast radiotherapy techniques. Methods: The study wasbased on the planning-computed tomography-datasets of 20patients who underwent whole breast radiotherapy. A total offour treatment plans (wedge, field-in-field [FIF], hybrid intensitymodulatedradiotherapy [IMRT], and full IMRT) were created foreach patient. The hybrid IMRT plans comprised two opposedtangential open beams plus two IMRT beams. Setup errors weresimulated by moving the beam isocenters by 5 mm in the anterioror posterior direction. Results: With the original plan, thewedge technique yielded a high volume receiving ≥107% of theprescription dose (V107; 7.5%±4.2%), whereas the other threetechniques yielded excellent target coverage and homogeneity. A 5 mm anterior displacement caused a large and significant increasein the V107 (+5.2%±4.1%, p<0.01) with the FIF plan, butnot with the hybrid IMRT (+0.4%±1.2%, p=0.11) or full IMRT(+0.7%±1.8%, p=0.10) plan. A 5-mm posterior displacementcaused a large decrease in the V95 with the hybrid IMRT (-2.5%±3.7%, p<0.01) and full IMRT (-4.3%±5.1%, p<0.01) plans, butnot with the FIF plan (+0.1%±0.7%, p=0.74). The decrease inV95 was significantly smaller with the hybrid IMRT plan than withthe full IMRT plan (p<0.01). Conclusion: The FIF, hybrid IMRT,and full IMRT plans offered excellent target coverage and homogeneity. Hybrid IMRT provided better robustness against geometricaluncertainties than full IMRT, whereas FIF provided comparablerobustness to that of hybrid IMRT
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Masayuki Ohashi,Toru Hirano,Kei Watanabe,Kazuhiro Hasegawa,Takui Ito,Keiichi Katsumi,Hirokazu Shoji,Tatsuki Mizouchi,Ikuko Takahashi,Takao Homma,Naoto Endo 대한척추외과학회 2019 Asian Spine Journal Vol.13 No.2
Study Design: Retrospective case series. Purpose: To investigate the oncological outcomes, including distant relapse, after en bloc spondylectomy (EBS) for spinal metastases in patients with a minimum of 2-year follow-up. Overview of Literature: Although EBS has been reported to be locally curative and extend survival in select patients with spinal metastases, detailed reports regarding the control of distant relapse after EBS are lacking. Methods: We conducted a retrospective review of 18 consecutive patients (median age at EBS, 62 years; range, 40–77 years) who underwent EBS for spinal metastases between 1991 and 2015. The primary cancer sites included the kidney (n=7), thyroid (n=4), liver (n=3), and other locations (n=4). Survival rates were estimated using the Kaplan–Meier method, and groups were compared using the log-rank method. Results: The median operative time and intraoperative blood loss were 767.5 minutes and 2,375 g, respectively. Twelve patients (66.7%) experienced perioperative complications. Five patients (27.8%) experienced local recurrence of the tumor at a median of 12.5 months after EBS, four of which had a positive resection margin status. Thirteen patients (72.2%) experienced distant relapse at a median of 21 months after EBS. The estimated median survival period after distant relapse was 20 months (95% confidence interval, 0.71–39.29 months). No association was found between resection margin status and distant relapse. Overall, the 2-year, 5-year, and 10-year survival rates after EBS were 72.2%, 48.8%, and 27.1%, respectively. Importantly, the era in which EBS was performed did not impact the oncological outcomes. Conclusions: Our results suggest that EBS by itself, even if margin-free, cannot prevent further dissemination, which occurred in >70% of patients at a median of 21 months after EBS. These results should be considered and conveyed to patients for clinical decision-making.
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