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Aina Kunitomo,Kazunari Misawa,Yuichi Ito,Seiji Ito,Eiji Higaki,Seiji Natsume,Takashi Kinoshita,Tetsuya Abe,Koji Komori,Yasuhiro Shimizu 대한위암학회 2021 Journal of gastric cancer Vol.21 No.4
Purpose: Type 4 gastric cancer (GC) has a very poor prognosis even after curative resection, and the survival benefit of splenectomy for splenic hilar lymph node (LN; #10) dissection in type 4 GC remains equivocal. This study aimed to clarify the clinical significance of splenectomy for #10 dissection in patients with type 4 GC. Materials and Methods: The data of a total of 56 patients with type 4 GC who underwent total gastrectomy with splenectomy were retrospectively analyzed. Postoperative morbidity, state of LN metastasis, survival outcomes, and therapeutic value index (TVI) of each LN station were evaluated. TVI was calculated by multiplying the incidence of LN metastasis at each nodal station and the 5-year overall survival (OS) of patients who had metastasis to each node. Results: Overall, the postoperative morbidity rate was 28.6%, and the incidence of #10 metastasis in the patients was 28.6%. The 5-year OS rate for all patients was 29.9%, and most patients developed peritoneal recurrence. Moreover, the 5-year OS rates with and without #10 metastasis were 6.7% and 39.1% (median survival time, 20.4 vs. 46.0 months; P=0.006). The TVI of #10 was as low as 1.92. Conclusions: The clinical significance of splenectomy in the dissection of #10 for type 4 GC is limited and splenectomy for splenic hilar dissection alone should be omitted.
Status of a Carbon-Ion Therapy Facility and Development for Advanced Treatment
Atsushi Kitagawa,Takashi Fujita,Akifumi Fukumura,Takuji Furukawa,Taku Inaniwa,Yoshiyuki Iwata,Tatsuaki Kanai,Mitsutaka Kanazawa,Nobuyuki Kanematsu,Yuki Kase,Masataka Komori,Koji Noda,Yumiko Ohno,Shinj 한국물리학회 2008 THE JOURNAL OF THE KOREAN PHYSICAL SOCIETY Vol.53 No.6
Over 3000 cancer patients have already been treated with 140- to 400-MeV/n carbon beams produced by the heavy ion medical accelerator in Chiba (HIMAC) at the National Institute of Radiological Sciences (NIRS) since 1994. These clinical results have clearly verified the advantages of carbon ions. Based on our experience at HIMAC, a hospital-specific facility optimized for carbon-ion therapy has been designed. The prototype developments of an electron cyclotron resonance (ECR) ion source, a radio frequency quadruple (RFQ) linac, an inter digital H (IH) linac, an acceleration system of synchrotron, a beam-delivery system and other key-technology parts have been successfully finished. Thus, in co-operation with NIRS, Gunma University has been constructing a carbon-therapy facility since April, 2006. If the present clinical results are to be improved, it is necessary to create a more accurate dose distribution on tumors without an undesired dose being deposited in normal tissue. Beam-scanning methods with respiration-gated irradiation are especially important to treat a cancer tumor located in the trunk of a patient. Over 3000 cancer patients have already been treated with 140- to 400-MeV/n carbon beams produced by the heavy ion medical accelerator in Chiba (HIMAC) at the National Institute of Radiological Sciences (NIRS) since 1994. These clinical results have clearly verified the advantages of carbon ions. Based on our experience at HIMAC, a hospital-specific facility optimized for carbon-ion therapy has been designed. The prototype developments of an electron cyclotron resonance (ECR) ion source, a radio frequency quadruple (RFQ) linac, an inter digital H (IH) linac, an acceleration system of synchrotron, a beam-delivery system and other key-technology parts have been successfully finished. Thus, in co-operation with NIRS, Gunma University has been constructing a carbon-therapy facility since April, 2006. If the present clinical results are to be improved, it is necessary to create a more accurate dose distribution on tumors without an undesired dose being deposited in normal tissue. Beam-scanning methods with respiration-gated irradiation are especially important to treat a cancer tumor located in the trunk of a patient.