The evaluation of late adverse effects of adjuvant radiotherapy using in silico sarrogate end marker

• Project/Area Number: 15K19760
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Radiation science
• Research Institution: Hokkaido University
• Principal Investigator: Kinoshita Rumiko 北海道大学, 大学病院, 助教 (70507582)
• Research Collaborator: Yoshimura Takaaki
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥2,860,000 (Direct Cost: ¥2,200,000、Indirect Cost: ¥660,000); Fiscal Year 2017: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2016: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2015: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
• Keywords: 術後照射 / NTCP / 婦人科癌 / 全骨盤照射 / 乳癌術後照射 / 陽子線治療 / 乳癌 / 強度変調放射線治療 / X線治療 / 婦人科腫瘍 / NTCPモデル

Outline of Final Research Achievements

IMRT and spot sccaning proton therapy(SSPT) plans were created for 13 gynecologic malignancy patients who had received hysterectomies and irradiation to the pelvic region. The Bone marrow(BM）dose using SSPT was significantly lower than with IMRT. The NTCP modeling analysis showed that the risk of grade≧3 hematologic toxicity (HT3+) using SSPT was significantly lower than with IMRT The SSPT achieves significant reductions in the dose to BM without compromising target coverage, compared with IMRT. The NTCP value for HT3+ in SSPT was significantly lower than in IMRT.
Dose volume anlaysis was carried out to eveluate the dose to the internal mammary lymph node(IMN) and normal tissure using 50 patients who reieved breaset concervation therapy(BCT).
The IMN-PTV mean doses were less than 30 Gy in all cases.The IMN dose in standard tangential irradiation for BCT is insufficient for treatment.

Academic Significance and Societal Importance of the Research Achievements

婦人科癌の術後照射において、陽子線治療はX線のIMRTと比較し正常組織の線量が低減されている事が示され、更に血液毒性を低減しうる事が理論上示された。このことは陽子線治療を実際に臨床で使用する事による理論的根拠となりうる。
乳癌の術後照射において、X線で乳房と領域リンパ節に照射を行うと正常組織の線量が増大する事が示され、正常組織の線量を低減可能な照射法の考案が必要である事が示唆された。

Research Products

• [Journal Article] NTCP Modeling Analysis of Acute Hematologic Toxicity in Whole Pelvic Radiation Therapy for Gynecologic Malignancies - A Dosimetric Comparison of IMRT and Spot-Scanning Proton Therapy (SSPT) (2016)
  • Author(s): Takaaki Yoshimura, Rumiko Kinoshita, Shunsuke Onodera, Chie Toramatsu, Ryusuke Suzuki, Yoichi M. Ito, Seishin Takao, Taeko Matsuura, Yuka Matsuzaki, Kikuo Umegaki, Hiroki Shirato, Shinichi Shimizu
  • Journal Title: Physica Medica Volume: 32 Pages: 1095-1102
  • NAID: 120005972937
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Presentation] 全乳房及び腋窩リンパ節領域に対する強度変調放射線治療の初期経験(Initial Report of Intensity Modulated Radiotherapy of the Whole Breast and Axillary Lymph Node with Positive Sentinel Node) (2018)
  • Author(s): Kinoshita Rumiko(Hokkaido Univ. Hosp. Radiation Oncology), Nishikawa Yukiko, Shimizu Shinichi, Nishioka Kentaro, Hashimoto Takayuki, Suzuki Ryusuke, Baba Motoi, Yamashita Hiroko, Shirato Hiroki
  • Organizer: The 77th Annual meeting of the Japan Radiological Society
• [Presentation] Inidental radiation dose to internal mammary lymph node in tangential breast irradiation: comparison of calculation algorithm (2017)
  • Author(s): Rumiko Kinoshita, Yukiko Nishikawa, Kentaro Nishioka, Takayuki Hashimoto, Shinichi Shimizu, Ryuusuke Suzuki, Hiroki Shirato
  • Organizer: The 76th Annual meeting of the Japan Radiological Society
• [Presentation] Radiation dose to internal mammary lymph node in standard tangential breast irradiation (2016)
  • Author(s): Rumiko Kinoshita , Shinichi Shimizu, Yukiko Nishikawa, Kentaro Nishioka, Takayuki Hashimoto, Ryusuke Suzuki, Hiroki Shirato
  • Organizer: The58th Annual Meeting of the American Society of Radiation Oncology (ASTRO)
  • Place of Presentation: Boston Convention and Exhibition Center, （Boston, Massachusetts、USA)
  • Year and Date: 2016-09-25
  • Int'l Joint Research
• [Presentation] Analysis of volumetirc dose of the lung and the heart for tangential breast irradiation (2016)
  • Author(s): Rumiko Kinoshita,Yukiko Nishikawa, Kentaro Nishioka, Takayuki Hashimoto, Shinichi Shimizu, Ryuusuke Suzuki, Hiroki Shirato
  • Organizer: The 75th Annual meeting of the Japan Radiological Society
  • Place of Presentation: Pacifico Yokohama (Yokohama, Kanagawa)
  • Year and Date: 2016-04-14
• [Presentation] Analysis of volumetric dose of the lung and the heart for tangential breast irradiation (2016)
  • Author(s): Rumiko Kinoshita, Yukiko Nishikawa, Kentaro Nishioka,Takayuki Hashimoto, Shinichi Shimizu, Ryusuke Suzuki、Hiroki Shirato,
  • Organizer: The 75th Annual meeting of the Japan Radiological Society
  • Place of Presentation: Pacifico Yokohama (Yokohama，Kanagawa)
  • Year and Date: 2016-04-14
• [Presentation] Estimation of the risk of side effect for whole pelvic irradiation using spot scanning proton therapy with single field optimization (2016)
  • Author(s): Takaaki Yoshimura, Rumiko Kinoshita, Shunsuke Onodera , Chie Toramatsu, Ryusuke Suzuki, Seishin Takao, Taeko Matsuura, Yuka Matsuzaki , Shinichi Shimizu, Kikuo Umegaki, Hiroki Shirato
  • Organizer: The 3rd GI-CoRE Medical Science and Engineering Symposium
  • Place of Presentation: Hokkaido University (Sapporo，Hokkaido)
  • Year and Date: 2016-03-03
• [Presentation] NTCP Modeling Analysis of Acute Hematologic Toxicity in Whole Pelvic Radiation Therapy for Gynecologic Malignancies - A Dosimetric Comparison of IMRT and Spot-Scanning Proton Therapy (2015)
  • Author(s): T. Yoshimura, R. Kinoshita, S. Onodera， Toramatsu , R. Suzuki , Y. M. Ito , S. Takao , T. Matsuura, Y. Matsuzaki ,S. Shimizu, K. Umegaki, H. Shirato
  • Organizer: the 57th Annual Meeting of the American Society of Radiation Oncology (ASTRO)
  • Place of Presentation: Henry B.Gonzalez Convention Center (San Antonio, USA）
  • Year and Date: 2015-10-18
  • Int'l Joint Research