Establishment of Global Gold Standard about radiotherapy adaptation criteria in patients with lung cancer using pulmonary quantification by Xenon CT

• Project/Area Number: 20K16442
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 50020:Tumor diagnostics and therapeutics-related
• Research Institution: Kobe University
• Principal Investigator: Ishihara Takeaki 神戸大学, 医学部附属病院, 特命講師 (10546477)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Project Status: Completed (Fiscal Year 2021)
• Budget Amount: ¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000); Fiscal Year 2021: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2020: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
• Keywords: 肺定量評価 / 放射線治療 / 肺の定量評価 / 肺定位照射 / COPD / 呼吸機能低下 / 在宅酸素導入 / 肺定位照射の安全基準 / 呼吸機能定量評価 / キセノンガス

Outline of Research at the Start

低肺機能の患者に対する治療適応は、放射線治療に関しては、明確な基準がないまま実臨床で行われてきた経緯がある。当研究では、キセノンガスを用いたCT（以 下,XeCT）を放射線治療前に撮像し、肺機能の定量化を行い、放射線治療後の呼吸機能の変化と比較することで、低肺機能患者における安全に放射線治療が行えるGold standardを確立するものである。XeCTを用いることで治療前に、生活の質を著しく下げる状 態まで呼吸機能が低下するか予測できれば、放射線治療前より、治療後の経過が予測できることで、より安全な放射線治療が提供できるようになり、世界的な指標を提唱する非常に有用な研究である。

Outline of Final Research Achievements

We have extracted cases of stereotactic irradiation of the lungs in the past, and analyzed how much emphysema and how normal lungs are damaged at a certain dose, resulting in extreme respiratory depression or introducing home oxygen therapy.
The following images were obtained using the treatment planning assistance software. A) Lung field B) Area of emphysematous changes visualized using CT values C) Area irradiated by each dose of 30 Gy, 20 Gy, 5 Gy D) B is subtracted from A and defined as normal lung. And then each dose range of C is subtracted. This was defined as the final normal lung. We consider this a new indicator and are submitting a paper. Respiratory function decline was observed with significant differences in both cases.

Academic Significance and Societal Importance of the Research Achievements

今研究は肺障害と放射線治療の関連性の指標を見つけ出す研究であり、対象治療患者が将来在宅酸素導入になるかどうかを予測可能とする研究である。よって、この指標をうまく使うことで、患者に正確な予測事象を伝えることができ、よりよい放射線治療を行うことにつながると考えられる

Research Products

• [Journal Article] Exosome-mediated radiosensitizing effect on neighboring cancer cells via increase in intracellular levels of reactive oxygen species (2021)
  • Author(s): Nakaoka Ai、Nakahana Makiko、Inubushi Sachiko、Akasaka Hiroaki、Salah Mohammed、Fujita Yoshiko、Kubota Hikaru、Hassan Mennaallah、Nishikawa Ryo、Mukumoto Naritoshi、Ishihara Takeaki、Miyawaki Daisuke、Sasayama Takashi、Sasaki Ryohei
  • Journal Title: Oncology Reports Volume: 45 Issue: 4 Pages: 1-1
  • DOI: 10.3892/or.2021.7964
  • NAID: 120006975755
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Rationale and Design for a Multicenter, Phase II Study of Durvalumab Plus Concurrent Radiation Therapy in Locally Advanced Non-Small Cell Lung Cancer: The DOLPHIN Study (WJOG11619L) (2021)
  • Author(s): Tachihara Motoko、Tsujino Kayoko、Ishihara Takeaki、Hayashi Hidetoshi、Sato Yuki、Kurata Takayasu、Sugawara Shunichi、Okamoto Isamu、Teraoka Shunsuke、Azuma Koichi、Daga Haruko、Yamaguchi Masafumi、Kodaira Takeshi、Satouchi Miyako、Shimokawa Mototsugu、Yamamoto Nobuyuki、Nakagawa Kazuhiko
  • Journal Title: Cancer Management and Research Volume: Volume 13 Pages: 9167-9173
  • DOI: 10.2147/cmar.s336262
  • NAID: 120007188928
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] 喫煙歴のある患者において胸部定位照射を施行した患者の呼吸機能低下とHOT導入の解析 (2021)
  • Author(s): 石原 武明
  • Organizer: 日本放射線腫瘍学会