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Total marrow irradiation as a conditioning therapy before allogeneic hematopoietic cell transplantation

Research Project

Project/Area Number 20K16818
Research Category

Grant-in-Aid for Early-Career Scientists

Allocation TypeMulti-year Fund
Review Section Basic Section 52040:Radiological sciences-related
Research InstitutionInternational University of Health and Welfare (2022-2023)
The University of Tokyo (2020-2021)

Principal Investigator

Takenaka Ryosuke  国際医療福祉大学, 国際医療福祉大学成田病院, 教授 (30823421)

Project Period (FY) 2020-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥3,640,000 (Direct Cost: ¥2,800,000、Indirect Cost: ¥840,000)
Fiscal Year 2023: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2022: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2021: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000)
Fiscal Year 2020: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
Keywords全身照射 / 強度変調放射線治療 / 造血幹細胞移植 / 造血幹細胞医移植
Outline of Research at the Start

同種造血幹細胞移植の骨髄破壊的前処置を、全身照射ではなく全骨髄リンパ系照射で行なうことによって、正常臓器への被曝による重篤な放射線障害を減らすことを目的とする。移植適応となる血液原疾患の種類や、併用化学療法の種類については特段の制限を設けない。全骨髄リンパ系への線量を従来の12Gyから15Gyに増加して抗腫瘍効果を上昇させるとともに、正常臓器への被曝線量を4Gy程度に抑える治療ビームを作成し全骨髄リンパ系照射を施行する。移植後の全生存、無再発生存、有害事象を評価して、当院において過去に全身照射を施行した症例との比較を行ない、全骨髄リンパ系照射の優越性を評価する。

Outline of Final Research Achievements

Hematopoietic stem cell transplantation is a radical treatment for many blood diseases. Before allogeneic hematopoietic stem cell transplantation, pretreatment with high-dose chemotherapy and whole-body irradiation is performed to prevent engraftment failure, but with whole-body irradiation, radiation damage caused by exposure to normal organs can sometimes be a serious problem. . The purpose of this study is to avoid radiation damage by irradiating only the entire bone marrow and lymphatic system, rather than irradiating the whole body, and to improve the prognosis after transplantation.
One year after transplantation, the overall survival rate was 81.8%, the recurrence-free survival rate was 54.0%, and the recurrence-free survival rate without adverse events was 42.0%. These are the results of whole body irradiation using conventional irradiation methods.
The results were comparable to those reported in the literature after transplantation.

Academic Significance and Societal Importance of the Research Achievements

高齢者や有合併症症例におけるミニ移植でも、骨髄非破壊的前処置として従来施行されている4GyのTBIをTMLIに代えることで、有害事象を増やすことなく線量増加が可能となり、血液原疾患の予後を改善できる可能性がある。
さらに、若年女性においては、前処置としてTBIを行うと永久不妊がほぼ必発するが、TMLIにより卵巣への被曝を避けることで妊孕性の温存を図ることが可能となる。若年者が多い血液悪性疾患で、妊孕性を温存する治療と可能となれば、患者のQOLを飛躍的に向上できるだろう。

Report

(5 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • 2020 Research-status Report
  • Research Products

    (6 results)

All 2022 2021

All Journal Article (4 results) (of which Int'l Joint Research: 3 results,  Peer Reviewed: 4 results,  Open Access: 3 results) Presentation (1 results) Book (1 results)

  • [Journal Article] Establishment of a Prediction Model for Overall Survival after Stereotactic Body Radiation Therapy for Primary Non-Small Cell Lung Cancer Using Radiomics Analysis2022

    • Author(s)
      Subaru Sawayanagi, Hideomi Yamashita, Yuki Nozawa, Ryosuke Takenaka, Yosuke Miki, Kosuke Morishima, Hiroyuki Ueno, Takeshi Ohta, Atsuto Katano.
    • Journal Title

      Cancers (Basel)

      Volume: 14 Issue: 16 Pages: 3859-3859

    • DOI

      10.3390/cancers14163859

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Cumulative Incidence and Clinical Risk Factors of Radiation Cystitis after Radiotherapy for Prostate Cancer2022

    • Author(s)
      Katsuhiro Makino, Yusuke Sato, Ryosuke Takenaka, Hideomi Yamashita, Yoshiyuki Akiyama, Yuta Yamada, Masaki Nakamura, Taketo Kawai, Daisuke Yamada, Motofumi Suzuki, Haruki Kume.
    • Journal Title

      Urol Int

      Volume: 1 Issue: 5 Pages: 1-7

    • DOI

      10.1159/000521723

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Injection of hydrogel spacer increased maximal intrafractional prostate motion in anterior and superior directions during volumetric modulated arc therapy-stereotactic body radiation therapy for prostate cancer2022

    • Author(s)
      Subaru Sawayanagi, Hideomi Yamashita, Mami Ogita, Ryosuke Takenaka, Yuki Nozawa, Yuichi Watanabe, Toshikazu Imae, Osamu Abe
    • Journal Title

      Radiation Oncology

      Volume: 17 Issue: 1 Pages: 41-41

    • DOI

      10.1186/s13014-022-02008-3

    • Related Report
      2022 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research
  • [Journal Article] Helical Skin Radiation Therapy Including Total Skin Radiation Therapy Using Tomotherapy for Primary Cutaneous Lymphoma With Bone Marrow Suppression as a Related Adverse Event2021

    • Author(s)
      Kitaguchi Mayuka、Yamashita Hideomi、Takenaka Ryosuke、Okuma Kae、Nawa Kanabu、Nakagawa Keiichi
    • Journal Title

      Practical Radiation Oncology

      Volume: - Issue: 3 Pages: e308-e321

    • DOI

      10.1016/j.prro.2020.11.007

    • Related Report
      2020 Research-status Report
    • Peer Reviewed
  • [Presentation] Helical TomoTherapyを用いた全身照射(TBI)の治療成績:単施設単群前向き試験2021

    • Author(s)
      竹中亮介,名和要武,山下英臣
    • Organizer
      日本放射線腫瘍学会第34回学術大会
    • Related Report
      2021 Research-status Report
  • [Book] 人体のメカニズムから学ぶ放射線治療学2022

    • Author(s)
      大友 邦 (監修), 小塚 拓洋 (編集), 橋本 光康 (編集)
    • Total Pages
      528
    • Publisher
      メジカルビュー社
    • ISBN
      4758320837
    • Related Report
      2022 Research-status Report

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Published: 2020-04-28   Modified: 2025-01-30  

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