Volumetric modulated arc therapy for thoracic esophageal cancer to decrease radiotherapy-induced herat toxicity

• Project/Area Number: 26461890
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: Hiroshima University
• Principal Investigator: Murakami Yuji 広島大学, 医歯薬保健学研究院(医), 講師 (10403528)
• Co-Investigator(Kenkyū-buntansha): 永田 靖 広島大学, 医歯薬保健学研究院(医), 教授 (10228033) ; 木村 智樹 広島大学, 病院(医), 講師 (90379876)
• Project Period (FY): 2014-04-01 – 2017-03-31
• Project Status: Completed (Fiscal Year 2016)
• Budget Amount: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000); Fiscal Year 2016: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2015: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2014: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
• Keywords: 胸部食道癌 / 強度変調回転照射 / VMAT / 晩期心毒性 / Automated-planning / 食道癌 / 放射線治療 / 強度変調放射線治療 / 心臓毒性 / 呼吸性移動 / 息止め照射

Outline of Final Research Achievements

We established the IGRT system of VMAT for thoracic esophageal cancer patients using immobilization with Vac-lock, bone-matching with OBI and CBCT-matching. We analyzed the physiological esophageal movement. There were remarkable individual differences in the movement, so we considered that setting conformal PTV margins was not suitable. Evaluation of inter-fractional displacement of esophageal position under breath-hold situation showed minimal.
Using automated VMAT planning engine, improvement of target dose conformity, significant reduction of high-middle dose area in whole heart, left ventricle, pericardium, lung and liver. Low dose area (D5) in all lung was maintained under 50% in 10/12 patients, and the maximum D5 among study patients was under 55%. We consider the automated planning system can introduce VMAT for thoracic esophageal cancer patients.

Research Products

• [Journal Article] Availability of applying diaphragm matching with the breathholding technique in stereotactic body radiation therapy for liver tumors (2016)
  • Author(s): Kawahara D, Ozawa S, Kimura T, Nakashima T, Aita M, Tsuda S, OchiY, Okumura T, Masuda H, Ohno Y, Murakami Y, Nagata Y
  • Journal Title: Physica Medica Volume: 32 Issue: 4 Pages: 557-561
  • DOI: 10.1016/j.ejmp.2016.02.007
  • Peer Reviewed / Open Access
• [Journal Article] Role of definitive chemoradiotherapy using docetaxel and 5-fluorouracil in patients with unresectable locally advanced esophageal squamous cell carcinoma: a phase II study. (2016)
  • Author(s): Hihara J, Hamai Y, Emi M, Murakami Y, Kenjo M, Nagata Y, Okada M.
  • Journal Title: Dis Esophagus Volume: in press Issue: 8 Pages: 1115-20
  • DOI: 10.1111/dote.12433
  • Peer Reviewed
• [Journal Article] Clinical outcomes of radiotherapy for esophageal cancer between 2004 and 2008: the second survey of the Japanese Radiation Oncology Study Group (JROSG). (2016)
  • Author(s): Nishimura Y, Jingu K, Itasaka S, Negoro Y, Murakami Y, Karasawa K, Kawaguchi G, Isohashi F, Kobayashi M, Itoh Y, Ariga T.
  • Journal Title: Int J Clin Oncol Volume: 21 Issue: 1 Pages: 88-94
  • DOI: 10.1007/s10147-015-0872-x
  • Peer Reviewed
• [Journal Article] Long-term results of definitive concurrent chemoradiotherapy for patients with esophageal submucosal cancer (T1bN0M0) (2015)
  • Author(s): Murakami Y, Takahashi I, Nishibuchi I, Doi Y, Okabe T, Kenjo M, Kimura T, Nagata Y.
  • Journal Title: Int J Clin Oncol Volume: 20 Issue: 5 Pages: 315-324
  • DOI: 10.1007/s10147-015-0819-2
  • Peer Reviewed
• [Journal Article] Results of Neoadjuvant Chemoradiotherapy With Docetaxel and 5-Fluorouracil Followed by Esophagectomy to Treat Locally Advanced Esophageal Cancer (2015)
  • Author(s): Hamai Y, Hihara J, Emi M, Murakami Y, Kenjo M, Nagata Y, Okada M
  • Journal Title: Ann Thorac Surg Volume: in press Issue: 6 Pages: 1887-1893
  • DOI: 10.1016/j.athoracsur.2015.02.042
  • Peer Reviewed / Open Access
• [Journal Article] Clinical experience of volumetric modulated arc therapy for malignant pleural mesothelioma after extrapleural pneumonectomy (2015)
  • Author(s): Tomoki Kimura, Yoshiko Doi, Takeo Nakashima, Nobuki Imano, Tsuyoshi Katsuta, Shigeo Takahashi, Masahiro Kenjo, Shuichi Ozawa, Yuji Murakami, Yasushi Nagata
  • Journal Title: Journal of Radiation Research Volume: In press Issue: 2 Pages: 315-324
  • DOI: 10.1093/jrr/rru102
  • Peer Reviewed
• [Presentation] シンポジウム2 気管食道科領域の難治癌とQuality of survival 切除不能食道癌に対する放射線治療 (2017)
  • Author(s): 村上祐司
  • Organizer: 第27回日本気管食道科学会認定気管食道科専門医大会
  • Place of Presentation: 仙台国際センター
  • Year and Date: 2017-04-08
  • Invited
• [Presentation] Role of chemoradiotherapy in multi-modality treatment for resectable esophageal cancer (2016)
  • Author(s): 村上祐司
  • Organizer: 日本放射線腫瘍学会第29回学術大会
  • Place of Presentation: 国立京都国際会館
  • Year and Date: 2016-11-25
  • Invited
• [Presentation] Educational lecture 37: Radiation therapy 6 IMRT Head & Neck cancer (2016)
  • Author(s): 村上祐司
  • Organizer: 日本医学放射線学会総会
  • Place of Presentation: パシフィコ横浜
  • Year and Date: 2016-04-14
  • Invited
• [Presentation] Incidence and clinical features of metachronous esophageal cancer after definitive radiation therapy for esophageal cancer. (2015)
  • Author(s): Murakami Y, Kawabata H, Takeuchi Y, Doi Y, Okabe T, Kenjo M, Kimura T, Nagata Y.
  • Organizer: American Society for Radiation Oncology 57th annual meeting
  • Place of Presentation: San Antonio,Texas, USA
  • Year and Date: 2015-10-18
  • Int'l Joint Research
• [Presentation] Preliminary Outcomes of Induction Chemotherapy+VMAT with Concurrent Chemotherapy for Stage IVA/IVB oro- and Hypopharyngeal Cancer (2015)
  • Author(s): Yuji Murakami, Tomoki Kimura, Katsumaro Kubo, Hiromi Sakaguchi, Nobuki Imano, Hideo Kawabata, Yoshiko Doi, Masahiro Kenjo, Yasushi Nagata
  • Organizer: International congress of Radiation Research(ICRR)
  • Place of Presentation: KYOTO, JAPAN
  • Year and Date: 2015-05-25
  • Int'l Joint Research
• [Presentation] Results Of Neoadjuvant Chemoradiotherapy Followed By Surgery For Locally Advanced Esophageal Squamous Cell Carcinom (2014)
  • Author(s): Y. Murakami, N. Imano, Y. Doi, T. Okabe, M. Kenjo, T. Kimura, J. Hihara, Y. Nagata
  • Organizer: American Society for Radiation Oncology 56th annual meeting(ASTRO)
  • Place of Presentation: 米国 サンフランシスコ
  • Year and Date: 2014-09-14 – 2014-09-17
• [Presentation] Four-dimensional assessment of the internal motion of the esophagus in early-stage esophageal cancer patients using metal markers (2014)
  • Author(s): Yoshiko Doi, Y. Murakami, T. Katsuta, N. Imano, T. Okabe, M.Kenjo, T. Kimura, Y. Kaneyasu, S. Ozawa, Y. Nagata
  • Organizer: American Society for Radiation Oncology 56th annual meeting(ASTRO)
  • Place of Presentation: 米国 サンフランシスコ
  • Year and Date: 2014-09-14 – 2014-09-17
• [Presentation] 上咽頭癌に対する強度変調回転照射の短期成績 (2014)
  • Author(s): 村上祐司, 木村智樹, 勝田 剛, 今野伸樹, 土井歓子, 岡部智行, 権丈雅浩, 兼安祐子, 永田 靖
  • Organizer: 第73回日本医学放射線学会総会
  • Place of Presentation: 横浜
  • Year and Date: 2014-04-10 – 2014-04-13