早期の癌に対する標準的放射線治療方法確立と適応決定に関する研究

2012 Fiscal Year Annual Research Report

• Project/Area Number: 21249066
• Research Institution: Tohoku University
• Principal Investigator: 山田 章吾 東北大学, 医学(系)研究科(研究院), 名誉教授 (60158194)
• Co-Investigator(Kenkyū-buntansha): 西村 恭昌 近畿大学, 医学部, 教授 (00218207) ; 晴山 雅人 札幌医科大学, 医学部, 名誉教授 (10173098) ; 根本 建二 山形大学, 医学部, 教授 (10208291) ; 早渕 尚文 久留米大学, 医学部, 教授 (20108731) ; 芝本 雄太 名古屋市立大学, 医学(系)研究科(研究院), 教授 (20144719) ; 白土 博樹 北海道大学, 医学(系)研究科(研究院), 教授 (20187537) ; 中村 和正 九州大学, 大学病院, 准教授 (20284507) ; 梅田 みか(渡辺みか) 東北大学, 病院, 准教授 (20292344) ; 大西 洋 山梨大学, 医学工学総合研究部, 准教授 (30213804) ; 戸板 孝文 琉球大学, 医学(系)研究科(研究院), 准教授 (30237036) ; 有賀 久哲 岩手医科大学, 医学部, 教授 (30333818) ; 佐々木 良平 神戸大学, 医学部附属病院, 教授 (30346267) ; 手島 昭樹 地方独立行政法人大阪府立病院機構大阪府立成人病センター(研究所), 放射線治療科, 主任部長 (40136049) ; 西尾 禎治 独立行政法人国立がん研究センター, 臨床開発センター, 室長 (40415526) ; 高井 良尋 弘前大学, 医学(系)研究科(研究院), 教授 (50107653) ; 村上 昌雄 神戸大学, 医学(系)研究科(研究院), 教授 (50210018) ; 平岡 眞寛 京都大学, 医学(系)研究科(研究院), 教授 (70173218) ; 土橋 卓 東北大学, 医学(系)研究科(研究院), 助教 (70399806) ; 鎌田 正 独立行政法人放射線医学総合研究所, 重粒子医科学センター, センター長 (90150242) ; 大内 憲明 東北大学, 医学(系)研究科(研究院), 教授 (90203710) ; 神宮 啓一 東北大学, 医学(系)研究科(研究院), 教授 (00451592) ; 松下 晴雄 東北大学, 医学(系)研究科(研究院), 講師 (20302250) ; 清水 伸一 北海道大学, 医学(系)研究科(研究院), 特任教授 (50463724)
• Project Period (FY): 2009-04-01 – 2013-03-31
• Keywords: 放射線治療 / 早期の癌 / 標準的放射線治療 / 臨床試験 / 放射線適応 / 放射線感受性 / QOL / PET

Research Abstract

画像診断の進歩により早期の癌が高率に発見されるようになり、また放射線治療成績の向上、QOL重視の中で早期のがんに対する放射線治療の役割が急増している。しかし、治癒の可能性の高いこれらの癌に対する標準的放射線治療方法（照射野、線量分割法、化学療法との併用など）は確立していないのが現状である。私どもの研究班はすでに早期の頭頸部癌、食道癌、肺癌、乳癌、子宮頸癌、前立腺癌などを対象として、全国集計によるretrospectiveな解析と文献データによるエビデンスの収集を行い、標準的と考えられる放射線治療方法提示を行った(早期のがん治療法の選択－放射線治療－、金原出版)。その過程で標準的放射線治療方法確立のための様々な臨床試験が提案された。今回は臨床試験を全国多施設で実施し、早期のがんに対する標準的放射線治療方法を確立すると同時に、手術との適応をより明確にするために早期のがんの放射線感受性を明らかにする。各種臓器がん毎に臨床試験を検討し、プロトコールを作成した。早期頭頸部癌に対するTS1併用化学放射線療法の第1、2相臨床試験、早期の食道癌を対象とした照射野設定に関する第2相臨床試験、乳房温存術後照射の照射基準に関する臨床試験、腎臓癌に対する定位放射線治療の第1,2相臨床試験、子宮頸癌画像誘導腔内照射の弟１相臨床試験、前立腺癌に対するIMRT（強度変調放射線治療法）による線量増加試験、肛門癌に対する化学放射線療法の第1、2相臨床試験、ギメラシルの放射線増感効果に関する医師主導第1相臨床試験、並びに粒子線による臨床試験などについて検討した。各臨床試験の継続と、新規プロトコールの検証および登録症例数の予備調査を行った。また、PETなど画像診断および生検組織標本による分子生物学的指標と予後との相関を求める研究を行い、さらに放射線治療後の早期の再発癌に対する治療法の確立についても検討した。

Current Status of Research Progress

Reason

24年度が最終年度であるため、記入しない。

Strategy for Future Research Activity

24年度が最終年度であるため、記入しない。

Research Products

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  • Author(s): Onishi H
  • Organizer: International Atomic Energy Agency (IAEA) Asian Training course of Stereotactic Body Radiotherapy.
  • Place of Presentation: National cancer center. Singapore
  • Year and Date: 20121203-20121203
  • Invited
• [Presentation] Combination Efficacy of MGMT Promoter Methylation Status and MIB-1 Labeling Index for Pattern of Recurrence in Glioblastoma (2012)
  • Author(s): Uehara K
  • Organizer: 98th Scientific Assembly and Annual Meeting of The Radiological Society of North America
  • Place of Presentation: Chicago, USA
  • Year and Date: 20121125-20121130
• [Presentation] 治療装置導入時の物理・技術的品質管理−新規導入時の物理士の役割− (2012)
  • Author(s): 西尾禎治
  • Organizer: 日本放射線腫瘍学会第２５回学術大会、パネルディスカッション
  • Place of Presentation: 東京、東京国際フォーラム
  • Year and Date: 20121123-20121125
  • Invited
• [Presentation] 子宮頸癌に対する放射線療法の後方視的検討 (2012)
  • Author(s): 前畠良康
  • Organizer: 日本放射線腫瘍学会第25回学術大会
  • Place of Presentation: 東京
  • Year and Date: 20121123-20121125
• [Presentation] モノクロマティックイメージングによる腫瘍の物質分析 (2012)
  • Author(s): 青木昌彦
  • Organizer: 第25回日本放射線腫瘍学会学術大会
  • Place of Presentation: 東京
  • Year and Date: 20121123-20121125
• [Presentation] すりがらす影(GGO)を呈する肺結節95症例に対する定位放射線治療成績 (2012)
  • Author(s): 大西洋
  • Organizer: 第53回日本肺癌学会総会
  • Place of Presentation: 岡山
  • Year and Date: 20121108-20121109
• [Presentation] Radiation-Induced Rib Fracture after Hypofractionated Stereotactic BodyRadiotherapy for Patients with Peripheral Lung Tumor:Impact of the Maximum Dose and the Fraction Size. (2012)
  • Author(s): M.Aoki
  • Organizer: The 54th Annual meeting of the ASTRO
  • Place of Presentation: Boston,MA,USA
  • Year and Date: 20121029-20121031
• [Presentation] Efficacy of Surgically Implanted Flexible Spacer in Particle Therapy: A novel strategy Making Temporal Space between Tumor and Adjacent Organs (2012)
  • Author(s): Akasaka H
  • Organizer: 54th ASTRO Annual Meeting
  • Place of Presentation: Boston, USA
  • Year and Date: 20121028-20121031
• [Presentation] Stereotactic Body Radiation Therapy in 95 Patients With Lung Tumors Composed of Ground-glass Opacity (GGO): Results of a Retrospective Multicenter Study (2012)
  • Author(s): Onishi H
  • Organizer: 54th ASTRO Annual Meeting
  • Place of Presentation: Boston, USA
  • Year and Date: 20121028-20121031
• [Presentation] Decreasing acute and late toxicity using urethral dose reduction and smaller safety margin around CTV for prostate cancer intensity-modulated radiation therapy (IMRT) with a real-time tumor-tracking (RTRT) system (2012)
  • Author(s): Shimizu S
  • Organizer: American Society for Radiation Oncology 54th Annual meeting
  • Place of Presentation: Boston (USA)
  • Year and Date: 20121028-20121031
• [Presentation] Interfractional setup error and intrafractional bladder motion during radiotherapy for bladder tumors. (2012)
  • Author(s): Nishioka K
  • Organizer: American Society for Radiation Oncology 54th Annual meeting
  • Place of Presentation: Boston (USA)
  • Year and Date: 20121028-20121031
• [Presentation] Primary central nervous system lymphoma (PCNSL) treated by radiation therapy: a nationwide survey of 2005-2009 patients and comparison with 1985-2004 data (2012)
  • Author(s): Shibamoto Y
  • Organizer: 54th Annual Meeting of American Society
  • Place of Presentation: Boston (USA)
  • Year and Date: 20121028-20121031
• [Presentation] Stereotactic Body Radiotherapy for Non-small Cell Lung Cancer Causes Immune Suppression. (2012)
  • Author(s): Maehata Y
  • Organizer: American Society for Radiation Oncology 54rd annual meeting(ASTRO)
  • Place of Presentation: Boston,USA
  • Year and Date: 20121028-20121031
• [Presentation] Stereotactic Body Radiotherapy in 95 Patients With Lung Tumors Composed of Ground-glass Opacity (GGO) : Results of a Retrospective Multicenter study. (2012)
  • Author(s): Onishi H
  • Organizer: American Society for Radiation Oncology 54rd annual meeting(ASTRO)
  • Place of Presentation: Boston,USA
  • Year and Date: 20121028-20121031
• [Presentation] Primary Central Nervous System Lymphoma (PCNSL) treated by radiation therapy: a nationwide survey of 2005-2009 patients and comparison with 1985-2004 data. (2012)
  • Author(s): Shibamoto Y
  • Organizer: American Society for Radiation Oncology 54th annual meeting(ASTRO)
  • Place of Presentation: Boston,USA
  • Year and Date: 20121028-20121031
• [Presentation] 陽子線がん治療における原子核反応の重要性 (2012)
  • Author(s): 西尾禎治
  • Organizer: ２０１２年度RCNP研究会
  • Place of Presentation: 大阪、大阪大学核物理研究センター
  • Year and Date: 20120928-20120929
• [Presentation] 陽子線治療のためのhybrid Beam ON-LINE PET/Compton Camera systemの研究 (2012)
  • Author(s): 西尾禎治
  • Organizer: 日本医学物理学会第１０４回学術大会
  • Place of Presentation: 筑波、つくば国際会議場
  • Year and Date: 20120914-20120915
• [Presentation] 放射線治療装置別プラグイン機能を有した国産治療計画装置の開発 (2012)
  • Author(s): 西尾禎治
  • Organizer: 日本医学物理学会第１０４回学術大会
  • Place of Presentation: 筑波、つくば国際会議場
  • Year and Date: 20120914-20120915
• [Presentation] Radiation therapy for brainstem gliomas in children and adults (2012)
  • Author(s): Yoshida K
  • Organizer: The 14th Asian Oceanian Congress of Radiology
  • Place of Presentation: Sydney, Australia
  • Year and Date: 20120831-20120902
• [Presentation] がんの陽子線照射において人体内での原子核反応を観る (2012)
  • Author(s): 西尾禎治
  • Organizer: 基研主導研究会２０１２-原子力・生物学と物理
  • Place of Presentation: 京都、京都大学基礎物理学研究所
  • Year and Date: 20120808-20120810
• [Presentation] On-line PET imaging for proton therapy system (2012)
  • Author(s): M. Yamada
  • Organizer: 22nd International Conference on the Application of Accelerators in Research and Industry
  • Place of Presentation: Texas, Renaissance Worthington Hotel (USA)
  • Year and Date: 20120805-20120810
  • Invited
• [Presentation] Performace of beam ON-LINE PET system constructed with two opposing planar-type detector heads in proton therapy (2012)
  • Author(s): T. Nishio
  • Organizer: The 31st Sapporo International Cancer Symposium / Advanced Radiation Therapy and Cancer Research Up-to-Date
  • Place of Presentation: Sapporo, Hokkaido University
  • Year and Date: 20120723-20120724
• [Presentation] Surgically Implanted Flexible Spacer in Particle Therapy: Making Temporal Space between Tumor and Adjacent Organs! (2012)
  • Author(s): Sasaki R
  • Organizer: The 6th S.Takahashi Memorial Symposium & The 6th Japan-US Cancer Therapy International Joint Symposium
  • Place of Presentation: Hiroshima, Japan
  • Year and Date: 20120719-20120721
• [Presentation] Radiotherapy for Squamous Cell Carcinomas of Oropharynx (2012)
  • Author(s): Miyawaki D
  • Organizer: The 6th S.Takahashi Memorial Symposium & The 6th Japan-US Cancer Therapy International Joint Symposium
  • Place of Presentation: Hiroshima, Japan
  • Year and Date: 20120719-20120721
• [Presentation] Postoperative radiotherapy for the malignant tumors of the parotid gland (2012)
  • Author(s): Muraoka O
  • Organizer: The 6th S.Takahashi Memorial Symposium & The 6th Japan-US Cancer Therapy International Joint Symposium
  • Place of Presentation: Hiroshima, Japan
  • Year and Date: 20120719-20120721
• [Presentation] Therapeutic Strategies aimed at Laryngeal Preservation of T1-T3N0 Glottic Laryngeal cancer (2012)
  • Author(s): Harada A
  • Organizer: The 6th S.Takahashi Memorial Symposium & The 6th Japan-US Cancer Therapy International Joint Symposium
  • Place of Presentation: Hiroshima, Japan
  • Year and Date: 20120719-20120721
• [Presentation] Radiation-Induced Rib Fracture after Hypofractionated Stereotactic BodyRadiotherapy for Patients with Peripheral Lung Tumor:Impact of the Maximum Dose and the Fraction Size. (2012)
  • Author(s): Masahiko Aoki
  • Organizer: The 6th Japan-US Cancer Therapy Symposium&The 6th S.Takahashi Memorial Joint Symposium
  • Place of Presentation: Hiroshima,Japan
  • Year and Date: 20120719-20120721
• [Presentation] T1-3N0M0頭頸部腺様嚢胞癌に対する炭素イオン線治療 (2012)
  • Author(s): 小藤 昌志
  • Organizer: 第126回日本医学放射線学会北日本地方会
  • Place of Presentation: 札幌市
  • Year and Date: 20120629-20120630
• [Presentation] Endovascular treatments of stent-graft placement of hemorrhage after hepatectomy:Report of 2 cases. (2012)
  • Author(s): F.Tsushima
  • Organizer: APCCVIR 2012 JSIR&ISIR
  • Place of Presentation: Kobe,Japan
  • Year and Date: 20120530-20120602
• [Presentation] Efficacy and safty of preoperative portal vein embolization with microfibrillar collagen for hepatobiliary malignancies. (2012)
  • Author(s): Shibutani K
  • Organizer: APCCVIR 2012 JSIR&ISIR
  • Place of Presentation: Kobe,Japan
  • Year and Date: 20120530-20120602
• [Presentation] Contribution of dynamic images of sentinel lymphoscintigraphy to the diagnosis of patients with malignant skin neoplasms in the upper and lower extremities (2012)
  • Author(s): Hiroyuki Miura
  • Organizer: ARRS(American Roentgen Ray Society)2012 Annual Meeting
  • Place of Presentation: Vancouver,Canada
  • Year and Date: 20120426-20120507
• [Presentation] 前立腺陽子線治療における膀胱へのリアルタイム照射線量計測法の研究 (2012)
  • Author(s): 西尾禎治
  • Organizer: 日本医学物理学会第１０３回学術大会
  • Place of Presentation: 横浜、パシフィコ横浜
  • Year and Date: 20120412-20120415
• [Presentation] Maximizing the availability of positron emitting nuclei for proton therapy
  • Author(s): Yagi M
  • Organizer: AAPM 54th Annual Meeting
  • Place of Presentation: Charlotte USA
• [Presentation] Japanese Structure Survey of Radiation Oncology in 2009 based on institutional stratification of Patterns of Care Study.
  • Author(s): Numasaki H
  • Organizer: ASTRO 54th Annual Meeting
  • Place of Presentation: Boston, USA
• [Presentation] A comparison of lung tumor on maximum intensity projection (MIP) and averageintensity projection (AIP) of respiratory correlated four-dimensional simulation CT (4DCT).
  • Author(s): Tsudou S
  • Organizer: ASTRO 54th Annual Meeting
  • Place of Presentation: Boston, USA
• [Presentation] 婦人科腫瘍に対する放射線治療の現状と新戦略
  • Author(s): 手島昭樹
  • Organizer: 第127回近畿産科婦人科学会総会
  • Place of Presentation: 大阪市
  • Invited
• [Presentation] がん放射線治療の質と診療基盤
  • Author(s): 手島昭樹
  • Organizer: 日本歯科放射線学会 第17回臨床画像大会
  • Place of Presentation: 大阪市
  • Invited
• [Presentation] 膵臓癌に対する放射線治療戦略
  • Author(s): 手島昭樹
  • Organizer: 第24回日本放射線腫瘍学会学術大会
  • Place of Presentation: 東京
• [Presentation] 治療機器の更新、新規設置の現状 -JASTRO構造調査データより-
  • Author(s): 沼崎穂高
  • Organizer: 日本放射線腫瘍学会 第25回学術大会
  • Place of Presentation: 東京
• [Presentation] 閉経後転移・再発乳癌に対するAI逐次投与の効果
  • Author(s): 甘利正和
  • Organizer: 第112回日本外科学会定期学術集会
  • Place of Presentation: 千葉
• [Presentation] 疫学的にみた乳がんハイリスクグループ
  • Author(s): 河合賢朗
  • Organizer: 第22回日本乳癌検診学会学術総会
  • Place of Presentation: 沖縄
  • Invited
• [Presentation] 前立腺癌の密封小線源永久挿入療法の勃起不全と休部尿道海綿体や神経管束の線量は相関しない
  • Author(s): 菊池光洋
  • Organizer: 日本医学放射線学会総会
  • Place of Presentation: 横浜
• [Presentation] 放射線治療と医学物理学
  • Author(s): 西尾禎治
  • Organizer: 第３回獨協大学放射線治療センターセミナー 特別講演
  • Place of Presentation: 宇都宮、獨協医科大学
  • Invited
• [Presentation] 高精度放射線治療における医学物理学
  • Author(s): 西尾禎治
  • Organizer: がんプロフェッショナル養成基盤推進プラン 東海大学公開シンポジウム 各分野において望まれる医学物理士のあり方
  • Place of Presentation: 勢原、東海大学
  • Invited
• [Presentation] Study of Beam On-Line PET system for proton therapy
  • Author(s): 西尾禎治
  • Organizer: 群馬大学博士課程教育リーディングプログラム「重粒子線医工学グローバルリーダー養成プログラム」公開シンポジウム
  • Place of Presentation: 前橋、群馬大学
  • Invited
• [Presentation] 陽子線照射による患者体内での生成ポジトロン放出核の強度分布シミュレーションの研究
  • Author(s): 西尾禎治
  • Organizer: 第２回OpenPET研究会
  • Place of Presentation: 千葉、放射線医学総合研究所
  • Invited
• [Presentation] Inter-observer variability of target volume definition in a multi-institutional trial of hypofractionated intensity-modulated radiotherapy using image-guided techniques for localized prostate cancer.
  • Author(s): K. Nakamura
  • Organizer: The 6th S. Takahashi Memorial Symposium and the 6th Japan US Cancer Therapy Symposium.
  • Place of Presentation: 広島市
• [Presentation] BRT for stage I non-small cell lung cancer: Treatment outcomes in a long follow-up of early (1998-2004) patients in 14 institutions.
  • Author(s): Onishi H
  • Organizer: The 6th S. Takahashi Memorial Symposium & The 6th Japan-US Cancer Therapy International Joint Symposium.
  • Place of Presentation: 広島市
  • Invited
• [Presentation] SABR for lung cancer.
  • Author(s): Onishi H
  • Organizer: The 11th Seoul Radiation Oncology Symposium.
  • Place of Presentation: Seoul National University.Korea
  • Invited
• [Presentation] Stereotactic body radiotherapy(SBRT) for lung Definition, History and Survey.
  • Author(s): Onishi H.
  • Organizer: International Atomic Energy Agency(IAEA) Asian Training course of Stereotactic Body Radiotherapy.
  • Place of Presentation: National cancer center. Singapore
  • Invited
• [Presentation] Dose prescription, Tolerances, Side effects and Safety and efficacy of SBRT of Lung tumors: Results of Clinical studies.
  • Author(s): Onishi H
  • Organizer: International Atomic Energy Agency (IAEA) Asian Training course of Stereotactic Body Radiotherapy.
  • Place of Presentation: National cancer center. Singapore
  • Invited
• [Presentation] Steps in setting up a lung SBRT program.
  • Author(s): Onishi H
  • Organizer: International Atomic Energy Agency (IAEA) Asian Training course of Stereotactic Body Radiotherapy.
  • Place of Presentation: National cancer center. Singapore
  • Invited
• [Presentation] 肺癌に対する定位放射線治療の最前線
  • Author(s): 大西洋
  • Organizer: 第36回新潟肺癌研究会総会
  • Place of Presentation: 新潟
  • Invited
• [Presentation] 体幹部定位照射後の助骨骨折の検討
  • Author(s): 青木昌彦
  • Organizer: 第71回日本医学放射線学会総会
  • Place of Presentation: 横浜
• [Presentation] IGRTの実施に向けた品質管理ファントムTM-WINSの開発と使用経験
  • Author(s): 成田雄一郎
  • Organizer: 第103回日本医学物理学会学術大会
  • Place of Presentation: 横浜
• [Presentation] 前立腺がんの強度変調回転照射（VMAT）における患者固定具による放射線吸収の影響と照射MU値誤差低減の方策
  • Author(s): 成田雄一郎
  • Organizer: 第25回日本高精度放射線外部照射研究会
  • Place of Presentation: 広島
• [Presentation] 肺腫瘍に対する少分割三門照射の治療成績
  • Author(s): 畑山佳臣
  • Organizer: 第25回日本放射線腫瘍学会学術大会
  • Place of Presentation: 東京
• [Presentation] 当科における食道癌放射線治療成績の遡及的検討
  • Author(s): 堀 正和
  • Organizer: 日本放射線腫瘍学会 第25回学術大会
  • Place of Presentation: 東京
• [Book] 最新放射線医学（放射線医学総論)第8巻19章 皮膚・軟部・骨疾患の放射線治療 (2012)
  • Author(s): 佐々木良平
  • Total Pages: 39-43
  • Publisher: 金芳堂
• [Book] 臨床放射線腫瘍学 (2012)
  • Author(s): 手島昭樹
  • Total Pages: 534-534
  • Publisher: 南江堂
• [Book] 子宮頸がん B術後照射. 「臨床放射線腫瘍学 最新知見に基づいた放射線治療の実践」日本放射線腫瘍学会、日本放射線腫瘍学研究機構 編. (2012)
  • Author(s): 中村和正
  • Total Pages: 402-406
  • Publisher: 南江堂
• [Book] 放射線腫瘍学(I期非小細胞肺癌) (2012)
  • Author(s): 大西洋
  • Total Pages: 290-295
  • Publisher: 南江堂
• [Book] 放射線治療計画ガイドライン2012(呼吸性移動対策) (2012)
  • Author(s): 大西洋
  • Total Pages: 35-40
  • Publisher: 原出版
• [Book] 最新放射線医学（放射線医学総論) 第8巻2章 放射線治療計画 (2012)
  • Author(s): 西村英輝
  • Total Pages: 6-9
  • Publisher: 金芳堂
• [Book] 最新放射線医学（放射線医学総論) 第8巻7章 放射線治療における医療事故防止 (2012)
  • Author(s): 吉田賢史
  • Total Pages: 39-43
  • Publisher: 金芳堂
• [Book] Comprehensive Registry of Esophageal Cancer in Japan, 2004. (2012)
  • Author(s): Ozawa S
  • Total Pages: 51-51
  • Publisher: The Japan Esophageal Society