The development of the innovative treatment using intensiy-modulated radiotherapy for thoracic esophageal cancer

• Project/Area Number: 17K16434
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Radiation science
• Research Institution: Kyoto University
• Principal Investigator: Sakanaka Katsuyuki 京都大学, 医学研究科, 助教 (90637208)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000); Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2018: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2017: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 強度変調放射線治療 / 高精度放射線治療 / 食道癌 / 化学放射線療法 / トランスレーショナルリサーチ / 放射線 / 癌

Outline of Final Research Achievements

The current study included nine patients with locally advanced unresectable thoracic esophageal squamous cell carcinoma with good performance status. They underwent chemoradiotherapy using simultaneous integrated boost intensity-modulated radiotherapy with elective nodal irradiation. The radiation dose to the unresectable gross tumor was escalated from 66 Gy to a planned maximum dose of 72 Gy in 3 Gy increments in a standard 3 + 3 design. Dose limiting toxicity occurred in one of six and two of three patients at doses of 66 and 69 Gy, respectively. All DLTs were grade 3 esophagitis. The recommended dose for this population was determined as 66 Gy delivered in 30 fractions based on the predefined criteria.

Academic Significance and Societal Importance of the Research Achievements

食道癌に対する化学放射線療法において、強度変調放射線治療は安全に標的病変への放射線線量増加を可能にする治療技術であると考えられた。食道癌に対する放射線線量増加試験は現在も海外で複数進行しているが、本研究成果は患者の安全性を担保し、線量増加した放射線治療を実施する上で重要な基礎データとなり、社会的意義も高いと考えられた。

Research Products

• [Journal Article] A Case of Recurrent Esophageal Cancer Treated with Concurrent Chemoradiation Therapy in Pregnancy (2018)
  • Author(s): Yamada Kaori、Chigusa Yoshitsugu、Nomura Motoo、Sakanaka Katsuyuki、Nakamura Mitsuhiro、Yano Shinsuke、Tsunoda Shigeru、Kondoh Eiji、Mandai Masaki
  • Journal Title: Case Reports in Obstetrics and Gynecology Volume: 2018 Pages: 1-6
  • DOI: 10.1155/2018/1280582
  • NAID: 120006550438
  • Peer Reviewed / Open Access
• [Journal Article] Long-term outcome of definitive radiotherapy for cervical esophageal squamous cell carcinoma (2018)
  • Author(s): Sakanaka Katsuyuki、Ishida Yuichi、Fujii Kota、Itasaka Satoshi、Miyamoto Shin’ichi、Horimatsu Takahiro、Muto Manabu、Mizowaki Takashi
  • Journal Title: Radiation Oncology Volume: 13 Issue: 1 Pages: 7-7
  • DOI: 10.1186/s13014-018-0957-6
  • Peer Reviewed / Open Access
• [Journal Article] Effect of long fasting on myocardial accumulation in 18F-fluorodeoxyglucose positron emission tomography after chemoradiotherapy for esophageal carcinoma (2017)
  • Author(s): Ishida Yuichi、Sakanaka Katsuyuki、Itasaka Satoshi、Nakamoto Yuji、Togashi Kaori、Mizowaki Takashi、Hiraoka Masahiro
  • Journal Title: Journal of Radiation Research Volume: 59 Issue: 2 Pages: 182-189
  • DOI: 10.1093/jrr/rrx076
  • Peer Reviewed / Open Access
• [Presentation] 局所進行切除不能胸部食道癌に対する強度変調放射線治療を利用した放射線線量増加試験 (2019)
  • Author(s): 坂中 克行 , 石田 祐一 , 藤井 康太 , 石原 佳知 , 中村 光宏 , 平岡 真寛 , 溝脇 尚志
  • Organizer: 第57回日本癌治療学会学術集会
• [Presentation] Radiation dose escalated chemoradiotherapy using simultaneous integrated boost intensity-modulated radiotherapy for locally advanced unresectable thoracic esophageal squamous cell carcinoma: a single institutional phase I study (2019)
  • Author(s): Katsuyuki Sakanaka, Yuichi Ishida, Kota Fujii, Yoshitomo Ishihara, Mitsuhiro Nakamura, Masahiro Hiraoka, and Takashi Mizowaki
  • Organizer: American Society for Radiation Oncology 61st Annual Meeting
  • Int'l Joint Research
• [Presentation] 胸部食道扁平上皮癌に対する放射線治療が胸椎骨折発生に与える影響 (2018)
  • Author(s): 藤井康太 坂中克行 堀松高博 宮本心一 角田茂 武藤学 溝脇尚志
  • Organizer: 日本放射線腫瘍学会第31回学術大会
• [Presentation] Evaluation of the eighth ypTNM classification system in esophageal cancer patients (2018)
  • Author(s): Motoo Nomura, Shigeru Tsunoda, Katsuyuki Sakanaka, Masashi Tamaoki, Yusuke Amanuma, Shinichi Miyamoto, Kohta Fujii, Shigeo Hisamori, Kazuki Obama, Manabu
  • Organizer: 16th World Congress of the International Society for Diseases of the Esophagus
  • Int'l Joint Research
• [Presentation] 進行食道癌に対し、3次治療としてS1+オキサリプラチン(SOX)療法を施行した1例 (2018)
  • Author(s): 野村基雄、玉置将司、天沼裕介、藤井康太、坂中克行、角田茂、武藤学
  • Organizer: 第72回日本食道学会学術集会
• [Presentation] cT1N0M0食道癌に対する化学放射線療法の侵襲が患者栄養状態に与える影響 (2018)
  • Author(s): 坂中克行、石田祐一、藤井康太、宮本心一、堀松高博、武藤学、溝脇尚志
  • Organizer: 日本放射線腫瘍学会第31回学術集会
• [Presentation] 食道癌術後妊娠中に発生した吻合部再発に対し化学放射線療法を施行し生児を得た1例 (2018)
  • Author(s): 野村基雄、佐藤千尋、玉置将司、天沼裕介、松原淳一、藤井康太、坂中克行、山田香、千草義継、武藤学
  • Organizer: 第72回日本食道学会学術集会