Keiko Endo

The status of Tsukuba BNCT trial: BPA-based boron neutron capture therapy combined with X-ray irradiation.

The phase II trial has been prepared to assess the effectiveness of BPA (250 mg/kg)-based NCT combined with X-ray irradiation and temozolomide (75 mg/m(2)) for the treatment of newly diagnosed GBM. BPA uptake is determined by (18)F-BPA-PET and/or (11)C-MET-PET, and a tumor with the lesion to normal ratio of 2 or more is indicated for BNCT. The maximum normal brain point dose prescribed was limited to 13.0 Gy or less. Primary end point is overall survival.

Boron neutron capture therapy combined with fractionated photon irradiation for glioblastoma: A recursive partitioning analysis of BNCT patients

Eight patients to received Boron Neuron Capture Therapy (BNCT) were selected from 33 newly diagnosed glioblastoma patients (NCT(+) group). Serial 42 glioblastoma patients (NCT(-) group) were treated without BNCT. The median OS of the NCT(+) group and NCT (-) group were 24.4 months and 14.9 months. In the high risk patients (RPA class V), the median OS of the NCT(+) group tended to be better than that of NCT(-) group. 50% of BNCT patients were RPA class V.

A clinical trial protocol for second line treatment of malignant brain tumors with BNCT at University of Tsukuba

We have evaluated the efficacy and safety of boron neutron capture therapy (BNCT) for recurrent glioma and malignant brain tumor using a new protocol. One of the two patients enrolled in this trial is a man with recurrent glioblastoma and the other is a woman with anaplastic meningioma. Both are still alive and no severe adverse events have been observed. Our findings suggest that NCT will be safe as a palliative therapy for malignant brain tumors.

Demonstration of inter- and intracellular distribution of boron and gadolinium using micro-proton-induced X-ray emission (Micro-PIXE).

Micro-proton-induced X-ray emission (Micro-PIXE) was applied to determine inter- and intracellular distribution of boron (10B) and gadolinium (157Gd), the capture atoms used to kill tumor cells in neutron capture therapy (NCT). Cultured 9L gliosarcoma cells on Mylar film were exposed to sodium borocaptate (BSH) and gadobenate dimeglumine (Gd-BOPTA). To analyze the inter- and intracellular distribution of 10B and 157Gd in 9L gliosarcoma cells, the cells were irradiated using a proton beam of 1.7 or 3 MeV energy collimated to 1 microm diameter and emission X-ray was detected. The distribution of 10B and 157Gd in 9L gliosarcoma cells was then examined. In this study, we could directly analyze the inter- and intracellular distribution of 10B and 157Gd elements in 9L gliosarcoma cells directly using Micro-PIXE. This is the first report on the distribution of 10B employing a method to detect gamma-rays resulting from the nuclear reaction of 10B using particle-induced gamma-ray emission (PIGE). These results show that the distribution of 157Gd elements was correctly measured using micro-PIXE. 157Gd should have the same tendency as 10B in cultured 9L gliosarcoma cells and agree with the distribution in 9L gliosarcoma cells. Further investigation is necessary for a higher spatial resolution and optimization of the measurement time or improvement of the sampling method. In the future, it will be possible to employ this method to analyze the intracellular microdistribution of the capture element and in the development of new drugs for NCT.

The effects of professional oral health care on patients in the subacute stage of emergent neurosurgical disorders

This study evaluated the effectiveness of professional oral health care (POHC) on patients who were in the subacute stage of neurosurgical disorders. Forty subjects (26 male, 14 female) with acute cerebrovascular disorders or neurotrauma were randomly divided into two groups. The intervention group (n = 21) received POHC treatment by dental hygienists, and the control group (n = 19) did not. To evaluate the change in oral health status of the subjects, an oral examination was carried out at baseline and four weeks later. For the subjects in the intervention group, periodontal condition, oral hygiene status, and oral function improved statistically significantly. The detection rate for methicillin-resistant Staphylococcus aureus (MRSA) was statistically significantly lower in the intervention group than in the control group. These results suggest that POHC performed by dental hygienists in collaboration with nurses plays an important role in the promotion not only of oral health but also of general health.

Career History and Perceptions of Dental Hygiene Education Programs

This study was conducted to investigate the career history and perceptions about dental hygiene education programs among the alumni (1952-1999 graduates) of the School of Dental Hygiene in Tokyo Medical and Dental University. A questionnaire containing demographic, practice characteristics and views on the programs was mailed to 997 alumni in 1999, and 576 alumni (57.8%) responded. Three hundred and forty-one respondents worked as dental hygienists. The majority who responded were in clinical practice. One hundred and thirty-one of the respondents worked in private clinics, 76 in public health centers, and 72 in clinics in companies. The rate of them who worked in public health centers was much higher than the national average cited in the Statistical Report on Public Health Administration and Services. Two hundred and ninety-one respondents reported inadequate programs. The rate of them who reported inadequate programs was significantly higher in alumni who were working than in alumni who were not. The items cited as insufficiently taught at the school were clinical practice, instrumentation, foreign language, psychology, counseling, and nursing related subjects. Thus, many alumni suggested the need for better programs and continuing education. From these results, it was suggested that dental hygienists need to change their education programs in order to meet the present and future needs of more diversified society. This view was particularly prevalent among alumni who were working. The result showed that dental hygiene educators and dental hygienists urgently need to reconsider the professionalism of their field.