Satoru Uehara

Clinical results of radiation therapy for stage I esophageal cancer: a single institutional experience.

From 1992 through 2001, 29 patients with stage I esophageal cancer were treated with radiation therapy. All patients had squamous cell carcinoma. Seventeen patients were treated with radiotherapy alone, and 12 were treated with a combination of chemotherapy and radiotherapy. Most of the chemotherapy regimens included cisplatin and/or 5-fluorouracil (5-FU). Twelve patients were treated with intracavitary irradiation (low-dose rate: 6, high-dose rate: 6) after external radiotherapy. Median fraction and total doses of external radiotherapy given were 2.0 Gy and 60.6 Gy, respectively. Median doses of intracavitary irradiation were 18 Gy/6 fractions in low-dose-rate brachytherapy and 13.5 Gy/4.5 fractions in high-dose-rate brachytherapy. The 5-year overall survival rate was 62%. The 5-year local control rate was 44%. Of the 29 patients, 9 had in-field recurrence in the esophagus and 1 had recurrence in the esophagus outside of the irradiated field. Of 9 patients with in-field local recurrence, 1 also developed mediastinal lymph node metastases and 1 had distant metastasis. Radiation therapy is an effective treatment modality for stage I esophageal cancer.

Treatment Outcome of High-dose-rate Interstitial Radiation Therapy for Patients with Stage I and II Mobile Tongue Cancer

OBJECTIVES The aim of the study was to investigate the outcomes of high-dose-rate interstitial radiation therapy for patients with Stage I and II mobile tongue cancer retrospectively. METHODS Sixty-seven patients with Stage I and II mobile tongue cancer were treated with high-dose-rate interstitial radiation therapy, with or without external beam radiation therapy, between 1997 and 2007. The median dose of interstitial radiation therapy was 50 Gy in 10 fractions over 6 days. Thirty-five patients received external beam radiation therapy before interstitial radiation therapy. The median dose of external beam radiation therapy was 20 Gy delivered with single-lateral or bilateral fields, including the primary tumor site and upper jugular lymph nodes. Thirty-seven patients received concurrent chemotherapy, including carboplatin, cisplatin, fluorouracil or tegafur, gimeracil and oteracil (TS-1) systemically or with intra-arterial injection. Thirty-three patients received intratumoral injection of bleomycin before catheter insertion. The median follow-up time was 58.6 months (range 15.1-102.4 months). RESULTS The 5-year overall, cause-specific, progression-free survival rate and local control rate were 88.7, 92.1, 76.0 and 94.0%, respectively. Fourteen patients developed cervical lymph node recurrence, 11 of which were distributed within the external beam radiation therapy field. We found local failures in four cases within 2 years after the treatment and in three cases after >7 years, even though the latter were difficult to distinguish from second primary cancers. CONCLUSIONS The treatment results of our institutions were equivalent to previous reports. Most cervical lymph node metastases occurred within the external beam radiation therapy field, which implied that the external beam radiation therapy dose of 20-30 Gy was insufficient to prevent late cervical lymph node metastases.

Primary non-Hodgkin's lymphoma of the maxillary sinus.

Primary non-Hodgkins lymphoma of the maxillary sinus is a rare lesion. We studied nine patients with malignant lymphoma involving the maxillary sinus, treated between 1980 and 1994 in the Kyushu University Hospital. All lymphomas had a diffuse pattern; five were the large-cell type, two the mixed type, and one the small lymphatic and small cleaved type. Immunohistologically, all tumors were B-cell type. Using the Ann Arbor staging system, six patients were classified as stage I, two stage II, and one stage IV. Two patients received only radiotherapy because of advanced age; the remaining seven received a combination of radiotherapy and chemotherapy (CHOP or VEPA). The tumor doses ranged from 30 to 51 Gy (mean, 46.7). The mean follow-up was 51 months. Only one patient (stage IV) died of disease, and eight stage I-II patients were rendered disease-free. The 5-year survival rate was 80%, suggesting that primary lymphoma of the maxillary sinus has a relatively good prognosis.

A new, simple method of making a spacer in interstitial brachytherapy for mobile tongue cancer

OBJECTIVES This article demonstrates a new method of making a spacer that increases the distance between the mandible and implanted radioactive sources in interstitial brachytherapy for patients with mobile tongue cancer. STUDY DESIGN Fifty-three patients with mobile tongue cancer underwent interstitial brachytherapy with spacers made by this new technique. RESULTS Our spacer is not difficult to create or to use. The spacer was made from a plastic splint by using thermoforming techniques and quick self-curing resin, which did not need waxing, wiring, or casting. The surface of the spacer, which comes in contact with the tongue, is smooth because it is covered with tissue-conditioning material. There were no complaints of pain from the patients. Osteoradionecrosis of the mandible developed in only 1 (1.9%) of these patients. CONCLUSIONS This spacer is simple to make and prevented osteoradionecrosis.

Comparison of survival rates of patients with nasopharyngeal carcinoma treated with radiotherapy, 5-fluorouracil and vitamin A ("FAR" therapy) vs FAR therapy plus adjunctive cisplatin and peplomycin chemotherapy.

Abstract The overall survival rate (OSR) of 36 patients with nasopharyngeal carcinomas (NPC) treated at Kyushu University hospital between 1983 to 1992 was analyzed. As primary treatment, 16 patients received a combination therapy of 5-fluorouracil, vitamin A, and radiation (FAR therapy); two patients received radiotherapy only; 18 patients received FAR therapy plus adjunctive systemic chemotherapy consisting of cisplatin and peplomycin. The radiation dose to the nasopharynx was 6000 to 7050 cGy while that to the neck was 4000–6000 cGy. The 5-year OSR of all the patients was 49%. Histological type (moderately differentiated squamous cell carcinoma) and patient age (≥ 55) were found to be significant prognostic factors for a worse OSR. Although survival decreased with increasing T stage, no significant difference was observed. The 5-year OSR of the patients treated with FAR therapy was 53% and was 51% with FAR therapy plus chemotherapy. Compared to FAR therapy alone, adjunctive chemotherapy did not increase OSR of the patients with NPC.

Angiomyolipomas of the mediastinum and the lung.

Angiomyolipomas are benign neoplasms composed of various tissues, including components of fat, abnormal blood vessels, and smooth muscle cells. They most commonly occur in the kidney, but on rare occasions they occur in extrarenal sites. We present a case of angiomyolipomas in the mediastinum and lung, possibly associated with lymphangioleiomyomatosis and tuberous sclerosis complex.