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Takashi NAKANO
2015 Volume 64 Issue 6 Pages
365
Published: June 15, 2015
Released on J-STAGE: June 27, 2015
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Shin-ei NODA, Kazutoshi MURATA, Takashi NAKANO
2015 Volume 64 Issue 6 Pages
367-369
Published: June 15, 2015
Released on J-STAGE: June 27, 2015
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It has been 120 years since the discovery of X-ray, and evolution of radiotherapy has been accomplished by the remarkable advancement of engineering technology. Particle beam therapy has started with the technology of neutron therapy, and, at present, proton and heavy ion therapy are implemented in 57 facilities around the world. The major contribution to this development of particle beam therapy is the development of particle accelerator technology since 1940's.
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Hiroyuki KATOH
2015 Volume 64 Issue 6 Pages
370-376
Published: June 15, 2015
Released on J-STAGE: June 27, 2015
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The particle beam therapy has the excellent physical and biological characteristics that are very different from the X-ray used mainly in conventional radiotherapy. Therefore, the particle therapy can treat loco-regional lesions more strongly with less toxicity than conventional radiotherapy. In recent years in Japan, we can use proton and carbon ion as a particle beam therapy. In this article, we describe the overview of the basis, the advantage and weak points about the particle beam therapy, and the differences between proton and carbon ion therapy.
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Akihisa TAKAHASHI, Yukari YOSHIDA
2015 Volume 64 Issue 6 Pages
377-381
Published: June 15, 2015
Released on J-STAGE: June 27, 2015
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As for the particle beam therapy, there is to theoretical evidence by radiobiology. The particle beam therapy becomes high precision by development of the medicine engineering. We demonstrated the past contribution for the particle beam therapy and recent knowledge about radiobiological phenomenon such as (1) DNA damage and the repair, (2) cell killing effect, (3) metastasis, and (4)therapeutic gain. Finally, we discuss it about the radiobiological perspective for the particle beam therapy.
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Kota TORIKAI, Hikaru SOUDA
2015 Volume 64 Issue 6 Pages
382-387
Published: June 15, 2015
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Particle accelerators dedicated for the particle therapy require energies of 230 MeV
(proton) or 400 MeV/u
(carbon) which correspond to the range of 25 - 30 cm
. Cyclotrons and synchrotrons are utilized for proton therapy, while only synchrotrons are used for carbon ion therapy due to its requirement for the higher energy. Further development of downsizing by superconducting magnets and laser-plasma acceleration are being carried out.
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Kota TORIKAI, Kyohei FUKATA
2015 Volume 64 Issue 6 Pages
388-393
Published: June 15, 2015
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The system of particle therapy consists of a lot of elements, the accelerators, the irradiation mechanisms, dose calculation system, the management software for treatment process control and so on. In this section, the processes of the beam delivery to the target(tumor lesion), after the acceleration part, were shown from the two points of view, hardware and software.
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Mutsumi TASHIRO, Hirofumi SHIMADA, Motohiro KAWASHIMA
2015 Volume 64 Issue 6 Pages
394-399
Published: June 15, 2015
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In a general meaning, ‘treatment planning' is recognized as a schedule or an agenda for an entire medical practice such as hospitalization and discharge, examinations, medications, procedures, etc. On the other hand, that in radiation therapy field usually means to define a target of the tumor to be treated on X-ray CT images, and to actually determine an irradiation scheme and prescribed dose through verifying radiation dose distributions in a patient body. In this article, we briefly introduce treatment planning for heavy-ion beam therapy which is carried out in Gunma University Heavy Ion Medical Center.
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Ken YUSA, Yoshiki KUBOTA
2015 Volume 64 Issue 6 Pages
400-405
Published: June 15, 2015
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In radiation therapy, it is essential that a prescribed target area is irradiated with the prescribed dose concentration to reduce the possibility cancer reoccurrence or to mitigate its side effects. Particle beam therapy is a high accuracy radiation therapy, which has superior characteristics. Specifically, a high dose region, namely, Bragg peak formed around the beam stopping point can be adjusted to the target volume. The routine of particle beam therapy should be performed with various verifications, called quality assurance(QA), at its each step, i.e., treatment planning, dosimetry, patient positioning and respiratory gating system. Each particle beam therapy facility should have and conduct its own QA program. Methods and materials for the QA should be developed according to the progress of techniques in particle beam therapy.
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Mutsumi TASHIRO, Takayoshi ISHII
2015 Volume 64 Issue 6 Pages
406-408
Published: June 15, 2015
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For radiation control and protection in a particle beam therapy facility, the use of radiation is regulated by Medical Care Act(MCA) in addition to Act on Prevention of Radiation Disease Due to Radioisotopes etc., because it is not only a radiation but also a medical facility. X-ray radiographic equipments are regulated only by the MCA. On the other hand, the regulations for the facility having accelerators are essentially similar to those for general radiation facilities. In this article, designing and operation of a particle beam therapy facility are summarized from the aspect of radiation control and protection.
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Jun-ichi SAITOH
2015 Volume 64 Issue 6 Pages
409-415
Published: June 15, 2015
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As for the treatment of head and neck tumors, radiation therapy plays an important role for the purpose of preservation of shapes or functions of the organ. However, non-squamous cell tumors which are rarely observed in the head and neck region are relatively X-ray resistant, and the curability by X-ray radiotherapy has been low as for the treatment of non-squamous cell tumors. Charged particle beams provide superior physical dose distribution, and carbon ion beams possess a biological advantage due to their high relative biological effectiveness in the Bragg peak. It is therefore expected to improve the treatment outcome of tumors characterized by poor radiosensitivity, such as adenoid cystic carcinoma, malignant melanoma, sarcoma, and so on.
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Katsuyuki SHIRAI, Takashi NAKANO
2015 Volume 64 Issue 6 Pages
416-421
Published: June 15, 2015
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Particle therapy, such as proton and carbon-ion radiotherapy, has better dose distribution than X-irradiation. Therefore, high dose of particle therapy is expected to control the primary tumor without high sever adverse effects. Several studies have reported that efficacy and safety of particle therapy for lung cancer, and we will review the overview these clinical results.
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Kei SHIBUYA, Yoshinari KOYAMA
2015 Volume 64 Issue 6 Pages
422-426
Published: June 15, 2015
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Charged particle therapy is expected to be a novel treatment modality for hepatic tumor due to the physical properties for ideal radiation dose distribution that offers the promise of maximizing tumor control via dose escalation without excessive liver radiation exposure in patients with limited functional liver reserves. In this review, we discuss the clinical outcomes, the toxicity and implications of charged particle therapy, particularly for the treatment of hepatocellular carcinoma.
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Hiroki KIYOHARA, Masahiko OKAMOTO, Naoko OKANO
2015 Volume 64 Issue 6 Pages
427-431
Published: June 15, 2015
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First choice of treatment for bone and soft tissue tumors is surgical tumor resection, but some cases have difficulties to resect radically because of tumor size, location, or their reduction in QOL after surgery. Carbon ion radiotherapy has been reported that have both good local tumor control and high QOL for patients with bone and soft tissue tumors, especially sacral chordoma and unresectable osteosarcoma of the tract. Some articles of the results with carbon ion radiotherapy for sacral chordoma show better local control and QOL than that of surgery. Moreover, several reports show good local control and preservation of QOL for patients with unresectable osteosarcoma of the tract, retroperitoneal sarcoma, and other situations of sarcomas. Now carbon ion radiotherapy can offer a promising alternative to surgery for patients with unresectable sarcomas. We will discuss about the results of carbon ion radiotherapy for bone and soft tissue tumors in this issue.
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Masahiko OKAMOTO, Hiroki KIYOHARA, Naoko OKANO
2015 Volume 64 Issue 6 Pages
432-437
Published: June 15, 2015
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Gastrointestinal cancer is still difficult to treat even using the particle therapy. However, because of their excellent dose distribution, cancer surrounded by gastrointestinal tract such as pancreatic cancer and local recurrence of colorectal cancer after surgery becomes to be treated by particle beam with curative intent. The usefulness of particle beam is reported in the patients with locally advanced pancreatic cancer and patents who received preoperative irradiation with resectable pancreatic cancer. In addition, the postoperative recurrence of rectal cancer is reported to achieve more than 90 percent of local control by particle beam.
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Hidemasa KAWAMURA, Nobuteru KUBO
2015 Volume 64 Issue 6 Pages
438-442
Published: June 15, 2015
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Radiation therapy for prostate cancer has been established as a curative treatment option with improving radiation technique such as X-ray intensity modulated radiation therapy. Proton therapy has been started as the boost of X-ray irradiation and later used as the mono-therapy for the dose escalation because of its conformal dose distribution. Heavy ion therapy has superior dose distribution and biological effect, and has been trying in hypo-fractionated schedule. It is reported that good local control and low possibility of adverse event with both proton and heavy ion therapy.
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Masaru WAKATSUKI, Shintaro SHIBA, Tadashi KAMADA
2015 Volume 64 Issue 6 Pages
443-449
Published: June 15, 2015
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Carbon ion beams offer improved dose distribution, resulting in the concentration of a sufficient dose within a target volume while minimizing the dose in surrounding normal tissues. Moreover, carbon ions possess a biological advantage due to their high relative biological effectiveness(RBE) in the Bragg Peak. A number of reports have demonstrated the favorable results of carbon ion radiotherapy(C-ion RT) in the treatment of several malignant tumors. As for clinical trials of C-ion RT for locally advanced cervical cancer, 5 have already been completed, and 2 are still ongoing.
Between June 1995 and March 2014, about 200 patients with locally advanced cervical cancer in 8 protocols were treated with C-ion RT. Carbon-ion RT has been established as a safe short-term treatment for locally advanced uterine cervical cancer. Although the patient population in these trials was small, it was shown that C-ion RT has the potential to improve the treatment for locally advanced bulky squamous cell carcinoma or adenocarcinoma of the uterine cervix, with the results supporting the view that investigations should be continued to confirm the therapeutic efficacy. In addition, we are now conducting a new clinical trial of C-ion RT with concurrent chemotherapy.
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Tomoaki TAMAKI, Takashi NAKANO
2015 Volume 64 Issue 6 Pages
450-453
Published: June 15, 2015
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The number of particle beam therapy facilities is increasing globally. Among the countries practicing particle beam therapy, Japan is one of the leading countries in the field with four operating carbon-ion therapy facilities and ten operating proton therapy facilities. With the increasing number of particle beam therapy facilities, the human resource development is becoming extremely important, and there has been many such efforts including the Gunma University Program for Cultivating Global Leaders in Heavy Ion Therapeutics and Engineering, which aimed to educate and train the radiation oncologists, medical physicists, accelerator engineers, and radiation biologists to become global leaders in the field of particle beam therapy. In the future, the benefit and effectiveness of particle beam therapy should be discussed and elucidated objectively in a framework of comprehensive cancer care.
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