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Biomedical subjects

Y Akine

Publications and source records attributed to Y Akine.

At least 37 records · Page 2Linked to original sources
PubMed1997

Design and preparation of gadolinium-reservoir microcapsules for neutron-capture therapy by means of the Wurster process.

Gadolinium (Gd)-containing microcapsules designed for neutron-capture therapy (NCT) were prepared by a spouted bed coating process. Microcapsules were designed as a Gd-reservoir. They were prepared with the following properties: particle size was smaller than 50 microns, Gd-content was as high as possible, and release of Gd was suppressed as long as possible. Calcium carbonate (20-32 microns) was selected as a speed particle. As a Gd-source, gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) or a synthesized water-insoluble Gd-DTPA derivative, Gd-DTPA-distearylamide (Gd-DTPA-SA), was layered onto the seed particles. The release-suppressing layer was composed of aqueous acrylic latex of 9:9:4 poly(ethyl acrylate/methyl methacrylate/2-hydroxyethyl methacrylate). In preliminary studies, Gd-DTPA microcapsules with 41-45 microns (mass median diameter) were prepared; they released Gd with a short lag-time and 3h-prolongation. Complete release suppression was, however, difficult to achieve because of high water-solubility of Gd-DTPA. Hence, a hydrophobic derivative, Gd-DTPA-SA, was next used as a Gd source. Gd-DTPA-SA microcapsules could be prepared with a mass median diameter of 52 microns. Gd-DTPA-SA content of the microcapsules was 38% and release of Gd was suppressed to less than 0.2% over 60 d.

Acrylates↗
PubMed1996

Clearance of parenchymal tumors following radiotherapy: analysis of hepatocellular carcinomas treated by proton beams.

Clearance of a parenchymal tumor following radiotherapy was determined by using follow-up CT scans of 18 hepatocellular carcinoma tumors treated with focused proton beams. Regression analysis of the daily decrement (DD) and the diameter (D) of a tumor mass in each CT observation interval, DD = a*Db, showed that the exponent b was 3.0 or larger in early periods and 2.0 or smaller in late periods. This suggests that the clearance depends initially on the tumor volume, subsequently on the tumor surface area, and then it becomes much more moderate, possibly due to radiation damage to the parenchymal tissues.

Aged↗
PubMed1995

High dose rate brachytherapy for carcinoma of the uterine cervix: comparison of two different fractionation regimens.

PURPOSE: There is no consensus as to the best dose-fractionation regimen in high dose rate (HDR) brachytherapy for cervix cancer. Since 1983, two fractionation regimens have been used in different time periods at National Cancer Center Hospital, and their treatment results have been compared in terms of 5-year survival, local control, and complication rate to find the better therapeutic regimen. METHODS AND MATERIALS: From November 1983 to October 1990, 130 patients with uterine cervix carcinoma were treated with HDR intracavitary brachytherapy using a remote afterloading system. There were 21 Stage Ib patients, 5 Stage IIa, 29 Stage IIb, 2 Stage IIIa, 68 Stage IIIb, and 5 Stage IVa. The median age was 64 years. The median follow-up time was 50 months. Radiotherapy consisted of external beam irradiation to the pelvis (mean dose of 50 Gy), combined with HDR brachytherapy (mean dose of 20 Gy to point A) given 5 Gy per session twice weekly (group A: 54 patients) or 6 Gy once weekly (group B: 76 patients). RESULTS: The overall 5-year survival was 52% in group A and 72% in group B. Local recurrence rate was 11%, and distant failure rate was 21%, with no difference between the two groups. The complication rate was significantly lower in group B (37%) than in group A (55%). Multivariate analysis has shown that factors affecting survival were stage, brachytherapy dose, and local control status. No factor was predictive of local control, but the external beam radiation dose significantly influenced the risk of complications. CONCLUSION: The once-weekly HDR intracavitary applications combined with properly adjusted external beam pelvic irradiation is a safe and effective treatment for patients with uterine cervix cancer.

Adenocarcinoma↗
PubMed1995

The possible role of linac-based stereotactic radiotherapy in the treatment of multifocally and heterochronously recurrent malignant astrocytomas. A case report.

We present a 24-year-old woman with multifocal and heterochronous recurrence of malignant astrocytomas that were consecutively treated by linac-based sterotactic radiotherapy. The patient had previously received multimodalities of treatment for malignant astrocytomas in the right occipital lobe consisting of surgical resection on four occasions, conventional external-beam irradiation, immunological therapy, and systemic chemotherapy. Thereafter she developed relatively small and well-demarcated recurrent lesions in eight different sites, most of which were located in eloquent and deep-seated regions. She underwent ten fractionated linac-based stereotactic radiotherapy courses with a median total dose of 42 Gy, seven fractions of 6 Gy each in 15 days, experiencing neither any adverse effects nor neurologic deterioration. Three out of 10 treated lesions responded well with subsequent reduction in size, and 80% of them did not increase at least for 6 months, although 66.7% of the lesions eventually exhibited enlargement of the enhanced areas, some of which were presumed as radiation necrosis. These clinical results suggest that the fractionated linac-based stereotactic radiotherapy had significant effects on tumor growth inhibition and attainment of acceptable patient performance status.

Adult↗
PubMed1994

Case report: hepatocellular carcinoma diagnosed radiologically, treated by transcatheter arterial embolization and limited-field radiotherapy.

Even though the resection rate for hepatocellular carcinoma (HCC) has risen recently, many patients cannot be treated surgically because of the advanced stage of the tumour and/or coexisting cirrhosis. An alternative therapeutic approach for some of these patients is transcatheter arterial embolization (TAE) which has become very common in Japan. However, it is not a curative measure, and an additional therapy is required to eradicate the residual disease. In this communication, we report a case in which a patient with HCC has been successfully treated by TAE followed by limited-field radiotherapy. The results suggest that this is a very promising therapeutic approach for HCC and that the potential of limited-field radiotherapy for HCC with or without TAE also needs to be explored.

Carcinoma, Hepatocellular↗
PubMed1994

Radiotherapy for hepatocellular carcinoma: clinicopathological study of seven autopsy cases.

The clinical value of radiotherapy for hepatocellular carcinoma (total tumor dose: 50-70 Gy) was evaluated in seven autopsied patients with nine tumors. A partial response as defined by the WHO criteria for chemotherapy was observed in three tumors (33%). Progressive and marked shrinkage of the noncancerous liver tissue within the irradiated field was also observed in all cases. Histological examination revealed viable cancer cells in all cases. These results indicate that local radiotherapy applying 50-70 Gy achieved some clinical benefit, but was not capable of curing hepatocellular carcinoma.

Aged↗
PubMed1993

Linac-based small-field radiotherapy for brain tumors.

Small-field radiotherapy based on a 6-MeV linac and a conventional head mold is investigated as an alternative to radiosurgery with stereotactic frames. The system requires no additional device and allows fractionated treatment. The dose distributions obtained are comparable to those reported with a Gamma Unit. Overall positioning errors are within 2 mm. Using this approach, seven patients with brain tumors who could not have been treated otherwise, underwent fractionated radiotherapy with total accumulated doses ranging from 70 to 108 Gy. The treatment was tolerated well with no acute toxicity or adverse effect encountered during the follow-up period of 8-14 months. All of the patients remained free from disease progression in the treated volumes. Although the follow-up is brief, the preliminary results suggest that this is a simple and inexpensive but effective system for the treatment of small intracranial malignancies.

Brain Neoplasms↗
PubMed1993

Suppression of rabbit VX-2 subcutaneous tumor growth by gadolinium neutron capture therapy.

VX-2 tumors growing in hind legs of New Zealand White rabbits (n = 4) were exposed to thermal neutrons for 40 min (2.1 x 10(12) neutrons cm-2) while one of two hind leg tumors of each rabbit was infused continuously with meglumine gadopentetate through a branch of the left femoral artery. The contralateral (uninfused) tumors served as controls. Although no differential distribution of gadolinium was achieved between the tumor and its adjacent normal tissue, the gadolinium concentration in the infused tumor was approximately 5-6 fold higher than that in the contralateral tumor. Growth of gadolinium-infused tumors was significantly inhibited compared to that of control tumors (P < 0.05) between the 16th and 23rd days after treatment.

Animals↗
PubMed1993

Design and preparation of ethyl cellulose microcapsules of gadopentetate dimeglumine for neutron-capture therapy using the Wurster process.

Microcapsules of hygroscopic, highly water-soluble gadopentetate dimeglumine (Gd-DTPA-DM) for use in preliminary in vivo experiments for neutron-capture therapy were designed. They were prepared with such properties as a particle size small enough to be suspended and injected through a syringe, a negligible release of Gd-DTPA-DM, and a high drug content by means of the Wurster process, a spray coating method using a spouted bed with a draft tube. They were composed of lactose cores of 53-63 microm, an undercoat of ethyl cellulose (EC) and polyvinylpyrrolidone (PVP), a drug-layer of Gd-DTPA-DM, EC and PVP, a waterproof coat and a release-sustaining overcoat of EC and cholesterol (1:1), and a surface treated with hydrogenated egg lecithin. By curing at 110 degrees C for 30 min after mixing with 20% pulverized mannitol powder, the 20% overcoating suppressed the release of Gd-DTPA-DM from 75-106 microm microcapsules to less than 10% for the first 20 min, which was the period required to prepare a suspension, inject it and irradiate the neutron. The microcapsules could be used to confirm that the intracellular presence of Gd is not critical in gadolinium neutron-capture therapy.

Cellulose↗
PubMed1993

Electron-equivalent dose for the effect of gadolinium neutron capture therapy on the growth of subcutaneously-inoculated Ehrlich tumor cells in mice.

The present in vivo study estimates the dose resulting from the gadolinium neutron capture reaction and the gadolinium enhancement extent of the thermal neutron effect. The assay is based on the time required from cell inoculation to the formation of tumors with an arbitrary size of 200 mm2. Mice were inoculated subcutaneously with Ehrlich tumor cells with or without meglumine gadopentetate (1.2 mg 157Gd/0.2 ml), and were exposed to 1.1 x 10(12) thermal neutrons cm-2(n 8), or 3 MeV electrons at three dose levels (each n 10). To reach 200 mm2 in size, it took 18.8 days for tumors treated with neutrons only and 34.7 days for those treated with gadolinium and neutrons. From the time-dose relation obtained with 3 MeV electrons, the equivalent doses corresponding to delays of 34.7 and 18.8 days were 15.0 and 7.4 Gy, respectively. Thus, gadolinium enhanced the thermal neutron effect two-fold (15.0/7.4) in the present study.

Animals↗
PubMed1992

Neutron-capture therapy of murine ascites tumor with gadolinium-containing microcapsules.

Gadolinium-containing microcapsules were evaluated as an agent for gadolinium neutron-capture therapy. Mice were inoculated intraperitoneally with 10(7) Ehrlich ascites tumor cells and gadolinium microcapsules and exposed to thermal neutrons for 12 min (approximately 1.86 x 10(12) neutrons cm-2). Significantly more mice given gadolinium microcapsules than those given placebo microcapsules or control survived for 60 days and considerably longer (P < 0.0001), indicating that gadolinium neutron-capture reactions effectively suppressed the growth of ascites tumor cells in mice. The results suggest that these microcapsules are an effective gadolinium carrier for neutron-capture therapy.

Animals↗
PubMed1992

Radiotherapy for bone metastases of hepatocellular carcinoma.

Radiotherapeutic effects of 42 bone metastases in 26 hepatocellular carcinoma patients were retrospectively analyzed. Pain relief was observed in 79% of 37 bone metastases treated (29/37). Antitumor effects and improvement of paralysis were also observed in 88% (8/9) and 17% (1/6), respectively. The toxicities experienced were tolerable. Radiotherapy was an effective means of palliation in the treatment of hepatocellular carcinoma bone metastases.

Adult↗
PubMed1992

[Linac based radiosurgery; a technical report].

A method for highly dose-localized irradiation using a linear accelerator (linac) for a brain tumor has been developed. The method requires a linac, a computed tomography (CT) system, a CT simulator, and a treatment planning system for radiotherapy, with which most major radiotherapy centers are equipped. To immobilize a patient during irradiation, a custom-made device made of synthetic material which became flexible with heating was used. With the CT system and the CT simulator the target was identified and geometrical data for positioning the tumor at a point to which x-ray beams were directed (an isocenter of the linac) were obtained. By rotating a treatment couch it was made possible for the x-ray source to rotate around the isocenter on multiple planes. Dose distribution obtained with this method was compared to that of the gamma unit and found comparable. Since the method requires no invasive procedure, it appears suitable for treatment, with fractionated irradiation, of malignant tumors.

Brain Neoplasms↗
PubMed1991

Stage I-II carcinoma of the anterior two-thirds of the tongue treated with different modalities: a retrospective analysis of 244 patients.

Treatment results of 244 patients with stage I-II cancer of the mobile tongue were analyzed according to the modalities employed (implantation, surgery, cryosurgery and intraoral irradiation). Overall local control rates at three years were 90 +/- 3% for implant, 89 +/- 7% for cryosurgery, and 84 +/- 9% for surgery. Local control rates in stage II patients treated with intraoral electron irradiation, however, were only 50 +/- 13%. Five-year survival rates were 72 +/- 3% with no significant differences observed in patients with either stage I or stage II regardless of treatment modality. Sixty percent (29/48) of the patients with local recurrences were salvaged by the second treatment. Since the local control and survival achieved by these modalities were similar, with the exception of patients with stage II treated by intraoral electron irradiation, we recommend interstitial implantation with iridium, intraoral electron irradiation or surgery for patients with T1 tumors, and iridium implantation or surgery for patients with T2 tumors. For those with superficial lesions measuring 5 mm or less in thickness, cryosurgery is being offered as an alternative. The patient can choose the treatment modality taking into account his/her age, sex and profession.

Combined Modality Therapy↗
PubMed1991

Radiotherapy of T1 glottic cancer with 6 MeV X rays.

We treated 154 patients with T1 glottic carcinoma with 6 MeV X rays through 16 cm2 parallel-opposing open fields on a free set-up delivering a median dose of 67 Gy in 6 2/3 weeks. Observed and relative 5-year survival rates for all patients were 87% and 100%, respectively. The local control rate at 5 years was 89%. Of 18 patients who clinically had local recurrence, 17 were salvaged by a secondary treatment. There were no complications requiring medical or surgical attention. A tendency toward increasing local control rates with increasing total doses was observed in the range between 57.5 Gy and 72.5. No significant correlation was found between local control rates and field size, daily dose, or the technique used. A tendency toward a lower local control rate was noted for patients whose anterior commissures were grossly involved; however, it is not known if this could be attributed to the use of 6 MeV X rays. The results are comparable to those obtained with 60Co as reported in the literature. It is concluded that 6 MeV X rays on a free set-up delivering 65-70 Gy in 6 1/2-7 weeks can be used satisfactorily for the treatment of early glottic carcinoma.

Adult↗
PubMed1990

[Radiotherapy for endobronchially invading recurrence of esophageal cancer after resective surgery].

Sixty-eight patients with endobronchially invading recurrence of esophageal cancer after resective surgery were treated with radiotherapy from 1966 to 1988. The mean interval between resective surgery and diagnosis of recurrence was 11.1 months, that was significantly shortened in a3 group. The dose of radiation for recurrence ranged from 2 to 70.3 Gy, with a mean dose of 42.6 Gy. The mean survival time after treatment of recurrence was 4.9 months. The dose of radiation was found to have a positive correlation with survival time. The cause of death was bleeding in 20 patients, and respiratory failure in 36. High dose of radiation was thought to induce high incidence of bleeding. The results indicated that external beam radiotherapy with conventional fractionation was not so much effective for the recurrence.

Adult↗