がんの科学と治療

Objective: Prostate cancer treatment as radical prostatectomy or radiation therapy is associated with collateral tissue damage resulting inside-effects. Irreversible electroporation is a minimally invasive technique that has shown to be effective in destroying tumour cells and has been proposed to diminish the treatment related morbidity. The aim of the study was to evaluate the safety and quality of life (QoL) and functional outcomes of extended and focal irreversible electroporation (IRE) in prostate cancer.

Methods: IRE-ablations of the prostate were performed using two treatment protocols (focal and extended) to assess potential variation in outcomes. The safety of IRE was assessed by the device-related, periprocedural- and post procedural adverse events. Post-procedural quality of life was measured by prostate cancer-specific QoL questionnaires. Several validated questionnaires were used to determine the following outcomes: genitourinary side effects, urinary and erectile function. Post-procedural pain was scored using the visual analogue scale and the length of hospital stay was documented.

Results: Mainly mild adverse events (grade 1-2) occurred during the short-term follow-up, mostly concerning lower urinary tract symptoms. Nearly all resolved between the first and fourth week post treatment. Quality of life assessment showed deterioration in the urinary domain for both treatment protocols. Functional outcome questionnaire results remained stable over time. The reported post-procedural pain was low with a median of 0.5 one day post-IRE, and the length of hospital stay was short (mean of 3 days). Analysis per treatment protocol showed a significant increase between one and four weeks post treatment (p=0.03) in the extended treatment group.

Conclusion: Irreversible electroporation can be performed safely in patients suffering from prostate cancer. The adverse events are mostly temporary. Quality of life assessment shows deterioration in the urinary domain; however, functional outcomes remain stable over time.

We retrospectively analyzed outcomes of patients who underwent reirradiation for brain metastasis. We analyzed the records of 23 patients with brain metastasis who were initially treated with palliative brain radiotherapy (RT) and were retreated with a second course of brain RT between June 2008 and December 2012. WBRT, 3DCRT, and SRS were used for brain metastasis. The median dose of the first course of WBRT was 30 Gy (range, 23.4-30 Gy). The dose of the first course of 3DCRT for the lesion was 30 Gy in 3 Gy per fraction. The median dose of the first course of SRS was 16 Gy in one fraction (range, 12-24 Gy). The median dose of the second course of WBRT was 27.5 Gy (range, 12-30 Gy). The median dose of the second course of 3DCRT for the lesion was 30 Gy (range, 25-30 Gy). The dose of the second course of SRS was 16 Gy in one fraction. The second course of WBRT was administered on the basis of radiographically proven disease progression with clinical symptoms. With a median follow-up of 25 months, the overall symptom resolution rate was 47.8%. The rate of palliative efficacy was 82.6% including patients with stable disease. The median survival time after initiation of reirradiation was 3.2 months. The median Karnofsky performance status (KPS) value prior to reirradiation was 30, and the median KPS value following reirradiation was 60. Reirradiation of brain metastasis is feasible and effective in select patients with performance status of KPS ≥ 60 (Eastern Cooperative Oncology Group (ECOG) 0-2) prior to reirradiation.

Background: The WWOX gene (WW-Oxidoreductase) gene is frequently lower expressed in variety of tumor.

Methods: Screening for WWOX gene expression was assessed using real-time reverse transcriptase polymerase chain in 50 ALL cases and 50 healthy control.

Results: WWOX gene was significantly lower in ALL cases (0.43239 ± 1.38925) when compared with healthy control (10.501 ± 9.0338) (p=<0.001). No significant differences were found between high and low WWOX gene expression regarding clinical data, age, sex, hematological data. Patients who highly expressed WWOX gene achieved CR at significantly higher rates in ALL (p=0.002), and had significantly lower frequency refractory disease in ALL patients (p=0.017). Higher expression WWOX gene patients have statistically longer OS (p=0.049) when compared with low expression WWOX gene patients.

Conclusion: Our result suggested that WWOX gene was a predictor for better outcome, could be a useful target for immunotherapy and might represent a candidate marker for monitoring of minimal residual disease.

Aims: The main aim of our study is to analyse Electron Beam Profiles like Flatness, Symmetry with 2D Array Detectors. The 2D Array can be used as an alternative device to measure the Electron beam profiles.

Introduction: Flatness and symmetry of a radiation beam: The flatness of the beam is defined by the following formula: Flatness (%) = Dmax/Dmin × 100% (1) Where Dmax and Dmin are the maximum and minimum doses respectively within the area. Radiation field symmetry is defined as the maximum ratio of doses at two symmetric points relative to the central axis of the field. Symmetry (%) = [D(x, y)]/[D (-x,-y)] × 100% (2)

Methods and Material: The beam symmetry is easily defined and is not very dependent on the depth of measurement. However, the flatness of the beam depends on the size and shape of the measurement phantom. However, 3% is sufficient measurement accuracy for a quick check. We measured the electron profiles of energies (4 MeV, 6 MeV, 8 MeV, 10 MeV, 12 MeV, 15 MeV and 18 MeV) from Elekta Synergy Linear accelerator for different electron applicators (6 × 6, 10 × 10, 14 × 14 and 20 × 20) at their depth of maximum dose (dm) respectively and Source-Surface-Distance (SSD) of 100 cm using PTW 729 2D array detectors.

Results: We analyzed the variations in Flatness and Symmetry of electron energies obtained from 729 2D Array Detector and compared with the standard values obtained from the Radiation Field Analyzer (RFA) during Commissioning.

Conclusions: We found that there is no significant variation in Flatness and symmetry obtained from the 729 2D Array detector as compared to the standard Flatness and symmetry obtained from the RFA .Thus we conclude that 729 2 D Array detector can be used for the routine measurement of electron beam profiles.