Publications by authors named "Tetsuo Saito"

Article Synopsis
  • This study aimed to evaluate the real-world impact of radiotherapy for bone metastases on patients' quality of life (QOL) using data from 26 centers in Japan.
  • Out of 333 patients receiving treatment, 232 were included, and their QOL was assessed at enrollment and followed up at two and six months using standardized questionnaires.
  • Results showed significant improvements in several QOL areas, especially pain and insomnia, indicating that radiotherapy can positively affect some aspects of patient well-being in practice.
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Article Synopsis
  • * A phase III trial is being conducted to compare the effectiveness of re-irradiation using stereotactic body radiotherapy (24 Gy in 2 fractions) against conventional radiotherapy (8 Gy in one fraction) for pain relief from spinal metastases.
  • * The study will enroll 158 patients from 33 hospitals in Japan over 3.5 years and is officially registered for tracking purposes.
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Background: The 3-variable number-of-risk-factors (NRF) model is a prognostic tool for patients undergoing palliative radiotherapy (PRT). However, there is little research on the NRF model for patients with painful non-bone-metastasis tumours treated with PRT, and the efficacy of the NRF model in predicting survival is unclear to date. Therefore, we aimed to assess the prognostic accuracy of a 3-variable NRF model in patients undergoing PRT for bone and non- bone-metastasis tumours.

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Introduction: In an MRI-guided linear accelerator (MR-LINAC) system, the planned doses for organs at risk and for tumours are assessed by MR imaging and re-contouring at every treatment. This allows treatment to be safer and more precise by ensuring that it is suitable for the state of the patient's organs on that day, as well as by allowing images to be acquired during radiation therapy to prevent radiation while organs are in motion.Here, we will conduct a confirmatory study of two-fractionated stereotactic magnetic resonance-guided adaptive radiation therapy for patients with localised prostate cancer.

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Article Synopsis
  • This study assessed the characteristics, treatments, and outcomes of patients receiving radiotherapy for bone metastases across 26 hospitals in Japan from December 2020 to March 2021.* -
  • Out of 232 patients enrolled, findings showed that 52% experienced pain relief within two months, with a notable overall survival rate of 70.2% at six months.* -
  • Key observations included that 59% of patients had spinal metastases, the biologically effective dose (BED) of radiation varied widely, and the incidence of severe adverse events was low, with no significant relationship between BED and pain relief.*
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We sought to identify potential evidence-practice gaps in palliative radiotherapy using quality indicators (QIs), previously developed using a modified Delphi method. Seven QIs were used to assess the quality of radiotherapy for bone metastases (BoM) and brain metastases (BrM). Compliance rate was calculated as the percentage of patients for whom recommended medical care was conducted.

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The effectiveness of single-fraction 8-Gy radiotherapy for painful bone metastases has been verified in numerous randomized controlled trials. However, few reports have described the effectiveness of single-fraction 8-Gy radiotherapy in painful tumors other than bone metastases. We conducted a retrospective analysis to evaluate the pain response to single-fraction 8-Gy radiotherapy in painful non-bone-metastasis tumors.

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Radiation-induced myonecrosis is a rare but serious complication of radiation therapy. We present a case of a 49-year-old woman with systemic lupus erythematosus who developed radiation-induced myonecrosis after concurrent chemoradiation for cervical cancer. She underwent external-beam radiation therapy, weekly cisplatin chemotherapy (40 mg/m), and intracavitary brachytherapy.

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Article Synopsis
  • The study evaluated the effectiveness of the Radiation Therapy Oncology Group 8502 "QUAD shot" regimen using volumetric modulated arc therapy (VMAT) for patients with incurable head and neck cancer, involving 105 subjects.
  • A total of 98 (93%) patients achieved a positive response, with significant tumor response in 88% and symptom relief in 71% of subjects.
  • The findings suggest that more cycles of the QUAD shot regimen lead to better outcomes, with median overall survival recorded at 6.8 months and minimal severe toxicity observed.
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Objective: To identify factors significantly associated with quality of life (QOL) and determine if these associations are strong enough to predict certain aspects of QOL without measuring them.

Methods: We conducted an exploratory secondary analysis of baseline data of 224 patients (enrolled between December 2020 and March 2021) from a previously published prospective observational study on radiotherapy for bone metastases at 26 centres. Using univariable linear regression, we assessed the association between patient/treatment factors and QOL scale scores as measured by the European Organization for Research and Treatment of Cancer (EORTC) QOL Questionnaire Core 15-Palliative (QLQ-C15-PAL) and the EORTC QOL Questionnaire Bone Metastases module (QLQ-BM22).

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Background: We evaluated the prevalence and identified the risk factors for retropharyngeal and retro-styloid lymph node metastasis (LNM) in patients with hypopharyngeal carcinoma (HPC). This was achieved using a combination of magnetic resonance (MR) and [ F]-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET)/computed tomography (CT) images.

Methods: Two board-certified radiation oncologists retrospectively reviewed pretreatment FDG-PET/CT images and contrast-enhanced thin-slice CT and MR images of 155 patients with HPC who underwent radiotherapy.

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Purpose: Although the Palliative Prognostic Index (PPI) has been used to predict survival in various cancers, to our knowledge, no study has examined its applicability in gastric cancer. This study aimed to determine the baseline PPI cutoff value for recommending single-fraction radiotherapy in patients with bleeding gastric cancer.

Materials And Methods: This was a secondary analysis of the Japanese Radiation Oncology Study Group (JROSG) 17-3, a multicenter prospective study of palliative radiotherapy for bleeding gastric cancer.

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Purpose: The aim of this study was to understand the income and employment status of patients at the start of and during follow-up after palliative radiation therapy for bone metastasis.

Methods And Materials: From December 2020 to March 2021, a prospective multi-institutional observational study was conducted to investigate income and employment of patients at the start of administration of radiation therapy for bone metastasis and at 2 and 6 months after treatment. Of 333 patients referred to radiation therapy for bone metastasis, 101 were not registered, mainly because of their poor general condition, and another 8 were excluded from the follow-up analysis owing to ineligibility.

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Appropriate use of radiotherapy leads to a better patient care. Oncologists may wonder when to apply radiotherapy for painful bone metastases, what patients should particularly be offered radiotherapy, when to apply re-irradiation, when to apply radiotherapy to malignant spinal cord compression, or whether to apply radiotherapy to prevent symptoms. This paper aims to offer non-radiation oncologist physicians knowledge to help them better refer patients to radiation oncology.

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Previous meta-analysis of conventional radiation therapy for painful bone metastases showed overall response (OR) rates of 72% to 75% (evaluable patients), 61% to 62% (intent-to-treat patients) for initial radiation therapy, and 68% for reirradiation (evaluable patients). However, the definition of pain response differed among the studies included. Hence, we conducted a systematic review and meta-analysis to determine the pain response rates assessed by the International Consensus Pain Response Endpoints (ICPRE) for both initial radiation therapy and reirradiation.

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Article Synopsis
  • Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced non-small cell lung cancer (LA-NSCLC), and the PACIFIC trial established durvalumab as an effective post-CCRT therapy.
  • This study analyzed data from 113 Japanese LA-NSCLC patients treated with CCRT and durvalumab, focusing on survival outcomes and prognostic factors.
  • Key findings indicate that factors like pretreatment ILA scores, adenocarcinoma type, and patient performance status significantly affect overall survival (OS) in patients receiving this combination therapy.
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Background: There is a lack of data on combined radiotherapy (RT) and cyclin-dependent kinase 4 and 6 inhibitor (CDK4/6i) risk factors and toxicity. This study aimed to assess the incidence of and risk factors for non-hematologic toxicities in patients treated with combined RT and CDK4/6i using dose-volume parameter analysis.

Methods: We conducted a retrospective multicenter cohort study of patients with metastatic breast cancer receiving RT within 14 days of CDK4/6i use.

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Objectives: We investigated the influence of handling death and reirradiation on the estimation of duration of response (DOR).

Methods: First, we performed a scoping review on methods to assess DOR in palliative radiotherapy. Second, we performed three different analyses on a subgroup of patients from a previously published prospective study.

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Background: Stereotactic body radiotherapy (SBRT) is a promising approach in treating painful bone metastases. However, the superiority of SBRT over conventional external beam radiotherapy (cEBRT) remains controversial. Therefore, this systematic review and meta-analysis of randomised controlled trials was conducted to compare SBRT and cEBRT for the treatment of bone metastases.

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Background: Time to progression (TTP) is the length of time from the date of diagnosis or the start of treatment to disease progression. In the analysis of TTP, standard survival analysis, where death events are censored, may be problematic and competing risks analysis should be used instead. We investigated statistical methods used in the analysis of TTP.

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Purpose: A quality indicator (QI) is a valuable tool to evaluate the quality of health care systems. In palliative radiation oncology, only a few related QIs have been developed to date. In this study, we sought to develop and pilot test QIs that assess the quality of care in palliative radiation therapy.

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Background: Supporting data defining the selection criteria of level VIIb for inclusion in the target volume in radiotherapy (RT) planning are insufficient. We evaluated the prevalence of level VIIb retro-styloid lymph node metastasis (RSLNM) and associated risk factors in patients with oropharyngeal carcinoma (OPC).

Materials And Methods: We retrospectively reviewed pre-treatment [F]-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography (CT) along with contrast-enhanced thin slice CT and magnetic resonance (MR) images of 137 patients pathologically confirmed as having OPC who underwent RT.

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Background/aim: We retrospectively evaluated the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin, and 5-fluorouracil (TPF) for T3 N0 glottic carcinoma without vocal cord fixation.

Patients And Methods: Twenty-five patients underwent TPF-CCRT without elective nodal irradiaion (ENI). After the RT of 40 Gy, five patients (20%) without tumor regression underwent surgery.

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