Browsing by Author "Saitama Medical University International Medical Center"

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    Assessment of adult women with ovarian masses and treatment of epithelial ovarian cancer: Asco resource-stratified guideline
    (2021-01-01) Verna D. Vanderpuye; Jean Rene V. Clemenceau; Sarah Temin; Zeba Aziz; William M. Burke; Nixon Leonardo Cevallos; Linus T. Chuang; Terence J. Colgan; Marcela G. del Carmen; Keiichi Fujiwara; Elise C. Kohn; Jose Enrique Gonzáles Nogales; Thomas Okpoti Konney; Asima Mukhopadhyay; Bishnu D. Paudel; Ićo Tóth; Sarikapan Wilailak; Rahel G. Ghebre; Ramathibodi Hospital; Saitama Medical University International Medical Center; St. Paul‘s Hospital Millennium Medical College; Komfo Anokye Teaching Hospital; Bir Hospital; Massachusetts General Hospital; Hospital Angeles del Pedregal; Chittaranjan National Cancer Institute; National Cancer Institute (NCI); University of Minnesota Medical School; American Society of Clinical Oncology; Stony Brook University Hospital; LifeLabs; Mallow Flower Foundation; Sociedad Lucha Contra Cancer Ecuador; Instituto Nacional de Cancerología; Nuvance Health; Hameed Latif Hospital; Korlebu Teaching Hospital; Northern Gynaecological Oncology Centre
    PURPOSE To provide expert guidance to clinicians and policymakers in three resource-constrained settings on diagnosis and staging of adult women with ovarian masses and treatment of patients with epithelial ovarian (including fallopian tube and primary peritoneal) cancer. METHODS A multidisciplinary, multinational ASCO Expert Panel reviewed existing guidelines, conducted a modified ADAPTE process, and conducted a formal consensus process with additional experts. RESULTS Existing sets of guidelines from eight guideline developers were found and reviewed for resourceconstrained settings; adapted recommendations from nine guidelines form the evidence base, informing two rounds of formal consensus; and all recommendations received ≥ 75% agreement. RECOMMENDATIONS Evaluation of adult symptomatic women in all settings includes symptom assessment, family history, and ultrasound and cancer antigen 125 serum tumor marker levels where feasible. In limited and enhanced settings, additional imaging may be requested. Diagnosis, staging, and/or treatment involves surgery. Presurgical workup of every suspected ovarian cancer requires a metastatic workup. Only trained clinicians with logistical support should perform surgical staging; treatment requires histologic confirmation; surgical goal is staging disease and performing complete cytoreduction to no gross residual disease. In first-line therapy, platinum-based chemotherapy is recommended; in advanced stages, patients may receive neoadjuvant chemotherapy. After neoadjuvant chemotherapy, all patients should be evaluated for interval debulking surgery. Targeted therapy is not recommended in basic or limited settings. Specialized interventions are resourcedependent, for example, laparoscopy, fertility-sparing surgery, genetic testing, and targeted therapy. Multidisciplinary cancer care and palliative care should be offered. Additional information can be found at www.asco.org/resource-stratified-guidelines. It is ASCO's view that health care providers and health care system decision makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.
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    Preliminary survey of 3D image-guided brachytherapy for cervical cancer at representative hospitals in Asian countries
    (2020-07-06) Noriyuki Okonogi; Masaru Wakatsuki; Hideyuki Mizuno; Shigekazu Fukuda; Jianping Cao; Henry Kodrat; Fen Nee Lau; Miriam Joy Calaguas; Rey H. de Los Reyes; Yaowalak Chansilpa; A. F.M.Kamal Uddin; Tasbolat Adylkhanov; Chul Koo Cho; Uranchimeg Tsegmed; Nguyen Cong Hoang; Tatsuya Ohno; Takashi Nakano; Shingo Kato; Saitama Medical University International Medical Center; Graduate School of Medicine; National Institutes for Quantum and Radiological Science and Technology; QST Hospital; Jichi Medical University; Semey Medical University; St. Luke's Medical Center Quezon City; Jose R. Reyes Memorial Medical Center; University of Indonesia, RSUPN Dr. Cipto Mangunkusumo; Korea Institute of Radiological and Medical Sciences; Faculty of Medicine, Siriraj Hospital, Mahidol University; Soochow University; National Cancer Council of Mongolia; Institut Kanser Negara; United Hospital Limited; National Cancer Hospital
    © The Author(s) 2020. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology. 3D image-guided brachytherapy (3D-IGBT) has become a standard therapy for cervical cancer. However, the use of 3D-IGBT is limited in East and Southeast Asia. This study aimed to clarify the current usage patterns of 3D-IGBT for cervical cancer in East and Southeast Asia. A questionnaire-based survey was performed in 11 countries within the framework of the Forum for Nuclear Cooperation in Asia. The questionnaire collected the treatment information of patients with cervical cancer who underwent 3D-IGBT. The cumulative external beam radiotherapy and 3D-IGBT doses were summarized and normalized to a biological equivalent dose of 2 Gy per fraction (EQD2) using a linear-quadratic model. Of the 11 institutions representing the participating countries, six (55%) responded to the questionnaire. Overall, data of 36 patients were collected from the six institutions. Twenty-one patients underwent whole-pelvic irradiation and 15 underwent whole-pelvic irradiation with central shielding. Patients received a median of four treatment sessions of 3D-IGBT (range, 2-6). All 3D-IGBT sessions were computed tomography (CT)-based and not magnetic resonance image-based. The median doses to the high-risk clinical target volume D90, bladder D2cc, rectum D2cc and sigmoid colon D2cc were 80.9 Gy EQD2 (range, 58.9-105.9), 77.7 Gy EQD2 (range, 56.9-99.1), 68.0 Gy EQD2 (range, 48.6-90.7) and 62.0 Gy EQD2 (range, 39.6-83.7), respectively. This study elucidated the current patterns of 3D-IGBT for the treatment of cervical cancer in East and Southeast Asia. The results indicate the feasibility of observational studies of CT-based 3D-IGBT for cervical cancer in these countries.
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    Why not de-intensification for uterine cervical cancer?
    (2021-10-01) Naoya Murakami; Ken Ando; Masumi Murata; Kazutoshi Murata; Tatsuya Ohno; Tomomi Aoshika; Shingo Kato; Noriyuki Okonogi; Anneyuko I. Saito; Joo Young Kim; Yasuko Kumai; Yasuo Yoshioka; Shuhei Sekii; Kayoko Tsujino; Chairat Lowanichkiattikul; Poompis Pattaranutaporn; Yuko Kaneyasu; Tomio Nakagawa; Miho Watanabe; Takashi Uno; Rei Umezawa; Keiichi Jingu; Ayae Kanemoto; Masaru Wakatsuki; Katsuyuki Shirai; Hiroshi Igaki; Jun Itami; Hyogo Cancer Center; National Hospital Organization Fukuyama Medical Center; Graduate School of Medicine; Saitama Medical University International Medical Center; Graduate School of Medicine; QST Hospital; Gunma Prefectural Cancer Center; Jichi Medical University; National Cancer Center, Gyeonggi; Cancer Institute Hospital of Japan Foundation for Cancer Research; National Cancer Center Hospital; Faculty of Medicine Ramathibodi Hospital, Mahidol University; Niigata Cancer Center Hospital; Juntendo University School of Medicine; Chiba University Hospital; Kita-Harima Medical Center
    Objective: The majority of uterine cervical cancer is known to be related to human papillomavirus (HPV), and HPV-related tumors are known to be radio-sensitive. In the management of HPV-related oropharyngeal cancer, de-intensification of treatment has been attempted; however, no such attempt is performed in the management of cervical cancer. The aim of this study was to identify a group of patients who can safely be treated by de-escalated treatment intensity. Methods: From the Asian international multi-institutional retrospective study involving 13 Japanese, one Thailand, and one Korean institutions based on 469 patients, squamous cell carcinoma (Scc), tumor reduction ratio ≥29%, tumor size before brachytherapy ≤4 cm, and total treatment time (TTT) <9 weeks were identified as factors having an influence on local control. Based on these findings, low-risk patients having these four factors were extracted, and treatment outcomes categorized in 10 Gy increment of CTVHR D90 were compared. Results: Among 469 patients, 162 patients (34.5%) met the criteria of low-risk group, and 63, 41, 43, and 15 patients were categorized in CTVHR D90 50–60 Gy, 60–70 Gy, 70–80 Gy, and >80 Gy, respectively. While 4-y progression-free survival ranged from 66 to 80%, 4-y local control was consistently over 90% in every dose group. Rectum and bladder D2cc and incidence of late adverse events decreased as CTVHR D90 decreased. Conclusions: The low-risk patients achieved favorable local control with CTVHR D90 <80 Gy. A personalized treatment strategy based on tumor response could also be adopted for cervical cancer.