徳島大学 / 教育研究者総覧 --- 外礒千智

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徳島大学 ⟩ 病院 ⟩ 先端医療開発研究プロジェクト ⟩
徳島大学 ⟩ 病院 ⟩ 診療科 ⟩ 放射線科 ⟩ 放射線治療科 ⟩
徳島大学 ⟩ 病院 ⟩ 診療科 ⟩ 放射線科 ⟩
徳島大学 ⟩ 医学部 ⟩ 医学科 ⟩ 生体防御腫瘍医学講座 ⟩ 放射線科学分野 ⟩

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研究活動

専門分野

研究テーマ

著書・論文

学術論文(審査論文):

1.	Akiko Abe, Masao Yuasa, Yoshie Imai, Tomohiro Kagawa, Ayuka Mineda, Masato Nishimura, Chisato Tonoiso, Akiko Kubo, Takashi Kawanaka, Hitoshi Ikushima and Takeshi Iwasa : Extreme leanness, lower skeletal muscle quality, and loss of muscle mass during treatment are predictors of poor prognosis in cervical cancer treated with concurrent chemoradiation therapy, International Journal of Clinical Oncology, Vol.27, No.5, 983-991, 2022. (要約) Human papillomavirus vaccination is not widespread in Japan, and the low screening rates result in many cases of locally advanced cervical cancer. We investigated the prognostic significance of sarcopenia in patients with cervical cancer to guide healthcare policies to improve treatment outcomes. This retrospective study included 83 patients with cervical cancer without distant metastasis who underwent primary concurrent chemoradiotherapy between 2013 and 2018. We analyzed the indicators of physical condition and muscle quantity using the SYNAPSE VINCENT software. Muscle mass and the relationship between treatment toxicity and prognosis were evaluated. The patients' median age was 60 (range 33-80) years. Cancer stage distribution was as follows: cT2b or higher, 84.3%; N1, 65.1%; and MA, 27.7%. The overall sarcopenia (skeletal muscle index [SMI] < 38.5) rate was 30.1%, and the rate was 33.9 and 22.2% in patients aged < 64 and ≥ 65 years, respectively. No correlation was observed between clinical stage and musculoskeletal indices. Treatment resulted in decreased body weight and SMI; after treatment, the sarcopenia rate increased to 37.3%. A higher intramuscular adipose tissue content (IMAC) reduced the number of chemotherapy cycles needed. Treatment-associated SMI decreases of ≥ 7% indicated poor prognosis, with significant differences in progression-free survival and overall survival (p = 0.013 and p = 0.012, respectively). Patients who were very lean (body mass index < 18.5 kg/m) before treatment had a poor prognosis (p = 0.016 and p < 0.001). Our findings emphasize the importance of assessing original nutritional status and maintaining muscle mass and quality during the treatment of patients with cervical cancer. (キーワード) Adult / Aged / Aged, 80 and over / Chemoradiotherapy / Female / Humans / Middle Aged / Muscle, Skeletal / Papillomavirus Infections / Papillomavirus Vaccines / Prognosis / Retrospective Studies / Sarcopenia / Thinness / Uterine Cervical Neoplasms (出版サイトへのリンク) ● Publication site (DOI): 10.1007/s10147-022-02140-w (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 35212828 ● Summary page in Scopus @ Elsevier: 2-s2.0-85125283470 (DOI: 10.1007/s10147-022-02140-w, PubMed: 35212828, Elsevier: Scopus)
2.	Kenta Kitagawa, Hitoshi Ikushima, Motoharu Sasaki, Shunsuke Furutani, Takashi Kawanaka, Akiko Kubo, Chisato Tonoiso, Takaharu Kudoh, Yohsuke Kanoh and Tsuzuki Akira : Effect of dental metal artifact conversion volume on dose distribution in head-and-neck volumetric-modulated arc therapy, Journal of Applied Clinical Medical Physics, Vol.21, No.12, 253-262, 2020. (要約) Purpose: During treatment planning for head-and-neck volumetric-modulated arc therapy (VMAT), manual contouring of the metal artifact area of artificial teeth is done, and the area is replaced with water computed tomography (CT) values for dose calculation. This contouring of the metal artifact areas, which is performed manually, is subject to human variability. The purpose of this study is to evaluate and analyze the effect of inter-observer variation on dose distribution.Methods: The subjects were 25 cases of cancer of the oropharynx for which VMAT was performed. Six radiation oncologists (ROs) performed metal artifact contouring for all of the cases. Gross tumor volume, clinical target volume, planning target volume (PTV), and oral cavity were evaluated. The contouring of the six ROs was divided into two groups, small and large groups. A reference RO was determined for each group and the dose distribution was compared with those of the other radiation oncologists by gamma analysis (GA).As an additional experiment, we changed the contouring of each dental metal artifact area, creating enlarged contours (L), reduced contours (S), and undrawn contours (N) based on the contouring by the six ROs and compared these structure-sets.Results: The evaluation of inter-observer variation showed no significant difference between the large and small groups, and the GA pass rate was 100%. Similar results were obtained comparing structure-sets L and S, but in the comparison of structure-sets L and N, there were cases with pass rates below 70%.Conclusions: The results show that the artificial variability of manual artificial tooth metal artifact contouring has little effect on the dose distribution of VMAT. However, it should be noted that the dose distribution may change depending on the contouring method in cases where the overlap between PTV and metal artifact areas is large. (キーワード) dental metal artifact / head-and-neck / volumetric-modulated arc therapy (徳島大学機関リポジトリ) ● Metadata: 115924 (出版サイトへのリンク) ● Publication site (DOI): 10.1002/acm2.13101 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 33226172 ● Summary page in Scopus @ Elsevier: 2-s2.0-85097008301 (徳島大学機関リポジトリ: 115924, DOI: 10.1002/acm2.13101, PubMed: 33226172, Elsevier: Scopus)
3.	Shunsuke Furutani, Hitoshi Ikushima, Motoharu Sasaki, Chisato Tonoiso, Ayaka Takahashi, Akiko Kubo, Takashi Kawanaka and Masafumi Harada : Clinical outcomes of hypofractionated image-guided multifocal irradiation using volumetric-modulated arc therapy for brain metastases., Journal of Radiation Research, Vol.60, No.1, 134-141, 2019. (要約) Volumetric-modulated arc therapy (VMAT) can be used to design hypofractionated radiotherapy treatment plans for multiple brain metastases. The purpose of this study was to evaluate treatment outcomes of hypofractionated image-guided multifocal irradiation using VMAT (HFIGMI-VMAT) for brain metastases. From July 2012 to December 2016, 67 consecutive patients with 601 brain metastases were treated with HFIGMI-VMAT at our institution. The prescribed dose was 50 Gy to a 95% volume of the planning target volume in 10 fractions. Fifty-five of the 67 patients had non-small-cell lung cancer, and the remaining 12 had other types of cancer. The median number of brain metastases was five, and the median maximum diameter was 1.2 cm. The median duration of follow-up was 12.0 months (range, 1.9-44.8 months), and the median survival time 18.7 months. Four patients with six lesions had local recurrences. The local control rate in the 64 assessed patients was 98.4% and 95.3% at 6 and 12 months, respectively (three died before assessment). The local control rate for the 572 assessed lesions was 99.8% and 99.3% at 6 and 12 months, respectively. Thirty-nine patients developed distant brain metastases, the distant brain control rate being 59.7% and 40.5% at 6 and 12 months, respectively. Acute toxicities were generally mild (Grade 1-2). Three patients (4.5%) developed radiation necrosis requiring corticosteroid therapy. The HFIGMI-VMAT technique with flat dose delivery was well tolerated and achieved excellent local control. This technique is a promising treatment option for patients with multiple and large brain metastases. (徳島大学機関リポジトリ) ● Metadata: 115535 (出版サイトへのリンク) ● Publication site (DOI): 10.1093/jrr/rry091 (文献検索サイトへのリンク) ● PubMed @ National Institutes of Health, US National Library of Medicine (PMID): 30445426 ● Search Scopus @ Elsevier (PMID): 30445426 ● Search Scopus @ Elsevier (DOI): 10.1093/jrr/rry091 (徳島大学機関リポジトリ: 115535, DOI: 10.1093/jrr/rry091, PubMed: 30445426)

国際会議:

1.	Takashi Kawanaka, Chisato Tonoiso, Akiko Kubo and Hitoshi Ikushima : Compatibility of SAVI applicator and resection cavity underwent cylindrical breast resection for early-stage breast cancer and its solution: initial experience of Hybrid APBI, RSNA2021, Chicago, Nov. 2020.
2.	Takashi Kawanaka, Akiko Kubo, Shunsuke Furutani, Chisato Tonoiso, Hitoshi Ikushima and Masafumi Harada : Long-Term Outcome of Low-Dose Rate Brachytherapy with I-125 Seeds as a Monotherapy for High-Risk Prostate Cancer Patients: A Propensity Score-Matched Analysis, RSNA2018, Nov. 2018.

国内講演発表:

1.	久保亜貴子, 生島仁史, 川中崇, 外礒千智, 原田雅史 : 子宮頸癌放射線治療における標的体積内同時ブースト(SIB)併用についての試み, 第136回日本医学放射線学会中国・四国地方会, 2022年6月.
2.	久保亜貴子, 生島仁史, 外礒千智, 川中崇 : 当院でのVenezia applicatorによる子宮頸がん小線源治療の使用経験, 日本放射線腫瘍学会小線源治療部会第24回学術大会, 2022年5月.
3.	久保亜貴子, 生島仁史, 川中崇, 外礒千智 : 当院でのVenezia applicatorによる子宮頸がん小線源治療の使用経験, 小線源治療部会第24回学術大会, 2022年5月.
4.	外礒千智, 久保亜貴子, 川中崇, 生島仁史, 原田雅史 : 乳房の照射後に発生した放射線誘発腫瘍の一例, 日本放射線腫瘍学会第34回学術大会, 2021年11月.
5.	久保亜貴子, 生島仁史, 川中崇, 外礒千智, 工藤隆治, 原田雅史 : 子宮頸癌化学放射線治療後の照射野内リンパ節転移についての検討, 日本放射線腫瘍学会第34回学術大会, 2021年11月.
6.	工藤隆治, 芳賀昭弘, 佐々木幹治, 外礒千智, 久保亜貴子, 川中崇, 古谷俊介, 生島仁史 : Radiomicsの手法を用いたPETによる舌癌頸部リンパ節転移の予測, 日本放射線腫瘍学会第33回学術大会, 2020年10月.
7.	川中崇, 久保亜貴子, 外礒千智, 生島仁史 : Single-entry applicatorとinterstitial needleを併用した小線源治療によるAPBIの1例, 日本放射線腫瘍学会第33回学術大会, 2020年10月.
8.	久保亜貴子, 生島仁史, 外礒千智, 川中崇, 古谷俊介, 原田雅史 : 腋か領域を含めた乳癌術後照射における放射線肺臓炎の検討, 日本放射線腫瘍学会第32回学術大会, 2019年11月.
9.	外礒千智, 芳賀昭弘, 久保亜貴子, 川中崇, 古谷俊介, 工藤隆治, 生島仁史, 原田雅史 : 子宮頸部扁平上皮癌における予後因子の検討, 日本放射線腫瘍学会第32回学術大会, 2019年11月.
10.	川中崇, 久保亜貴子, 外礒千智, 古谷俊介, 生島仁史, 原田雅史 : 当院におけるSAVIアプリケータを用いたAPBIの術式と整合性についての検討, 日本放射線腫瘍学会第32回学術大会, 2019年11月.
11.	古谷俊介, 生島仁史, 外礒千智, 久保亜貴子, 川中崇, 原田雅史 : 非小細胞肺癌能転移に対する全脳照射の局所制御に関する検討, 日本放射線腫瘍学会第32回学術大会, 2019年11月.
12.	外礒千智, 高橋彩加, 久保亜貴子, 川中崇, 古谷俊介, 工藤隆治, 生島仁史, 原田雅史 : 乳房原発悪性リンパ腫の1 例, 第54回日本医学放射線学会秋季臨床大会, 2018年10月.
13.	久保亜貴子, 高橋彩加, 外礒千智, 川中崇, 古谷俊介, 生島仁史, 原田雅史 : 子宮頚部扁平上皮癌放射線治療後局所残存を疑った症例, 2018年10月.
14.	高橋彩加, 川中崇, 外礒千智, 久保亜貴子, 古谷俊介, 生島仁史, 原田雅史 : 乳癌放射線治療後の難治性潰瘍に対して胸壁再建を施行した1 例, 第54回日本医学放射線学会秋季臨床大会, 2018年10月.
15.	久保亜貴子, 生島仁史, 外礒千智, 川中崇, 古谷俊介 : Image registration softwareを用いた子宮頸癌放射線治療の統合線量評価の検討, 2018年6月.
16.	高橋彩加, 古谷俊介, 外礒千智, 久保亜貴子, 川中崇, 生島仁史, 原田雅史, 阿部彰子, 西村正人 : 子宮頸部及び膣の異形成・上皮内癌に対する高線量率小線源治療, 2018年6月.
17.	三橋遼太, 川中崇, 久保亜貴子, 外礒千智, 高橋彩加, 古谷俊介, 生島仁史, 原田雅史 : 子宮頚部小細胞癌に対して放射線治療を行った2症例, 2018年6月.
18.	外礒千智, 久保亜貴子, 川中崇, 古谷俊介, 生島仁史, 原田雅史 : 放射線治療を施行した乳房原発悪性リンパ腫の1例, 2018年5月.