http://hdl.handle.net/10564/4183 2022-06 2026-04-10T15:30:17Z http://hdl.handle.net/10564/4189 タイトル: A Case Of Nivolumab-Induced Immune-Related Adverse Event In The Upper Gastrointestinal Tract In Recurrence/Metastatic Head And Neck Cancer. 著者: Iwakura, Shinya; Okamoto, Hideyuki; Otsuka, Shintaro; Miyahara, Hiroshi; Uemura, Hirokazu; Kitahara, Tadashi; Okazaki, Shunsuke 抄録: A 61-year-old male patient underwent partial glossectomy and right neck dissection for tongue cancer cT2N1MO. Because of the locoregional recurrence, the patient received neoadjuvant chemotherapy followed by subtotal glossectomy, neck dissection, and reconstruction. However, new locoregional lesions and distant metastasis were detected during postoperative chemotherapy. Seven courses of nivolumab were administered, but the tumor grew. Hence, the chemotherapy regimen was switched to paclitaxel and cetuximab. After eight courses of this regimen, leakage of liquid enteral nutrients around the gastrostoma began, and the patient was hospitalized urgently due to severe abdominal distension and nausea. Upper gastrointestinal endoscopy revealed edematous esophageal and gastric mucosa covered with white coating spots. Histopathological examination of the duodenal mucosa specimen showed CD8-+ natural killer (NK) T-cells infiltrating the lamina propria mucosae, which corresponded with an immune-related adverse event (irAE). Pulse steroid therapy significantly improved the findings of upper gastrointestinal endoscopy and symptoms. 2022-06-29T15:00:00Z http://hdl.handle.net/10564/4188 タイトル: Study Of Factors Promoting And Hindering Subjective Well-Being Among Institutionalized Older Adults In Japan. 著者: Kimura, Mitsuo; Sawami, Kazue 抄録: Objective: This study aimed to examine the factors that promote or inhibit subjective well-being among Japanese older adults. Methods: Factors that promote or hinder subjective well-being among residents of Japanese senior care facilities were identified and analyzed based on the background and characteristics of the Japanese people. Results: Factors found to promote subjective well-being included a total of 23 items related to age and physical and mental health, functions and roles in life, health and vitality, participation and perception of roles, level of freedom in activities and level of staff responsiveness, and connection with nature. The inhibiting factors included 14 items related to aging, morbidity, pain, decreased mental and physical functions that inhibit activities, and dissatisfaction with family and facilities. Conclusion: The subjective well-being of the institutionalized elderly in Japan is promoted when the degree of freedom at the behavioral level is high and inhibited when it is low. In addition, because of the Japanese elderly's unique traditions, culture, and lifestyle, they are less receptive to care from others outside the family, making institutionalization an inhibiting factor for their subjective well-being. In this context, it is useful older adults to acquire new roles and thereby recognize their dignity. 2022-06-29T15:00:00Z http://hdl.handle.net/10564/4187 タイトル: Carboplatin-Paclitaxel Chemoradiotherapy With 66 Gy For Elderly Patients With Locally Advanced Non-Small-Cell Lung Cancer. 著者: Miura, Sachiko; Inoue, Kazuya; Hontsu, Shigeto; Tanaka, Hiroaki; Miyauchi, Masaki; Yamaki, Kaori; Inoue, Masayoshi; Asakawa, Isao; Tamamoto, Tetsuro; Hasegawa, Masatoshi 抄録: Background/ Aim: The common radiation dose administered with chemoradiotherapy for stage III non-small-cell lung cancer (NSCLC) is 60 Gy. We aimed to examine the feasibility and effectiveness of carboplatin-paclitaxel chemoradiotherapy with 66 Gy for elderly NSCLC patients. Patients and Methods: Forty-five patients with stage III NSCLC were enrolled from 2011 to 2014 at our hospital. They were divided into three groups according to their status and underwent different treatments. Overall survival (OS), progression-free survival (PFS), and local control (LC) were determined. Toxicity was evaluated with NCI-CTCAE ver. 4.0; intergroup differences were analysed statistically. Results: The group receiving carboplatin-paclitaxel chemotherapy with 66 Gy showed the longest median OS (40.4 months), PFS (17.9 months), and LC (44.3 months). Toxicity was acceptable in all groups. Conclusion: For elderly patients with stage III NSCLC, carboplatin-paclitaxel chemoradiotherapy with 66 Gy is suggested to be feasible and effective. 2022-06-29T15:00:00Z http://hdl.handle.net/10564/4186 タイトル: Biological Dose Evaluation Of Radiotherapy By Equivalent Dose In 2Gy Fractions (EQD2) In Recurrent Glioblastoma. 著者: Yamaki, Kaori; Wakai, Nobuhide; Matsuda, Ryosuke; Miyasaka, Toshiteru; Inooka, Nobuyoshi; Inoue, Kazuya; Miura, Sachiko; Asakawa, Isao; Hasegawa, Masatoshi 抄録: The standard treatment for glioblastoma is surgery followed by radiation therapy (RT) and temozolomide (TMZ) chemotherapy. A total dose of 60 Gy given in 2 Gy fractions (fr) with concurrent and adjuvant TMZ has been recommended; however, local recurrences are frequent and the prognosis remains very poor. In this study, the equivalent dose in 2Gy fr (EQD2) at the recurrent site of glioblastoma was assessed to evaluate the biological effect of RT on glioblastoma considering that α/β ratios might vary from 1 to 10 Gy. Recurrences were found in gross tumor volume (GTV) areas in all 11 patients, and 8 of them also showed recurrence in clinical target volume (CTV). Differences in EQD2 according to α/β ratios were relatively small in high-dose areas around 60 Gy; however, low-dose areas often showed significant differences of EQD2 according to the α/β ratios. In patients that received 60 Gy in 2 Gy fr, EQD2 was less than the original physical dose and became smaller as the α/β ratio became smaller. The comparison of the dose distribution of EQD2 and dose volume histogram (DVH) of EQD2 between α/β ratios 1 and 10 suggested that little difference was found in relatively high-dose areas but a significant difference was found in low-dose areas. In contrast, if the fraction size was larger than 2 Gy, EQD2 was greater than the original physical dose and it became larger as the α/β ratio became smaller. In conclusion, this study showed that the standard RT 60 Gy in 2 Gy fr is insufficient for glioblastoma, and it suggested that biological effects might differ significantly according to each fraction size of radiation and α/β ratio of the linear quadratic (LQ) model. 2022-06-29T15:00:00Z