Successful Treatment of Epilepsy by Resection of Periventricular Nodular Heterotopia

We report on a case of successful surgical treatment of drug-resistant epilepsy associated with a solitary lesion of periventricular nodular heterotopia (PNH). In the reported patient, intracranial ictal electroencephalography disclosed that seizures did not originate from the heterotopic nodules. However, the seizures were completely suppressed by lesionectomy of PNH alone. Epileptogenesis associated with PNH likely involves a very complex network between PNH and the surrounding cortex, and the disruption of this network may be an effective means of curing intractable, PNH-associated epilepsy

Biological Dose Evaluation Of Radiotherapy By Equivalent Dose In 2Gy Fractions (EQD2) In Recurrent Glioblastoma.

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

中枢神経系原発悪性リンパ腫の放射線治療個別化の妥当性と有用性：画像評価を用いた治療効果に基づく放射線治療計画

Background: To assess the feasibility and efficacy of individualized treatment selection in radiation therapy (RT) for primary central nervous system lymphoma (PCNSL) according to treatment response by radiographic assessment. Methods: The details of recurrence and change in performance status (PS) were assessed in 31 patients with histologically confirmed PCNSL treated between 2000 and 2016. During the treatment period, radiographic assessment was conducted, and RT planning (RTP) was determined individually by treatment response. Results: At a median follow-up of 28.2 months, 9 patients were alive and 7 of whom were relapse-free. Two-year overall survival (OS) and progression-free survival (PFS) rates were 69.3% and 52.7%, with median survival times (MSTs) of 36.5 months and 24.4 months, respectively. Two-year local recurrence rate was 40.5% and the median time to local recurrence from treatment initiation was 27.9 months. All patients were scheduled to receive whole-brain RT (WBRT) and subsequent partial-brain RT(PBRT), with a median total dose to the tumor bed of 46 Gy and median WBRT dose of 30 Gy. Eight patients received reduced-dose WBRT (rd-WBRT) (<30 GY), and 13 patients who could not achive a complete response (CR) during the RT period received additional boost radiation after WBRT and PBRT, with a median dose of 6 Gy. Over 70% of local recurrence occurred within areas in which only WBRT was conducted (median dose of 30.3 Gy). Two-year occurrence rate of neurotoxicity over grade 2 was 49.5%. PS at 24 months after RT was maintained in 12 patIents. Conclusions: lndividual RTP using radiographic assessment led to reasonable survival and disease control rates with mild treatment-related toxicity. For patients not receiving chemotherapy or lacking a CR after chemotherapy and WBRT, WBRT followed by PBRT and additional boost radiation for poor RT responders might be effective. However, even for patients with CR after chemotherapy, a WBRT dose of 30 Gy or higher might be necessary for local control.博士（医学）・甲第705号・平成31年3月15

Childhood cancer incidence and survival in Japan and England: A population-based study (1993-2010).

The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population-based cancer registry data. The analysis was based on 5192 children with cancer (age 0-14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993-2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan-Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5-year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5-year survival remained less than 80% in 2005-2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1-14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib)

がん登録データを用いた、小児がんの罹患率・死亡率の日英比較（1993-2010年）

The present study aimed to compare cancer incidence and trends in survival for children diagnosed in Japan and England, using population-based cancer registry data. The analysis was based on 5192 children with cancer (age 0-14 years) from 6 prefectural cancer registries in Japan and 21 295 children diagnosed in England during 1993-2010. Differences in incidence rates between the 2 countries were measured with Poisson regression models. Overall survival was estimated using the Kaplan-Meier method. Incidence rates for Hodgkin lymphoma, renal tumors and Ewing sarcomas in England were more than twice as high as those in Japan. Incidence of germ cell tumors, hepatic tumors, neuroblastoma and acute myeloid leukemia (AML) was higher in Japan than in England. Incidence of all cancers combined decreased in Japan throughout the period 1993 to 2010, which was mainly explained by a decrease in registration of neuroblastoma in infants. For many cancers, 5-year survival improved in both countries. The improvement in survival in chronic myeloid leukemia (CML) was particularly dramatic in both countries. However, 5-year survival remained less than 80% in 2005-2008 in both countries for AML, brain tumors, soft tissue sarcomas, malignant bone tumors and neuroblastoma (age 1-14 years). There were significant differences in incidence of several cancers between countries, suggesting variation in genetic susceptibility and possibly environmental factors. The decrease in incidence for all cancers combined in Japan was related to the cessation of the national screening program for neuroblastoma. The large improvement in survival in CML coincided with the introduction of effective therapy (imatinib).博士（医学）・乙第1425号・平成31年3月15日© 2017 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.This is an open access article under the terms of the Creative Commons Attribution License(https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited

μSR study of Al-0.67%Mg-0.77%Si alloys

Zero-field muon spin relaxation measurements were carried out with Al-0.67%Mg- 0.77%Si alloys in the temperature range from 20 K to 300 K. Observed relaxation spectra were compared with the relaxation functions calculated by a Monte Carlo simulation with four fitting parameters: the dipolar width, trapping rate, detrapping rate and fraction of initially trapped muons. From the fitting, the temperature variations of the trapping rates reveal that there are three temperature regions concerning muon kinetics. In the low temperature region below 120 K, muons appeared to be trapped in a shallow potential yielded by dissolved Mg atoms, and thus little effect of heat treatment of the samples was observed, while in the mid and hightemperature regions, the trapping rates clearly depended on the heat treatment of the samples suggesting muon-cluster and/or muon-vacancy interactions