Scores of Child–Pugh Classification Impact Overall Survival After Stereotactic Body Radiation Therapy for Primary and Metastatic Liver Tumors

BackgroundStereotactic body radiotherapy (SBRT) delivers high-dose radiation to tumor tissues in few fractions, thereby reducing radiation damage to at-risk organs. There are more potential effects of SBRT owing to the higher biological equivalent dose delivered. Herein, we retrospectively analyzed its effectiveness and toxicity at our institution.MethodsData from patients with hepatocellular carcinoma (HCC; n = 10) and liver metastases (n = 10) who underwent SBRT (total dose of 30–50 Gy in 5–10 fractions) between 2013 and 2016 were analyzed. Adverse events were recorded at the end of RT, 6 months after treatment, or upon death. Overall survival (OS) was calculated according to the biological effective dose (BED α/β = 10) and liver function (Child–Pugh [CP] classification 5 or 6 vs. 7 or 8) after SBRT, using Kaplan–Meier analyses.ResultsOf the 20 patients, 6 declined the CP classification score after SBRT; grade 3 adverse events were not seen in any patient. A higher OS rate was seen in patients receiving a higher BED and in those with better CP classification after SBRT. Kaplan–Meier survival analysis yielded a median OS of 401 days and 1- and 2-year OS of 45% and 15%, respectively.ConclusionThe higher BED was significantly associated with tumor control, and there were no differences in the tumor control rate between HCC and metastatic tumors. Changes in CP scores after SBRT also affected the survival rate. Good liver function may permit multiple rounds of SBRT

COVID‐19治療後患者に対する廃用リハの重要性

This study examined the effects of rehabilitation on patients after coronavirus disease ２０１９ recovery. ４５ patients（male１８, female ２７, aged ４９‐９７, median：７９ years old）were evaluated for physical and cognitive functions using eight assessment items. We compared and analyzed these data at the time of admission with at the time of discharge, as well as outcome assessment using a performance index. Among the evaluated items, significant improvements were observed in FIM motor（p<０．００１）, cognitive（p<０．００１）, MMSE（p<０．００１）, right hand grip strength（p<０．０１）, left hand grip strength（p<０．００１）, skeletal muscle mass（p<０．０５）, and ６‐minute walk test（p<０．０５）. In addition, the performance index of the subjects was １００．６, which was much higher than the facility standard requirement. Furthermore, it was suggested that the establishment of exercise habits and lifestyle rhythms through rehabilitation may have contributed to the cessation of oxygen administration, insulin and psychotropic medication, it was clarified that the implementation of rehabilitation is effective