Changes in Knowledge Levels through Lectures on Radiotherapy to Nursing Students in Japan

Background:Recently, the number of patients choosing radiotherapy is increasing in Japan. It is necessary for even nurses to have knowledge of radiotherapy. We measured the degree of awareness with a lecture on how a nursing student can obtain knowledge of radiotherapy.Materials and methods: Forty nursing students who were in their third year and preparing for their national nursing certification in two months were recruited. The 90-min lecture covered a range of topics from general theories to specific concepts. The students were not informed that they would be required to fill a survey at the end of the lecture. This was to avoid bias that could occur from knowing in advance that a survey would be conducted.Results: The following items below were particularly remarkable. The distinction between the radiologist and the radiation oncologist. The radiotherapy is a local therapy. The pain from bone metastasis could be relieved.Conclusion: Students had very little knowledge on radiotherapy before the lecture. the results of this study indicated the need to increase the number of lectures on radiotherapy for nursing as well medical students. As the number of radiotherapy patients increases

Comparison of Conventional 2D CC (Cranio-Caudal) + MLO (Medio-Lateral Oblique) Bi-Directional Photography and 2D-MLO + DBT-MLO (Digital Breast Tomosynthesis) in Mammography Examination

Introduction: Mammography (MMG) is an excellent examination for breast cancer detection and is widely used in both screening and clinical practice. However, the breast thickness and background the concentration of the mammary gland is large among individuals, and the mammary gland and cancer may overlap and it may not be possible to point out a lesion. In recent years, digital breast tomosynthesis (hereinafter referred to as DBT) has been introduced to solve these problems, and its usefulness has been reported in clinical practice. Therefore, in anticipation of a higher cancer detection rate etc., we compared the conventional 2D CC + MLO 2-way MMG examination with 2DMLO + DBTMLO 2-way MMG examination.Materials and Methods: The combination of 2D CC + MLO and 2DMLO + DBTMLO was read for 95 cases of breast cancer taking 2D CC and MLO and DBT MLO from May 2016 to October 2017. It was judged that the category 3 or more required detailed examination, cancer detection, and cancer detection rates were compared. Subjects were 28 to 87 years of age (median: 55 years), breast composition: high concentration 15.8% (15 cases), heterogeneous high concentration 47.4% (45 cases), mammary gland 28.4% (27 cases), Fatty was 8.4% (8 cases).Results: The cancer detection rate was 87% for the 2D CC + MLO combination and 94% for the 2DMLO + DBTMLO combination in 95 cases of breast cancer. The interpretation time was 95 minutes for the 2D CC + MLO combination and 110 minutes for the 2DMLO + DBTMLO combination.The breast cancer detected only by the combination of 2D CC + MLO was scattered in 1 case and was classified as Category 3 by FAD. Breast cancer detected only by the combination of 2DMLO + DBTMLO: 8 cases with uneven distribution of breast composition, 3 cases with scattered mammary gland, 3 cases with 5 cases with disordered construction, Category 4 with 3 cases with FAD was.Conclusion: Both 2D CC + MLO combination and 2DMLO + DBTMLO combination are considered useful for screening MMG examination. In particular, we would like to consider the introduction to medical examinations for the addition of MMG in DBT, but the issue of the amount of image information, the problem of exposure to radiation, the direction of imaging, the establishment of interpretation methods etc. are future issues

Usefulness of diffusion-weighted magnetic resonance imaging for evaluating the effect of hemostatic radiotherapy for unresectable gastric cancer

There are several reports that vouch for the usefulness of diffusion-weighted image (DWI) in making a diagnosis before treatment. However, no study has evaluated the effect of radiotherapy (RT) for unresectable gastric cancer. In the present case report, we evaluated the effectiveness of RT using DWI. An 81-year-old man was hospitalized with a broken bone and then diagnosed with advanced gastric cancer with breeding. He had chorionic renal failure and surgery was impossible. Further, contrast-enhanced computed tomography and magnetic resonance imaging (MRI) were not performed due to renal failure, whereas palliative RT was performed. We followed up the patient using blood test and MRI (DWI) to estimate whether bleeding had stopped or not after radiotherapy. Hemostasis effect was found after 2 weeks of RT. In DWI examination, there was a decrease in the tumor signal intensity 30 days after RT. Similarly, at day 60, the tumor signal intensity further decreased on DWI and the blood test results indicated no progression of anemia. At 4 months after the RT, the patient died because of respiratory failure without any bleeding. DWI is useful not only for the initial diagnosis but also for evaluating the effectiveness of RT.Trial registration: National clinical study registered number: UMIN000026362

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

Stereotactic body radiation therapy to the spine: contouring the cauda equina instead of the spinal cord is more practical as the organ at risk

Background: Stereotactic body radiotherapy (SBRT) is recognized as a curative treatment for oligometastasis. The spinal cord becomes the cauda equina at the lumbar level, and the nerves are located dorsally. Recently, a consensus has been reached that the cauda equina should be contoured as an organ at risk (OAR). Here, we examined the separate contouring benefits for the spinal canal versus the cauda equina only as the OAR. Materials and methods: A medical physicist designed a simulation plan for 10 patients with isolated lumbar metastasis. The OAR was set with three contours: the whole spinal canal, cauda equina only, and cauda equina with bilateral nerve roots. The prescribed dose for the planning target volume (PTV) was 30 Gy/3 fx. Results: For the constrained QAR doses, D90 and D95 were statistically significant due to the different OAR contouring. The maximum dose (Dmax) was increased to the spinal canal when the cauda equina max was set to ≤ 20 Gy, but dose hotspots were observed in most cases in the medullary area. The Dmax and PTV coverage were negatively correlated for the cauda equina and the spinal canal if Dmax was set to ≤ 20 Gy for both. Conclusions: A portion of the spinal fluid is also included when the spinal canal is set as the OAR. Thus, the PTV coverage rate will be poor if the tumor is in contact with the spinal canal. However, the PTV coverage rate increases if only the cauda equina is set as the OAR

A Research on a New Science Curriculum Development Based on ‘Nature Of Science’ Ⅲ : Reconstruction of a Coherence Science Curriculum from Elementary School to Upper Secondary School

本研究は，新しい科学観を取り入れた小学校から高等学校までの理科カリキュラムを開発することを目的としており，今年度は３年次にあたる。これまでの成果と課題をもとに，初等・中等教育で一貫して「科学の本質」を学ぶためのフレームワーク構築に向け，小学校から高等学校を通じて系統的に取り扱うことが可能な内容について検討を行った。 中学校における実践からは，理科教師が，科学者コミュニティーによる知，政策決定者や教師たちによる教えるべき知，児童・生徒の発達段階や文脈などを考慮した教える知，について可能な限り熟知する必要があることが示唆された。また，論証活動を行う際の，教師の振る舞い方も重要であることも明らかとなった。 また，小学校における実践では，学年による差異はあるものの，見たことや考えたことの違いを次第に意識化させることによって，観察や実験等のレポートの書き方の指導にも繋がることが明らかとなった。 以上の実践より，科学の本質を初等・中等教育で一貫して教えるためには，これまでの実践の視点の変容に基づく教師による授業方略の在り方や投げ込み的教材を使用する教師の意図が，いかに重要であるかを示唆している。This study develops a new science curriculum for elementary to upper secondary schools which include the concept of the “Nature of Science”. We examined possible content to build a systematic framework for mentioned above science education. The practice at junior high school shows that teachers should be familiar with scholarly knowledge, knowledge to be taught by the policy makers and teachers, and taught knowledge which students understand through learning along with the students’ ages and contexts. The teacher’s behavior in argumentation by pupils is also important. The practice at elementary school shows that perceptions of the crucial distinction between inference and observation lead students to write good reports. These practices exemplify that teaching Nature of Science consistently to elementary and lower secondary students should largely depend on the teachers’ methods of instruction and what material they develop from a new viewpoint

Changes in patients’ quality of life during radiotherapy and 1 month after treatment

BackgroundThe EORTC QLQ-C30 quality of life (QOL) questionnaire is designed to measure cancer patients’ physical, psychological, and social functions. There are few reports on the impact of radiotherapy (RT) on QOL; thus, we investigated QOL changes during the RT period and 1 month after RT.MethodsWe scored EORTC QLQ-C30 (version 3.0) questionnaires from 66 patients. The questionnaire contained 30 items, including 1 item on financial concerns, a global health domain, 5 functional domains, 3 symptom domains, and 5 single-symptom items. Assessments were performed before RT, at the end of the day after RT, and 1 month after RT. Correlations between the patients’ characteristics (e.g., age, sex, organ, RT response) and QOL change were evaluated.ResultsNo specific patient characteristic significantly correlated with a QOL change during RT. In 15 QLQ-C30 items, those items in which the change in score achieved statistical significance (P < 0.05) were the following: physical function was improved from the end of RT to 1 month after RT; role function worsened from the end of RT to 1 month after RT; and emotional function worsened from the start of RT to 1 month after RT.ConclusionsThe QOL was poorest at the end of RT. If treatment was completed, physical function improved, but role function and emotional function worsened just 1 month after treatment. For role and emotional function, observation by medical staff is necessary

Investigation of the changes in the prostate, bladder, and rectal wall sizes during external beam radiotherapy

Aim and backgroundThe change in the prostate size for radiotherapy has not yet been elucidated. The coverage of radiation dose is affected by changes in the prostate size. We evaluated the changes in the prostate, rectum, and bladder wall sizes during IMRT of fraction 2Gy/day using MRI.Materials and methodsTwenty-four patients with prostate cancer were enrolled in this study. MRI was performed at three time points. While the initial MRI was performed before the start of radiotherapy (RT), the second MRI was performed at 38Gy (range: 36–40Gy), which represented the halfway point of the RT course. The last MRI was performed on the day of completion of the RT course (76Gy; range: 74–78Gy). We estimated the prostate, rectum, and bladder wall sizes at three time points.ResultsWe observed no significant difference between the estimated sizes of the prostate during RT in all three phases. In addition, the volume of the rectal wall remained unchanged in all phases. However, the volume of the bladder wall significantly decreased from the initial to the last time points. Furthermore, the standard deviation (SD) obtained by subtracting the final size from the initial one was large (mean, 30.1; SD, 10.1).ConclusionsThe volume of the bladder wall decreased during IMRT. The range of subtraction of the volume of the bladder wall was extensive. Thus, the estimation of the bladder wall may be useful to reduce the inter-fraction variation