Objective: To present the results of the clinical study of carbon ion radiotherapy (CIRT) for skull base and paracervical spine tumors at the National Institute of Radiological Sciences in Chiba, Japan. Methods: The study is comprised of three protocols: a pilot study, a phase I/II dose escalation study, and a phase II study. All the patients were treated by 16 fractions for 4 weeks with total doses of 48.0, 52.8, 57.6, and 60.8 Gy equivalents (GyE). Results: As a result of the dose escalation study of CIRT for skull base tumors, a dose fractionation of 60.8 GyE/16 fractions for 4 weeks was decided as the recommended dose because of acceptable normal tissue reactions and good local tumor control. Conclusions: Preliminary results of the phase II clinical study of CIRT for skull base chordoma showed local control at 5 years at 100%, and normal tissues showed a mild reaction without any severe morbidity of important organs.
Dental College : Various oral mucosal diseases such as oral potentially malignant disorders(OPMD)and squamous cell carcinoma (SCC)may develop in the oral cavity and are difficult to differentiate. Optical instruments are not invasive and can be repeatedly used. Since 2010, we have used optical instruments effectively to improve diagnosis and treatment. In this study, we conducted subjective and objective evaluations using optical instruments for distinguishing between leukoplakia and SCC.Eighty-two patients diagnosed with SCC and leukoplakia at the Department of Oral and Maxillofacial Surgery, Tokyo Dental College, between April 2017 and March 2018 were selected and evaluated using optical instruments. Also, an oral cancer screening model that used AI(AI oral cancer screening system:AIOS)was prepared and its effectiveness was evaluated.In the subjective evaluation by optical instruments, Fluorescence Visualization Loss(FVL)was confirmed in all SCC cases. In the objective evaluation, SCC was lower than leukoplakia in luminance(SCC 52.6 vs Leukoplakia 74.5cd/m 2 ) . In the coefficient of variation of luminance, SCC was higher than leukoplakia in luminance(SCC 0.22 vs Leukoplakia 0.12) . Regarding luminance ra-
Oral cancer screening is important for early detection and early treatment, which help improve survival rates. Biopsy is invasive and painful, while fluorescence visualization using optical instruments is non-invasive, convenient, and provides results in real time, and examinations can be repeated. The purpose of this study was to determine the usefulness of optical instruments in oral screening. A total of 314 patients who were examined using optical instruments at Tokyo Dental College between 2014 and 2018 were enrolled in this study. Fluorescence visualization images were analyzed using subjective and objective evaluations. Subjective evaluation for detecting oral cancer offered 98.0% sensitivity and 43.2% specificity. Regarding the objective evaluations for detecting oral cancer, sensitivity and specificity were 61.9% and 62.7% for mean luminance, 90.3% and 55.7% for luminance ratio, 56.5% and 67.7% for standard deviation of luminance, and 72.5% and 85.4% for coefficient of variation of luminance. Fluorescence visualization with subjective and objective evaluation using optical instruments is useful for oral cancer screening.
To determine the 'hard palate representing' area in the primary somatosensory cortex, we recorded somatosensory-evoked magnetic fields from the cortex in ten healthy volunteers, using magnetoencephalography. Following electrical stimulation of 3 sites on the hard palate (the first and third transverse palatine ridges, and the greater palatine foramen), magnetic responses showed peak latencies of 15, 65, and 125 ms. Equivalent current dipoles for early magnetic responses were found along the posterior wall of the inferior part of the central sulcus. These dipoles were localized anterior-inferiorly, compared with locations for the hand area in the cortex. However, there were no significant differences in three-dimensional locations among the 3 selected regions for hard palate stimulation. These results demonstrated the precise location of palatal representation in the primary somatosensory cortex, the actual area being small.
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