Impact of upgraded radiotherapy system on outcomes in postoperative head and neck squamous cell carcinoma patients.

Background: This study was performed to evaluate the impact of upgrade of radiotherapy system, including launch of intensity-modulated radiation therapy (IMRT), on the therapeutic outcomes. Materials and methods: Patients with head and neck (H&N) squamous cell carcinoma (SCC) who underwent postoperative radiotherapy at our hospital between June 2009 and July 2019 were retrospectively reviewed. In July 2014, we converted the radiotherapy technique for these patients from a 3-dimensional conformal radiotherapy (3D-CRT) to IMRT, along with the adoption of a meticulous planning policy and a few advanced procedures, including online imaging guidance. Results: A total of 136 patients (57 treated with the previous system and 79 treated with the upgraded system) were reviewed. There were significantly more patients with extracapsular extension in the upgraded-system group than the previous-system group (p = 0.0021). There were significantly fewer patients with ≥ Grade 2 acute and late adverse events in the upgraded-system group than the previous-system group. The differences in progression-free survival (PFS), distant metastasis-free survival (DFFS), locoregional progression-free survival (LRPFS), and overall survival (OS) between the two groups were not statistically significant (p = 0.8962, 0.9926, 0.6244, and 0.4827, respectively). Multivariate analysis revealed that the upgrade had neither positive nor negative impact on survival outcomes. Extracapsular extension was independently associated with decreased LRPFS and OS (p = 0.0499 and 0.0392, respectively). Conclusions: The IMRT-centered upgrade was beneficial for the postoperative patients with H&N SCC, because survival outcomes were sustained with less toxicities.

Ten-Year Experience of Stereotactic Body Radiotherapy at a Single Institution: Impact of Technological Development on the Outcome of Patients With Early Lung Cancer.

PURPOSE: Advanced radiotherapeutic techniques and apparatus have been developed and widely applied in stereotactic body radiation therapy for early-stage non-small cell lung cancer, but their clinical benefits have not necessarily been confirmed. This study was performed to review our 10-year experience with therapy for the disease and to evaluate whether the advanced radiotherapeutic system implemented in our hospital 5 years after we began the therapy improved the clinical outcomes of patients. MATERIALS AND METHODS: Patients who underwent the therapy at our hospital between April 2008 and March 2018 were retrospectively reviewed. They were divided into 2 groups treated with the conventional system or the advanced system, and the characteristics and clinical outcomes were compared between the groups. The same analyses were also performed in propensity-matched patients from the 2 groups. RESULTS: Among the 73 patients eligible for this study, 42 were treated with the conventional system and 31 with the advanced system. All were treated as planned, and severe adverse events were rare. The local progression-free survival rate in the advanced system group was significantly higher than in the conventional system group (P = 0.025). In the propensity-matched patients, both the local progression-free survival rate and the overall survival rate were significantly higher compared in the advanced system group than the conventional system group (P = 0.089 and 0.080, respectively). CONCLUSION: The advanced system improved the outcomes of patients with the disease, suggesting that technological development has had a strong impact on clinical outcomes.

Comparisons of Usual Dose of Pharmaceutical Products Used in Japan and United States: Can Differences Be Explained by Pharmacokinetics Alone?

BACKGROUND: It is important to examine how a usual drug dose is established in Japan and other countries, and to evaluate that on the basis of pharmacokinetic and pharmacodynamic properties. In the present study, we examined the contributions of area under the curve (AUC) ratio and other factors on differences of usual dose between Japan and the United States. METHODS: We examined drugs approved from January 2008 to January 2011 in Japan and collected related information. For the usual dose set for the same indication in both countries, we compared the maintenance dose values between the countries. We also examined the relationships of AUC ratio and difference of usual dose in both countries. RESULTS: Our results clarified that the usual dose for the same indication is comparable between Japan and the United States for 68.75% of the examined drugs, while that for 31.25% is different. Moreover, among products with different approved doses, the dosage was set higher in the United States for 18.75% and higher in Japan for 12.50%. Our findings indicate that the difference in dose between the countries is associated with AUC ratio for 82.1% and by factors other than AUC ratio for 17.9% of the examined medications. CONCLUSIONS: The approved dose varies between the countries for about one-third of products commonly used. Additionally, it was clarified that not only AUC ratio but also other factors are involved in dosage differences. The present results provide useful information for analysis of factors related to the different usual doses between countries.

Sensory incongruence leading to hand disownership modulates somatosensory cortical processing.

The sense of body ownership is based on integration of multimodal sensory information, including tactile sensation, proprioception, and vision. Distorted body ownership contributes to the development of chronic pain syndromes and possibly symptoms of psychiatric disease. However, the effects of disownership on cortical processing of somatosensory information are unknown. In the present study, we created a "disownership" condition in healthy individuals by manipulating the visual information indicating the location of the subject's own left hand using a mirror box and examined the influence of this disownership on cortical responses to electrical stimulation of the left index finger using magnetoencephalography (MEG). The event-related magnetic field in the right primary somatosensory cortex at approximately 50 msec (M50) after stimulus was enhanced under the disownership condition. The present results suggest that M50 reflects a cortical incongruence detection mechanism involving integration of sensory inputs from visual and proprioceptive systems. This signal may be valuable for future studies of the mechanisms underlying sense of body ownership and the role that disrupted sense of ownership has in neurological disease.

Atypical gaze patterns in children and adults with autism spectrum disorders dissociated from developmental changes in gaze behaviour.

Eye tracking has been used to investigate gaze behaviours in individuals with autism spectrum disorder (ASD). However, traditional analysis has yet to find behavioural characteristics shared by both children and adults with ASD. To distinguish core ASD gaze behaviours from those that change with development, we examined temporo-spatial gaze patterns in children and adults with and without ASD while they viewed video clips. We summarized the gaze patterns of 104 participants using multidimensional scaling so that participants with similar gaze patterns would cluster together in a two-dimensional plane. Control participants clustered in the centre, reflecting a standard gaze behaviour, whereas participants with ASD were distributed around the periphery. Moreover, children and adults were separated on the plane, thereby showing a clear effect of development on gaze behaviours. Post hoc frame-by-frame analyses revealed the following findings: (i) both ASD groups shifted their gaze away from a speaker earlier than the control groups; (ii) both ASD groups showed a particular preference for letters; and (iii) typical infants preferred to watch the mouth rather than the eyes during speech, a preference that reversed with development. These results highlight the importance of taking the effect of development into account when addressing gaze behaviours characteristic of ASD.