Radiation Oncology

We provide safe and high-quality radiation therapy.

Kobe City Medical Center General Hospital
Radiation Oncology Director

Masaki Kokubo

Cancer has been the leading cause of death in Japan since 1980, and with the advent of an aging society, the number of cancer patients is increasing.

Radiation therapy is one of the three pillars of cancer treatment along with surgery and chemotherapy. Radiation therapy has the characteristic of being less invasive compared to others, and has the following major advantages.

1. It is excellent in preserving function and shape because it treats without resecting the affected area.
2. Treatment can be performed even in difficult-to-operate sites.
3. Compared to surgery and chemotherapy, the burden on the body is less, and it can be applied to patients with complications and the elderly.

Radiation therapy, when combined with anticancer drugs, enables radical treatment without cutting, and when combined with surgery, it plays a major role in reducing the extent of resection and preventing recurrence. Palliative treatment for bone metastasis and brain metastasis also contributes to maintaining quality of life (QOL). Radiation therapy is a very good option for those who cannot undergo surgery due to old age or heart failure, or who do not want complications from surgery. In recent years, along with the development of IT technology, the development and progress of treatment equipment and treatment technology has progressed dramatically, and high-precision radiation therapy such as minimally invasive intensity-modulated radiation therapy (IMRT) and stereotactic radiation therapy (pinpoint irradiation) has become widespread. I have.

In our department, we use three high-precision radiotherapy devices to treat various malignant tumors (solid tumors, hematologic tumors, and sarcomas). We offer a wide range of treatments, including internal therapy for resistant prostate cancer bone metastasis, radiation therapy for benign tumors such as acoustic neuroma, arteriovenous malformation (AVM), thyroid eye disease, and benign diseases such as keloids.

​Radiation Therapy Center was established in April 2008, and currently provides treatment with a multidisciplinary team including eight radiation therapists (four radiation oncologists), nine dedicated radiation therapy technicians, one dedicated medical physicist, and three nurses (one certified nurse for cancer radiation therapy). The center is also certified as a facility by the Japan Society for Radiation Oncology, and provides high-quality medical care.

Medical record

Radiation therapy cases per year

The number of radiation therapy treatments performed each year is approximately 500 for new patients, and approximately 600 in total.

Number of irradiations by primary site/special/high-precision radiotherapy

The number of irradiation cases by primary site and by special/high-precision radiation therapy over the past five years is shown below. In particular, we are actively conducting high-precision radiation therapy.

By primary site

Special/high-precision radiotherapy

Departmental statistics

Main diseases/treatments

Main diseases and their treatment

Treat almost all malignancies. Indications for radiotherapy are determined by considering the type, localization, tissue type, degree of progression, and size of the primary organ of the malignant tumor, as well as the age, condition, medical history, and wishes of the patient.

Applicable diseases: brain tumor, head and neck tumor, lung cancer, breast cancer, esophageal cancer, liver cancer, pancreatic cancer, gynecological cancer, prostate cancer, skin cancer, sarcoma, bone metastasis, etc.

Irradiation method and duration will be decided after consultation between the patient and the attending physician at the pre-radiation examination. The irradiation dose and irradiation period for each disease are guidelines, and the optimum irradiation dose and irradiation period are determined according to the patient's condition.

brain tumor

There are various types of brain tumors, and they can be roughly divided into two types: primary brain tumors that originate from within the skull and metastatic brain tumors that have spread to the brain from cancer in other parts of the body. Both brain tumors are indicated for radiation therapy, but there are cases where radiation therapy is used alone, and there are cases where radiation is performed after surgery. The irradiation dose is 20Gy to 60Gy, and the irradiation period is about 1 to 6 weeks.

head and neck tumor

Chemoradiotherapy combined with anticancer drugs is one of the standard treatments for tumors that occur in the head and neck, such as laryngeal cancer and pharyngeal cancer. Early-stage glottic cancer can be cured with radiotherapy alone. Surgery may require removal of the larynx, while radiotherapy may allow the preservation of the larynx (speech preservation). Chemoradiation therapy may also be given to prevent recurrence after surgery. Intensity-modulated radiation therapy (IMRT) is used for treatment, and the irradiation dose is 50 to 70 Gy, and the irradiation period is about 5 to 7 weeks.

lung cancer

For early-stage lung cancer, when surgery is difficult due to the patient's condition, stereotactic body radiotherapy (SBRT) is performed as a definitive treatment. SBRT for early-stage lung cancer has been reported to have the same treatment results as surgery, and the treatment period is about 1 to 2 weeks. Furthermore, for locally advanced lung cancer, if surgery is difficult, chemoradiotherapy combined with anticancer drugs is performed with the aim of radical cure. Intensity-modulated radiation therapy (IMRT) is often used for treatment, with a dose of 60 Gy and a duration of about 6 weeks. In advanced stages, radiation therapy may also be used to alleviate symptoms. In the treatment of lung cancer, we have participated in many clinical trials and clinical trials.

breast cancer

After surgery for breast cancer, radiotherapy is performed to prevent local recurrence. If necessary, the irradiation range may be expanded to areas with lymph nodes. The conventional irradiation dose is 50Gy to 60Gy, and the irradiation period is about 5 to 6 weeks, but if a short-term irradiation is desired, the dose per time may be increased to about 3 weeks. Only for target patients, we may have them participate in a clinical trial and perform ultra-short-term irradiation for one week.

Esophageal cancer

The treatment of esophageal cancer varies greatly depending on the stage of the disease. Depending on the patient's condition, we will consult with the gastroenterological surgery, Gastroenterology and Oncology doctor to select the most appropriate treatment. Chemoradiotherapy is a local treatment method similar to surgery, but it has the advantage of preserving organ function and morphology compared to surgery. The irradiation dose is 50Gy to 60Gy, and the irradiation period is about 5 to 6 weeks. In addition, palliative irradiation may be performed for dysphagia, which makes it difficult to swallow food, for the purpose of alleviating symptoms.

liver cancer

The main treatments for early liver cancer are surgery, radiofrequency ablation, and hepatic artery chemoembolization. If other treatments are difficult due to the patient's condition or tumor condition/position, stereotactic body radiotherapy (SBRT) may be used. The irradiation dose is 40 Gy, and the irradiation period is about one week.

pancreatic cancer

Surgical resection is the standard treatment for pancreatic cancer, but preoperative irradiation combined with anticancer drugs may be performed to ensure surgical resection. Chemoradiation therapy may also be used in cases where surgery is difficult. The irradiation dose is 40Gy to 50Gy, and the irradiation period is about 4 to 6 weeks.

gynecological cancer

Gynecologic cancers such as cervical cancer also differ greatly in treatment depending on the stage. Surgery is performed in the early stages, but chemoradiotherapy combined with anticancer agents is performed in the disease stage when the lesion has spread to some extent. Radiation therapy uses a combination of external irradiation, which includes the pelvic lymph node area, and intracavitary irradiation, which irradiates the uterus and vagina from the inside. The irradiation dose is 40Gy to 60Gy, and the irradiation period is about 4 to 6 weeks.

prostate cancer

For prostate cancer, radiation therapy is one of the standard curative treatments, just like surgery. Depending on the stage of the disease, hormone therapy is administered for a certain period before and after radiation therapy. Intensity-modulated radiation therapy (IMRT) is used for treatment, with an irradiation dose of 66Gy to 78Gy and an irradiation period of about 6 to 8 weeks. In some cases, the dose per session is increased and the treatment is performed for a short period of about 4 weeks.

bone metastasis

Bone metastasis occurs when cancer spreads through the bloodstream to the bone. If bone metastasis progresses despite drug therapy and pain begins to appear, radiation therapy is performed to alleviate symptoms. Pain is relieved in 70% of patients treated with radiotherapy. The irradiation dose is 20Gy to 30Gy, and the irradiation period is about 1 to 2 weeks. If there are few bone metastases, treatment aiming at radical cure by stereotactic body radiation therapy (SBRT) may be performed.

relaxation irradiation

Irradiation is performed with the aim of relieving various symptoms (pain, bleeding, passage obstruction, airway obstruction) due to the progression of cancer. If it is determined that the symptoms can be alleviated by irradiation, irradiation is possible at any site. The irradiation dose is 20Gy to 50Gy, and the irradiation period is about 1 to 3 weeks.

Benign tumor/benign disease

Radiation therapy may also be used for benign tumors such as meningioma and acoustic neuroma when surgery is difficult. It is an effective treatment that can stop the growth of long-term tumors. We also perform radiotherapy for benign diseases such as cerebral arteriovenous malformation (AVM), thyroid eye disease, and keloids.

Other treatments

In addition, we perform whole body irradiation as a pretreatment for leukemia treatment, intracavitary irradiation using iridium 192, and treatment of castration-resistant prostate cancer with bone metastasis using radium chloride 223Ra.

High-precision radiotherapy

In our department, we actively perform high-precision radiotherapy, stereotactic brain radiotherapy (SRT) for small intracranial lesions, and stereotactic body radiotherapy (SBRT) for small lesions in the trunk. , Intensity-modulated radiation therapy (IMRT/VMAT) is performed for tumors in close proximity to normal organs. As a special treatment, we perform whole body irradiation as a pretreatment for bone marrow transplantation and intracavitary irradiation for gynecologic cancer.

Stereotactic radiotherapy (SRT)

Stereotactic radiotherapy is a treatment method that irradiates a small lesion in the skull with pinpoint radiation from multiple directions, thereby reducing the radiation dose to the normal part of the brain and irradiating a large amount of radiation to the lesion. . Treatment is performed once to several times depending on the type, size, location and symptoms of the lesion. A mask that holds the head in place is worn so that the lesion can be accurately targeted. Treatment time is 30-60 minutes per session.

Target diseases include primary brain tumors (malignant and benign), metastatic brain tumors, and cerebral arteriovenous malformations.

Stereotactic body radiation therapy (SBRT)

This is a treatment that applies the technology of stereotactic brain radiotherapy to the trunk, and is a treatment method in which highly precise and concentrated radiation is applied to lesions in the chest and abdomen. Treatment is performed in 4 to 10 times depending on the type, size and location of the lesion. Although it depends on the disease, local control can be expected in about 80% to 90% of patients.

The target diseases are primary, metastatic lung or liver tumors, metastatic spinal tumors and oligometastases (oligometastases).

Intensity Modulated Radiation Therapy (IMRT)

It is a treatment technique that uses radiation whose intensity is adjusted spatially and temporally using a dedicated computer. Even if the tumor has an irregular or complicated shape, it is possible to irradiate nearby normal organs without increasing side effects. In order to accurately target the lesion, we create a mask that fixes the head and shoulders and a special cushion that fixes the body. Because of the extremely high precision of the treatment, it takes time to plan the treatment and verify its accuracy. Health insurance coverage is for localized solid malignant tumors, and the main target diseases are primary brain tumors, head and neck cancer, lung cancer, prostate cancer, and gynecologic cancer. If we judge that the merits of IMRT can also be used for other malignant tumors, we are actively doing it.

Comparison of fixed multifield irradiation (left) and IMRT (right) for prostate cancer

This is a comparison of conventional fixed multifield irradiation (left figure) and IMRT (right figure) for prostate cancer. The red part is the high dose part. The prostate (the part you want to treat) receives an adequate dose with either method. However, for the rectum, where side effects are likely to occur, high doses are observed in fixed multifield irradiation, but can be suppressed by using IMRT.

Intensity-modulated rotational radiation therapy (VMAT)

Intensity-modulated rotational radiation therapy (VMAT) is an application of IMRT, in which the radiation therapy device is rotated while changing the rotation speed and dose rate to perform IMRT. With this method, it is possible to shorten the treatment time while achieving a dose distribution equivalent to or better than that of conventional IMRT.

clinical research

clinical trial

Clinical research is medical research conducted on human subjects. There are various clinical studies such as observational studies and intervention studies. Clinical trials are intervention studies in which treatment or guidance is given and the results are evaluated. Furthermore, among clinical trials, clinical trials are conducted to obtain approval from the government for the manufacture and sale of new drugs and medical devices.

The Radiation Oncology is based on the hospital's basic policy of "Working on advanced and advanced medical care to fulfill its function as a core hospital" and "Aiming to improve the level of medical care and enhancing staff training, education, and research." , We are working on various clinical research independently or jointly with other facilities.

In particular, our department has been approved as the only participating facility from our hospital to the Japan Clinical Oncology Group ( JCOG), the largest clinical trial group in Japan, and has cooperated and contributed to various clinical trials. rice field. For applicable patients, we actively propose participation in new clinical trials, including those conducted by the same group. Participation in clinical trials and trials is based on the patient's own free will, so please do not hesitate to contact us if you have any questions. If you do not wish to participate, we will provide standard treatment at our hospital.

We are also working on observational studies that use existing clinical information (information obtained in daily clinical practice) to examine the progress and the effects and influences of medical care. We ask for your understanding of the purpose of this research and for your cooperation.

Ongoing clinical trials

Ongoing observational studies

Ongoing clinical trials

There are no clinical trials conducted by our department. We are conducting the following clinical doctor for which other clinical departments serve as investigators.

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