Koji Kawaguchi

Publications (10) View all

• Article: Stereotactic radiosurgery in combination with chemotherapy as primary treatment for head and neck cancer.

  Koji Kawaguchi, Kengo Sato, Hiroyuki Yamada, Akihisa Horie, Takayoshi Nomura, Susumu Iketani, Ikuyo Kanai, Satoshi Suzuki, Yasunori Nakatani, Yoshiki Hamada
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  ABSTRACT: The purpose of this study was to investigate the effect of stereotactic radiosurgery on local control and organ preservation in cases of primary head and neck cancer. In this retrospective study, 14 patients with a mean age of 73 years were treated between March 2006 and September 2007 with stereotactic radiosurgery for the management of primary head and neck cancer. The patients had biopsy confirmation of disease before treatment and all patients were confirmed with squamous cell carcinoma. The staging consisted of T2 (5 cases), T3 (3 cases), T4 (6 cases), N0 (13 cases), and N1 (1 case). Marginal doses were 3,500 to 4,200 cGy in 3 or 5 fractions. The outcome was assessed according to Response Evaluation Criteria in Solid Tumors criteria based on magnetic resonance imaging and positron emission tomography/computed tomography. Significant tumor reduction was noted at the third month of follow-up with 5 complete responses and 9 partial responses. At a mean follow-up of 36 months (range, 14-40 mo) the local control and overall survival rates were 71.4% (10/14) and 78.6% (11/14), respectively. These results show the feasibility of using stereotactic radiosurgery for primary head and neck cancer and its potential benefit in local control and organ preservation.
  Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 07/2011; 70(2):461-72. · 1.58 Impact Factor
• Article: Evidence for the changes of antitumor immune response during lymph node metastasis in head and neck squamous cell carcinoma.

  Kenichi Kumagai, Yoshiki Hamada, Akito Gotoh, Hiroshi Kobayashi, Koji Kawaguchi, Akihisa Horie, Hiroyuki Yamada, Satsuki Suzuki, Ryuji Suzuki
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  ABSTRACT: This study aimed to elucidate the differences in antitumor immune responses between primary tumors and metastatic regional lymph nodes in head and neck squamous cell carcinoma (HNSCC). The clonality of tumor-infiltrating lymphocytes in tissue specimens from 17 HNSCC patients was examined regarding their T-cell receptor (TCR) repertoires and their complementary determining region 3 (CDR3) size spectratyping. Cytokine expression profiles and T-cell phenotypes also were measured by using real-time quantitative polymerase chain reaction. The host immune responses to HNSCC cells, reflected by the TCR repertoire, differed between primary tumors and metastatic lymph nodes. CD8+-T cells and T helper type 1 (TH1)/T cytotoxic 1 (TC1) cell cytokine production in metastatic and nonmetastatic lymph nodes were similar. The antitumor immune response to HNSCC cells changes during lymph node metastasis, and HNSCC cells can escape the cytotoxic immune responses mediated by CD8+-T cells and TH1/TC1 cells. These results suggest that lymph node metastasis might be associated with changes in the nature of the primary tumor antigens.
  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 09/2010; 110(3):341-50. · 1.50 Impact Factor
• Article: A nodular buccal mass.

  Hiroyuki Yamada, Kenji Mishima, Koji Kawaguchi, Toshikatsu Horiuchi, Kazutoshi Nakaoka, Mitsuyoshi Iino, Ichiro Saito, Yoshiki Hamada
  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics 08/2010; 110(2):140-4. · 1.50 Impact Factor
• Article: A study on the prognostic evaluation of carbon ion radiotherapy for head and neck adenocarcinoma with C-11 methionine PET.

  Mitsuhiko Hasebe, Kyosan Yoshikawa, Seiya Ohashi, Sachiko Toubaru, Koji Kawaguchi, Junichi Sato, Junetsu Mizoe, Hirohiko Tsujii
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  ABSTRACT: Carbon ion radiotherapy (CIRT) has been developed, and a phase I/II CIRT trial has been conducted in patients with adenocarcinoma in the head and neck region. We evaluated whether the L-methyl [11C]-methionine (MET) uptake could be an early predictor for local recurrence, metastasis, and the prognosis in patients with adenocarcinoma in the head and neck region. Twenty-six patients were prospectively studied by MET-positron emission tomography (PET) before and about 1 month after CIRT. The tumor MET uptake was measured with the semiquantitative tumor to normal tissue ratio (TNR). The tumor TNR and relevant clinical parameters were then evaluated by both univariate and multivariate analyses. The average TNRs before and after the treatment were 6.2 (± 2.2) and 3.9 (± 1.7), respectively, and significant differences were observed between them. In a univariate analysis, both local recurrence and metastasis were observed more frequently in the group with a higher TNR before and after the treatment than a lower TNR, and the prognosis was also poor. The cut-off values were 9.3, 4.9, and 5.1 before the treatment and 4.9, 4.2, and 4.3 after the treatment, respectively. In the rate of TNR changes before and after the treatment, metastasis was observed more frequently in the group with lower rates of change, and the prognosis was poor. The cut-off values for metastasis and prognosis determination were 18.0% and 16.9%, respectively. In a multivariate analysis, significant differences were observed for all relationships except for the relationship between the TNR before the treatment and local recurrence. Significant differences were observed for metastasis and prognosis in the rate of TNR changes before and after the treatment. The determination of treatment effectiveness using TNR in CIRT for head and neck adenocarcinoma is an independent factor for predicting local recurrence, the incidence of metastasis, and the prognosis. MET-PET is therefore considered to be useful for determining the treatment effectiveness in patients with head and neck adenocarcinoma undergoing CIRT.
  Molecular imaging and biology: MIB: the official publication of the Academy of Molecular Imaging 04/2010; 12(5):554-62. · 2.47 Impact Factor
• Source

  Available from: PubMed Central

  Article: Stereotactic radiosurgery may contribute to overall survival for patients with recurrent head and neck carcinoma.

  Koji Kawaguchi, Kengo Sato, Akihisa Horie, Susumu Iketani, Hiroyuki Yamada, Yasunori Nakatani, Junichi Sato, Yoshiki Hamada
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  ABSTRACT: The aim of this study is to examine the effect of stereotactic radiosurgery (SRS) in the treatment of advanced, recurrent lesions for head and neck carcinoma both with and without lymph node involvement. Between April 2006 and July 2007, 22 patients (mean age 67 years) with advanced, recurrent head and neck carcinoma were treated with stereotactic radiosurgery. All of the patients except one had biopsy confirmed disease prior to stereotactic radiosurgery. Patients included 3 rT2, 8 rT3, and 9 rT4; 8 of the patients had lymph node metastases. Marginal SRS doses were 20-42 Gy delivered in two to five fractions. Starting one month after SRS, all patients received S-1 oral chemotherapy for one year. At an overall median follow-up of 24 months (range, 4-39 months), for the 14 locally recurrent patients without lymph node metastases, 9 patients (64.3%) had a complete response (CR), 1 patient (7.1%) had a partial response (PR), 1 patient (7.1%) had stable disease (SD), and 3 patients (21.4%) had progressive disease (PD). For the 8 patients with lymph node metastases, 1 patient with a single retropharyngeal (12.5%) had CR; the remaining 7 patients (87.5%) all progressed. Nine patients have died from their cancer. The overall actuarial 2-year survival for the patients with and without lymph node metastases is 12.5% and 78.6%, respectively. These results show the benefit of stereotactic radiosurgery salvage treatment for advanced, recurrent lesions, without lymph node metastases in previously irradiated head and neck cancer.
  Radiation Oncology 01/2010; 5:51. · 2.32 Impact Factor