私にとっての放射線治療―放射線集中性の改善を目指して

My 35-year experience of radiotherapy：seeking concentration of radiation

筆者が放射線治療を専門としてがんに向き合ったのは35年前になる。その当時は，がんの告知を行っていた施設はほとんどなく，化学放射線療法も高精度放射線治療も行われていなかった。今ではとても考えられないことだが，乳癌の治療においては大・小胸筋，腋窩・鎖骨上窩リンパ節まで一塊として切除する定型的乳房除去術を行う施設が大半であり，現在の状況とは隔世の感がある。このように放射線治療は急速に進歩し，現在も加速度的に進歩し続けている。

I have engaged in radiotherapy for 35 years, during which time radiotherapy technologies have progressed remarkably. Our research group showed that stereotactic radiotherapy offered long-term control for localized intracranial malignancies with minimal toxicities by the 1990’s. Proton beam therapy was shown to be effective to control hepatocellular carcinomas while saving hepatic reserves, regardless of the presence or absence of vascular invasion or tumor size. It was also effective in treating large volume lung cancer and achieved bladder conservation for invasive urinary bladder cancer. Non-coplanar intensity-modulated radiotherapy brought excellent overall survival and local control rates for stage I non-small cell lung cancer. They can be offered as a less-invasive alternative to surgery. If patients have chance to select treatment methods without prejudice, radiotherapy would be selected by more patients.