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Although whole brain radiation therapy (WBRT) is commonly used as first-line treatment for leptomeningeal carcinomatosis, the prognosis is uncertain despite treatment. Moreover, the benefit of WBRT for leptomeningeal carcinomatosis has not been adequately evaluated. Therefore, this study aimed to clarify the utility of WBRT for leptomeningeal carcinomatosis. Consecutive patients who received WBRT for leptomeningeal carcinomatosis or brain metastasis from solid tumors between January 2008 and July 2017 were retrospectively evaluated. The overall survival, symptom relief, and adverse events were compared between patients with leptomeningeal carcinomatosis and those with brain metastasis after WBRT. Of the 277 treated patients, 204 patients (22 with leptomeningeal carcinomatosis and 182 with brain metastasis) were included in the study. The median overall survival was 440 days (95% confidence interval [CI] 0–931 days) for patients with leptomeningeal carcinomatosis and 322 days (95% CI 196–448 days) for those with brain metastasis (p = 0.972 on the log-rank test). On evaluating the overall survival of patients with leptomeningeal carcinomatosis, the prognostic factors of performance status 0–1, no extracranial metastasis, and no symptoms at the time of WBRT showed a significant survival advantage on univariate analysis. Among patients with leptomeningeal carcinomatosis, those with headache and nausea often showed improvement while those with depressed levels of consciousness and seizures did not. On comparing all-grade adverse events, vomiting and seizures were more frequent in patients with leptomeningeal carcinomatosis than in those with brain metastasis. WBRT was generally well tolerated and effective for treating patients with leptomeningeal carcinomatosis.

Primary testicular lymphoma (PTL) is a rare, extranodal lymphoma that often relapses in the contralateral testis. We evaluated outcomes in patients with any stage of PTL who had received CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) with rituximab chemotherapy and prophylactic radiotherapy to the contralateral testis. We retrospectively identified 15 patients (median age 66 years; range 39–81) diagnosed with diffuse large B-cell PTL in the period 2000–2014. Characteristics and outcomes of these cases were evaluated. All patients received initial orchiectomy followed by CHOP with or without rituximab. Thirteen patients received prophylactic irradiation to the contralateral testis. During follow-up (median 67 months; range 8–190), one patient died of PTL, three died of other disease, and nine were free from relapse. For stage I–II disease, 5-year progression-free and overall survival rates were 80 and 100%, respectively. For stage III–IV PTL, 5-year progression-free and overall survival rates were 50 and 72%, respectively. Notably, no patient developed contralateral testicular involvement after prophylactic irradiation. The observed outcomes suggest that the combination of (i) CHOP plus rituximab and (ii) radiotherapy for local recurrence prophylaxis is promising for both stage I–II and stage III–IV PTL.

The global population is aging. As people age, they typically experience gradual changes in hearing, vision, coordination, balance, working memory, and cognitive function. Products, communication materials, and information provision are often accommodated for older adults. In this study, we examined various information delivery methods and their association with older adults’ working memory and cognitive function (N=18; 10 women). Participants completed tests or followed instructions that consisted of either only figures, only words, or a combination of both figures and words. First, concerning working memory, six well-known information symbols were shown to participants in one of three patterns. Each pattern was displayed on a screen for 20 sec, and working memory was measured as the number of correct items participants recalled. Cognitive function was assessed by participants’ ability to construct three different objects (giraffe, flower, and tulip) using blocks. Participants were presented with various forms of instruction concerning how to build the objects-pictures only, words only, or both pictures and words. Results revealed that the total number of items recalled were 4.3 ± 1.4, 3.1 ± 1.1, and 3.9 ± 0.8 for figures only, words only, and both figures and words, respectively (χ2=10.13, p=0.006). Higher working memory scores were associated with “figure only” and “figures and words” as compared with the “words only” method. Regarding comprehension, higher scores were associated with “figures and words” instructions as compared to the “figures only” and “words only” instructions. In conclusion, information provision for older adults should be simple and easy, visuals should be employed, and supplemental information should be explained in words to avoid any misunderstandings.

In Japan, there are still no reports of long-term outcome for hypofractionated radiotherapy to the whole breast after breast-conserving surgery (BCS). We report our institution's results from evaluation of the efficacy and safety of hypofractionated radiotherapy for Japanese women.Data in the medical records of 327 patients were retrospectively reviewed. The patients were treated with hypofractionated radiotherapy between January 2003 and December 2006 at the Kawasaki Medical School Hospital and were followed for more than 3 years. The median age was 54 years old (the age range was 28-80 years). The whole breast was irradiated with a total dose of 42.56 Gy/16 fx with boost irradiation to positive margins. Adjuvant therapy consisted of chemotherapy and/or hormone therapy and was administered to 300 patients, based on their stage or pathological findings.Follow-up periods ranged from 21 to 92 months; the median follow-up period was 60 months. At 5-year follow-up, overall survival, cause-specific survival, relapse-free survival, and local control were 96.0, 97.5, 95.3, and 99.7% respectively. Grade 2 radiation pneumonitis occurred in five patients. Grade 2 radiation dermatitis occurred in 17 patients. Severe late complications were not observed.In our study, hypofractionated radiotherapy led to good results without severe toxicity. We believe hypofractionated radiotherapy after BCS is safe and efficient treatment for Japanese women.