Yoshihiro MURAGAKI1, Masanori MAEDA1, Hiroshi ISEKI1, Jun OKAMOTO1, Shinji KISHIMOTO1, Ken MASAMUNE1, Ryo TAKAGI2, Shin YOSHIZAWA2, Shinichiro UMEMURA2
1Faculty of Advanced Techno-Surgery（FATS）, Institute of Advanced Biomedical Engineering & Science, Tokyo Women’s Medical University, 2School of Engineering, Tohoku University
High intensity therapeutic ultrasound（HITU）is the next-generation treatment that wide disease application is expected from nerve stimulation to cancer treatment by parameter setting. Government approvals of HITU are got for myoma uterus, prostatic hypertrophy, the pain palliation of metastatic bone tumor, and clinical applications are tested for prostate cancer, breast cancer, pancreatic cancer, and liver cancer. However, an area of heat coagulation by one shot of HITU is relatively small once, and a side effect risk when irradiation deviated from the plan lesion is high because heat coagulation by the high energy is necessary for tumor treatment. Therefore we aimed at effect improvement and the risk reduction and developed a sound dynamic therapy（Sono-dynamic therapy: SDT）that combines drug with HITU together. The SDT is the treatment having an effect of tumor control by the active oxygen generated from irradiating a sono-sensitive drug with the HITU. Up to the sono-sentive drug, we have chosen a nano-miselle drug including doxorubicin that accumulates in a tumor and that active oxygen outbreak by SDT. We have confirmed the generation of active oxygen by SDT in vitro experiment, and the tumor control effect in vivo experiments using the tumor-bearing mice and rabbits. We also perform the clinical study for disease dogs（spontaneous tumor-bearing pet dog）. The irradiation monitoring would be by the high-speed imaging of the diagnostic ultrasound for detection of the air bubbles, but not by MRI thermometry. In addition, I aim at the irradiation that positioning it does not have the overlap and exception using a robot for “the industry”. We are making a protocol of phase I and II clinical trials for recurrent pancreatic cancer under the support of AMED（medical research and development mechanism in Japan）to detect the adequate dose and check the safety. We also report a monitoring method of the SDT that is extremely necessary for development of domestic SDT which can become a novel minimally-invasive cancer treatment.