Efficacy and safety of carbon ion radiotherapy in bone and soft tissue sarcomas.

Abstract

PURPOSE:

To evaluate the tolerance for and effectiveness of carbon ion radiotherapy in patients with unresectable bone and soft tissue sarcomas.

PATIENTS AND METHODS:

We conducted a phase I/II dose escalation study of carbon ion radiotherapy. Fifty-seven patients with 64 sites of bone and soft tissue sarcomas not suited for resection received carbon ion radiotherapy. Tumors involved the spine or paraspinous soft tissues in 19 patients, pelvis in 32 patients, and extremities in six patients. The total dose ranged from 52.8 to 73.6 gray equivalent (GyE) and was administered in 16 fixed fractions over 4 weeks (3.3 to 4.6 GyE/fraction). The median tumor size was 559 cm(3) (range, 20 to 2,290 cm(3)). The minimum follow-up was 18 months.

RESULTS:

Seven of 17 patients treated with the highest total dose of 73.6 GyE experienced Radiation Therapy Oncology Group grade 3 acute skin reactions. Dose escalation was then halted at this level. No other severe acute reactions (grade > 3) were observed in this series. The overall local control rates were 88% and 73% at 1 year and 3 years of follow-up, respectively. The median survival time was 31 months (range, 2 to 60 months), and the 1- and 3-year overall survival rates were 82% and 46%, respectively.

CONCLUSION:

Carbon ion radiotherapy seems to be a safe and effective modality in the management of bone and soft tissue sarcomas not eligible for surgical resection, providing good local control and offering a survival advantage without unacceptable morbidity.

• Authors: Tadashi Kamada, Hirohiko Tsujii, Hiroshi Tsuji, Tsuyoshi Yanagi, Jun-etsu Mizoe, Tadaaki Miyamoto, Hirotoshi Kato, Shigeru Yamada, Shinroku Morita, Kyousan Yoshikawa, Susumu Kandatsu, Akio Tateishi, Working Group for the Bone and Soft Tissue Sarcomas
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 20 Issue 22 Pg. 4466-71 (Nov 15 2002) ISSN: 0732-183X [Print] United States
• PMID: 12431970 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Carbon Radioisotopes

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Bone Neoplasms (diagnosis, radiotherapy)
• Carbon Radioisotopes (administration & dosage, adverse effects, therapeutic use)
• Female
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Radiotherapy Dosage
• Sarcoma (diagnosis, radiotherapy)
• Soft Tissue Neoplasms (diagnosis, radiotherapy)
• Survival Analysis
• Treatment Outcome