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ABSTRACT: The prognosis of high-risk prostate cancer is poor with a high mortality rate. The Radiation Therapy Oncology Group (RTOG) has performed dose-escalation studies of external beam radiation therapy (EBRT) and has developed high-precision radiation therapy (RT) methods such as intensity-modulated RT, carbon ion therapy, and proton beam therapy. High-dose rate brachytherapy (HDR-BT) is also studied as an option for high-risk prostate cancer treatment. Past clinical trials have suggested that the local control rate of high-risk prostate cancer improves with total EBRT dose, even for doses >70Gy. Several randomized controlled trials, including RTOG 94-06, have shown significantly better prognoses with higher doses (>75Gy) than with lower doses (<70Gy). A proton beam therapy trial (PROG 95-09) also showed similar results. A phase II clinical trial (National Institute for Radiological Sciences, Japan; trial 9904) showed that carbon ion therapy resulted in very good biochemical recurrence-free survival rates among high-risk prostate cancer patients, demonstrating particle therapy to be a valid treatment option. RTOG 86-10 showed that short-term neo-adjuvant hormonal therapy (HT) was inadequate for high-risk prostate cancer but effective for intermediate-risk prostate cancer, whereas RTOG 92-02 and the European Organisation for Research and Treatment of Cancer (EORTC) 22863 showed significant improvements in the prognosis of high-risk groups receiving long-term (>2years) HT combined with definitive RT. Further studies are warranted to elucidate optimal irradiation doses, HT treatment durations, and combination therapy schedules.
Cancer treatment reviews 05/2013; · 5.30 Impact Factor
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ABSTRACT: PURPOSE: To determine the long-term results of carbon ion radiation therapy (C-ion RT) in patients with choroidal melanoma, and to assess the usefulness of CT-based 2-port irradiation in reducing the risk of neovascular glaucoma (NVG). METHODS AND MATERIALS: Between January 2001 and February 2012, a total of 116 patients with locally advanced or unfavorably located choroidal melanoma received CT-based C-ion RT. Of these patients, 114 were followed up for more than 6 months and their data analyzed. The numbers of T3 and T2 patients (International Union Against Cancer [UICC], 5th edition) were 106 and 8, respectively. The total dose of C-ion RT varied from 60 to 85 GyE, with each dose given in 5 fractions. Since October 2005, 2-port therapy (51 patients) has been used in an attempt to reduce the risk of NVG. A dose-volume histogram analysis was also performed in 106 patients. RESULTS: The median follow-up was 4.6 years (range, 0.5-10.6 years). The 5-year overall survival, cause-specific survival, local control, distant metastasis-free survival, and eye retention rates were 80.4% (95% confidence interval 89.0%-71.8%), 82.2% (90.6%-73.8%), 92.8% (98.5%-87.1%), 72.1% (81.9%-62.3%), and 92.8% (98.1%-87.5%), respectively. The overall 5-year NVG incidence rate was 35.9% (25.9%-45.9%) and that of 1-port group and 2-port group were 41.6% (29.3%-54.0%) and 13.9% (3.2%-24.6%) with statistically significant difference (P<.001). The dose-volume histogram analysis showed that the average irradiated volume of the iris-ciliary body was significantly lower in the non-NVG group than in the NVG group at all dose levels, and significantly lower in the 2-port group than in the 1-port group at high dose levels. CONCLUSIONS: The long-term results of C-ion RT for choroidal melanoma are satisfactory. CT-based 2-port C-ion RT can be used to reduce the high-dose irradiated volume of the iris-ciliary body and the resulting risk of NVG.
International journal of radiation oncology, biology, physics 02/2013; · 4.59 Impact Factor
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ABSTRACT: We quantified dose variation effects due to respiratory-induced intrafractional motion in conventional carbon-ion prostate treatment by using four-dimensional computed tomography (4DCT). 4DCT scans of 20 patients were acquired under free-breathing conditions using a 256 multi-slice CT scanner. The clinical target volume (CTV) was defined as the prostate and the seminal vesicle. Two types of planning target volumes (PTVs) were defined to minimize excessive dose to the rectum. The first PTV (= PTV1) was calculated by adding a 3D uniform margin to the CTV. The second PTV (= PTV2) was cut in a straight line from the top surface of the rectum from PTV1. Compensating boli were designed for the respective PTVs at the peak-exhalation phase, and carbon-ion dose distributions for a single respiratory cycle were calculated using these boli. Dose conformation to prostate, CTV, PTV1 and PTV2 were unchanged for all respiratory phases. The dose for >95% volume irradiation (D95) was 97.7% for prostate, 92.5% for CTV, 74.1% for PTV1 and 96.1% for PTV2 averaged over all patients. The rectum volume at inhalation phase receiving ≤50% of the prescribed dose was smaller than the planning dose due to the abdominal thickness variation. The target dose is not affected by intrafractional respiration in carbon-ion prostate treatment. Small dose variations, however, were observed due to respiratory-induced abdominal thickness variation; therefore the geometrical changes should be considered for prostate particle therapy.
Journal of Radiation Research 12/2012; · 1.68 Impact Factor
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ABSTRACT: PURPOSE: To determine the effectiveness of carbon ion radiotherapy (CIRT) for localized primary sarcomas of the extremities in a prospective study. PATIENTS AND MATERIALS: From April 2000 to May 2010, 17 (male/female: 12/5) patients with localized primary sarcoma of the extremities received CIRT. The median age was 53years (range: 14-87years). Nine patients had primary diseases and eight had recurrent diseases. Of the 17 patients, eight refused amputation, and the remaining nine refused surgical resection. Tumors were located in the upper limbs in four patients and lower limbs in 13. Histological diagnosis was osteosarcoma in three patients, liposarcoma in two, synovial sarcoma in two, rhabdomyosarcoma in two, pleomorphic sarcoma in two, and miscellaneous in six. The CIRT dose to the limb was 52.8GyE for one patient, 64GyE for three, 70.4GyE for 13 in 16 fixed fractions over 4weeks. Records were reviewed and outcomes including radiologic response, local control (progression-free), and survival were analyzed. RESULTS: The median follow-up was 37months (range: 11-97months). Radiological response rate was 65% (PR in 11, SD in 5, and PD in 1). The local control rate at 5years was 76%. The overall survival rate at 5years was 56%. Of the 17 patients, 10 survived without disease progression. Four patients had local recurrences, one was salvaged by repeated CIRT and the other three died due to systemic diseases. Distant failure was observed in six patients. One patient suffered from femoral fracture (grade 3) and received surgical fixation 27months after CIRT. No other severe reactions (grade 3) were observed. CONCLUSIONS: CIRT is suggested to be an effective and safe treatment for patients who refuse surgery for localized primary sarcomas of the extremities.
Radiotherapy and Oncology 10/2012; · 5.58 Impact Factor
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ABSTRACT: To assess the effects of differences in dose fractionation on late radiation toxicity and biochemical control in patients with prostate cancer treated with carbon ion radiotherapy (C-ion RT).
A total of 740 prostate cancer patients who received C-ion RT between April 2000 and February 2009 were analyzed. Of those, 664 patients followed for at least 1 year were analyzed with regard to late radiation toxicity. Biochemical relapse-free (BRF) and overall survival (OS) rates in patient subgroups with each dose-fractionation were analyzed.
Only 1 case of grade 3 genitourinary (GU) morbidity was observed in 20 fractions, and none of the patients developed higher grade morbidities. The incidence of late GU toxicity in patients treated with 16 fractions was lower than that of patients treated with 20 fractions. The OS rate and BRF rate of the entire group at 5 years were 95.2% and 89.7%, respectively. The 5-year BRF rate of the patients treated with 16 fractions of C-ion RT (88.5%) was comparable to that of the patients treated with 20 fractions (90.2%).
C-ion RT of 57.6 GyE (the physical C-ion dose [Gy] × RBE) in 16 fractions could offer an even lower incidence of genitourinary toxicity and comparable BRF rate than that in 20 fractions. Advancement in hypofractionation could be safely achieved with C-ion RT for prostate cancer.
International journal of radiation oncology, biology, physics 08/2012; 84(4):968-72. · 4.59 Impact Factor
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ABSTRACT: Biochemical failure after radiotherapy for prostate cancer occurs infrequently, but some cases progress to a poor outcome. The aim of this study was to examine prognosis after biochemical failure.
A total of 728 patients were treated with carbon ion radiotherapy, and biochemical failure occurred in 90 (12.4%). Their outcomes were examined according to risk factors, histological findings, and androgen deprivation therapy (ADT).
Biochemical failure rates were 12%, 6%, and 15% in low-, intermediate- and high-risk patients. Most patients responded favorably to salvage therapy. Some high-risk patients (25%) progressed to poor outcome; half experienced failure after ADT, while the rest during ADT, indicating that ADT had a slight influence. Patients who died from their disease had approximately two years of biochemical failure-free time and three years of survival after failure. Their tumor showed the presence and the increased proportion of histologically high-grade growth patterns.
Histological growth patterns and short biochemical failure-free time are prognostic factors for poor outcome regardless of ADT.
Anticancer research 08/2012; 32(8):3267-73. · 1.73 Impact Factor
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ABSTRACT: BACKGROUND: The authors summarized the outcomes of patients with unresectable osteosarcoma of the trunk who received carbon ion radiotherapy (CIRT). METHODS: The authors performed a retrospective analysis of 78 patients who had medically inoperable osteosarcoma of the trunk and received treatment with CIRT between 1996 and 2009. Tumor sites included the pelvis in 61 patients, the spine and paraspinal region in 15 patients, and other sites in 2 patients. The median applied CIRT dose was 70.4 Gray equivalent (GyE) in a total of 16 fixed fractions over 4 weeks. RESULTS: The minimum duration of follow-up for survivors was 14 months. Forty-eight patients remained alive. The 5-year overall survival rate was 33%, and the local control rate was 62%. Thirty-eight patients who had a clinical target volume <500 cm(3) had a 5-year overall survival rate of 46% and a 5-year local control rate of 88%. Except for 3 patients who experienced severe skin/soft tissue complications requiring skin grafts, no other severe toxicities were observed. Of 9 patients who were continuously disease free for >5 years, 8 were able to walk with or without the help of a cane, and 6 were free from pain killers. CONCLUSIONS: CIRT appeared to be a safe and effective modality for the management of unresectable osteosarcoma of the trunk, providing good local control and offering a survival advantage and good long-term functional results without unacceptable morbidity. Cancer 2012. © 2012 American Cancer Society.
Cancer 02/2012; 118(18):4555-4563. · 4.77 Impact Factor
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ABSTRACT: In 1994, carbon-ion radiotherapy was started at the National Institute of Radiological Sciences using the Heavy-Ion Medical Accelerator in Chiba. Between June 1995 and March 2000, two phase I/II dose escalation studies (protocols 9402 and 9703) of hypofractionated carbon-ion radiotherapy for both early- and advance-stage prostate cancer patients had been carried out to establish radiotherapy technique and to determine the optimal radiation dose. To validate the feasibility and efficacy of hypofractionated carbon-ion radiotherapy, a phase II study (9904) was initiated in April 2000 using the shrinking field technique and the recommended dose fractionation (66 gray equivalents in 20 fractions over 5 weeks) obtained from the phase I/II studies, and was successfully completed in October 2003. The data from 175 patients in the phase II study showed the importance of an appropriate use of androgen deprivation therapy according to tumor risk group. Since November 2003, carbon-ion radiotherapy for prostate cancer was approved as "Highly Advanced Medical Technology" from the Ministry of Health, Labor, and Welfare, and since then approximately 1100 patients have received carbon-ion radiotherapy as of July 2011. In this review, we introduce our steps thorough three clinical trials carried out at National Institute of Radiological Sciences, and show the updated data of carbon-ion radiotherapy obtained from approximately 1000 prostate cancer patients. In addition, our recent challenge and future direction will be also described.
International Journal of Urology 02/2012; 19(4):296-305. · 1.75 Impact Factor
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Jun-Etsu Mizoe,
Azusa Hasegawa,
Keiichi Jingu,
Ryo Takagi,
Hiroki Bessyo,
Takamichi Morikawa,
Morio Tonoki, Hiroshi Tsuji,
Tadashi Kamada,
Hirohiko Tsujii,
Yoshitaka Okamoto
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ABSTRACT: To evaluate the efficacy of carbon ion radiotherapy for head-and-neck cancer in a phase II clinical trial.
Between April 1997 and February 2006, 236 patients with locally advanced, histologically proven, and new or recurrent cancer of the head and neck were treated with carbon ions. The treatment dose was 64.0 GyE/16 fractions/4 weeks (or 57.6 GyE/16 fractions/4 weeks when the wide-range skin was included in the target volume).
There were grade 3 acute skin reactions in 6% and grade 3 acute mucosal reactions in 10% with no acute reactions worse than grade 3, and grade 2 late skin reactions in 3% and grade 2 late mucosal reactions in 2% with no late reactions worse than grade 2. The 5-year local control rate, by histological type, was 75% for the 85 patients with malignant melanoma, 73% for the 69 with adenoid cystic carcinoma, 73% for the 27 with adenocarcinoma, 61% for the 13 with papillary adenocarcinoma, 61% for the 12 with squamous cell carcinoma and 24% for the 14 with sarcomas. The 5-year over-all survival rate was 68% for adenoid cystic carcinoma, 56% for adenocarcinoma and 35% for malignant melanoma.
Carbon ion radiotherapy for head and neck cancer showed the therapeutic effectiveness for malignant melanoma and adenoid cystic carcinoma without severe morbidity of the normal tissues.
Radiotherapy and Oncology 02/2012; 103(1):32-7. · 5.58 Impact Factor
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Keiichi Jingu,
Hirohiko Tsujii,
Jun-Etsu Mizoe,
Azusa Hasegawa,
Hiroki Bessho,
Ryo Takagi,
Takamichi Morikawa,
Morio Tonogi, Hiroshi Tsuji,
Tadashi Kamada,
Shogo Yamada
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ABSTRACT: To evaluate the safety and efficacy of carbon ion radiotherapy (C-ion RT) with 70.4 GyE for unresectable bone and soft-tissue sarcoma of the adult head and neck.
Twenty-seven patients (mean age, 46.2 years) were enrolled in this prospective study on C-ion RT with 70.4 GyE/16 fractions (fr) between April 2001 and February 2008. The primary end points were acute and late reactions of normal tissues, local control rate, and overall survival rate. The secondary end point was efficacy of the treatment in comparison to historical results with 57.6 or 64.0 GyE/16 fr.
The 3-year local control rate and overall survival rate for all patients were 91.8% (95% confidence interval [CI] = 81.0-100%) and 74.1% (95% CI = 57.5-90.6%), respectively. Acute reaction of Grade 3 or more was observed in only 1 patient. With regard to late reactions, visual loss was observed in 1 patient and a Grade 3 reaction of the maxillary bone was observed in 4 patients. A comparison with historical results revealed that the local control rate with 70.4 GyE was significantly higher than that with 57.6 or 64.0 GyE (3-year, 91.8% vs. 23.6%, p < 0.0001). Furthermore, the overall survival with 70.4 GyE tended to be higher than that with 57.6 or 64.0 GyE (3-year, 74.1% vs. 42.9%, p = 0.09).
C-ion RT with 70.4 GyE/16 fr for bone and soft-tissue sarcoma of the adult head and neck appears to be effective with acceptable toxicities in comparison to conventional RT and C-ion RT with lower doses.
International journal of radiation oncology, biology, physics 07/2011; 82(5):2125-31. · 4.59 Impact Factor
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Nippon rinsho. Japanese journal of clinical medicine 06/2011; 69 Suppl 5:455-8.
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ABSTRACT: Carbon ion radiotherapy is expected to be suitable to treat localized prostate cancer because it yields great biological and physical effects. The aim of this study was to examine long-term results and subsequent outcomes after biochemical failure.
A total of 254 patients were treated from the beginning of 2003 and followed through 2009. Long-term hormone therapy was also used for some intermediate-risk and high-risk patients.
Among the patients examined, 54 patients experienced biochemical failure. Failure-free survival was 76%, 91% and 76% at eight years in low-risk, intermediate-risk and high-risk patients, respectively. Clinical progression occurred only in high-risk patients, with 89% progression-free survival at eight years. After biochemical failure, diseases of most patients were well controlled by salvage therapy but twelve high-risk patients (5%) died of prostate cancer.
Carbon ion radiotherapy had an excellent effect on localized prostate cancer. Factors influencing salvage therapy included PSA kinetics and duration between radiation and failure.
Anticancer research 12/2010; 30(12):5105-11. · 1.73 Impact Factor
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ABSTRACT: Basal cell adenocarcinoma accounts for approximately 1.6% of all salivary gland neoplasms. In this report, we describe our experiences of treatment for BCAC with carbon ion radiotherapy in our institution.
Case records of 6 patients with diagnosis of basal cell adenocarcinoma of the head and neck, who were treated by carbon ion radiotherapy with 64.0 GyE/16 fractions in our institution, were retrospectively reviewed.
In a mean follow-up period of 32.1 months (14.0-51.3 months), overall survival and local control rates of 100% were achieved. Only one grade 4 (CTCAE v3.0) late complication occurred. There was no other grade 3 or higher toxicity.
Carbon ion radiotherapy should be considered as an appropriate curative approach for treatment of basal cell adenocarcinoma in certain cases, particularly in cases of unresectable disease and postoperative gross residual or recurrent disease.
Radiation Oncology 10/2010; 5:89. · 2.32 Impact Factor
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ABSTRACT: To evaluate the potential of apparent diffusion coefficient (ADC) value before carbon ion radiotherapy (C-ion RT) for malignant mucosal melanoma (MMM) to predict prognosis.
We recruited 37 patients with MMM in the head and neck treated by C-ion RT with concomitant chemotherapy. Univariate and multivariate analyses of minimum ADC, mean ADC, tumor volume, age, PS, and gender were performed to identify prognostic factors.
The 3-year local control rate, distant metastasis-free survival rate and overall survival rate of all patients were 81.1%, 37.6% and 65.3%, respectively, with a median follow-up period of 19.0 months. In univariate analyses, lower minimum ADC (≤0.6380 × 10(-3) mm(2)/s) and lower mean ADC (≤1.1523 × 10(-3) mm(2)/s) were unfavorable prognostic factors for distant metastasis (p=0.029 and p=0.014, respectively), and lower minimum ADC was an unfavorable prognostic factor for overall survival (p=0.019). However, there was no significant prognostic factor of local control including ADC value. In multivariate analyses, only minimum ADC was selected as a prognostic factor of distant metastasis-free survival and overall survival (p=0.015 and p=0.006, respectively).
Minimum ADC can be a prognostic factor of MMM in the head and neck after C-ion RT.
Radiotherapy and Oncology 10/2010; 98(1):68-73. · 5.58 Impact Factor
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Tohru Okada,
Tadashi Kamada, Hiroshi Tsuji,
Jun-etsu Mizoe,
Masayuki Baba,
Shingo Kato,
Shigeru Yamada,
Shinji Sugahara,
Shigeo Yasuda,
Naoyoshi Yamamoto,
Reiko Imai,
Azusa Hasegawa,
Hiroshi Imada,
Hiroki Kiyohara,
Kenichi Jingu,
Makoto Shinoto,
Hirohiko Tsujii
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ABSTRACT: In June 1994, the world's first clinical center offering carbon ion radiotherapy opened at the National Institute of Radiological Science (NIRS), Japan. Among several types of ion species, carbon ions were chosen for cancer therapy because they were judged to have the most optimal properties in terms of superior physical and biological characteristics. As of March 2010, 5,196 patients have been registered for carbon ion radiotherapy. Clinical results have shown that carbon ion radiotherapy has the potential to provide a sufficient radiation dose to the tumor, while having acceptable morbidity in the surrounding normal tissues. Tumors that appear to respond favorably to carbon ions include locally advanced tumors as well as histologically non-squamous cell tumor types such as adenocarcinoma, adenoid cystic carcinoma, malignant melanoma, hepatoma, and bone/soft tissue sarcoma. By taking advantage of the unique properties of carbon ions, treatment with small fractions within a short treatment period has been successfully carried out for a variety of tumors. This means that carbon ion radiotherapy can offer treatment for larger numbers of patients than is possible with other modalities over the same time period.
Journal of Radiation Research 01/2010; 51(4):355-64. · 1.68 Impact Factor
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ABSTRACT: To summarize the results of treatment for sacral chordoma in Phase I-II and Phase II carbon ion radiotherapy trials for bone and soft-tissue sarcomas.
We performed a retrospective analysis of 38 patients with medically unresectable sacral chordomas treated with the Heavy Ion Medical Accelerator in Chiba, Japan between 1996 and 2003. Of the 38 patients, 30 had not received previous treatment and 8 had locally recurrent tumor after previous resection. The applied carbon ion dose was 52.8-73.6 Gray equivalents (median, 70.4) in a total of 16 fixed fractions within 4 weeks.
The median patient age was 66 years. The cranial tumor extension was S2 or greater in 31 patients. The median clinical target volume was 523 cm(3). The median follow-up period was 80 months. The 5-year overall survival rate was 86%, and the 5-year local control rate was 89%. After treatment, 27 of 30 patients with primary tumor remained ambulatory with or without supportive devices. Two patients experienced severe skin or soft-tissue complications requiring skin grafts.
Carbon ion radiotherapy appears effective and safe in the treatment of patients with sacral chordoma and offers a promising alternative to surgery.
International journal of radiation oncology, biology, physics 11/2009; 77(5):1470-6. · 4.59 Impact Factor
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ABSTRACT: To evaluate the usefulness of the dose-volume histogram (DVH) and dose-surface histogram (DSH) as clinically relevant and available parameters that helped to identify bone and soft tissue sarcoma patients at risk of developing late skin reactions, including ulceration, when treated with carbon ion radiotherapy.
Thirty-five patients with bone and soft tissue sarcoma treated with carbon ion beams were studied. The clinical skin reactions were evaluated. Some pretreatment variables were compared with the grade of late skin reactions.
Average DVH and DSH were established in accordance with the grading of the skin reactions. Prescribed dose, the difference in depths between the skin surface and the proximal extent of the tumor, and some DVH/DSH parameters were correlated with late skin reaction (> or = grade 3) according to univariate analysis. Furthermore, the area irradiated with over 60 GyE (S(60)>20 cm(2)) on DSH was the most important factor by multivariate analysis.
The area irradiated with over 60 GyE (S(60)>20 cm(2)) on DSH was found to be a parameter for use as a predictor of late skin reactions.
Radiotherapy and Oncology 09/2009; 95(1):60-5. · 5.58 Impact Factor
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ABSTRACT: To evaluate the applicability of carbon ion radiotherapy (CIRT) for unresectable retroperitoneal sarcomas with regard to normal tissue morbidity and local tumor control.
From May 1997 to February 2006, 24 patients (17 male and 7 female) with unresectable retroperitoneal sarcoma received CIRT. Age ranged from 16 to 77 years (median, 48.6 years). Of the patients, 16 had primary disease and 8 recurrent disease. Histologic diagnoses were as follows: malignant fibrous histiocytoma in 6, liposarcoma in 3, malignant peripheral nerve sheath tumor in 3, Ewing/primitive neuroectodermal tumor (PNET) in 2, and miscellaneous in 10 patients. The histologic grades were as follows: Grade 3 in 15, Grade 2-3 in 2, Grade 2 in 3, and unknown in 4. Clinical target volumes ranged between 57 cm(3) and 1,194 cm(3) (median 525 cm(3)). The delivered carbon ion dose ranged from 52.8 to 73.6 GyE in 16 fixed fractions over 4 weeks.
The median follow-up was 36 months (range, 6-143 months). The overall survival rates at 2 and 5 years were 75% and 50%, respectively. The local control rates at 2 and 5 years were 77% and 69%. No complications of the gastrointestinal tract were encountered. No other toxicity greater than Grade 2 was observed.
Use of CIRT is suggested to be effective and safe for retroperitoneal sarcomas. The results obtained with CIRT were a good overall survival rate and local control, notwithstanding the fact that most patients were not eligible for surgical resection and had high-grade sarcomas.
International journal of radiation oncology, biology, physics 06/2009; 75(4):1105-10. · 4.59 Impact Factor
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ABSTRACT: The aim of this study was to assess the feasibility of MET-PET as an evaluation method of the therapeutic effect of carbon ion beam radiotherapy.
Twenty-four choroidal melanoma patients who were treated with a carbon ion beam underwent at least three MET-PET scans before and after therapy. The uptake was visually and semiquantitatively evaluated on the basis of the tumor-to-brain ratio (TBR).
The accumulation was significantly decreased at 6 months or more after therapy and disappeared in 50% of the patients at 12 months after therapy. The baseline TBR, 1, 6, 12 and 24 months after therapy averaged 1.88+/-0.65, 1.73+/-0.52, 1.08+/-0.42, 0.67+/-0.27 and 0.65+/-0.30, respectively. TBR was significantly decreased at 6 months or more after therapy.
MET-PET may be an alternative method for evaluating the effect of radiotherapy.
Anticancer research 06/2009; 29(5):1507-14. · 1.73 Impact Factor
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Hirohiko Tsujii,
Tadashi Kamada,
Masayuki Baba, Hiroshi Tsuji,
Hirotoshi Kato,
Shingo Kato,
Shigeru Yamada,
Shigeo Yasuda,
Takeshi Yanagi,
Hiroyuki Kato,
Ryusuke Hara,
Naotaka Yamamoto,
Junetsu Mizoe
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ABSTRACT: Carbon-ion radiotherapy (C-ion RT) possesses physical and biological advantages. It was started at NIRS in 1994 using the Heavy Ion Medical Accelerator in Chiba (HIMAC); since then more than 50 protocol studies have been conducted on almost 4000 patients with a variety of tumors. Clinical experiences have demonstrated that C-ion RT is effective in such regions as the head and neck, skull base, lung, liver, prostate, bone and soft tissues, and pelvic recurrence of rectal cancer, as well as for histological types including adenocarcinoma, adenoid cystic carcinoma, malignant melanoma and various types of sarcomas, against which photon therapy could be less effective. Furthermore, when compared with photon and proton RT, a significant reduction of overall treatment time and fractions has been accomplished without enhancing toxicities. Currently, the number of irradiation sessions per patient averages 13 fractions spread over approximately three weeks. This means that in a carbon therapy facility a larger number of patients than is possible with other modalities can be treated over the same period of time.
New Journal of Physics 07/2008; 10(7):075009. · 4.18 Impact Factor
