Carbon ion radiotherapy for sacral chordoma
Carbon ion radiotherapy for sacral chordoma
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DOI：
10.1259/bjr/13783281
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发表时间：
2011-12-01
影响因子：
2.6
通讯作者：
Tsujii, H.
中科院分区：
文献类型：
--
作者：
Imai, R.;Kamada, T.;Tsujii, H.
日本千叶国立放射线科学研究所自 1994 年起使用千叶重离子医疗加速器 (HIMAC) 产生的碳离子束提供碳离子放射治疗 (CIRT)。 2009 年 7 月，HIMAC 治疗的病例总数超过 5000 例。在此，我们对 CIRT 治疗骶骨脊索瘤进行回顾性分析。该研究纳入了 1996 年至 2007 年间接受治疗的 95 名医学上无法切除的骶骨脊索瘤患者。患者的中位年龄为 66 岁。在所有患者中，84 名患者先前未接受过治疗，11 名患者在先前切除后出现局部复发肿瘤。碳离子剂量范围为 52.8 至 73.6 GyE（中位值 70.4 GyE），4 周内总共 16 个固定剂量。中位临床靶体积为 370 cm(3)。所有95名患者的5年总生存率为86%，随访生存时间为42个月（范围13-112个月）。 5年局部控制率为88%，局部失败中位时间为35个月（范围13-60个月）。在 95 名患者中，91% 的患者在使用或不使用支持装置的情况下仍能行走。两名患者出现严重的皮肤或软组织并发症，需要植皮。 15 名患者经历了严重的坐骨神经并发症，需要继续用药。 CIRT 在治疗骶骨脊索瘤患者方面似乎有效且安全，并提供了一种有前途的手术替代方案。
The National Institute of Radiological Sciences in Chiba, Japan has offered carbon ion radiotherapy (CIRT) since 1994 using carbon ion beams generated by the heavy ion medical accelerator in Chiba (HIMAC). The total number of cases treated with the HIMAC exceeded 5000 in July 2009. Here, we present a retrospective analysis of CIRT for sacral chordoma. The study included 95 patients with medically unresectable sacral chordomas treated between 1996 and 2007. The median age of the patients was 66 years. Of all the patients, 84 had not been treated previously and 11 had a locally recurrent tumour following previous resection. The carbon ion dose ranged from 52.8 to 73.6 GyE (median 70.4 GyE) in a total of 16 fixed fractions over 4 weeks. The median clinical target volume was 370 cm(3). The overall survival rate at 5 years for all 95 patients was 86%, and follow-up survival time was 42 months (range, 13-112 months). The 5-year local control rate was 88% and median time to local failure was 35 months (range, 13-60 months). Of the 95 patients, 91% remained ambulatory with or without a supportive device. Two patients experienced severe skin or soft tissue complications requiring skin grafts. 15 patients experienced severe sciatic nerve complications requiring continuing medication. CIRT appears effective and safe in the management of patients with sacral chordoma and offers a promising alternative to surgery.