Tsujii Hirohiko, Mizoe Junetsu, Kamada Tadashi, Baba Masayuki, Tsuji Hiroshi, Kato Hirotoshi, Kato Shingo, Yamada Shigeru, Yasuda Shigeo, Ohno Tatsuya, Yanagi Takeshi, Imai Reiko, Kagei Kenji, Kato Hiroyuki, Hara Ryusuke, Hasegawa Azusa, Nakajima Mio, Sugane Norio, Tamaki Noriaki, Takagi Ryo, Kandatsu Susumu, Yoshikawa Kyosan, Kishimoto Riwa, Miyamoto Tadaaki
Research Center for Charged Particle Therapy, National Institute of Radiological Sciences.
J Radiat Res. 2007;48 Suppl A:A1-A13. doi: 10.1269/jrr.48.a1.
In 1994 a Phase I/II clinical study on carbon ion radiotherapy was begun at NIRS using HIMAC, which was then the world's only heavy ion accelerator complex dedicated to medical use in a hospital environment. Among several types of ion species, we have chosen carbon ions for cancer therapy because they had the most optimal properties in terms of possessing, both physically and biologically, the most effective dose-localization in the body. The purpose of the clinical study was to investigate the efficacy of carbon ion radiotherapy against a variety of tumors as well as to develop effective techniques for delivering an efficient dose to the tumor. The RBE of carbon ions was estimated to be 2.0 to 3.0 along the SOBP for acute skin reactions. As of August 2006, a total of 2,867 patients had been entered into Phase I/II or Phase II studies and analyzed for toxicity and local tumor response. The results have shown that carbon ion radiotherapy has the potential ability to provide a sufficient dose to the tumor with acceptable morbidity in the surrounding normal tissues. Tumors that appear to respond favorably to carbon ions include locally advanced tumors and those with histologically non-squamous cell type of tumors such as adenocarcinoma, adenoid cystic carcinoma, malignant melanoma, hepatoma, and bone/soft tissue sarcoma. By taking advantage of the biological and physical properties of high-LET radiation, the efficacy of treatment regimens with small fractions in short treatment times has been confirmed for almost all types of tumors in carbon ion radiotherapy.
1994年，日本国立放射医学综合研究所（NIRS）利用当时世界上唯一一台专门用于医院环境医疗用途的重离子加速器——高能医学加速器（HIMAC），开展了一项碳离子放射治疗的I/II期临床研究。在几种离子种类中，我们选择碳离子用于癌症治疗，因为它们在物理和生物学方面都具有在体内实现最有效剂量定位的最佳特性。该临床研究的目的是研究碳离子放射治疗对各种肿瘤的疗效，并开发向肿瘤有效输送高效剂量的有效技术。对于急性皮肤反应，沿扩展布拉格峰（SOBP）碳离子的相对生物效应（RBE）估计为2.0至3.0。截至2006年8月，共有2867名患者进入I/II期或II期研究，并对毒性和局部肿瘤反应进行了分析。结果表明，碳离子放射治疗有潜力在周围正常组织可接受的发病率情况下，为肿瘤提供足够的剂量。对碳离子似乎反应良好的肿瘤包括局部晚期肿瘤以及组织学上非鳞状细胞类型的肿瘤，如腺癌、腺样囊性癌、恶性黑色素瘤、肝癌和骨/软组织肉瘤。通过利用高传能线密度（LET）辐射的生物学和物理特性，在碳离子放射治疗中，几乎所有类型的肿瘤都已证实了在短治疗时间内采用小分次治疗方案的疗效。
