Weber Damien C, Rutz Hans Peter, Bolsi Alessandra, Pedroni Eros, Coray Adolf, Jermann Martin, Lomax Antony J, Hug Eugen B, Goitein Gudrun
Center for Proton Radiation Therapy, Paul Scherrer Institute, Villigen, Switzerland.
Int J Radiat Oncol Biol Phys. 2007 Nov 1;69(3):865-71. doi: 10.1016/j.ijrobp.2007.04.034. Epub 2007 Jul 2.
To assess the safety and efficacy of spot scanning proton beam therapy (PT) in the curative treatment of soft-tissue sarcoma (STS) in adults patients.
We identified 13 STS patients treated with PT between July 1998 and May 2005 in our institutional database. Tumor histology varied with the most common histologic subtypes including liposarcoma and peripheral nerve sheet tumor. All tumors were located in vicinity of critical structures, such as the spinal cord, optic apparatus, bowel, kidney, or bowel. Of the patients, 6 and 5 patients received PT either as adjuvant therapy for non-R0 resection or for recurrence, respectively. Two patients received radical PT for unresectable disease. The median prescribed dose was 69.4 CGE (CGE = proton Gy x 1.1)-Gy (range, 50.4-76.0) at 1.8 to 2 CGE-Gy (median, 1.9) per fraction. Pre-PT anthracycline-based chemotherapy was delivered to 3 patients only. No patient has been lost to follow-up (median 48.1 months, range, 19.1-100.7 months).
Of the 13 patients, all but 2 patients were alive. Local recurrence developed in 3 (23%) patients. The administered dose to these patients was < or =60 Gy-CGE. Distant control was achieved in all but 2 patients (lung metastasis), 1 of whom presented with a concomitant local recurrence. The 4-year local control and metastasis-free survival rates were 74.1% and 84.6%, respectively. Late grade > or =2 toxicity was observed in only 2 patients.
Spot scanning PT is an effective and safe treatment for patient with STS in critical locations. The observed toxicity rate was acceptable.
评估点扫描质子束疗法（PT）在成人软组织肉瘤（STS）根治性治疗中的安全性和有效性。
我们在机构数据库中确定了1998年7月至2005年5月期间接受PT治疗的13例STS患者。肿瘤组织学类型各异，最常见的组织学亚型包括脂肪肉瘤和周围神经鞘瘤。所有肿瘤均位于关键结构附近，如脊髓、视觉器官、肠道、肾脏或膀胱。其中，6例和5例患者分别接受PT作为非R0切除的辅助治疗或复发治疗。2例患者接受了不可切除疾病的根治性PT。中位处方剂量为69.4 CGE（CGE = 质子戈瑞×1.1）-戈瑞（范围为50.4 - 76.0），每次分割剂量为1.8至2 CGE - 戈瑞（中位值为1.9）。仅3例患者在PT前接受了基于蒽环类药物的化疗。无患者失访（中位随访时间48.1个月，范围为19.1 - 100.7个月）。
13例患者中，除2例患者外均存活。3例（23%）患者出现局部复发。这些患者接受的剂量≤60 Gy - CGE。除2例患者（肺转移）外，所有患者均实现远处控制，其中1例伴有局部复发。4年局部控制率和无转移生存率分别为74.1%和84.6%。仅2例患者观察到≥2级晚期毒性反应。
点扫描PT是治疗关键部位STS患者的一种有效且安全的方法。观察到的毒性率是可接受的。
