Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
Int J Radiat Oncol Biol Phys. 2010 Aug 1;77(5):1470-6. doi: 10.1016/j.ijrobp.2009.06.048. Epub 2009 Nov 24.
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.
总结 I 期- II 期和 II 期碳离子放疗治疗骨和软组织肉瘤的结果。
我们回顾性分析了 1996 年至 2003 年间在日本千叶重离子医疗加速器接受治疗的 38 例无法手术的骶骨脊索瘤患者。38 例患者中，30 例未接受过治疗，8 例为局部复发性肿瘤。共 16 个固定剂量，4 周内总剂量为 52.8-73.6 Gray 等效物（中位数为 70.4）。
患者的中位年龄为 66 岁。31 例患者的颅肿瘤延伸至 S2 或更高水平。中位临床靶区体积为 523cm³。中位随访时间为 80 个月。5 年总生存率为 86%，5 年局部控制率为 89%。治疗后，30 例原发性肿瘤患者中有 27 例在有或没有辅助设备的情况下仍能行走。2 例患者发生严重皮肤或软组织并发症，需要植皮。
碳离子放疗治疗骶骨脊索瘤有效且安全，为手术提供了一种有前途的替代方法。
