Karasawa Kumiko, Wakatsuki Masaru, Kato Shingo, Kiyohara Hiroki, Kamada Tadashi
Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba-city, Chiba 263-8555, Japan.
J Radiat Res. 2014 Mar 1;55(2):343-50. doi: 10.1093/jrr/rrt120. Epub 2014 Feb 16.
Carbon ion radiotherapy (C-ion RT) is an advanced modality for treating malignant melanoma. After we treated our first case of gynecological melanoma using C-ion RT in November 2004, we decided to conduct a clinical trial to evaluate its usefulness for the treatment of gynecological melanoma. The eligibility criteria for enrollment in this study were histologically proven malignant melanoma of the gynecological regions with lymph node metastasis remaining in the inguinal and pelvic regions. The small pelvic space, including the GTV and the metastatic lymph node, was irradiated with up to a total dose of 36 GyE followed by a GTV boost of up to a total dose of 57.6 GyE or 64 GyE in 16 fractions. A series of 23 patients were treated between November 2004 and October 2012. Patient age ranged from 51-80 with a median of 71. Of the tumor sites, 14 were located in the vagina, 6 in the vulva, and 3 in the cervix uteri. Of the 23 patients, 22 were irradiated with up to a total dose of 57.6 GyE, and 1 patient was irradiated with up to a total dose of 64 GyE. Chemotherapy and interferon-β were also used to treat 11 of the patients. Acute and late toxicities of Grade 3 or higher were observed in 1 patient treated with concurrent interferon-β. The median follow-up time was 17 months (range, 6-53 months). There was recurrence in 14 patients, and the 3-year local control and overall survival rates were 49.9% and 53.0%, respectively. C-ion RT may become a non-invasive treatment option for gynecological melanoma.
碳离子放射治疗（C离子RT）是治疗恶性黑色素瘤的一种先进方式。2004年11月我们使用C离子RT治疗了首例妇科黑色素瘤患者后，决定开展一项临床试验以评估其对妇科黑色素瘤治疗的有效性。本研究的入组标准为组织学确诊的妇科区域恶性黑色素瘤，腹股沟和盆腔区域存在淋巴结转移。对包括大体肿瘤体积（GTV）和转移淋巴结在内的小盆腔区域进行照射，总剂量最高达36 GyE，随后对GTV进行推量照射，总剂量最高达57.6 GyE或64 GyE，分16次进行。2004年11月至2012年10月期间共治疗了23例患者。患者年龄在51至80岁之间，中位年龄为71岁。肿瘤部位中，14例位于阴道，6例位于外阴，3例位于子宫颈。23例患者中，22例接受了最高总剂量为57.6 GyE的照射，1例接受了最高总剂量为64 GyE的照射。11例患者还接受了化疗和干扰素-β治疗。1例接受同步干扰素-β治疗的患者出现了3级或更高等级的急性和晚期毒性反应。中位随访时间为17个月（范围6至53个月）。14例患者出现复发，3年局部控制率和总生存率分别为49.9%和53.0%。C离子RT可能成为妇科黑色素瘤的一种非侵入性治疗选择。
