Ohkubo Jun-Ichi, Hohchi Nobusuke, Takeuchi Shoko, Ikezaki Shoji, Kise Yasuhiro, Koizumi Hiroki, Suzuki Hideaki
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
Eur Arch Otorhinolaryngol. 2016 Dec;273(12):4397-4402. doi: 10.1007/s00405-016-4086-2. Epub 2016 May 11.
Ion beam therapy has enabled us to treat formerly untreatable malignant tumors. The aim of the present study was to investigate the long-term follow-up course of patients with head and neck cancers who received ion beam therapy. The subjects were 8 patients (3 men and 5 women aged 43-78 years) with head and neck cancers who visited our department from 2006 to 2015 and received ion beam therapy. Six patients received carbon ion beam therapy, and the other two patients received proton beam therapy. The medical records of the patients were retrospectively analyzed. The primary site was the nasal and paranasal sinuses in six cases, nasopharynx in one case, and external auditory canal in one case. The histological type was olfactory neuroblastoma, malignant melanoma, and adenoid cystic carcinoma in two cases each, and chondrosarcoma and squamous cell carcinoma in one case each. The exposure dose ranged from 64 to 70.4 GyE. The average follow-up period was 42.0 months. Early adverse events were generally mild, and complete therapeutic response was obtained in all cases. However, five patients developed severe late complications including craniospinal dissemination, osteoradionecrosis of the maxilla and skull base, brain necrosis, and loss of eyesight. Three patients died of distant metastasis, local recurrence and/or brain necrosis within 2 years, and four patients have been surviving with distant metastasis or severe late complications. Ion beam therapy exhibits outstanding antitumor effects, but the severe late complications of the therapy must also be recognized.
离子束治疗使我们能够治疗以前无法治疗的恶性肿瘤。本研究的目的是调查接受离子束治疗的头颈癌患者的长期随访过程。研究对象为2006年至2015年到我院就诊并接受离子束治疗的8例头颈癌患者（3例男性，5例女性，年龄43 - 78岁）。6例患者接受碳离子束治疗，另外2例患者接受质子束治疗。对患者的病历进行了回顾性分析。原发部位：鼻窦及鼻旁窦6例，鼻咽癌1例，外耳道癌1例。组织学类型：嗅神经母细胞瘤、恶性黑色素瘤、腺样囊性癌各2例，软骨肉瘤和鳞状细胞癌各1例。照射剂量为64 - 70.4 GyE。平均随访时间为42.0个月。早期不良事件一般较轻，所有病例均获得完全治疗反应。然而，5例患者出现了严重的晚期并发症，包括颅脊髓播散、上颌骨和颅底骨放射性坏死、脑坏死和视力丧失。3例患者在2年内死于远处转移、局部复发和/或脑坏死，4例患者因远处转移或严重晚期并发症存活。离子束治疗显示出出色的抗肿瘤效果，但也必须认识到该治疗的严重晚期并发症。
