Okonogi Noriyuki, Wakatsuki Masaru, Kato Shingo, Shiba Shintaro, Kobayashi Daijiro, Kiyohara Hiroki, Karasawa Kumiko, Ohno Tatsuya, Nakano Takashi, Kamada Tadashi, Shozu Makio
Hospital, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
Department of Radiology, Jichi Medical University, Tochigi, Japan.
Anticancer Res. 2018 Jan;38(1):457-463. doi: 10.21873/anticanres.12244.
BACKGROUND/AIM: To evaluate the long-term outcomes of carbon-ion radiotherapy (C-ion RT) for locally advanced cervical squamous cell carcinoma (LAC-SqCC) in 2 prospective phase I/II studies.
In the first study, 14 patients were treated with 68.8-72.8 Gy (RBE)/24 fractions. In a subsequent study, 22 patients were treated with 64.0-72.0 Gy (RBE)/20 fractions while limiting the dose to the gastro-intestinal (GI) <60 Gy (RBE).
The 10-year local control rates were 92% and 61% for the patients administered a total dose of 72.0-72.8 Gy (RBE) and 64.0-68.8 Gy (RBE), respectively. Two patients in the first study developed grade 3/4 rectal or bladder complications; however, no grade 3 or higher complications occurred in the second study.
C-ion RT with a higher dose was associated with excellent LC in LAC-SqCC. Long-term safety was confirmed based on the establishment of dose constraints for the GI tract.
背景/目的：在两项前瞻性I/II期研究中评估碳离子放疗（C离子放疗）治疗局部晚期宫颈鳞状细胞癌（LAC-SqCC）的长期疗效。
在第一项研究中，14例患者接受了68.8 - 72.8 Gy（相对生物效应）/24次分割的治疗。在随后的一项研究中，22例患者接受了64.0 - 72.0 Gy（相对生物效应）/20次分割的治疗，同时将胃肠道（GI）剂量限制在<60 Gy（相对生物效应）。
总剂量为72.0 - 72.8 Gy（相对生物效应）和64.0 - 68.8 Gy（相对生物效应）的患者10年局部控制率分别为92%和61%。第一项研究中有2例患者出现3/4级直肠或膀胱并发症；然而，第二项研究中未出现3级或更高等级的并发症。
高剂量的C离子放疗与LAC-SqCC的良好局部控制相关。基于对胃肠道建立的剂量限制，证实了长期安全性。
