Gunma University Heavy Ion Medical Center, Maebashi, Japan.
Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan.
Cancer Med. 2018 Dec;7(12):6077-6083. doi: 10.1002/cam4.1884. Epub 2018 Nov 18.
This multi-institutional retrospective study focused on the clinical outcome of carbon-ion radiotherapy (C-ion RT) for non-squamous cell malignant tumors of the nasopharynx.
The Japan Carbon-ion Radiation Oncology Study Group collected and analyzed data for 43 patients with non-squamous cell malignant tumors of the nasopharynx treated with C-ion RT at four institutions in Japan.
Twenty-nine patients had adenoid cystic carcinomas, seven had malignant melanomas, three had adenocarcinomas, two had mucoepidermoid carcinomas, and two had other pathologies. Twenty-six of the 43 patients (61%) had T4 tumors. The most common dose-fractionation schedule was 64 Gy (relative biological effectiveness) in 16 fractions. The median follow-up period was 30 months. The 2-year local control (LC) and overall survival (OS) rates were 88% and 84%, respectively. For late toxicity, one patient developed grade 4 optic nerve disorder and two developed grade 5 pharyngeal hemorrhage. Actual incidence of grade 3 or higher late adverse events was 19%, and included cranial nerve dysfunction, jaw bone necrosis, central nervous system necrosis, and ear inflammation.
C-ion RT provided good LC and OS rates with acceptable toxicity for treatment of non-squamous cell malignant tumors of the nasopharynx.
本多机构回顾性研究专注于碳离子放射治疗（C-ion RT）治疗非鳞状细胞鼻咽癌的临床结果。
日本碳离子放射肿瘤学研究组收集并分析了在日本四家机构接受 C-ion RT 治疗的 43 例非鳞状细胞鼻咽癌患者的数据。
29 例患者为腺样囊性癌，7 例为恶性黑色素瘤，3 例为腺癌，2 例为黏液表皮样癌，2 例为其他病理类型。43 例患者中有 26 例（61%）为 T4 肿瘤。最常见的剂量分割方案是 64Gy（相对生物效应），共 16 次。中位随访时间为 30 个月。2 年局部控制（LC）和总生存率（OS）分别为 88%和 84%。晚期毒性方面，1 例患者发生 4 级视神经障碍，2 例患者发生 5 级咽出血。实际发生 3 级或更高级别的晚期不良事件的发生率为 19%，包括颅神经功能障碍、颌骨坏死、中枢神经系统坏死和耳部炎症。
C-ion RT 为治疗非鳞状细胞鼻咽癌提供了良好的 LC 和 OS 率，且毒性可接受。
