Biomedical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennohdai, Tsukuba, Ibaraki 305-8575, Japan.
Department of Radiation Oncology, Proton Beam Therapy Center, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan.
J Radiat Res. 2021 May 12;62(3):427-437. doi: 10.1093/jrr/rrab017.
This study aimed to evaluate the long-term efficacy of proton beam therapy (PBT) for unresectable benign meningiomas at the University of Tsukuba, Japan. From 1986-1998, 10 patients were treated at the Particle Radiation Medical Science Center (PRMSC) with a relative biological effectiveness (RBE) value of 1.0 using an accelerator built for physics experiments. The total dose was compensated with an X-ray in three patients. Following that, from 2002-2017, 17 patients were treated with a RBE value of 1.1 at the Proton Medical Research Center (PMRC) which was built for medical use. At the PRMSC, the total dose ranged from 50.4-66 Gy (median: 54 Gy). During the follow-up, which lasted between 3.8 and 31.6 years (median: 25.1 years), the 5-, 10-, 15-, 20- and 30-year local control rates were 100%, and the 5-, 10-, 15-, 20- and 30-year survival rates were 90, 80, 70, 70 and 36%, respectively. One patient died of brainstem radiation necrosis 5.1 years after PBT. At PMRC, the total dose ranged from 45.0-61.2 GyE, with a median of 50.4 GyE. During the follow-up, which lasted between 3 and 17 years with a median of 10.5 years, the 5-, 10- and 15-year local control rates were 94.1%, and the 5-, 10- and 15-year survival rates were 100, 100 and 88.9%, respectively. Neither malignant transformation nor secondary malignancy was observed, indicating that fractionated PBT may be effective and safely control benign unresectable meningioma even for the lifelong period of time.
本研究旨在评估日本筑波大学质子束治疗（PBT）不可切除良性脑膜瘤的长期疗效。1986 年至 1998 年，10 名患者在粒子辐射医学科学中心（PRMSC）接受治疗，使用为物理实验而建的加速器，相对生物效应（RBE）值为 1.0。其中 3 名患者的总剂量用 X 射线进行补偿。此后，2002 年至 2017 年，在为医疗用途而建的质子医学研究中心（PMRC），17 名患者采用 RBE 值为 1.1 进行治疗。在 PRMSC，总剂量范围为 50.4-66Gy（中位数：54Gy）。在随访期间，随访时间为 3.8 至 31.6 年（中位数：25.1 年），5 年、10 年、15 年、20 年和 30 年局部控制率分别为 100%，5 年、10 年、15 年、20 年和 30 年生存率分别为 90%、80%、70%、70%和 36%。1 例患者在 PBT 后 5.1 年死于脑干放射性坏死。在 PMRC，总剂量范围为 45.0-61.2GyE，中位数为 50.4GyE。在随访期间，中位随访时间为 10.5 年（3-17 年），5 年、10 年和 15 年的局部控制率分别为 94.1%，5 年、10 年和 15 年的生存率分别为 100%、100%和 88.9%。未观察到恶性转化或继发性恶性肿瘤，表明分割式 PBT 可能对不可切除的良性脑膜瘤有效且安全，即使在终身时间内也能控制。
