Acute radiation-induced toxicity of heavy ion radiotherapy delivered with intensity modulated pencil beam scanning in patients with base of skull tumors.
OBJECTIVE
The purpose of this paper is to evaluate acute radiation-induced toxicity of carbon ion therapy.


METHODS
From December 1997 to November 2000, 37 patients with chordomas and low-grade chondrosarcomas of the skull base have been treated with carbon ions at the heavy ion synchrotron (SIS) at GSI, Darmstadt. Tumor-conformal application of carbon beams was realized by intensity-controlled raster scanning in combination with pulse-to-pulse energy variation. The treatment planning procedure included a biological plan optimization. We applied a cobalt-Gray equivalent dose of 60GyE. Acute toxicity was assessed according to the common toxicity criteria (CTC).


RESULTS
Acute toxicity included skin reactions ( degrees I+ degrees II) in four patients, mucositis ( degrees I- degrees III) in eight patients, otitis and middle ear effusion in four, sinusitis in four, nausea/weight loss in one and edema of the temporal lobes in one patient. In two patients, preexisting neurological symptoms worsened. We did not observe acute morbidity > degrees III of normal tissues.


CONCLUSIONS
Scanning beam delivery of heavy charged particles is safe and reliable. No unexpected acute dose limiting toxicity was observed. With regard to toxicity, a substantial improvement compared to passive beam shaping technology is achieved.
Schulz-Ertner
Daniela
D
Department of Clinical Radiology, University of Heidelberg, Heidelberg, Germany.
Haberer
Thomas
T
Scholz
Michael
M
Thilmann
Christoph
C
Wenz
Frederik
F
Jäkel
Oliver
O
Kraft
Gerhard
G
Wannenmacher
Michael
M
Debus
Jürgen
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D002250:Carbon Radioisotopes; D002813:Chondrosarcoma / Q000175:diagnosis / Q000532:radiotherapy*; D002817:Chordoma / Q000175:diagnosis / Q000532:radiotherapy*; D003037:Cobalt Radioisotopes; D004890:Erythema / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008417:Mastoiditis / Q000209:etiology; D008875:Middle Aged; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012852:Sinusitis / Q000209:etiology; D019292:Skull Base Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D013238:Stereotaxic Techniques
D002250:Carbon Radioisotopes; D003037:Cobalt Radioisotopes