title: Efficacy and safety of carbon ion radiotherapy in bone and soft tissue sarcomas.
abstract: OBJECTIVE
  To evaluate the tolerance for and effectiveness of carbon ion radiotherapy in patients with unresectable bone and soft tissue sarcomas.
  
  
  METHODS
  We conducted a phase I/II dose escalation study of carbon ion radiotherapy. Fifty-seven patients with 64 sites of bone and soft tissue sarcomas not suited for resection received carbon ion radiotherapy. Tumors involved the spine or paraspinous soft tissues in 19 patients, pelvis in 32 patients, and extremities in six patients. The total dose ranged from 52.8 to 73.6 gray equivalent (GyE) and was administered in 16 fixed fractions over 4 weeks (3.3 to 4.6 GyE/fraction). The median tumor size was 559 cm(3) (range, 20 to 2,290 cm(3)). The minimum follow-up was 18 months.
  
  
  RESULTS
  Seven of 17 patients treated with the highest total dose of 73.6 GyE experienced Radiation Therapy Oncology Group grade 3 acute skin reactions. Dose escalation was then halted at this level. No other severe acute reactions (grade > 3) were observed in this series. The overall local control rates were 88% and 73% at 1 year and 3 years of follow-up, respectively. The median survival time was 31 months (range, 2 to 60 months), and the 1- and 3-year overall survival rates were 82% and 46%, respectively.
  
  
  CONCLUSIONS
  Carbon ion radiotherapy seems to be a safe and effective modality in the management of bone and soft tissue sarcomas not eligible for surgical resection, providing good local control and offering a survival advantage without unacceptable morbidity.
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, and Chiba University Graduate School of Medicine, Chiba, Japan. t_kamada@nirs.go.jp
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kamada
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tsujii
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuji
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yanagi
authors.forename: Jun-etsu
authors.initials: JE
authors.lastname: Mizoe
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kato
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamada
authors.forename: Shinroku
authors.initials: S
authors.lastname: Morita
authors.forename: Kyousan
authors.initials: K
authors.lastname: Yoshikawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Kandatsu
authors.forename: Akio
authors.initials: A
authors.lastname: Tateishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D002250:Carbon Radioisotopes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012509:Sarcoma / Q000175:diagnosis / Q000532:radiotherapy*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D002250:Carbon Radioisotopes