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1、CARBONIONTHERAPY FORSACRALCHORDOMASTadashiKAMADA,MDResearchCenterforChargedParticleTherapyNationalInstituteofRadiologicalSciencesChiba,JAPANCTOS14thAnnualMeetingNovember13-15,2008LondonUKCarbonbeamhasadefiniterangeandtheBraggpeak.Inadditiontothisphysicalselectivity,io
2、nizationisenormousattheBraggpeak,andshowingbiologicaladvantagessuchascellcycleindependenteffect.Therefore,carbonbeamcouldbeapotentiallycurablearmamentforradio-resistanttumorssuchaschordoma.BraggpeakCarboniontherapyforchodoma:Background&MaterialSurgeryisthemainstayoftr
3、eatmentforchordomas.However,completeexcisionisfrequentlydifficultinS2orhigherlesionswithoutseverefunctionalloss.Ontheotherhand,chordomashowsminimalresponsetoradiationorchemotherapy.Between1996and2007,95patientswithsacralchordomawereincludedinthephaseI/II(Kamada,JCO200
4、2)andphaseII(Kamada,JCO2008)studyofcarboniontherapyforboneandsofttissuesarcomas.No.ofPts:95sacralchordmaGender:68males/27femalesAge:30-85(median65)Presentation:84primary/11postoprecTumorDiameter:3～17cm（Median：9cm）TumorVolume:47～1497cc（Median：370cc）(FromJun1996toFeb200
5、7)PatientsCharacteristicsL510S129S229S39S4~7Postoprec11SacralChordoma:LevelofInvasionMorethan80%wereS2orhigherlevellesionsCarboniontherapy-all16Fractionsover4weekTotaldose:52.8-64GyE:2,70.4GyE:86,73.6GyE:7(3.3-4.6GyE/fr.)Numberofport:Twoports:2,Threeports:91,Patch:2代表
6、的なものに変更96%90%50%30%10%With3ports;right-left,left-rightanterior-posterior(patch)With3ports;right-left,left-right,posterior-anteriorCarbonionDoseDistributioninSacralChordomaBowelswerespared!0.00.10.20.30.40.50.60.70.80.91.0Probability01224364860728496108120Months5yearOS
7、:86%5yearLC:88%OverallSurvivalandLocalControl afterCarbonIonTherapyinSacralChordomaSacralChordoma95patientsMediansurvivaltime42mo(13-112)Mediantimetolocalfailure35mo(13-60)RadiationMorbidityAcutegradeNo.012345Skin9508111300GItract959320000LategradeNo.012345Skin9508652
8、*2*0GItract959410000However,15patientsrequiredpersistentmedicationforperipheralneuropathyinthisseries.*receivingTDof73.6GyED
