Purpose/Objective(s): To determine the recommended irradiation dose of carbon ion radiotherapy and to evaluate the safety and effects of high-dose carbon ion radiotherapy for unresectable bone and soft tissue sarcoma in the adult head and neck. Materials/Methods: Adult patients with unresectable bone and soft tissue sarcoma in the head and neck were eligible for this phase I/II study. First, the patients were enrolled in a study on dose escalation from 70.4 GyE/16 fr. to determine the appropriate irradiation dose with carbon ion radiotherapy. Then a phase II study was performed using that irradiation dose. Results: A total of 27 evaluable patients were enrolled. The median follow-up period of survival patients was 29.0 months. As acute adverse effects, Grade 3 mucositis was observed in only 1 patient, and no patient had Grade 4 toxicity. As late adverse effects, Grade 4 optic nerve injury was observed in 1 patient and Grade 3 osteonecrosis was observed in 4 patients. Since the local control rate with the initial dose during the phase I study was approximately 100% and since results of another dose-escalation study with carbon ion for sarcomas of the trunk performed in our institution showed that a dose of more than 70.4 GyE has many unacceptable adverse effects, we considered 70.4 GyE/16 fr. to be an appropriate irradiation dose for unresectable bone and soft tissue sarcoma in the adult head and neck. We therefore used that irradiation dose in a phase II study. Overall response rate was 29.6%, with complete response in 3 patients and partial response in 5 patients. The 1-year and 3-year local control rates were 96.0% and 91.6%, respectively, the 1-year and 3-year overall survival rates were 92.6% and 72.6%, respectively. The local control rate was significantly better than that of our past results with carbon ion radiotherapy at a dose of 57.6 or 64.0 GyE/16 fr. for sarcomas in the head and neck (log-rank test: p\0.001); however, there was not significant difference of overall survival rate between 70.4 GyE and 57.6 or 64.0 GyE (log-rank test: p = 0.165). Conclusions: The recommended irradiation dose of carbon ion radiotherapy for bone and soft tissue sarcoma in the adult head and neck is 70.4 GyE/16 fr., and that dose is considered to be safe and relative effective.Purpose/Objective(s): Acral myxoinflammatory fibroblastic sarcoma (AMFS) represents a rare, low-grade sarcoma that commonly affects the distal extremities. The lesion often presents as a painless mass in the hands or feet. From the published cases,
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