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BackgroundUnresectable pediatric osteosarcoma has poor outcomes with conventional treatments.ResultsTwenty-six patients aged 11–20 years (median 16) had inoperable osteosarcoma of the trunk (24 pelvic, 1 mediastinal and 1 paravertebral) without any other lesion at initial examination. There were 22 primary, 1 locally recurrent and 3 metastatic cases. Median CIRT dose was 70.4 Gy RBE (relative biological effectiveness) delivered in 16 fractions. Median follow-up was 32.7 months. Overall survival was 50.0% and 41.7% at 3 and 5 years, respectively. Ten patients survived for more than 5 years (range 5–20.7 years). Local control was 69.9% and 62.9% at 3 and 5 years, respectively and progression-free survival was 34.6% at 3 and 5 years. Only largest tumor diameter correlated with 5-year overall survival and local control. There were 4 grade 3-4 CIRT-related late toxicities, 1 case of bone fracture and no treatment-related mortalities. All patients (except 1) were able to ambulate after CIRT.ConclusionsCIRT was safe and efficacious in the treatment of inoperable pediatric osteosarcoma with improved local control and overall survival compared to conventional treatments.MethodsWe retrospectively reviewed the records of pediatric and adolescent patients who received carbon ion radiotherapy (CIRT) for inoperable osteosarcoma between 1996 and 2014.

Background There are limited studies on the risk of secondary cancers after carbon‐ion radiotherapy (CIRT). We assessed the incidence of secondary cancers in patients treated with CIRT for cervical cancer. We also evaluated the incidence of secondary cancers in patients who received standard photon radiotherapy (RT) throughout the same period. Methods This retrospective study included patients with cervical cancer who underwent curative RT at our hospital. All cancers discovered for the first time after RT were classified as secondary cancers. To compare the risk of secondary cancers among cervical cancer survivors to the general population, standardized incidence ratios (SIRs) were calculated. Results The analysis included a total of 197 and 417 patients in the CIRT and photon RT groups, respectively. The total person‐years during the observation period were 1052.4 in the CIRT group and 2481.5 in the photon RT group. The SIR for all secondary cancers was 1.1 (95% confidence interval [CI], 0.6–2.1) in the CIRT group and 1.4 (95% CI, 1.0–2.1) in the photon RT group. The 10‐year cumulative incidence of all secondary cancers was 9.5% (95% CI, 4.0–21.5) in the CIRT group and 9.4% (95% CI, 6.2–14.1) in the photon RT group. The CIRT and photon RT groups were not significantly different in incidence (p = 0.268). Conclusions The incidence of secondary cancers after CIRT for cervical cancer was similar to that after photon RT. Validation of our findings after long‐term observation is warranted.

Purpose There have been very few reports of secondary malignancies after breast cancer treatment in Asia, particularly in Japan. This study aimed to evaluate the risk of secondary malignancies after radiotherapy (RT) in Japanese breast cancer patients. Methods This single-center retrospective study included patients who underwent RT between July 1961 and September 2006 for postoperative breast cancer. A total of 702 patients with a follow-up period of more than 5 years were analyzed. All malignancies observed at more than 5 years after the start of RT were defined as secondary malignancies. To calculate the relative risk (RR) of secondary malignancies, we applied data from the National Cancer Center in Japan. Results The median observation period was 9.7 (interquartile range 7.1–18.2) years. The cumulative person-years of observation were 6879.4. The RR of contralateral breast cancer increased by 1.85-fold (95% confidence interval [CI] 1.05–3.26) among patients compared with that among the general population; however, the difference was not significant (p = 0.053). The RR of secondary malignancies other than breast cancer increased by 2.71-fold (95% CI 1.99–3.70, p < 0.001) among the patients compared with the general population. Even when only malignancies detected more than 10 years after RT were defined as secondary malignancies, the RR of secondary malignancies other than breast cancer was 1.91 (95% CI 1.33–2.73, p < 0.001). Conclusion The incidence of secondary malignancies after RT may be somewhat higher in Japanese patients with breast cancer than in the general population.

We experienced a pancreatic cancer patient whose muscle cramp arose by using S-1 was improved by the administration of a Kampo formulation Goshajinkigan (GJG).Eighty-year-old female was diagnosed as having unresectable pancreatic cancer and then chemotherapy with S-1 and gemcitabine was initiated. After 4th course, gemcitabine had been discontinued by the toxicity, and then single administration for two weeks of a dose of 80 mg of S-1 was continued every three weeks. She often experienced muscle cramp at low legs, and she visited the emergency room with complaint of gait disturbance due to worse of muscle cramps. Her biochemical study showed almost normal electrolytes levels. Then a Kampo formulation Shakuyaku-kanzo-to (SKT), which was thought to be rapid-acting for these symptoms, was administered because of her sustained marked symptoms. No effect of SKT on these symptoms was observed; therefore, GJG was selected by Kampo medicine physician in combination with her complaints and body status. The administration of GJG was started 2.5 g once a day and then dose escalation was scheduled because it might induce gastrointestinal disorders. Since dose was escalated 5 g twice a day 2 weeks after initiation, incidence of muscle cramp was reduced three times a week. After 7 weeks, symptoms were disappeared. At this moment, she can continue the chemotherapy with S-1 under control of adverse event by the administration of 5 g of GJG twice a day.