Treatment outcome of ion beam therapy in eight patients with head and neck cancers

Abstract

Ion beam therapy has enabled us to treat formerly untreatable malignant tumors. The aim of the present study was to investigate the long-term follow-up course of patients with head and neck cancers who received ion beam therapy. The subjects were 8 patients (3 men and 5 women aged 43-78 years) with head and neck cancers who visited our department from 2006 to 2015 and received ion beam therapy. Six patients received carbon ion beam therapy, and the other two patients received proton beam therapy. The medical records of the patients were retrospectively analyzed. The primary site was the nasal and paranasal sinuses in six cases, nasopharynx in one case, and external auditory canal in one case. The histological type was olfactory neuroblastoma, malignant melanoma, and adenoid cystic carcinoma in two cases each, and chondrosarcoma and squamous cell carcinoma in one case each. The exposure dose ranged from 64 to 70.4 GyE. The average follow-up period was 42.0 months. Early adverse events were generally mild, and complete therapeutic response was obtained in all cases. However, five patients developed severe late complications including craniospinal dissemination, osteoradionecrosis of the maxilla and skull base, brain necrosis, and loss of eyesight. Three patients died of distant metastasis, local recurrence and/or brain necrosis within 2 years, and four patients have been surviving with distant metastasis or severe late complications. Ion beam therapy exhibits outstanding antitumor effects, but the severe late complications of the therapy must also be recognized.

Carbon ion radiation therapy for sinonasal malignancies: Promising results from 2282 cases from the real world

“…Seven of the eight CIRT cohorts covering 99.4% of the CIRT‐treated population reported acute grade 3‐5 AER. Only one case series of five patients did not report AER 12 . The rates were substantially lower in the PRT group (11/20 cohorts, 45.6% of the population) and the IMRT group (12/21 cohorts, 75.8% of the population).…”

“…Forty‐four (44) eligible studies (7 carbon ion, 11‐16 16 proton, 17,18,24,28,30‐41 and 21 IMRT 5‐7,42‐59 ) including the unpublished online data from our hospital 20 were identified from the database (see Figure 1). A representative sample of 2282 real‐world patients from 49 cohorts (8 CIRT cohorts, 20 PRT cohorts, and 21 IMRT cohorts) was included.…”

“…including 911 patients with SNM (along with 111 unpublished online cases from the authors' own institute) were analyzed [11][12][13][14][15][16]20 .…”

“…During the past 5 years, the prevailing use of advanced radiotherapy worldwide has made conventional 2DRT and 3D-CRT obsolete in the treatment of tumors with complex anatomy such as SNM. In addition, the clinical efficacy of CIRT or PRT has been suggested by the results of a few more recently published [11][12][13][14][15][16] retrospective studies, although many of them had a limited sample size. 15,17,18 However, it is highly improbable to initiate and complete a randomized clinical trial to confirm superior outcomes of CIRT and PRT over IMRT.…”

Brain MR findings in patients treated with particle therapy for skull base tumors

“…It has been reported that tissue damage after carbon ion therapy appears more frequently, is more severe, and lasts longer than after proton therapy; this seems due to the higher relative biological efficacy (RBE) of carbon ions compared to protons [29].…”