Journal Article Two cases of pelvic sarcoma in the acetabulum with >10-year follow-ups after carbon ion radiotherapy.

kawanami, Katsuhisa  ,  matsuo, Toshihiro  ,  matsuo, Keiji  ,  Imai, Reiko  ,  kamiya, Mitsuhiro  ,  wakao, Norimitsu  ,  hirasawa, Atsuhiko  ,  deie, Masataka

There are many cases of bone and soft-tissue sarcoma in whichresection is difficult. This difficulty is typically related to the lesion'soriginal location or the possibility that resection could leadto a marked decline in the patient's quality of life, based onpostoperative motor dysfunction or neurological damage [1].Moreover, even in cases where resection is possible, postoperativeirradiation is recommended for patients who experience incompleteresection or exhibit positive surgical margins. However,many kinds of bone and soft-tissue sarcomas are radio-resistanttumours, and it is can be difficult to control them using X-ray radiationtherapy.In the field of radiation oncology, heavy-ion beams are definedas radiation that is obtained by accelerating charged nuclei that areheavier than protons. Carbon ion radiotherapy is one type of heavyionradiotherapy having potential advantages over conventionalradiotherapy [2]. For example, carbon ions provide better physicaldose distribution, compared to conventional radiotherapy, becauseof the special characteristic of charged particle beams (the Braggpeak) [2,3]. Furthermore, they have a higher relative biologicaleffectiveness and a lower oxygen enhancement ratio. Some researchershave argued that protons represent a technicalimprovement for highly conformal therapy, and that heavier ionsmight even facilitate the treatment of cancers that are resistant toconventional X-ray therapy [4]. In Japan, the National Institute ofRadiological Science (NIRS) has treated patients using carbon ionradiotherapy since 1994, and over 8000 patients with various solidtumours have been treated using by carbon ion radiotherapy atNIRS [2].We informed two patients that there are not only advantages ofsurgery but also postoperative complications. In addition, we toldthem that carbon ion radiotherapy might be a safe and effectivemodality for patients who localized primary sarcoma who are unsuitablefor resection or for patients who refuse surgery includingamputation. As a result, both of them made a choose carbon iontherapy.In the present report, we describe two cases of pelvic sarcomaswith available oncological and functional results from prolongedfollow-ups (>10 years) after carbon ion radiotherapy without surgery.Informed consent has been obtained from these two patientsfor publication. This is the first report regarding delayed side effectsof carbon ion radiotherapy after a long-term follow-up.

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