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Koide Y, Kodaira T, Kitayama M, Kawakita D, Kirita T, Yoshimoto S, Nakamizo M, Nibu KI. Definitive radiotherapy for nasopharyngeal carcinoma in Japan: analysis of cases in the National Head and Neck Cancer Registry from 2011 to 2014. Jpn J Clin Oncol 2024; 54:54-61. [PMID: 37781753 DOI: 10.1093/jjco/hyad130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/09/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE This study aimed to analyze the nationwide prognosis of patients with nasopharyngeal carcinoma who underwent definitive radiotherapy in Japan, utilizing the National Head and Neck Cancer Registry data. METHODS A total of 741 patients diagnosed with primary nasopharyngeal carcinoma were screened from 2011 to 2014. The inclusion criteria were histologically proven nasopharyngeal squamous cell carcinoma, receiving definitive radiotherapy, and no distant metastases. Patients with unclear prognoses or unknown staging were excluded. The primary endpoint was 5-year overall survival, and secondary endpoints were 5-year progression-free survival and survival by stage. RESULTS A total of 457 patients met the inclusion criteria. The median age was 60 years, and 80% were male. The proportions of patients with performance status 0, 1, 2 and 3 were 69, 10, 1 and 1%, respectively. Chemoradiotherapy was administered to 84.7%. Radiotherapy modalities were recorded only for 29 patients (three received intensity-modulated radiotherapy and 26 received two/three-dimensional radiotherapy). Of those included, 7.4, 24.7, 35.7, 24.5 and 7.7% had Stage I, II, III, IVA and IVB disease, respectively. The 5-year overall survival was 72.5% for all patients: 82.6, 86.6, 76.0, 51.4 and 66.5% for Stage I, II, III, IVA and IVB disease, respectively. The 5-year progression-free survival was 58.6%: 75.6, 66.8, 61.5, 43.7 and 46.5% for Stage I, II, III, IVA and IVB disease, respectively. CONCLUSIONS This nationwide survey demonstrated favorable prognoses and provided valuable foundational data for similar future surveys to monitor the penetration of appropriate treatment and changes in clinical structures based on new evidence.
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Affiliation(s)
- Yutaro Koide
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya, Japan
- Japan Society for Head and Neck Cancer, Fukagawa, Koto-ku, Tokyo, Japan
| | - Megumi Kitayama
- Clinical Study Support Center, Data Center Department, Wakayama Medical University Hospital, Wakayama, Japan
| | - Daisuke Kawakita
- Japan Society for Head and Neck Cancer, Fukagawa, Koto-ku, Tokyo, Japan
- Department of Otorhinolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tadaaki Kirita
- Japan Society for Head and Neck Cancer, Fukagawa, Koto-ku, Tokyo, Japan
- Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Seiichi Yoshimoto
- Japan Society for Head and Neck Cancer, Fukagawa, Koto-ku, Tokyo, Japan
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Munenaga Nakamizo
- Japan Society for Head and Neck Cancer, Fukagawa, Koto-ku, Tokyo, Japan
- Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Ken-Ichi Nibu
- Japan Society for Head and Neck Cancer, Fukagawa, Koto-ku, Tokyo, Japan
- Department of Otolaryngology, Kobe University School of Medicine, Kobe, Hyogo, Japan
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Colombo E, Van Lierde C, Zlate A, Jensen A, Gatta G, Didonè F, Licitra LF, Grégoire V, Vander Poorten V, Locati LD. Salivary gland cancers in elderly patients: challenges and therapeutic strategies. Front Oncol 2022; 12:1032471. [PMID: 36505842 PMCID: PMC9733538 DOI: 10.3389/fonc.2022.1032471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/31/2022] [Indexed: 11/26/2022] Open
Abstract
Salivary gland carcinomas (SGCs) are the most heterogeneous subgroup of head and neck malignant tumors, accounting for more than 20 subtypes. The median age of SGC diagnosis is expected to rise in the following decades, leading to crucial clinical challenges in geriatric oncology. Elderly patients, in comparison with patients aged below 65 years, are generally considered less amenable to receiving state-of-the-art curative treatments for localized disease, such as surgery and radiation/particle therapy. In the advanced setting, chemotherapy regimens are often dampened by the consideration of cardiovascular and renal comorbidities. Nevertheless, the elderly population encompasses a broad spectrum of functionalities. In the last decades, some screening tools (e.g. the G8 questionnaire) have been developed to identify those subjects who should receive a multidimensional geriatric assessment, to answer the question about the feasibility of complex treatments. In the present article, we discuss the most frequent SGC histologies diagnosed in the elderly population and the relative 5-years survival outcomes based on the most recent data from the Surveillance, Epidemiology, and End Results (SEER) Program. Moreover, we review the therapeutic strategies currently available for locoregionally advanced and metastatic disease, taking into account the recent advances in precision oncology. The synergy between the Multidisciplinary Tumor Board and the Geriatrician aims to shape the most appropriate treatment pathway for each elderly patient, focusing on global functionality instead of the sole chronological age.
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Affiliation(s)
- Elena Colombo
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Charlotte Van Lierde
- Otorhinolaryngology-Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Alexandra Zlate
- Department of Radiation Oncology, Centre Leon Berard, Lyon, France
| | - Alexandra Jensen
- Department of Radiation Oncology, University Hospitals Giessen and Marburg (UKGM), Marburg, Germany
| | - Gemma Gatta
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Fabio Didonè
- Evaluative Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Lisa F. Licitra
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
- Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - Vincent Grégoire
- Department of Radiation Oncology, Centre Leon Berard, Lyon, France
| | - Vander Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery, Leuven Cancer Institute, University Hospitals Leuven and Department of Oncology, section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Laura D. Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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3
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Zhang W, Kong L, Lu JJ. A cross-sectional analysis of registered clinical trials on the use of particle beam radiation therapy in head and neck cancers. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:1192. [PMID: 36544687 PMCID: PMC9761119 DOI: 10.21037/atm-20-7760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 03/12/2021] [Indexed: 12/24/2022]
Abstract
Background To present and analyze the current status of registered clinical trials on particle beam (including proton and carbon ion beam) radiation therapy (PBRT) for head and neck (H&N) malignancies, and to provide insights for future clinical research, we designed the cross-sectional analysis. Methods We identified and analyzed all clinical trials of interest registered on ClinicalTrials.gov and PTCOG.ch until March 22, 2020. Results We identified 57 registered clinical trials related to the use of proton therapy or carbon ion radiation therapy (CIRT) in H&N malignancies. There were 20, 27, and 5 trials focused on CIRT, proton therapy, and both ions, respectively. The eligible trials were registered between 2007 and 2020, mainly focused on adenoid cystic carcinoma (ACC), squamous cell carcinoma (SCC), sinonasal malignancies (SNM), skull base tumors, locally advanced, and recurrent tumors. The nature of 23 (40%) trials were not stated and could not be identified. A total of 25 (44%) registered trials were phase II, including randomized controlled trials (RCTs). There were 14 RCTs (7 phase II, 2 phase II/III, 2 phase III, 1 phase I/II, and 2 phase not applicable), and 25 studies including RCTs were registered before the first enrolment. There were 11 completed clinical trials among the eligible trials, including 7 with published trial-related results. Conclusions Less than 10% of the countries with PBRT treatment facilities in operation have initiated clinical trials on H&N cancer. Furthermore, among all registered trials, less than 10% have been completed with results published. More clinical trials, especially high quality trials, are needed for optimizing and standardizing treatment techniques of PBRT for H&N malignancies.
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Affiliation(s)
- Wenna Zhang
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China;,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
| | - Lin Kong
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China;,Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Fudan University Cancer Hospital, Shanghai, China
| | - Jiade J. Lu
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, Shanghai, China;,Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai, China
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4
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Ng WT, But B, Wong CH, Choi CW, Chua ML, Blanchard P, Lee AW. Particle beam therapy for nasopharyngeal cancer: A systematic review and meta-analysis. Clin Transl Radiat Oncol 2022; 37:41-56. [PMID: 36065359 PMCID: PMC9440257 DOI: 10.1016/j.ctro.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/10/2022] [Accepted: 08/19/2022] [Indexed: 11/21/2022] Open
Abstract
Particle beam therapy yields excellent short-term treatment outcomes among NPC patients. Particle beam therapy is generally safe in primary and recurrent NPC patients, with ≥G3 late toxicity rates of 20 % or less. An approximately 5% mortality rate was reported among recurrent NPC patients.
Background/purpose A systematic review and meta-analysis were performed to better understand the benefits of particle beam therapy for nasopharyngeal cancer (NPC) treatment. The survival outcomes and toxicity of primary and recurrent NPC patients treated with proton or carbon ion beam therapy were investigated. Method PubMed, Scopus, and Embase were searched between 1 January 2007 to 3 November 2021. The inclusion and exclusion criteria included studies with either primary or recurrent NPC patients, sample size of ≥10 patients, and proton or carbon ion beam therapy as interventions. Twenty-six eligible studies with a total of 1502 patients were included. We used a random-effect meta-analysis to examine the impact of particle beam therapy on primary NPC patients and qualitatively described the results among recurrent patients. The primary outcome was overall survival (OS), while secondary outcomes included progression-free survival (PFS), local control (LC) and toxicity. Results The pooled OS at 1-year, 2-year and 3-year and 5-year for primary NPC patients who received particle beam therapy were 96 % (95 % confidence interval (CI) = 92 %-98 %), 93 % (95 % CI = 83 %-97 %), 90 % (95 % CI = 73 %-97 %) and 73 % (95 % CI = 52 %-87 %) respectively. The pooled 1-year and 2-year PFS, and LC for these patients were above 90 %. For locally recurrent NPC patients, the 1-year OS rate ranged from 65 % to 92 %, while the 1-year LC rate ranged from 80 % to 88 %. Both proton and carbon ion beam therapy were generally safe among primary and recurrent patients, with ≥G3 late toxicity rates of 20 % or less. Approximately a 5 % mortality rate was reported among recurrent patients. Conclusions This systematic review and meta-analysis demonstrated particle beam therapy has great potential in treating NPC, yielding excellent survival outcomes with low toxicity. However, further investigations are needed to assess the long-term outcomes and cost-effectiveness of this newer form of radiotherapy.
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5
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Kaneko T, Koto M, Ikawa H, Shinoto M, Takiyama H, Yamada S, Nemoto K, Tsuji H. Dosimetric analysis for otitis media with effusion due to Eustachian tube dysfunction after carbon-ion radiotherapy for head and neck cancers. Adv Radiat Oncol 2022; 8:101115. [DOI: 10.1016/j.adro.2022.101115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
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6
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Li S, Huang H, Xing M, Qin J, Zhang H, Liu Y, Zhang L, Zhang C, Tian Z, Gao X, Zhao R, Mao A. Carbon Ion Induces Cell Death and G2/M Arrest Through pRb/E2F1Chk2/Cdc2 Signaling Pathway in X-ray Resistant B16F10 Melanoma Cells. Dose Response 2022; 20:15593258221092364. [PMID: 35431695 PMCID: PMC9005744 DOI: 10.1177/15593258221092364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
To explore the effect of high-LET carbon ion (C-ion) radiation on malignant melanoma, we systematically compared the radiobiological effects of C-ion with that of X-rays in B16F10 melanoma cells. Results showed that C-ion radiation statistically inhibited clonogenic survival capacity of B16F10 melanoma cells. The RBE was 3.7 at D10 levels, meaning 1.0 Gy C-ion should cause the same biological effect as ≥ 3.0 Gy X-rays. In addition, we also observed a stronger proliferation-inhibiting and higher ratio of cell apoptosis and necrosis in B16F10 cells treated with C-ion than X-rays. Moreover, C-ion radiation exhibited stronger and long-lasting G2/M arrest than X-rays. As an underlying mechanism, we speculated that C-ion radiation-induced G2/M block through activating pRb/E2F1/Chk2 pathway. With these results, we highlighted the potential of C-ion in treatment of cutaneous melanoma. Further, in vitro experiments as well as clinical trials are needed to further evaluate the effect of carbon ion radiotherapy in melanoma.
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Affiliation(s)
- Sha Li
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
| | - Hefa Huang
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
- Department of Radiation Medicine, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
- School of Nuclear Science and Technology, Lanzhou University, Lanzhou, China
| | - Mengjie Xing
- Gansu Provincial Academic Institute for Medical Research, Lanzhou, China
- School of Biological& Pharmaceutical Engineering, Lanzhou Jiaotong University, Lanzhou, China
| | - Jin Qin
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
| | - Hong Zhang
- Department of Radiation Medicine, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Yang Liu
- Department of Radiation Medicine, Institute of Modern Physics, Chinese Academy of Sciences, Lanzhou, China
| | - Liping Zhang
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
| | - Chao Zhang
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
| | - Zhongze Tian
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
| | - Xingxin Gao
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
| | - Rui Zhao
- Department of Radiation Oncology, The 940th Hospital of Joint Logistics Support Force of Chinese People’s Liberation Army, Lanzhou, China
| | - Aihong Mao
- Gansu Provincial Academic Institute for Medical Research, Lanzhou, China
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7
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Loap P, Vischioni B, Bonora M, Ingargiola R, Ronchi S, Vitolo V, Barcellini A, Goanta L, De Marzi L, Dendale R, Pacelli R, Locati L, Calugaru V, Mammar H, Cavalieri S, Kirova Y, Orlandi E. Biological Rationale and Clinical Evidence of Carbon Ion Radiation Therapy for Adenoid Cystic Carcinoma: A Narrative Review. Front Oncol 2021; 11:789079. [PMID: 34917512 PMCID: PMC8668942 DOI: 10.3389/fonc.2021.789079] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/15/2021] [Indexed: 12/13/2022] Open
Abstract
Adenoid cystic carcinoma (ACC) is a rare, basaloid, epithelial tumor, arising mostly from salivary glands. Radiation therapy can be employed as a single modality for unresectable tumors, in an adjuvant setting after uncomplete resection, in case of high-risk pathological features, or for recurrent tumors. Due to ACC intrinsic radioresistance, high linear energy transfer (LET) radiotherapy techniques have been evaluated for ACC irradiation: while fast neutron therapy has now been abandoned due to toxicity concerns, charged particle beams such as protons and carbon ions are at present the beams used for hadron therapy. Carbon ion radiation therapy (CIRT) is currently increasingly used for ACC irradiation. The aim of this review is to describe the immunological, molecular and clinicopathological bases that support ACC treatment with CIRT, as well as to expose the current clinical evidence that reveal the advantages of using CIRT for treating ACC.
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Affiliation(s)
- Pierre Loap
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy.,Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Barbara Vischioni
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Maria Bonora
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Rossana Ingargiola
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Sara Ronchi
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Viviana Vitolo
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Amelia Barcellini
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Lucia Goanta
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli, Italy
| | - Ludovic De Marzi
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France.,Institut Curie, PSL Research University, University Paris Saclay, INSERM LITO, Orsay, France
| | - Remi Dendale
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Roberto Pacelli
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Napoli, Italy
| | - Laura Locati
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Valentin Calugaru
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Hamid Mammar
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Stefano Cavalieri
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Youlia Kirova
- Department of Radiation Oncology, Institut Curie, Paris, France.,Proton Therapy Center, Institut Curie, Orsay, France
| | - Ester Orlandi
- Radiation Oncology Unit, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
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8
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ALK-Positive Anaplastic Large Cell Lymphoma: A Diagnostic Dilemma for the Otolaryngologist in a Resource Poor Setting. Case Rep Otolaryngol 2021; 2021:3756742. [PMID: 34760325 PMCID: PMC8575600 DOI: 10.1155/2021/3756742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/27/2021] [Accepted: 10/22/2021] [Indexed: 11/18/2022] Open
Abstract
Anaplastic large cell lymphoma is a rare subtype of non-Hodgkin's lymphoma. The morphological diversity with which its anaplastic cells confer make the diagnosis of this hematological entity extremely challenging to the pathologist in a resource poor setting. We present a case of a 35-year-old male with a nasopharyngeal mass and cervical lymphadenopathy and the adversities faced by out otolaryngology department with obtaining the diagnosis of ALK-positive anaplastic large cell lymphoma.
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9
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Ebner DK, Malouff TD, Frank SJ, Koto M. The Role of Particle Therapy in Adenoid Cystic Carcinoma and Mucosal Melanoma of the Head and Neck. Int J Part Ther 2021; 8:273-284. [PMID: 34285953 PMCID: PMC8270088 DOI: 10.14338/ijpt-d-20-00076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/11/2021] [Indexed: 12/24/2022] Open
Abstract
Particle irradiation is suitable for resistant histologies owing to a combination of improved dose delivery with potential radiobiologic advantages in high linear energy transfer radiation. Within the head and neck, adenoid cystic carcinoma and mucosal melanoma are two such histologies, being radioresistant and lying closely proximal to critical structures. Here, we review the use of particle irradiation for adenoid cystic carcinoma and mucosal melanoma of the head and neck.
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Affiliation(s)
- Daniel K Ebner
- Hospital of the National Institutes of Quantum and Radiological Science and Technology (QST Hospital), Chiba, Japan
| | - Timothy D Malouff
- Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA
| | - Steven J Frank
- Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Masashi Koto
- Hospital of the National Institutes of Quantum and Radiological Science and Technology (QST Hospital), Chiba, Japan
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10
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Clinical features and dosimetric evaluation of carbon ion radiation-induced osteoradionecrosis of mandible in head and neck tumors. Radiother Oncol 2021; 161:205-210. [PMID: 34147522 DOI: 10.1016/j.radonc.2021.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 06/05/2021] [Accepted: 06/10/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND PURPOSE Osteoradionecrosis (ORN) affects the patient's quality of life by making eating and maintaining oral hygiene painful. This study aimed to analyze carbon ion radiotherapy (C-ion RT)-induced ORN of the mandible. MATERIALS AND METHODS A retrospective study of 199 patients with head and neck tumors treated with C-ion RT was performed from 2010 to 2019. Only 11 patients with tumors located in the oropharynx and floor of the mouth were analyzed. C-ion RT consisted of 57.6 Gy or 64.0 Gy (relative biological effectiveness) in 16 fractions. The mandible was analyzed for magnetic resonance imaging (MRI) changes and bone exposure. The relationship between the radiation dose and ORN of the mandible was analyzed. RESULTS Five patients (45.5%) had ORN of the mandible. The median follow-up time was 68 months. The median onset times based on MRI changes and bone exposure were 9 and 15 months, respectively. Doses of 30 Gy (relative biological effectiveness) to the mandible and teeth showed the most significant effect, causing ORN at 29.5 ± 6.7 cc and 3.9 ± 1.8 cc, respectively, with cut-off values at 16.5 cc (p = 0.002) and 1.8 cc (p = 0.0059), respectively. CONCLUSION This is the first study reporting the incidence, onset time, and risk-predictive dosimetry parameters of C-ion RT-induced ORN of the mandible. Our study will be useful for establishing clinical strategies for C-ion RT to the head and neck near the mandible.
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Musha A, Shimada H, Kubo N, Kawamura H, Okano N, Miyasaka Y, Sato H, Shirai K, Saitoh JI, Yokoo S, Chikamatsu K, Ohno T. Evaluation of Carbon Ion Radiation-Induced Trismus in Head and Neck Tumors Using Dose-Volume Histograms. Cancers (Basel) 2020; 12:cancers12113116. [PMID: 33113829 PMCID: PMC7693287 DOI: 10.3390/cancers12113116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 02/02/2023] Open
Abstract
Simple Summary Patients who receive carbon ion radiotherapy (C-ion RT) for tumors near the temporomandibular joint are likely to experience trismus, a condition characterized by reduced jaw opening. However, the relationship between the dose of carbon ion and the onset of trismus remains unclear. Therefore, we conducted a subgroup analysis of a prospective observational study to understand the relationship between the dose of carbon ion and the occurrence of trismus. Of 35 patients included in the study, six developed grade 2 trismus, and the median onset time was 12 months. The affected muscles included masticatory muscles and the coronoid process. Our findings suggest better treatment planning, such as dose optimization, to minimize the occurrence of muscle-related adverse effects associated with C-ion RT. Abstract Carbon ion radiotherapy (C-ion RT) provides a highly localized deposition of energy that can increase radiation doses to tumors while minimizing irradiation of adjacent normal tissues. For tumors located near the temporomandibular joint, C-ion RT-induced trismus may occur. However, the relationship between the carbon ion dose and the onset of trismus is unclear. In this prospective observational study, we assessed the trismus/carbon ion dose relationship using dose−volume histograms in 35 patients who received C-ion RT in their head and neck regions between 2010 and 2014. Trismus was evaluated in patients according to the Common Terminology Criteria for Adverse Events, version 4.0. All patients were treated with 57.6 or 64.0 Gy (relative biological effectiveness (RBE)) in 16 fractions, and the median follow-up time was 57 months. Grade 2 trismus was observed in six patients. The median onset time was 12 months. At maximum radiation doses, all masticatory muscles and coronoid processes, particularly the masseter muscle, were significantly different (p = 0.003). The contouring of the masseter muscle and coronoid process requires different treatment planning. The maximum radiation doses of the coronoid process can be proposed as a guideline for treatment planning, considering the ease of contouring in C-ion RT.
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Affiliation(s)
- Atsushi Musha
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan;
- Correspondence: ; Tel.: +81-(27)-220-8378
| | - Hirofumi Shimada
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
| | - Nobuteru Kubo
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
| | - Hidemasa Kawamura
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
| | - Naoko Okano
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
| | - Yuhei Miyasaka
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
| | - Hiro Sato
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
| | - Katsuyuki Shirai
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Tochigi 329-0498, Japan;
| | - Jun-ichi Saitoh
- Department of Radiation Oncology, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan;
| | - Satoshi Yokoo
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan;
| | - Kazuaki Chikamatsu
- Department of Otolaryngology-Head and Neck Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan;
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Gunma 371-8511, Japan; (H.S.); (N.K.); (H.K.); (N.O.); (Y.M.); (H.S.); (T.O.)
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Soltani-Nabipour J, Khorshidi A, Shojai F, Khorami K. Evaluation of dose distribution from 12C ion in radiation therapy by FLUKA code. NUCLEAR ENGINEERING AND TECHNOLOGY 2020. [DOI: 10.1016/j.net.2020.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Blakely EA, Faddegon B, Tinkle C, Bloch C, Dominello M, Griffin RJ, Joiner MC, Burmeister J. Three discipline collaborative radiation therapy (3DCRT) special debate: The United States needs at least one carbon ion facility. J Appl Clin Med Phys 2019; 20:6-13. [PMID: 31573146 PMCID: PMC6839391 DOI: 10.1002/acm2.12727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 08/29/2019] [Accepted: 09/04/2019] [Indexed: 01/07/2023] Open
Affiliation(s)
| | - Bruce Faddegon
- Department of Radiation OncologyUniversity of California – San FranciscoSan FranciscoCAUSA
| | - Christopher Tinkle
- Department of Radiation OncologySt. Jude Children’s Research HospitalMemphisTNUSA
| | - Charles Bloch
- Department of Radiation OncologyUniversity of WashingtonSeattleWAUSA
| | - Michael Dominello
- Department of OncologyWayne State University School of MedicineDetroitMIUSA
| | - Robert J Griffin
- Department of OncologyUniversity of Arkansas for Medical SciencesLittle RockARUSA
| | - Michael C Joiner
- Department of OncologyWayne State University School of MedicineDetroitMIUSA
| | - Jay Burmeister
- Department of OncologyWayne State University School of MedicineDetroitMIUSA,Gershenson Radiation Oncology CenterBarbara Ann Karmanos Cancer InstituteDetroitMIUSA
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Radiobiological Characterization of Canine Malignant Melanoma Cell Lines with Different Types of Ionizing Radiation and Efficacy Evaluation with Cytotoxic Agents. Int J Mol Sci 2019; 20:ijms20040841. [PMID: 30781345 PMCID: PMC6413050 DOI: 10.3390/ijms20040841] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 02/12/2019] [Accepted: 02/12/2019] [Indexed: 01/19/2023] Open
Abstract
Canine malignant melanoma (CMM) is a locally and systemically aggressive cancer that shares many biological and clinical characteristics with human mucosal melanoma. Hypofractionated radiation protocols have been used to treat CMM but little is known about its radiation biology. This pilot study is designed to investigate response of CMM cell lines to various ionizing radiations and cytotoxic agents to better understand this canine cancer. Four CMM cell lines were evaluated by clonogenic survival assay under aerobic and hypoxic conditions and parameters such as alpha beta (α/β) ratio, oxygen enhancement ratio (OER), and relative biological effectiveness (RBE) were calculated after 137Cs, 6 megavoltage (MV) photon, or carbon ion irradiation. Six cytotoxic agents (cisplatin, camptothecin, mitomycin C, bleomycin, methtyl methanesulfonate and etoposide) were also assessed for their efficacy. Under aerobic condition with 6 MV photon, the α/β ratio of the four cell lines ranged from 0.3 to >100, indicating a wide variation of cellular sensitivity. The ratio increased under hypoxic condition compared to aerobic condition and this was more dramatic in 137Cs and 6 MV photon treatments. OER of carbon was lower than 137Cs at D10 in 3 of the 4 cell lines. The RBE values generally increased with the increase of LET. Different cell lines showed sensitivity/resistance to different cytotoxic agents. This study revealed that CMM has a wide range of radiosensitivity and that hypoxia can reduce it, indicating that widely used hypofractionated protocols may not be optimal for all CMM patients. Several cytotoxic agents that have never been clinically assessed can improve treatment outcome.
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Abe T, Ohno T, Koto M, Demizu Y, Suefuji H, Tsuji H, Okimoto T, Shioyama Y, Saitoh JI, Shirai K, Nemoto K, Nakano T, Kamada T. A multi-institutional retrospective study of carbon-ion radiotherapy for non-squamous cell malignant tumors of the nasopharynx: Subanalysis of Japan Carbon-Ion Radiation Oncology Study Group study 1402 HN. Cancer Med 2018; 7:6077-6083. [PMID: 30449067 PMCID: PMC6308058 DOI: 10.1002/cam4.1884] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/26/2018] [Accepted: 10/29/2018] [Indexed: 12/20/2022] Open
Abstract
Background This multi‐institutional retrospective study focused on the clinical outcome of carbon‐ion radiotherapy (C‐ion RT) for non‐squamous cell malignant tumors of the nasopharynx. Methods The Japan Carbon‐ion Radiation Oncology Study Group collected and analyzed data for 43 patients with non‐squamous cell malignant tumors of the nasopharynx treated with C‐ion RT at four institutions in Japan. Results Twenty‐nine patients had adenoid cystic carcinomas, seven had malignant melanomas, three had adenocarcinomas, two had mucoepidermoid carcinomas, and two had other pathologies. Twenty‐six of the 43 patients (61%) had T4 tumors. The most common dose‐fractionation schedule was 64 Gy (relative biological effectiveness) in 16 fractions. The median follow‐up period was 30 months. The 2‐year local control (LC) and overall survival (OS) rates were 88% and 84%, respectively. For late toxicity, one patient developed grade 4 optic nerve disorder and two developed grade 5 pharyngeal hemorrhage. Actual incidence of grade 3 or higher late adverse events was 19%, and included cranial nerve dysfunction, jaw bone necrosis, central nervous system necrosis, and ear inflammation. Conclusions C‐ion RT provided good LC and OS rates with acceptable toxicity for treatment of non‐squamous cell malignant tumors of the nasopharynx.
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Affiliation(s)
- Takanori Abe
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Tatsuya Ohno
- Gunma University Heavy Ion Medical Center, Maebashi, Japan
| | - Masashi Koto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Yusuke Demizu
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | | | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Tomoaki Okimoto
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Japan
| | | | - Jun-Ichi Saitoh
- Department of Radiation Oncology, Toyama University, Toyama, Japan
| | - Katsuyuki Shirai
- Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | - Kenji Nemoto
- Department of Radiation Oncology, Faculty of Medicine, Yamagata University, Yamagata, Japan
| | - Takashi Nakano
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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