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Tsuchiya K, Akisue T, Ehara S, Kawai A, Kawano H, Hiraga H, Hosono A, Hutani H, Morii T, Morioka H, Nishida Y, Oda Y, Ogose A, Shimose S, Yamaguchi T, Yamamoto T, Yoshida M. Japanese orthopaedic association (JOA) clinical practice guidelines on the management of malignant bone tumors - Secondary publication. J Orthop Sci 2024:S0949-2658(23)00321-4. [PMID: 39003183 DOI: 10.1016/j.jos.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/13/2023] [Indexed: 07/15/2024]
Abstract
BACKGROUND In Japan, there are currently no general guidelines for the treatment of primary malignant bone tumors. Therefore, the Japanese Orthopaedic Association established a committee to develop guidelines for the appropriate diagnosis and treatment of primary malignant bone tumors for medical professionals in clinical practice. METHODS The guidelines were developed in accordance with "Minds Clinical Practice Guideline Development Handbook 2014″ and "Minds Clinical Practice Guideline Development Manual 2017". The Japanese Orthopaedic Association's Bone and Soft Tissue Tumor Committee established guideline development and systematic review committees, drawing members from orthopedic specialists leading the diagnosis and treatment of bone and soft tissue tumors. Pediatricians, radiologists, and diagnostic pathologists were added to both committees because of the importance of multidisciplinary treatment. Based on the diagnosis and treatment algorithm for primary malignant bone tumors, important decision-making points were selected, and clinical questions (CQ) were determined. The strength of recommendation was rated on two levels and the strength of evidence was rated on four levels. The recommendations published were selected based on agreement by 70% or more of the voters. RESULTS The guideline development committee examined the important clinical issues in the clinical algorithm and selected 22 CQs. The systematic review committee reviewed the evidence concerning each CQ and a clinical value judgment was added by experts. Eventually, 25 questions were published and the text of each recommendation was determined. CONCLUSION Since primary malignant bone tumors are rare, there is a dearth of strong evidence based on randomized controlled trials, and recommendations cannot be applied to all the patients. In clinical practice, appropriate treatment of patients with primary malignant bone tumors should be based on the histopathological diagnosis and degree of progression of each case, using these guidelines as a reference.
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Affiliation(s)
- Kazuaki Tsuchiya
- Department of Orthopaedic Surgery, Toho University of Medicine, Japan.
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Japan
| | - Shigeru Ehara
- Department of Radiology, Japan Community Healthcare Organization (JCHO) Sendai Hospital, Japan
| | - Akira Kawai
- Department of Musculoskeletal Oncology and Rehabilitation Medicine, Japan
| | - Hirotaka Kawano
- Department of Orthopaedic Surgery, Teikyo University of Medicine, Japan
| | - Hiroaki Hiraga
- Department of Musculoskeletal Oncology, National Hospital Organization Hokkaido Cancer Center, Japan
| | - Ako Hosono
- Department of Pediatric Oncology, National Cancer Center Hospital East, Japan
| | - Hiroyuki Hutani
- Department of Orthopaedic Surgery, Hyogo Medical University, Japan
| | - Takeshi Morii
- Department of Orthopaedic Surgery, Kyorin University Faculty of Medicine, Japan
| | - Hideo Morioka
- Department of Orthopaedic Surgery, National Hospital Organization Tokyo Medical Center, Japan
| | - Yoshihiro Nishida
- Department of Rehabilitation Medicine, Nagoya University Hospital, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Japan
| | - Akira Ogose
- Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Japan
| | - Shoji Shimose
- National Hospital Organization Kure Medical Center, Japan
| | - Takehiko Yamaguchi
- Department of Pathology, Dokkyo Medical University, Nikko Medical Center, Japan
| | - Tetsuji Yamamoto
- Department of Orthopaedic Surgery, Kagawa University Hospital, Japan
| | - Masahiro Yoshida
- International University of Health and Welfare, Japan Council for Quality Health Care, Japan
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Yagi M, Beltran CJ, Shimizu S, Hamatani N, Tsubouchi T, Takashina M, Kanai T, Ogawa K, Furutani KM. Carbon ion therapy for laterally located tumors require multiple fixed ports or a rotating gantry. Med Dosim 2024:S0958-3947(24)00013-X. [PMID: 38824052 DOI: 10.1016/j.meddos.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 01/30/2024] [Accepted: 02/24/2024] [Indexed: 06/03/2024]
Abstract
Mayo Clinic Florida will initially open with the capability to treat with a single horizontal port for carbon ion therapy. Carbon ion therapy is traditionally done using a multi fixed port treatment approach. In this study, for nine treatment sites, clinically approved treatment plan of Osaka Heavy Ion Therapy Center was compared to a treatment plan using only a horizontal port. The treatment sites evaluated in this study were prostate cancer, pancreatic cancer, cervical cancer, recurrent rectal cancer, liver cancer, head and neck cancer, bone cancer (sarcoma and chordoma), and lung cancer. As expected, the prostate plans are identical and are only included for completeness. The DVH results for the pancreas and cervical cancer were very similar. The results for recurrent rectal, head and neck, sarcoma, chordoma, and lung cancer indicate that a single horizontal port with couch roll and yaw will accommodate certain medial targets but will be challenging to treat for laterally located targets without creative mitigations.
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Affiliation(s)
- Masashi Yagi
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Chris J Beltran
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Division of Medical Physics, Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA
| | - Shinichi Shimizu
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Noriaki Hamatani
- Department of Medical Physics, Osaka Heavy Ion Center, Osaka, Osaka, Japan
| | - Toshiro Tsubouchi
- Department of Medical Physics, Osaka Heavy Ion Center, Osaka, Osaka, Japan
| | - Masaaki Takashina
- Department of Medical Physics, Osaka Heavy Ion Center, Osaka, Osaka, Japan
| | - Tatsuaki Kanai
- Department of Medical Physics, Osaka Heavy Ion Center, Osaka, Osaka, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Keith M Furutani
- Department of Carbon Ion Radiotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Division of Medical Physics, Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL 32224, USA.
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Vischioni B, Russo S, Meuli M, Bonora M, Ronchi S, Ingargiola R, Camarda AM, Imparato S, Preda L, Ciocca M, Molinelli S, Orlandi E. Dosimetric and Clinical Risk Factors for the Development of Maxillary Osteoradionecrosis in Adenoid Cystic Carcinoma (ACC) Patients Treated With Carbon Ion Radiotherapy. Front Oncol 2022; 12:829502. [PMID: 35311095 PMCID: PMC8924362 DOI: 10.3389/fonc.2022.829502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background The present study aims to evaluate dosimetric and clinical risk factors for the development of maxillary osteoradionecrosis (ORN) in head and neck adenoid cystic carcinoma (ACC) patients treated with carbon ion radiotherapy (CIRT). Methods Clinical data and treatment plans of ACC patients, consecutively treated from January 2013 to September 2016 within the phase II clinical trial CNAO S9/2012/C, were retrospectively reviewed. ORN and other treatment-related toxicity were graded according to the Common Terminology Criteria for Adverse Events (CTACE), version 4.0. The maxillary bone was contoured on the planning CT, and only patients receiving more than 10% of the prescription dose at their maxilla were considered for the analysis (67 patients). The volumes of maxilla receiving doses from 10 Gy (RBE) to 60 Gy (RBE) (VD), with an increment of 10 Gy (RBE), and additional clinical factors were correlated to the incidence of ORN with univariate analysis (Chi-square test). The logistic regression model was subsequently applied for multivariate analysis. Treatment plans calculated with a local effect model (LEM)-based optimization were recalculated with the modified microdosimetric kinetic model (MKM), and compared with literature data from the Japanese experience. Results The median time interval from the start of CIRT to ORN appearance was 24 months (range, 8–54 months). Maxillary ORN was observed in 11 patients (16.4%). Grade 1 ORN was observed in 2 patients (18.1%), G2 in 4 (36.3%), G3 in 4 (36.3%) and G4 in 1 (9.3%). From univariate analysis, the site of the tumor, the presence of teeth within the PTV and acute mucositis correlated with the development of maxillary ORN. VD were significantly higher for all the dose levels tested in patients with maxillary ORN than patients without necrosis, according to both radiobiological models. The multivariate analysis showed that V60 significantly correlated with ORN risk. Conclusion The volume of maxilla irradiated with high dose values was relevant for ORN development in our cohort of ACC patients. These results are in line with previously published data obtained with a different radiobiological model. Our findings might be helpful to prevent the risk of ORN in patients receiving CIRT.
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Affiliation(s)
- Barbara Vischioni
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Stefania Russo
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Martino Meuli
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Maria Bonora
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Sara Ronchi
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Rossana Ingargiola
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Anna Maria Camarda
- Division of Radiotherapy, Istituto Europeo di Oncologia (IEO) European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Milan, Italy.,Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Sara Imparato
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Lorenzo Preda
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy.,Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.,Radiology Institute, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo, Pavia, Italy
| | - Mario Ciocca
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Silvia Molinelli
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
| | - Ester Orlandi
- Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy, Pavia, Italy
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Lohberger B, Glänzer D, Eck N, Kerschbaum-Gruber S, Mara E, Deycmar S, Madl T, Kashofer K, Georg P, Leithner A, Georg D. Activation of efficient DNA repair mechanisms after photon and proton irradiation of human chondrosarcoma cells. Sci Rep 2021; 11:24116. [PMID: 34916568 PMCID: PMC8677811 DOI: 10.1038/s41598-021-03529-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/24/2021] [Indexed: 01/02/2023] Open
Abstract
Although particle therapy with protons has proven to be beneficial in the treatment of chondrosarcoma compared to photon-based (X-ray) radiation therapy, the cellular and molecular mechanisms have not yet been sufficiently investigated. Cell viability and colony forming ability were analyzed after X-ray and proton irradiation (IR). Cell cycle was analyzed using flow cytometry and corresponding regulator genes and key players of the DNA repair mechanisms were measured using next generation sequencing, protein expression and immunofluorescence staining. Changes in metabolic phenotypes were determined with nuclear magnetic resonance spectroscopy. Both X-ray and proton IR resulted in reduced cell survival and a G2/M phase arrest of the cell cycle. Especially 1 h after IR, a significant dose-dependent increase of phosphorylated γH2AX foci was observed. This was accompanied with a reprogramming in cellular metabolism. Interestingly, within 24 h the majority of clearly visible DNA damages were repaired and the metabolic phenotype restored. Involved DNA repair mechanisms are, besides the homology directed repair (HDR) and the non-homologous end-joining (NHEJ), especially the mismatch mediated repair (MMR) pathway with the key players EXO1, MSH3, and PCNA. Chondrosarcoma cells regenerates the majority of DNA damages within 24 h. These molecular mechanisms represent an important basis for an improved therapy.
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Affiliation(s)
- Birgit Lohberger
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5-7, 8036, Graz, Austria.
| | - Dietmar Glänzer
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5-7, 8036, Graz, Austria
| | - Nicole Eck
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5-7, 8036, Graz, Austria
| | - Sylvia Kerschbaum-Gruber
- Department of Radiation Oncology, Medical University of Vienna, 1090, Vienna, Austria
- MedAustron Ion Therapy Center, 2700, Wiener Neustadt, Austria
| | - Elisabeth Mara
- MedAustron Ion Therapy Center, 2700, Wiener Neustadt, Austria
- University of Applied Science, 2700, Wiener Neustadt, Austria
| | - Simon Deycmar
- Laboratory for Applied Radiobiology, University Zurich, 8006, Zurich, Switzerland
| | - Tobias Madl
- Gottfried Schatz Research Center for Cell Signaling, Metabolism and Aging Molecular Biology and Biochemistry, Medical University of Graz, 8010, Graz, Austria
- BioTechMed-Graz, 8010, Graz, Austria
| | - Karl Kashofer
- Institute of Pathology, Medical University of Graz, 8010, Graz, Austria
| | - Petra Georg
- MedAustron Ion Therapy Center, 2700, Wiener Neustadt, Austria
| | - Andreas Leithner
- Department of Orthopedics and Trauma, Medical University of Graz, Auenbruggerplatz 5-7, 8036, Graz, Austria
| | - Dietmar Georg
- Department of Radiation Oncology, Medical University of Vienna, 1090, Vienna, Austria
- MedAustron Ion Therapy Center, 2700, Wiener Neustadt, Austria
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Iannalfi A, D'Ippolito E, Riva G, Molinelli S, Gandini S, Viselner G, Fiore MR, Vischioni B, Vitolo V, Bonora M, Ronchi S, Petrucci R, Barcellini A, Mirandola A, Russo S, Vai A, Mastella E, Magro G, Maestri D, Ciocca M, Preda L, Valvo F, Orecchia R. Proton and carbon ion radiotherapy in skull base chordomas: a prospective study based on a dual particle and a patient-customized treatment strategy. Neuro Oncol 2021; 22:1348-1358. [PMID: 32193546 DOI: 10.1093/neuonc/noaa067] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The aim of this study is to evaluate results in terms of local control (LC), overall survival (OS), and toxicity profile and to better identify factors influencing clinical outcome of skull base chordoma treated with proton therapy (PT) and carbon ion radiotherapy (CIRT). METHODS We prospectively collected and analyzed data of 135 patients treated between November 2011 and December 2018. Total prescription dose in the PT group (70 patients) and CIRT group (65 patients) was 74 Gy relative biological effectiveness (RBE) delivered in 37 fractions and 70.4 Gy(RBE) delivered in 16 fractions, respectively (CIRT in unfavorable patients). LC and OS were evaluated using the Kaplan-Meier method. Univariate and multivariate analyses were performed, to identify prognostic factors on clinical outcomes. RESULTS After a median follow-up of 44 (range, 6-87) months, 14 (21%) and 8 (11%) local failures were observed in CIRT and PT group, respectively. Five-year LC rate was 71% in CIRT cohort and 84% in PT cohort. The estimated 5-year OS rate in the CIRT and PT group was 82% and 83%, respectively. On multivariate analysis, gross tumor volume (GTV), optic pathways, and/or brainstem compression and dose coverage are independent prognostic factors of local failure risk. High rate toxicity grade ≥3 was reported in 11% of patients. CONCLUSIONS Particle radiotherapy is an effective treatment for skull base chordoma with acceptable late toxicity. GTV, optic pathways, and/or brainstem compression and target coverage were independent prognostic factors for LC. KEY POINTS • Proton and carbon ion therapy are effective and safe in skull base chordoma.• Prognostic factors are GTV, organs at risk compression, and dose coverage.• Dual particle therapy and customized strategy was adopted.
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Affiliation(s)
- Alberto Iannalfi
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Emma D'Ippolito
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Giulia Riva
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Silvia Molinelli
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | | | - Maria Rosaria Fiore
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Barbara Vischioni
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Viviana Vitolo
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Maria Bonora
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Sara Ronchi
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Rachele Petrucci
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Amelia Barcellini
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Alfredo Mirandola
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Stefania Russo
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Alessandro Vai
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Edoardo Mastella
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Giuseppe Magro
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Davide Maestri
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Mario Ciocca
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Lorenzo Preda
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Francesca Valvo
- Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy
| | - Roberto Orecchia
- Scientific Directorate, European Institute of Oncology, IRCCS, Milan, Italy
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Heavy Charged Particles: Does Improved Precision and Higher Biological Effectiveness Translate to Better Outcome in Patients? Semin Radiat Oncol 2018. [DOI: 10.1016/j.semradonc.2017.11.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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7
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Cirrone GAP, Cuttone G, Raffaele L, Salamone V, Avitabile T, Privitera G, Spatola C, Amico AG, Larosa G, Leanza R, Margarone D, Milluzzo G, Patti V, Petringa G, Romano F, Russo A, Russo A, Sabini MG, Schillaci F, Scuderi V, Valastro LM. Clinical and Research Activities at the CATANA Facility of INFN-LNS: From the Conventional Hadrontherapy to the Laser-Driven Approach. Front Oncol 2017; 7:223. [PMID: 28971066 PMCID: PMC5609572 DOI: 10.3389/fonc.2017.00223] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 09/01/2017] [Indexed: 01/16/2023] Open
Abstract
The CATANA proton therapy center was the first Italian clinical facility making use of energetic (62 MeV) proton beams for the radioactive treatment of solid tumors. Since the date of the first patient treatment in 2002, 294 patients have been successful treated whose majority was affected by choroidal and iris melanomas. In this paper, we report on the current clinical and physical status of the CATANA facility describing the last dosimetric studies and reporting on the last patient follow-up results. The last part of the paper is dedicated to the description of the INFN-LNS ongoing activities on the realization of a beamline for the transport of laser-accelerated ion beams for future applications. The ELIMED (ELI-Beamlines MEDical and multidisciplinary applications) project is introduced and the main scientific aspects will be described.
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Affiliation(s)
- Giuseppe A. P. Cirrone
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Giacomo Cuttone
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Luigi Raffaele
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio Gaspare Rodolico, Catania, Italy
| | - Vincenzo Salamone
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio Gaspare Rodolico, Catania, Italy
| | - Teresio Avitabile
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio Gaspare Rodolico, Catania, Italy
| | - Giuseppe Privitera
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio Gaspare Rodolico, Catania, Italy
| | - Corrado Spatola
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio Gaspare Rodolico, Catania, Italy
| | - Antonio G. Amico
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Giuseppina Larosa
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Renata Leanza
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Daniele Margarone
- ELI-Beamlines Project, Institute of Physics ASCR, v.v.i. (FZU), Prague, Czechia
| | - Giuliana Milluzzo
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Valeria Patti
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
- Medical Physics Section, Cannizzaro Hospital, Catania, Italy
| | - Giada Petringa
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Francesco Romano
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
- National Physical Laboratory, Acoustic and Ionizing Radiation Division, Middlesex, United Kingdom
| | - Andrea Russo
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele, Presidio Gaspare Rodolico, Catania, Italy
| | - Antonio Russo
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Maria G. Sabini
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
- Medical Physics Section, Cannizzaro Hospital, Catania, Italy
| | - Francesco Schillaci
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
| | - Valentina Scuderi
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
- ELI-Beamlines Project, Institute of Physics ASCR, v.v.i. (FZU), Prague, Czechia
| | - Lucia M. Valastro
- Laboratori Nazionali del Sud, Istituto Nazionale di Fisica Nucleare (INFN-LNS), Catania, Italy
- Medical Physics Section, Cannizzaro Hospital, Catania, Italy
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Ford S, Almond L, Gronchi A. An Update on Non-extremity Soft Tissue Sarcomas. Clin Oncol (R Coll Radiol) 2017; 29:516-527. [DOI: 10.1016/j.clon.2017.02.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 02/08/2017] [Indexed: 12/18/2022]
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Yan S, Lu HM, Flanz J, Adams J, Trofimov A, Bortfeld T. Reassessment of the Necessity of the Proton Gantry: Analysis of Beam Orientations From 4332 Treatments at the Massachusetts General Hospital Proton Center Over the Past 10 Years. Int J Radiat Oncol Biol Phys 2016; 95:224-233. [DOI: 10.1016/j.ijrobp.2015.09.033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 08/14/2015] [Accepted: 09/21/2015] [Indexed: 01/19/2023]
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Kamada T, Tsujii H, Blakely EA, Debus J, De Neve W, Durante M, Jäkel O, Mayer R, Orecchia R, Pötter R, Vatnitsky S, Chu WT. Carbon ion radiotherapy in Japan: an assessment of 20 years of clinical experience. Lancet Oncol 2015; 16:e93-e100. [PMID: 25638685 DOI: 10.1016/s1470-2045(14)70412-7] [Citation(s) in RCA: 349] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Charged particle therapy is generally regarded as cutting-edge technology in oncology. Many proton therapy centres are active in the USA, Europe, and Asia, but only a few centres use heavy ions, even though these ions are much more effective than x-rays owing to the special radiobiological properties of densely ionising radiation. The National Institute of Radiological Sciences (NIRS) Chiba, Japan, has been treating cancer with high-energy carbon ions since 1994. So far, more than 8000 patients have had this treatment at NIRS, and the centre thus has by far the greatest experience in carbon ion treatment worldwide. A panel of radiation oncologists, radiobiologists, and medical physicists from the USA and Europe recently completed peer review of the carbon ion therapy at NIRS. The review panel had access to the latest developments in treatment planning and beam delivery and to all updated clinical data produced at NIRS. A detailed comparison with the most advanced results obtained with x-rays or protons in Europe and the USA was then possible. In addition to those tumours for which carbon ions are known to produce excellent results, such as bone and soft-tissue sarcoma of the skull base, head and neck, and pelvis, promising data were obtained for other tumours, such as locally recurrent rectal cancer and pancreatic cancer. The most serious impediment to the worldwide spread of heavy ion therapy centres is the high initial capital cost. The 20 years of clinical experience at NIRS can help guide strategic decisions on the design and construction of new heavy ion therapy centres.
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Affiliation(s)
- Tadashi Kamada
- National Institute of Radiological Sciences, Chiba, Japan
| | | | | | - Jürgen Debus
- University of Heidelberg and Heidelberg Ion Therapy Centre, Heidelberg, Germany
| | | | - Marco Durante
- GSI Helmholtz Center for Heavy Ion Research and Darmstadt University of Technology, Darmstadt, Germany.
| | - Oliver Jäkel
- University of Heidelberg and Heidelberg Ion Therapy Centre, Heidelberg, Germany
| | | | - Roberto Orecchia
- CNAO Foundation, Pavia, and European Institute of Oncology, Milan, Italy
| | | | | | - William T Chu
- Lawrence Berkeley National Laboratory, Berkeley, CA, USA
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Dosanjh M, Cirilli M, Navin S. ENLIGHT and LEIR biomedical facility. Phys Med 2014; 30:544-50. [DOI: 10.1016/j.ejmp.2014.03.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Revised: 03/03/2014] [Accepted: 03/07/2014] [Indexed: 02/07/2023] Open
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Matsumoto Y, Matsuura T, Wada M, Egashira Y, Nishio T, Furusawa Y. Enhanced radiobiological effects at the distal end of a clinical proton beam: in vitro study. JOURNAL OF RADIATION RESEARCH 2014; 55:816-22. [PMID: 24824674 PMCID: PMC4099988 DOI: 10.1093/jrr/rrt230] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2013] [Revised: 12/13/2013] [Accepted: 12/28/2013] [Indexed: 05/21/2023]
Abstract
In the clinic, the relative biological effectiveness (RBE) value of 1.1 has usually been used in relation to the whole depth of the spread-out Bragg-peak (SOBP) of proton beams. The aim of this study was to confirm the actual biological effect in the SOBP at the very distal end of clinical proton beams using an in vitro cell system. A human salivary gland tumor cell line, HSG, was irradiated with clinical proton beams (accelerated by 190 MeV/u) and examined at different depths in the distal part and the center of the SOBP. Surviving fractions were analyzed with the colony formation assay. Cell survival curves and the survival parameters were obtained by fitting with the linear-quadratic (LQ) model. The RBE at each depth of the proton SOBP compared with that for X-rays was calculated by the biological equivalent dose, and the biological dose distribution was calculated from the RBE and the absorbed dose at each position. Although the physical dose distribution was flat in the SOBP, the RBE values calculated by the equivalent dose were significantly higher (up to 1.56 times) at the distal end than at the center of the SOBP. Additionally, the range of the isoeffective dose was extended beyond the range of the SOBP (up to 4.1 mm). From a clinical point of view, this may cause unexpected side effects to normal tissues at the distal position of the beam. It is important that the beam design and treatment planning take into consideration the biological dose distribution.
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Affiliation(s)
- Yoshitaka Matsumoto
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Taeko Matsuura
- Advanced Medical Sciences, Graduate School of Medicine, Hokkaido University, 15-7 Kita, Kita-ku, Sapporo, Hokkaido, 060-8638, Japan Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Mami Wada
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Yusuke Egashira
- Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Teiji Nishio
- Research Center for Innovative Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Yoshiya Furusawa
- Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
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Srivastava A, Vischioni B, Fiore MR, Vitolo V, Fossati P, Iannalfi A, Tuan JKL, Orecchia R. Quality of life in patients with chordomas/chondrosarcomas during treatment with proton beam therapy. JOURNAL OF RADIATION RESEARCH 2013; 54 Suppl 1:i43-8. [PMID: 23824125 PMCID: PMC3700519 DOI: 10.1093/jrr/rrt057] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
INTRODUCTION Health-related quality of life (HQL) parameters have never been tested in patients having chondromas/chondrosarcomas who are being treated with protons. The aim of this study was to document changes in HQL of chordoma/chondrosarcoma patients treated with proton beam radiotherapy. Treatments commenced in September 2011 at CNAO, and HQL studies were initiated in January 2012 for all patients undergoing treatment. METHODS The validated Italian translation of the EORTC QLQ-C30 version 3.0 was used for HQL evaluation. The HQL assessments were made prior to starting radiation and at completion of treatment. Scoring was as per the EORTC manual. As per standard norms, a difference of >10 points in the mean scores was taken to be clinically meaningful. RESULTS Between January and September 2012, 17 patients diagnosed with chordoma or chondrosarcoma, with a mean ± SD age of 49.5 ± 16.4 years, had completed treatment. The involved sites were skull base (n = 12) and sacral/paraspinal (n = 5). The prescribed dose was 70-74 GyE at 2 GyE per fraction, 5 days/week. When comparing pre- and post-treatment scores, neither a clinically meaningful nor a statistically significant change was documented. CONCLUSIONS During treatment, HQL is not adversely affected by protons, allowing normal life despite the long course of treatment. This is an ongoing study and more long-term assessment will help evaluate the actual impact of proton therapy on HQL for these slow-responding tumours.
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Affiliation(s)
- A Srivastava
- Department of Radiation Oncology, Medanta the Medicity, Sector 38, Gurgaon 122001, Haryana, India.
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