量研学術機関リポジトリ「QST-Repository」は、国立研究開発法人 量子科学技術研究開発機構に所属する職員等が生み出した学術成果（学会誌発表論文、学会発表、研究開発報告書、特許等）を集積しインターネット上で広く公開するサービスです。 Welcome to QST-Repository where we accumulates and discloses the academic research results(Journal Publications, Conference presentation, Research and Development Report, Patent, etc.) of the members of National Institutes for Quantum and Radiological Science and Technology.
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Purpose/Objective(s): To assess the toxicity and efficacy of chemo-carbon ion radiotherapy for mucosal malignant melanomas of the head-and-neck.
Material/Methods: Between April 2002 and February 2011, a total of 96 patients with mucosal malignant melanoma of the head-and-neck were treated with carbon ion radiotherapy combined with chemotherapy. None of these patients had either regional lymph node or distant metastasis before radiotherapy. The prescribed tumor dose was 57.6 GyE in 16 fractions over 4 weeks. Two cycles of concomitant chemotherapy (DTIC 120mg/m2, ACNU 70mg/m2, VCR 0.7mg/m2) were administered during the first and final weeks of irradiation. Then a further 3 cycles were administered with the same 4-week interval after carbon ion radiotherapy. All patients provided written informed consent before enrollment in this study. The National Institute of Radiological Sciences Ethical Committee on Human Clinical Research approved this study.
Results: The patients consisted of 42 males and 54 females aged from 26 to 79 years, with an average age of 61 years. Their KPS ranged from 70% to 100%, with a median of 90%. As for the tumor sites studied, there were 75 nasal cavity and paranasal sinus, 13 oral cavity, 5 pharynx and 3 orbit. The gross tumor volume ranged from 1 to 325.8 ml, with an average of 38.9 ml. The median follow-up time was 35.9 months (range, 3.3-107.1 months). Although acute grade 3 mucosal reactions appeared in 16 patients (17%), all of the late skin and mucosal reactions were grade 1 or less. At the time of analysis, there was no evidence of any unexpected severe toxicity to the critical organs. Although 53 of 96 patients (55%) completed 5 cycles of chemotherapy, the remaining patients discontinued chemotherapy after 4 cycles or less as 13 patients (14%) were diagnosed with distant metastasis and 30 patients (31%) were found to have bone-marrow suppression. Of the 13 patients with distant metastasis, 7 patients were given a different regimen of chemotherapy. The 3- and 5-year local control rates were 84% and 82%, respectively. Moreover, the 3- and 5-year overall survival rates were 67% and 59%, respectively.
Conclusion: Our results showed acceptable toxicities and excellent therapeutic effectiveness for mucosal malignant melanomas.
Combined Chemotherapy and Carbon Ion Radiotherapy For Mucosal Malignant Melanoma of the Head-and-Neck
