WEKO3
アイテム
Carbon beam therapy in recurrent ovarian cancer
https://repo.qst.go.jp/records/45838
https://repo.qst.go.jp/records/4583800730d11-786b-4b2e-9346-bae51f7a8e63
| Item type | 学術雑誌論文 / Journal Article(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2010-06-29 | |||||
| タイトル | ||||||
| タイトル | Carbon beam therapy in recurrent ovarian cancer | |||||
| 言語 | ||||||
| 言語 | eng | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
| 資源タイプ | journal article | |||||
| アクセス権 | ||||||
| アクセス権 | metadata only access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_14cb | |||||
| 著者 |
Niwa, Akihiro
× Niwa, Akihiro× Suzuki, Kyosuke× Kato, Shingo× Kajiyama, Hiraki× Shibata, Kiyosumi× Ino, Kazuhiko× Nakamura, Hisao× Kikkawa, Fumitaka× et.al× 加藤 眞吾 |
|||||
| 抄録 | ||||||
| 内容記述タイプ | Abstract | |||||
| 内容記述 | Ovarian cancer results in more deaths than any other gynecologic malignancy. In the United States and Japan, there are over 15,000 and 4,000 deaths from ovarian cancer per year, respectively [1]. This high mortality rate can be attributed to the approximately 75% of patients who are diagnosed with stage III and IV disease with intraperitoneal carcinomatosis [2]. Although the five-year survival rate of patients in whom lymph nodes are the only site of metastasis, the so-called "retroperitoneal stage IIIc", ranges from 84 to 96%, higher than the 20-30% of intraperitoneal stage IIIc patients [3], we have sometimes encountered cases of ovarian cancer with local recurrence in the lymph nodes which was completely unresectable at surgery and chemoresistant, resulting in salvage chemotherapy. Therefore, a more potent treatment should be introduced for this situation to achieve either disease-free survival or local control. High linear energy transfer (LET) particle therapy has various advantages in terms of radiobiological effects as well as dose distribution and has been expected to offer a therapeutic advantage over conventional photon therapy. The biological advantages of high LET radiation, including carbon beam therapy, are summarized as a decreased oxygen enhancement ratio, diminished capacity for sublethal and potentially lethal damage repair, and diminished cell cycle-dependent radiosensitivity [4]. Thus, these advantages prompted us to use carbon beam therapy for bulky recurrent ovarian tumor, which is considered to have a large fraction of hypoxic tumor. The patient was a 68-year-old woman with ovarian cancer who was optimally treated by hysterectomy, bilateral salpingo-oophorectomy, omentectomy and pelvic and para-aortic lymphadenectomy in Feb.2003, followed by three courses of paclitaxel and carboplatin (TJ) for right ovarian cancer, endometrioid type, grade 2, pT1cN0M0. Since local recurrence of ovarian cancer at the site of the right internal-iliac artery lymph node was detected in Nov.2004, six more courses of TJ were performed. The recurrent tumor had grown to a maximum 8 cm in diameter despite several protocols of chemotherapy, including platinium, taxane, CPT-11 and gemcitabine. After we had confirmed no metastasis besides the recurrence site with positron emission tomography using fluorine-18 fluorodeoxyglucose /CT (FDG-PET/CT), we decided to treat the lesion with carbon beam therapy. Before the therapy, the patient gave written informed consent, and the study was approved by the local ethics committee and institutional review board of our hospital. Moreover, the patient underwent an operation in which a Goretex sheet was inserted, the lesion was partially excised and an artificial anus was constructed to protect the intestine and rectum adjacent to the tumor from injury by high LET particles. The heavy-ion medical accelerator in Chiba is the first heavy ion accelerator specially dedicated to medicine in the world, and its design variables are based on the radiological requirements [5]. The carbon beam energy used was 350 to 400 MeV. As shown in Figs. A and B, anteroposterior, posteroanterior and lateral opposing ports were used for 16 fractions over 4 weeks with 4 fractions weekly, consequently, the total dose was a 57.6 Gy equivalent dose. Through out the treatment, no severe side effects were observed. At ten months after treatment, the pelvic tumor had drastically shrunk (Fig.C), and the patient has continued clinical disease free for 2 years. This is the first report, to our knowledge, showing that carbon beam therapy was effective for recurrent ovarian cancer. The result is sufficiently encouraging to continue the therapy in patients with metastatic, anti-cancer-drug-resistant ovarian cancer, as well as other types of gynecologic cancer. |
|||||
| 書誌情報 |
Annals of Oncology 巻 19, 号 1, p. 192-194, 発行日 2008-01 |
|||||
| ISSN | ||||||
| 収録物識別子タイプ | ISSN | |||||
| 収録物識別子 | 0923-7534 | |||||
