@misc{oai:repo.qst.go.jp:00070743,
 author = {Wakatuki, Masaru and Kato, Shingo and Ohno, Tatsuya and Karasawa, Kumiko and Ando, Ken and Kiyohara, Hiroki and Nakano, Takashi and Kamada, Tadashi and Syozu, Makio and 若月 優 and 加藤 眞吾 and 唐澤 久美子 and 安藤 謙 and 鎌田 正 and 生水 真紀夫},
 month = {May},
 note = {Purpose/Objective;
To evaluate the toxicity and efficacy of carbon ion radiotherapy (C-ion RT) forlocally advanced adenocarcinoma and adenosquamous carcinoma of the uterine cervix by phase I/II clinical trials.
Material/Methods;
The treatment consisted of 12 fractions of whole pelvic irradiation, 8 fractions of extended local boost. The whole pelvic dose was fixed at 36.0 gray equivalents (GyE). With regard to local boost, a dose-escalation study was planned with an initial dose of 26.4 GyE for 8 fractions and then gradually increased up to 38.4 GyE for 8 fractions by 2.4 or 3.6 GyE increments. At least 5 patients were treated at the same dose level, and dose escalation was performed after careful observation of acute normal tissue responses. Total dose to the cervical tumor was 62.4-74.4 GyE for 20 fractions. 
Results;
Between April 1998 and February 2010, 58 patients of locally advanced adenocarcinoma were treated with C-ion RT in this clinical trial. Median age was 59 years (range, 28-85 years). Twenty patients had stage IIB disease, 35 patients had stage IIIB disease, and 3 patients had stage IVA disease. Median tumor size was 5.5 cm (range, 3.0-11.8 cm). Histologically, 48 patients had adenocarcinoma and 10 patients had adenosquamous cell carcinoma. Twenty-seven patients had lymph node metastases in the pelvis. The median follow-up period for surviving and all patients were 44 and 31 months, respectively. Although 23 patients developed acute toxicity (G1-G3), all patients completed the scheduled therapy. Late toxicity was found in as many as 19 patients but toxicity observed was G1 or G2 except one: G1 toxicity was found 15 patients (24%): 12 patients for rectum/sigmoid, 4 for small intestine and 6 for bladder. G2 toxicity was detected 7 patients (12 %): 5 patients for bladder and 2 patients for small intestine.  Only exception was G4 for rectal complication, which was surgically salvaged. Complete response rate and partial response rate for C-ion RT were 60.3% and 34.5%, respectively. Twenty-seven patients (46.6%) had local recurrence, and ten of which received salvage surgery. The 3-year local control rate and overall survival rate were 53.4% and 53.4% respectively. Thirty-six patients (62.1%) had distant metastases. The overall 3-year local control rate including salvage surgery was 62.9%.
Conclusions;
Carbone ion radiotherapy is a safe and effective treatment for locally advanced adenocarcinoma of the uterine cervix., European Society for Therapeutic Radiology and Oncology　31（ESTRO31）},
 title = {Carbon ion Radiotherapy for locally advanced adenocarcinoma of the uterine cervix},
 year = {2012}
}