@misc{oai:repo.qst.go.jp:00070989,
 author = {Imai, Reiko and Kamada, Tadashi and Maruyama, Katsuya and 今井 礼子 and 鎌田 正 and 丸山 克也},
 month = {Nov},
 note = {Purpose: The standard treatment for spinal and paraspinal sarcomas has been en bloc resection. However those sarcomas involving or close to the spinal canal have been one of the most challenging for orthopedic surgeons. Due to the high linear energy transfer (LET) and the Bragg peak, carbon ion radiotherapy has been expected to be more effective and safe in the treatment for sarcomas than low-LET radiation like photons. We evaluated the effectiveness and safety of carbon ion radiotherapy in patients with spinal and paraspinal sarcoma not suitable for surgical resection.
Methods: Between Jun 1996 and February 2012, 100 cases with spinal and paraspinal sarcomas received carbon ion radiotherapy. Ages ranged from 12 to 84 (median 53 years). Forty nine spinal and 51 paraspianal sarcomas were included. Fifty nine patients had primary disease presentation, 25 patients with recurrent disease after surgery and 16 patients with metastases. Pathological types were as follows: chondrosarcoma in 20, osoteosarcoma in 17, chordoma in 12, MFH originated from soft tissue in 10, MPNST in 5. Carbon ion radiotherapy was delivered in 16 fractions over 4 weeks. Median total dose was 70.4GyE (range from 52.8 to 70.4GyE). Clinical target volumes ranged between 12 and 1259 cm3 (median 205 cm3). 
Results: Median follow up time was 31 (range: 2-162) months for all patients and all living patients were followed more than 6 months. At 5 years, actuarial overall local control (LC) rate and overall survival (OS) rate were 75% and 51%, respectively. Twelve patients with spinal sarcoma including 8 high grade sarcomas and 18 patients with paraspinal sarcoma including 12 high grade sarcomas have survived for 5 years. Two patients experienced grade 3 spinal cord late reaction in this series.
Conclusions: Carbon ion radiotherapy is suggested to be an effective and safe treatment for spinal and paraspinal sarcoma patients, especially for whom surgical resection is not a viable option., CTOS 17th Annual Meeting},
 title = {Carbon ion radiotherapy for Unresectable Spinal and Paraspinal Sarcomas},
 year = {2012}
}