@misc{oai:repo.qst.go.jp:00071271, author = {Irie, Daisuke and Wakatuki, Masaru and Kato, Shingo and Ohno, Tatsuya and Karasawa, Kumiko and Kiyohara, Hiroki and Tsujii, Hirohiko and Nakano, Takashi and Kamada, Tadashi and Syozu, Makio and 入江 大介 and 若月 優 and 加藤 眞吾 and 唐澤 久美子 and 辻井 博彦 and 鎌田 正 and 生水 真紀夫}, month = {Sep}, note = {Background The authors performed phase I / II clinical trials to evaluate the toxicity The authors performed phase I / II clinical trials to evaluate the toxicity and efficacy of carbon ion radiotherapy (C-ion RT) for locally advanced squamous cell carcinoma of the uterine cervix. efficacy of carbon ion radiotherapy (C-ion RT) for locally advanced squamous cell carcinoma of the uterine cervix. Materials and Methods The eligibility criteria for enrollment in this study were (1) histologically proven squamous cell carcinoma, (2) FIGO stage IIB (4cm <) – IVA, (3) no prior treatment, and (4) a expected prognosis of more than 6 months. The treatment consisted of 13 fractions of whole pelvic irradiation, and 5 fractions of extended local boost which was contained the gross tumor volume (GTV), uterus, parametrium, upper half of vagina and ovaries, and additional 2 fractions of local boost to GTV. The whole pelvic dose and extended local boost dose were fixed at 39 gray equivalents (GyE) and 15 GyE, respectively. With regard to local boost, a dose-escalation study was planned with an initial dose of 10 GyE to 18 GyE for 2 fractions to GTV. Planning CT scan was performed three times during the course for the field shrinkage. 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 64 – 72 GyE for 20 fractions. Results Between April 2000 and January 2006, 22 patients were treated in this trial. Median age was 58 years (range 31 – 80). The number of patients with stage IIB, IIIB, and IVA disease was 1, 18, and 3, respectively. Median tumor size was 6.2 cm (range, 4.0 –12.0 cm). Eleven patients received 64 GyE, 5 patients did 68 GyE and 6 patients did 72 GyE. All patients completed the scheduled therapy and no patient developed Grade 2 or higher acute toxicity. Overall treatment time (OTT) ranged from 32 to 37 days with a median of 36 days. There were no grade 3 or more late complications. The 5-year overall survival rate, local control rate and disease free survival rate were 68.2 %, 50.0 % and 50.0 %, respectively. Seven of 16 patients who were received 64 – 68 GyE developed local recurrences but all patients who were received 72 GyE maintained local control. Conclusions There were no severe acute or late complications and dose escalation was accomplished safety in this study. Although the number of patients in this study was small, C-ion RT has the potential to improve the treatment for locally advanced bulky cervical cancer by using the total dose of 72 GyE, and the results support continued investigation to confirm therapeutic efficacy., ASTRO's 55th Annual Meeting}, title = {Dose Escalation Study of Carbon Ion Radiotherapy for Locally Advanced Squamous Cell Carcinoma of the Uterine Cervix}, year = {2013} }