Research Papers:

Carbon ion radiotherapy for inoperable pediatric osteosarcoma

Osama Mohamad, Reiko Imai _, Tadashi Kamada, Yuki Nitta, Nobuhito Araki and the Working Group for Bone and Soft Tissue Sarcoma

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Oncotarget. 2018; 9:22976-22985. https://doi.org/10.18632/oncotarget.25165

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Osama Mohamad1,2, Reiko Imai1, Tadashi Kamada1, Yuki Nitta1, Nobuhito Araki3 and the Working Group for Bone and Soft Tissue Sarcoma

1Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan

2University of Texas Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA

3Ashiya Municipal Hospital, 3 9-1 Asahigaoka, Ashiya City, Hyogo, Japan

Correspondence to:

Reiko Imai, email: [email protected]

Keywords: carbon ion; radiotherapy; charged particles; pediatric; osteosarcoma

Received: January 20, 2018     Accepted: March 30, 2018     Published: May 01, 2018


Background: Unresectable pediatric osteosarcoma has poor outcomes with conventional treatments.

Results: Twenty-six patients aged 11–20 years (median 16) had inoperable osteosarcoma of the trunk (24 pelvic, 1 mediastinal and 1 paravertebral) without any other lesion at initial examination. There were 22 primary, 1 locally recurrent and 3 metastatic cases. Median CIRT dose was 70.4 Gy RBE (relative biological effectiveness) delivered in 16 fractions. Median follow-up was 32.7 months. Overall survival was 50.0% and 41.7% at 3 and 5 years, respectively. Ten patients survived for more than 5 years (range 5–20.7 years). Local control was 69.9% and 62.9% at 3 and 5 years, respectively and progression-free survival was 34.6% at 3 and 5 years. Only largest tumor diameter correlated with 5-year overall survival and local control. There were 4 grade 3-4 CIRT-related late toxicities, 1 case of bone fracture and no treatment-related mortalities. All patients (except 1) were able to ambulate after CIRT.

Conclusions: CIRT was safe and efficacious in the treatment of inoperable pediatric osteosarcoma with improved local control and overall survival compared to conventional treatments.

Methods: We retrospectively reviewed the records of pediatric and adolescent patients who received carbon ion radiotherapy (CIRT) for inoperable osteosarcoma between 1996 and 2014.

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