Carbon Ion Radiotherapy for Locally Advanced Adenocarcinoma of the Uterine Cervix

Purpose: To evaluate the toxicity and efficacy of carbon ion radiotherapy (CIRT) for locally advanced cervical adenocarcinoma by phase I/II dose-escalation study.\nMethods and Materials: Between April 1998 and August 2008, 45 patients with cervical adenocarcinoma were treated with CIRT. Histologically, 36 patients had adenocarcinomas and 9 had adenosquamous carcinomas. Fifteen patients had stage IIB, 28 had stage IIIB, and 2 had stage IVA disease. The dose of the whole pelvic irradiation was fixed at 36.0 gray equivalent (GyE) in 12 fractions, and an additional dose of 26.4-38.4 GyE in 8 fractions was delivered to the cervix (total dose: 62.4-74.4 GyE). The dose to the GI tracts was limited to less than 60 GyE. The median follow-up duration for all patients was 23 months (range, 6-93 months).\nResults: No patient developed severe acute toxicity. No patient developed major late complications except for one patient with a rectovaginal fistula. Local control was obtained in 4 of the 7 patients receiving a total of 62.4-64.8 GyE, in 7 of the 10 patients receiving 68.0 GyE, in 17 of the 21 patients receiving 71.2GyE, and in all of 7 patients receiving 74.4 GyE. The 5-year overall survival rates for all patients and the 33 patients with stage IIIB or IVA disease were 43% and 42%, respectively. \nConclusions: Although the number of patients was small, the results have suggested that CIRT provided favorable local tumor control and overall survival with acceptable rates of late complications in the treatment of locally advanced cervical adenocarcinoma.NIRS-IMP Joint Symposium on Carbon Ion Therap