Carbon Ion Radiotherapy Safe and Effective for Treating Inoperable Spinal Tumors


Key Points

  • Tumor growth was controlled for at least 5 years in 79% of patients with inoperable spinal sarcomas treated with carbon ion radiotherapy.
  • Five-year overall and progression-free survival was 52% and 48%, respectively.
  • Carbon ion radiotherapy appears to be a safe and effective treatment alternative for patients with unresectable spinal sarcoma, especially those with small tumors separated from the spinal cord.

A new analysis has found that a type of radiation therapy called carbon ion radiotherapy can control cancer growth and prolong survival in patients with spinal tumors. The study, published online in Cancer, indicates that the treatment is a promising alternative for patients whose spinal tumors cannot be surgically removed.

Surgery is the mainstay of treatment for spinal sarcomas; however the tumors are one of the most challenging diseases for orthopedic surgeons. In addition, some patients are not candidates for surgery due to the location of the tumor and/or the patient's condition. In these cases, radiation therapy is generally used. Carbon ion radiotherapy is a type of radiation therapy that is known to be effective for treating various types of inoperable sarcomas. Using carbon ions to target radiation to the tumor, the treatment is minimally invasive, has little effect on adjacent healthy tissues, and has the potential to preserve patients’ quality of life.

Study Details

To investigate the effectiveness and safety of carbon ion radiotherapy for inoperable spinal sarcomas, Reiko Imai, MD, PhD, of the Research Center Hospital for Charged Particle Therapy at the National Institute of Radiological Sciences in Japan, and colleagues studied the outcomes of 47 patients who received the treatment between 1996 and 2011.

The median follow-up time was 25 months, and the median survival was 44 months. In 79% of patients, tumor growth was controlled for at least 5 years. Five-year overall survival was 52%, with 48% of patients surviving that long without experiencing cancer progression. None of the 15 patients with tumors that were smaller than 100 cm3 had a cancer recurrence; 8 of the 33 patients with tumors ≥ 100 cm3 developed local recurrence (P = .0194). Large tumors were located < 5 mm from the spinal cord more frequently than small tumors.

No fatal toxicities occurred from the treatment, although one patient had a skin reaction, seven patients experienced vertebral compression salvaged by surgical intervention, and one developed a spinal cord reaction. Twenty-two of the 28 patients who were alive at the last follow-up appointment could walk without supportive devices.

“This report is the first one regarding spinal sarcomas treated with carbon ion radiotherapy, and our findings offer a treatment alternative to patients with inoperable tumors,” said Dr. Imai.

The study was supported by the Heavy Ions Research Project at the National Institute of Radiological Sciences–Heavy Ion Medical Accelerator in Chiba, Japan. The authors reported no potential conflicts of interest.

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