目的 评价碳离子(^12C^6+)束对皮肤恶性黑色素瘤放射治疗的近期疗效和副反应.方法 13例皮肤恶性黑色素瘤患者分6批接受^12C^6+束放射治疗,其中Ⅱa期2例,Ⅱb期3例,Ⅱc期5例,Ⅲc期3例.照射总剂量60~66 GyE分6~12 d,单次剂量2.2~4.4 GyE,1次/d,连续治疗.采用RTOG标准和WHO近期疗效标准分别评价副反应和近期疗效.结果 中位随访时间为13.5个月(1~25个月),随访率为100%.13例患者中完全缓解10例,部分缓解3例,有效率为100%,中位生存时间为21.3个月(95%可信区间为18.1~24.5个月).皮肤反应0级3例,1级6例,2级2例,3级2例.血液系统副反应治疗前后无明显改变.结论 ^12C^6+束治疗皮肤恶性黑色素瘤近期疗效好,且并发症轻.
Objective To evaluate the toxicity and efficacy of carbon ion radiotherapy for cutaneous malignant melanoma. Methods Form December 2006 to May 2009, 13 patients with superficial malignant melanoma were treated with carbon ion radiotherapy in the Institute of Modern Physics, Chinese Academy of Sciences. The total dose was 60 -66 GyE in 6 - 12 fractions within 6 - 12 days. The disease was Stage IIa in 2, IIb in 3, II c in 5, and III c in 3 patients. The toxicities were assessed according to the Radiation Therapy Oncology Group (RTOG) criteria, and the efficacy was evaluated with WHO criteria. Results The median follow-up time was 13.5 months (range, 1 -25 months) and the follow-up rate was 100%. Of the 13 patients, 10(77% ) achieved complete remission (CR), and 3(23% ) partial remission (PR). The overall response rate (RR) was 100%, and the median survival time was 21.3 months (95% CI, 18. 1 - 24.5 months). The grade 0, 1,2 and 3 skin reaction occurred in 3, 6, 2 and 2 patients, respectively. The hematologic toxicities were mild. Conclusions Carbon ion radiotherapy is a safe and effective treatment for cutaneous malignant melanoma.