High-technology intensity-modulated photon and charged-particle radiation techniques are allowing the delivery of substantially higher radiation doses than could be delivered in the past to patients with bone sarcomas while simultaneously reducing the doses to critical normal tissues. Local control has been improved with these high doses.[6,14] These techniques are particularly promising for lesions in challenging axial sites where resections are often incomplete or associated with significant morbidity. The use of protons reduces the integral dose to normal tissue, often by 2- to 3-fold; this can only reduce the risk of late radiation-associated complications. Protons have been successfully combined with chemotherapy for the treatment of adult and pediatric sarcomas. Heavier charged particles have greater RBE because of their higher LET properties, and some interesting results are available with neon and carbon ions[25,26] for bone sarcomas. Randomized comparative trials are warranted to determine if they are more effective than protons.
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Appreciation is expressed to Judy Adams, CMD, and her colleagues at the Francis Burr Proton Therapy Center for their assistance in providing the treatment planning images.Funding information
This work was supported in part by NIH grant 5 P01 CA021239-28. No significant relationship exists between the authors and the companies/organizations whose products or services may be referenced in this article. The editor of Cancer Control, John Horton, MB, ChB, FACP, has nothing to disclose.
RT = radiation therapy; IMRT = intensity-modulated photon radiation therapy; IMPT = intensity-modulated proton radiation therapy; GSI = Gesellschaft für Schwerionenforschung; RBE = relative biological effectiveness; CGE = cobalt Gray equivalents; LET = linear energy transfer.
Address correspondence to Thomas F. DeLaney, MD, Department of Radiation Oncology, Francis H. Burr Proton Therapy Center, Massachusetts General Hospital, 30 Fruit Street, Boston, MA 02114. E-mail: email@example.com
Cancer Control. 2008;15(1):21-37. © 2008 H. Lee Moffitt Cancer Center and Research Institute, Inc.
© Copyright by H. Lee Moffitt Cancer Center & Research Institute. All rights reserved.
Cite this: Advanced-Technology Radiation Therapy for Bone Sarcomas - Medscape - Jan 01, 2008.