Efficacy and safety of carbon‐ion radiotherapy for the malignant melanoma: A systematic review

ObjectiveThe purpose of this systematic review and meta-analysis is to evaluate the efficacy and safety of carbon ion radiotherapy (CI-RT) in improving meningioma by comparing photon and protons radiotherapy.MethodsA comprehensive search for relevant studies published until March 17, 2021, was conducted in PubMed, the Cochrane Library, Chinese Biomedical Literature Database and EMBASE. Statistical analyses were performed with R 4.0.3.ResultsWe identified 396 studies, of which 18 studies involving 985 participants were included. Except for one low quality study, the quality of the included studies was found to be either moderate or high quality. The analyses conducted according random effects model indicated that the 1-year overall survival rate (OS) of benign and non-benign meningiomas after the CI-RT treatment was 99% (95%CL=.91-1.00, I2 = 0%). The overall average 5-year OS for meningiomas was 72% (95%CL=0.52-0.86, I2 = 35%), not as effective as proton radiotherapy (PR-RT) 85% (95%CL=.72-.93, I2 = 73, Q=4.17, df=2, p=.12). Additionally, 5-year OS of atypical meningiomas (81%) was found to be significantly higher than anaplastic meningiomas (52%). The 10-year OS after CI-RT of patients with mixed grade meningioma was 91% (95%CL=.75-.97, I2 = 73%). The 15-year OS after CI-RT 87% (95%CL=.11-1.00) or PR-RT 87% (95%CL=.23-.99, I2 = 79%) were the same (Q=0, df=1, p=.99). After undergoing CI-RT for 3 and 5 years, the LC for benign meningioma was 100% and 88%, respectively, while the 2-year LC of non-benign meningiomas (atypical/anaplastic) was 33%. Headache, sensory impairment, cognitive impairment, and hearing impairment were found to be the most common adverse reactions, with individual incidences of 19.4%, 23.7%, 9.1%, and 9.1%, respectively.ConclusionCI-RT is a rapidly developing technique that has been proven to be an effective treatment against meningioma. The efficacy and safety of CI-RT for meningiomas were similar to those of PR-RT, better than photon radiotherapy (PH-RT). However, there is a need for more prospective trials in the future that can help provide more supportive evidence.

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Carbon ion radiotherapy with complete tumor regression for primary malignant melanoma of female urethra orifice: a case report

Journal of International Medical Research ◽

10.1177/03000605211072795 ◽

2022 ◽

Vol 50 (1) ◽

pp. 030006052110727

Author(s):

Xiaojun Li ◽

Yihe Zhang ◽

Yanshan Zhang ◽

Yancheng Ye ◽

Ying Qi ◽

...

Keyword(s):

Malignant Melanoma ◽

Tumor Regression ◽

Treatment Protocol ◽

Carbon Ion Radiotherapy ◽

Primary Malignant Melanoma ◽

Radiation Dermatitis ◽

Survival Duration ◽

Female Urethra ◽

Carbon Ion ◽

Complete Tumor

Primary malignant melanoma of the female urethra (PMMFU) is extremely rare, accounting for 0.2% of all melanomas, and fewer than 200 cases have been reported worldwide. Because of the small number of clinical cases and unclear biological characteristics, there is no uniform and standard treatment protocol. We herein describe the treatment of PMMFU using carbon ion radiotherapy. The radiotherapy was delivered at 60.8 Gy (RBE) in 16 fractions, once daily, five times per week. The patient achieved complete tumor disappearance within 1 year after carbon ion radiotherapy and remained disease-free thereafter. She developed acute grade 1 radiation dermatitis and urethritis, which resolved quickly; no other toxic effects were observed. At the time of this writing, her survival duration was 33 months. This case demonstrates that carbon ion radiotherapy may be a good option for primary genitourinary mucosal malignancies.

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Safety and Efficacy of Salvage Neck Dissection Following Carbon-ion Radiotherapy with Chemotherapy for a Patient with Mucosal Malignant Melanoma of Head and Neck

Diagnostics ◽

10.3390/diagnostics10020082 ◽

2020 ◽

Vol 10 (2) ◽

pp. 82

Author(s):

Hidenori Suzuki ◽

Eiichi Sasaki ◽

Risa Motai ◽

Seiya Goto ◽

Daisuke Nishikawa ◽

...

Keyword(s):

Malignant Melanoma ◽

Head And Neck ◽

Neck Dissection ◽

Initial Treatment ◽

Concurrent Chemotherapy ◽

Carbon Ion Radiotherapy ◽

Safety And Efficacy ◽

Carbon Ion ◽

Mucosal Malignant Melanoma ◽

Salvage Neck Dissection

Mucosal malignant melanoma of the head and neck is a rare diagnosis. The safety and efficacy of salvage neck dissection following carbon–ion radiotherapy with concurrent chemotherapy are not well described, and carbon–ion radiation protocols have not been fully developed. A 77 year old woman with crT0N1M0 mucosal melanoma of the head and neck achieved a complete response following initial treatment with carbon–ion radiotherapy and concurrent chemotherapy. She was treated with salvage neck dissection for as a cervical lymph node metastasis 16 months after initial treatment. She experienced neither Clavien-Dindo Grade 3 or 4 postoperative complications nor subsequent recurrence of disease at 3 months following salvage neck dissection. Surgical specimens may be useful for future precision oncology based on the molecular biology of recurrence melanoma with poor prognosis.

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Long-term outcomes after carbon ion-radiotherapy for oral mucosal malignant melanoma

Japanese Journal of Oral & Maxillofacial Surgery ◽

10.5794/jjoms.64.237 ◽

2018 ◽

Vol 64 (4) ◽

pp. 237-242

Author(s):

Kensuke NAGANAWA ◽

Masashi KOTO ◽

Ryo TAKAGI ◽

Azusa HASEGAWA ◽

Hiroaki IKAWA ◽

...

Keyword(s):

Malignant Melanoma ◽

Carbon Ion Radiotherapy ◽

Long Term Outcomes ◽

Carbon Ion ◽

Mucosal Malignant Melanoma

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Carbon Ion Radiotherapy for Malignant Melanoma of Female Genital Organs

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2009.07.847 ◽

2009 ◽

Vol 75 (3) ◽

pp. S369

Author(s):

H. Kiyohara ◽

S. Kato ◽

T. Ohno ◽

Y. Ohkubo ◽

T. Tamaki ◽

...

Keyword(s):

Malignant Melanoma ◽

Carbon Ion Radiotherapy ◽

Carbon Ion ◽

Female Genital

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Efficacy and Safety of Short Course Carbon-ion Radiotherapy for Patients with Preoperative Pancreatic Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2011.06.544 ◽

2011 ◽

Vol 81 (2) ◽

pp. S331

Author(s):

M. Shinoto ◽

S. Yamada ◽

S. Yasuda ◽

H. Imada ◽

T. Kamada ◽

...

Keyword(s):

Pancreatic Cancer ◽

Carbon Ion Radiotherapy ◽

Efficacy And Safety ◽

Carbon Ion ◽

Short Course

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Carbon ion radiotherapy for malignant melanoma of female genital organs

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e16548 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e16548-e16548

Author(s):

H. Kiyohara ◽

S. Kato ◽

T. Ohno ◽

Y. Ohkubo ◽

T. Tamaki ◽

...

Keyword(s):

Malignant Melanoma ◽

Late Toxicity ◽

Distant Metastases ◽

Local Tumor Control ◽

Carbon Ion Radiotherapy ◽

Tumor Control ◽

Carbon Ion ◽

Locally Recurrent ◽

Female Genital

e16548 Background: Malignant melanoma of the female genital organs is a very rare tumor and resistant to conventional photon radiotherapy. We report six cases of female genital malignant melanoma those were well controlled locally by carbon ion radiotherapy (CIRT). Methods: Between November 2004 and October 2008, six patients with unresectable female genital malignant melanoma were treated with CIRT. Age of the patients ranged from 55 to 80 years (median; 69 years). Four patients had previously untreated locally invasive tumors and other two had locally recurrent tumors after surgery and adjuvant chemotherapy. The tumor located in the vagina (4 patients), both the cervix and the vagina (1 patient), or both the vagina and the vulva (1 patient). Two patients had inguinal lymph node metastasis and two had distant metastases at CIRT. All patients received a total dose of 57.6 gray equivalent (GyE) in 16 fractions over 4 weeks of CIRT. Three patients received chemotherapy using dacarbazine, ACNU, and vincristine after CIRT. Results: The follow-up durations after CIRT were from 9 to 20 months (median; 13 months). No patient developed severe acute toxicity during CIRT. No late toxicity of greater Grade 2 was experienced, while Grade 1 proctitis was observed in a patient. All tumors completely responded to CIRT. No patient developed in-field recurrence. The four patients without distant metastasis were alive with no evidence of disease for 9–20 months after CIRT. The two patients with distant metastases died from metastatic disease 13 and 18 months after CIRT, respectively. Conclusions: CIRT achieved favorable local tumor control without developing severe acute and late toxicity in the treatment of unresectable malignant melanoma of the female genital organs. No significant financial relationships to disclose.

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