Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Carbon-ion radiotherapy in osteosarcoma of the mandible: a case report

  • Ha, Tae-Wook (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Park, Slmaro (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Youn, Min Yeong (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Kim, Dong Wook (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Kim, Hyung Jun (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • Received : 2019.07.17
  • Accepted : 2019.10.15
  • Published : 2021.08.31
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Abstract

Carbon-ion radiotherapy (CIRT) is on the rise as a treatment choice for malignant tumor. Compared to conventional radiotherapy, particle beams have different physical and biological properties. Particle beam provides a low entry dose, deposits most of the energy at the endpoint of the flight path, and forms an asymptotic dose peak (the "Bragg peak"). Compared to protons, carbon with its larger mass decreases beam scattering, resulting in a sharper dose distribution border. We report a 50-year-old male who underwent CIRT without surgical resection on osteosarcoma of the mandible. After CIRT, the patient's pain was gone, and the malignant mass remained stable with accompanying necrosis. Nine months later, however, magnetic resonance imaging demonstrated progression of the left mandibular osteosarcoma with pulmonary metastases. After multidisciplinary discussion, concurrent chemoradiotherapy was conducted. While necrotic bone segments came out of the mandible during subsequent periodic outpatient visits, the tumor itself was stable. Thirty months after his first visit and diagnosis, the patient is waiting for chemotherapy. Although CIRT is superior in treating radioresistant hypoxic disease, CIRT is in its infancy, so care must be taken for its indications and complications.

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References

  1. Lim S, Lee S, Rha SY, Rho JK. Cranofacial osteosarcoma: single institutional experience in Korea. Asia Pac J Clin Oncol 2016;12:e149-53. https://doi.org/10.1111/ajco.12072
  2. Sturgis EM, Potter BO. Sarcomas of the head and neck region. Curr Opin Oncol 2003;15:239-52. https://doi.org/10.1097/00001622-200305000-00011
  3. Schwarz R, Bruland O, Cassoni A, Schomberg P, Bielack S. The role of radiotherapy in oseosarcoma. In: Jaffe N, Bruland OS, Bielack S, eds. Pediatric and adolescent osteosarcoma. Cancer treatment and research. Boston: Springer; 2010:147-64.
  4. Jeong HI, Lee MJ, Nam W, Cha IH, Kim HJ. Osteosarcoma of the jaws in Koreans: analysis of 26 cases. J Korean Assoc Oral Maxillofac Surg 2017;43:312-7. https://doi.org/10.5125/jkaoms.2017.43.5.312
  5. Machak GN, Tkachev SI, Solovyev YN, Sinyukov PA, Ivanov SM, Kochergina NV, et al. Neoadjuvant chemotherapy and local radiotherapy for high-grade osteosarcoma of the extremities. Mayo Clin Proc 2003;78:147-55. https://doi.org/10.4065/78.2.147
  6. Delaney G, Jacob S, Featherstone C, Barton M. The role of radiotherapy in cancer treatment: estimating optimal utilization from a review of evidence-based clinical guidelines. Cancer 2005;104:1129-37. https://doi.org/10.1002/cncr.21324
  7. Neville B, Damm DD, Allen C, Chi A. Oral and maxillofacial pathology. 4th ed. Philadelphia: Saunders; 2015.
  8. Krishnamurthy A, Palaniappan R. Osteosarcomas of the head and neck region: a case series with a review of literature. J Maxillofac Oral Surg 2018;17:38-43. https://doi.org/10.1007/s12663-017-1017-8
  9. Makary RF, Gopinath A, Markiewicz MR, Fernandes R. Margin analysis: sarcoma of the head and neck. Oral Maxillofac Surg Clin North Am 2017;29:355-66. https://doi.org/10.1016/j.coms.2017.04.002
  10. Kimura Y, Tomihara K, Tachinami H, Imaue S, Nakamori K, Fujiwara K, et al. Conventional osteosarcoma of the mandible successfully treated with radical surgery and adjuvant chemotherapy after responding poorly to neoadjuvant chemotherapy: a case report. J Med Case Rep 2017;11:210. https://doi.org/10.1186/s13256-017-1386-0
  11. Ebner DK, Kamada T. The emerging role of carbon-ion radiotherapy. Front Oncol 2016;6:140. https://doi.org/10.3389/fonc.2016.00140
  12. Kong L, Gao J, Hu J, Lu R, Yang J, Qiu X, et al. Carbon ion radiotherapy boost in the treatment of glioblastoma: a randomized phase I/III clinical trial. Cancer Commun (Lond) 2019;39:5. https://doi.org/10.1186/s40880-019-0351-2
  13. Durante M, Paganetti H. Nuclear physics in particle therapy: a review. Rep Prog Phys 2016;79:096702. https://doi.org/10.1088/0034-4885/79/9/096702
  14. Mohamad O, Yamada S, Durante M. Clinical indications for carbon ion radiotherapy. Clin Oncol (R Coll Radiol) 2018;30:317-29. https://doi.org/10.1016/j.clon.2018.01.006
  15. Blattmann C, Oertel S, Schulz-Ertner D, Rieken S, Haufe S, Ewerbeck V, et al. Non-randomized therapy trial to determine the safety and efficacy of heavy ion radiotherapy in patients with nonresectable osteosarcoma. BMC Cancer 2010;10:96. https://doi.org/10.1186/1471-2407-10-96
  16. Mohamad O, Makishima H, Kamada T. Evolution of carbon ion radiotherapy at the National Institute of Radiological Sciences in Japan. Cancers (Basel) 2018;10:66. https://doi.org/10.3390/cancers10030066
  17. Ballo MT, Zagars GK, Cormier JN, Hunt KK, Feig BW, Patel SR, et al. Interval between surgery and radiotherapy: effect on local control of soft tissue sarcoma. Int J Radiat Oncol Biol Phys 2004;58:1461-7. https://doi.org/10.1016/j.ijrobp.2003.09.079
  18. Jingu K, Tsujii H, Mizoe JE, Hasegawa A, Bessho H, Takagi R, et al.; Organizing Committee for the Working Group for Head-andNeck Cancer. Carbon ion radiation therapy improves the prognosis of unresectable adult bone and soft-tissue sarcoma of the head and neck. Int J Radiat Oncol Biol Phys 2012;82:2125-31. https://doi.org/10.1016/j.ijrobp.2010.08.043
  19. Kohyama K, Yamada K, Sugiura H, Hyodo I, Ozawa T, Hasegawa Y, et al. Salvage surgery and microsurgical reconstruction for recurrence of skull base osteosarcoma after carbon ion radiotherapy. Nagoya J Med Sci 2015;77:667-73.
  20. Sasahara G, Koto M, Ikawa H, Hasegawa A, Takagi R, Okamoto Y, et al. Effects of the dose-volume relationship on and risk factors for maxillary osteoradionecrosis after carbon ion radiotherapy. Radiat Oncol 2014;9:92. https://doi.org/10.1186/1748-717X-9-92