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Unresectable Chondrosarcomas Treated With Carbon Ion Radiotherapy: Relationship Between Dose-averaged Linear Energy

Shinnosuke Matsumoto1, Sung Hyun Lee2, Reiko Imai3

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Summary

Higher linear energy transfer (LET) in carbon-ion radiotherapy (CIRT) improves local control for chondrosarcoma. Effective minimum LETd exceeding 40 keV/μm prevented recurrence in patients with unresectable tumors.

Keywords:
Radiotherapychondrosarcomalinear energy transfersarcoma

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Area of Science:

  • Radiation Oncology
  • Medical Physics
  • Skeletal Oncology

Background:

  • Chondrosarcoma local control with carbon-ion radiotherapy (CIRT) declines with increasing tumor size.
  • Intra-tumoral linear energy transfer (LET) distribution may influence treatment outcomes.
  • Understanding LET's role is crucial for optimizing CIRT in chondrosarcoma.

Purpose of the Study:

  • To investigate the association between intra-tumoral LET distribution and local recurrence in chondrosarcoma patients treated with CIRT.
  • To determine if specific LET thresholds correlate with improved local tumor control.

Main Methods:

  • Retrospective analysis of 30 patients with grade 2 chondrosarcoma treated with CIRT.
  • Calculation of dose-averaged LET (LETd) distribution within the planning tumor volume (PTV) using treatment planning systems.
  • Evaluation of the relationship between LETd distribution and local control rates.

Main Results:

  • Mean LETd in the PTV did not differ significantly between recurrent and non-recurrent cases.
  • No local recurrence was observed when the effective minimum LETd within the PTV exceeded 40 keV/μm.
  • This suggests a potential protective threshold for local control.

Conclusions:

  • LETd distribution within the PTV is a significant factor in achieving local control for chondrosarcomas treated with CIRT.
  • Higher LETd ion beam therapy may enhance local control rates for unresectable chondrosarcomas.
  • Targeting specific LETd levels could be a strategy to improve CIRT efficacy.