Particle beam therapy has been rapidly developed in these several decades. Proton and carbon ion beams are most frequently used in particle beam therapy. Proton and carbon ion beam radiotherapy have physical and biological advantage to the conventional photon radiotherapy. Cancers of the skull base, nasal cavity, and paranasal sinus are rare; however these diseases can receive the benefits of particle beam radiotherapy. This paper describes the clinical review of the cancer of the skull base, nasal cavity, and paranasal sinus treated with proton and carbon ion beams, adding some information of feature and future direction of proton and carbon ion beam radiotherapy. 1. Introduction Particle beam therapy was first proposed in the 1940s [1] and was investigated in the USA, Sweden, and the Soviet Union in the 1950–1960s. In the 1970s, particle beam therapy was rapidly developed in parallel with the development of X-ray computed tomography. Globally, more than 48,000 patients have been treated with particle beams. Most of these treatments were delivered using proton and carbon ion radiotherapy (RT). Currently, there are 36 particle beam therapy facilities in operation (proton: 33, carbon ion: 5, both particles: 2), according to the Particle Therapy Co-Operative Group homepage. Ten facilities are located in the USA, followed by eight in Japan, three in Germany, three in Russia, two in France, and 10 in other countries (Table 1). Table 1: Institution of particle beam therapy. This paper describes the status and prospects of particle beam therapy for the treatment of cancer of the skull base, nasal cavity, and paranasal sinus, including physical, biological, technical, and financial aspects. 2. Physical, Biological, Technical, and Financial Aspects of Particle Beam Therapy The physical, biological, technical, and financial aspects of particle beam therapy differ largely from those of conventional photon RT. 2.1. Physical Aspects Both proton and carbon ion beams have features that are extremely different from those of photons. Accelerated proton and carbon ion beams show an increase in energy deposition with penetration depth up to a sharp maximum followed by rapid decrease at the end of the penetration range; this phenomenon is known as the Bragg peak (Figure 1). The particle range is determined by the energy of the incoming particles, and the Bragg peak can be spread out. These features permit a more precise and conformal dose localization to the target, compared with photon beams. Figure 1: Relationship of depth and relative dose in photon, proton and carbon
References
[1]
R. R. Wilson, “Radiological use of fast protons,” Radiology, vol. 47, no. 5, pp. 487–491, 1946.
[2]
H. Eickhoff, T. Haberer, G. Kraft et al., “The GSI cancer therapy project,” Strahlentherapie und Onkologie, vol. 175, no. 2, pp. 21–24, 1999.
[3]
E. Pedroni, R. Bacher, H. Blattmann et al., “The 200-MeV proton therapy project at the Paul Scherrer Institute: conceptual design and practical realization,” Medical Physics, vol. 22, no. 1, pp. 37–53, 1995.
[4]
A. Peeters, J. P. C. Grutters, M. Pijls-Johannesma et al., “How costly is particle therapy? Cost analysis of external beam radiotherapy with carbon-ions, protons and photons,” Radiotherapy and Oncology, vol. 95, no. 1, pp. 45–53, 2010.
[5]
J. Debus, E. B. Hug, N. J. Liebsch et al., “Brainstem tolerance to conformal radiotherapy of skull base tumors,” International Journal of Radiation Oncology Biology Physics, vol. 39, no. 5, pp. 967–975, 1997.
[6]
J. E. Munzenrider and N. J. Liebsch, “Proton therapy for tumors of the skull base,” Strahlentherapie und Onkologie, vol. 175, no. 2, pp. 57–63, 1999.
[7]
B. O. Colli and O. Al-Mefty, “Chordomas of the craniocervical junction: follow-up review and prognostic factors,” Journal of Neurosurgery, vol. 95, no. 6, pp. 933–943, 2001.
[8]
G. No？l, J. L. Habrand, E. Jauffret et al., “Radiation therapy for chordoma and chondrosarcoma of the skull base and the cervical spine: prognostic factors and patterns of failure,” Strahlentherapie und Onkologie, vol. 179, no. 4, pp. 241–248, 2003.
[9]
D. Schulz-Ertner, A. Nikoghosyan, C. Thilmann et al., “Results of carbon ion radiotherapy in 152 patients,” International Journal of Radiation Oncology Biology Physics, vol. 58, no. 2, pp. 631–640, 2004.
[10]
H. Igaki, K. Tokuuye, T. Okumura et al., “Clinical results of proton beam therapy for skull base chordoma,” International Journal of Radiation Oncology Biology Physics, vol. 60, no. 4, pp. 1120–1126, 2004.
[11]
D. Schulz-Ertner, A. Nikoghosyan, B. Didinger et al., “Therapy strategies for locally advanced adenoid cystic carcinomas using modern radiation therapy techniques,” Cancer, vol. 104, no. 2, pp. 338–344, 2005.
[12]
P. Pommier, N. J. Liebsch, D. G. Deschler et al., “Proton beam radiation therapy for skull base adenoid cystic carcinoma,” Archives of Otolaryngology, vol. 132, no. 11, pp. 1242–1249, 2006.
[13]
H. Tsujii, J. Mizoe, T. Kamada et al., “Clinical results of carbon ion radiotherapy at NIRS,” Journal of Radiation Research, vol. 48, pp. A1–A13, 2007.
[14]
D. Schulz-Ertner, A. Nikoghosyan, H. Hof et al., “Carbon ion radiotherapy of skull base chondrosarcomas,” International Journal of Radiation Oncology Biology Physics, vol. 67, no. 1, pp. 171–177, 2007.
[15]
C. Ares, E. B. Hug, A. J. Lomax et al., “Effectiveness and safety of spot scanning proton radiation therapy for chordomas and chondrosarcomas of the skull base: first long-term report,” International Journal of Radiation Oncology Biology Physics, vol. 75, no. 4, pp. 1111–1118, 2009.
[16]
S. E. Combs, A. Nikoghosyan, O. Jaekel et al., “Carbon ion radiotherapy for pediatric patients and young adults treated for tumors of the skull base,” Cancer, vol. 115, no. 6, pp. 1348–1355, 2009.
[17]
D. Schulz-Ertner, A. Nikoghosyan, C. Thilmann et al., “Carbon ion radiotherapy for chordomas and low-grade chondrosarcomas of the skull base. Results in 67 patients,” Strahlentherapie und Onkologie, vol. 179, no. 9, pp. 598–605, 2003.
[18]
A. V. Nikoghosyan, I. Karapanagiotou-Schenkel, M. W. Münter, A. D. Jensen, S. E. Combs, and J. Debus, “Randomised trial of proton vs. carbon ion radiation therapy in patients with chordoma of the skull base, clinical phase III study HIT-1-Study,” BMC Cancer, vol. 10, article 607, 2010.
[19]
A. V. Nikoghosyan, G. Rauch, M. W. Münter et al., “Randomised trial of proton vs. carbon ion radiation therapy in patients with low and intermediate grade chondrosarcoma of the skull base, clinical phase III study,” BMC Cancer, vol. 10, article 606, 2010.
[20]
J. E. Mizoe, H. Tsujii, T. Kamada et al., “Dose escalation study of carbon ion radiotherapy for locally advanced head-and-neck cancer,” International Journal of Radiation Oncology Biology Physics, vol. 60, no. 2, pp. 358–364, 2004.
[21]
D. C. Weber, A. W. Chan, S. Lessell et al., “Visual outcome of accelerated fractionated radiation for advanced sinonasal malignancies employing photons/protons,” Radiotherapy and Oncology, vol. 81, no. 3, pp. 243–249, 2006.
[22]
M. Tamtruong, U. R. Kamat, N. J. Liebsch et al., “Proton radiation therapy for primary sphenoid sinus malignancies: treatment outcome and prognostic factors,” Head and Neck, vol. 31, no. 10, pp. 1297–1308, 2009.
[23]
S. Zenda, R. Kohno, M. Kawashima et al., “Proton Beam Therapy for Unresectable Malignancies of the Nasal Cavity and Paranasal Sinuses,” International Journal of Radiation Oncology, Biology, Physics, vol. 81, no. 5, pp. 1473–1478, 2010.
[24]
K. Jingu, R. Kishimoto, J. E. Mizoe et al., “Malignant mucosal melanoma treated with carbon ion radiotherapy with concurrent chemotherapy: prognostic value of pretreatment apparent diffusion coefficient (ADC),” Radiotherapy and Oncology, vol. 98, no. 1, pp. 68–73, 2011.
[25]
N. Fukumitsu, T. Okumura, M. Mizumoto et al., “Outcome of T4 (UICC 7th) or recurrent nasal cavity and paranasal sinus carcinoma treated with proton beam,” International Journal of Radiation Oncology, Biology, Physics, vol. 83, no. 2, pp. 704–711, 2012.
