炭离子放疗（CIRT）是治疗恶性盆部肿瘤患者中存在手术限制的新兴选择。然而，CIRT和手术的并发症和功能结果差异尚未被充分了解。本研究比较CIRT和手术的并发症和功能结果以便于治疗选择。纳入了28例理论上符合手术切除标准的盆骨肿瘤患者接受了CIRT，其中69例接受了盆骨肿瘤的手术治疗作为对照组。分别在组间的几个时间点（治疗前、出院和最终随访）评估和比较主要并发症率和功能结果（步行、疼痛、排尿、便秘）。CIRT组未出现早期（90天内）的严重并发症，但手术组发生了30%的比例，这在统计学上具有显著性（P <0.001）。相比之下，CIRT组的晚期（90天后）严重并发症比手术组更多（分别为18%和4%，P = 0.042）。从治疗前到出院，手术组所有功能结果恶化（所有P <0.001），而CIRT组结果无变化（P = 0.77-1.00）。最终随访时，所有功能结果在组间无显著差异（P = 0.28-0.92），这是由于手术组的恢复趋势和CIRT组的恶化趋势。与手术相比，CIRT在短期内可能具有有利的安全性和稳定的功能结果，但存在更多晚期并发症，中期功能结果两组相似。© 2023年外科肿瘤学会。

Carbon ion radiotherapy (CIRT) is an evolving treatment option for malignant pelvic tumors in patients with poor surgical indications. However, the difference in complications and functional outcomes between CIRT and surgery is poorly understood. This study compares the complications and functional outcomes of CIRT and surgery to facilitate treatment selection.A total of 28 patients who underwent CIRT for pelvic bone tumors while theoretically meeting the surgical resection criteria were included. Sixty-nine patients who underwent surgery for pelvic bone tumors were included as controls. Major complication rates and functional outcomes (ambulatory, pain, urination, constipation) were evaluated and compared at several time points (pretreatment, discharge, and final follow-up) between the groups.Early (within 90 days) major complications were not observed in the CIRT group but occurred in 30% of the surgery group, which was statistically significant (P < 0.001). In contrast, late (after 90 days) major complications occurred more often in the CIRT group than in the surgery group (18% and 4%, respectively; P = 0.042). From pretreatment until discharge, all functional outcomes in the surgery group deteriorated (P < 0.001 for all) but did not change in the CIRT group (P = 0.77-1.00). At the final follow-up, all functional outcomes showed no significant intergroup difference (P = 0.28-0.92) due to the recovery trend in the surgery group and the deterioration trend in the CIRT group.Compared with surgery, CIRT may have favorable safety and stable functional outcomes in the short-term but more late complications. Mid-term functional outcomes were similar between the groups.© 2023. Society of Surgical Oncology.