BACKGROUND: The authors evaluated the tolerance and efficacy of carbon-ion radiotherapy (CIRT) as a short-course, preoperative treatment and determined the recommended dose needed to reduce the risk of postoperative local recurrence without excess injury to normal tissue. METHODS: Patients radiographically defined with potentially resectable pancreatic cancer were eligible. A preoperative, short-course, dose-escalation study was performed with fixed 8 fractions in 2 weeks. The dose of irradiation was increased by 5% increments from 30 grays equivalents (GyE) to 36.8 GyE. Surgery was to be performed 2 to 4 weeks after the completion of CIRT. RESULTS: The study enrolled 26 patients. At the time of restaging after CIRT, disease progression with distant metastasis or refusal ruled out 5 patients from surgery. Twenty-one of 26 patients (81%) patients underwent surgery. The pattern of initial disease progression was distant metastasis in 17 patients (65%) and regional recurrence in 2 patients (8%). No patients experienced local recurrence. The 5-year survival rates for all 26 patients and for those who underwent surgery were 42% and 52%, respectively. CONCLUSIONS: Preoperative, short-course CIRT followed by surgery is feasible and tolerable without unacceptable morbidity.
BACKGROUND: The authors evaluated the tolerance and efficacy of carbon-ion radiotherapy (CIRT) as a short-course, preoperative treatment and determined the recommended dose needed to reduce the risk of postoperative local recurrence without excess injury to normal tissue. METHODS:Patients radiographically defined with potentially resectable pancreatic cancer were eligible. A preoperative, short-course, dose-escalation study was performed with fixed 8 fractions in 2 weeks. The dose of irradiation was increased by 5% increments from 30 grays equivalents (GyE) to 36.8 GyE. Surgery was to be performed 2 to 4 weeks after the completion of CIRT. RESULTS: The study enrolled 26 patients. At the time of restaging after CIRT, disease progression with distant metastasis or refusal ruled out 5 patients from surgery. Twenty-one of 26 patients (81%) patients underwent surgery. The pattern of initial disease progression was distant metastasis in 17 patients (65%) and regional recurrence in 2 patients (8%). No patients experienced local recurrence. The 5-year survival rates for all 26 patients and for those who underwent surgery were 42% and 52%, respectively. CONCLUSIONS: Preoperative, short-course CIRT followed by surgery is feasible and tolerable without unacceptable morbidity.
Authors: Theodore S Hong; David P Ryan; Darrell R Borger; Lawrence S Blaszkowsky; Beow Y Yeap; Marek Ancukiewicz; Vikram Deshpande; Shweta Shinagare; Jennifer Y Wo; Yves Boucher; Raymond C Wadlow; Eunice L Kwak; Jill N Allen; Jeffrey W Clark; Andrew X Zhu; Cristina R Ferrone; Harvey J Mamon; Judith Adams; Barbara Winrich; Tarin Grillo; Rakesh K Jain; Thomas F DeLaney; Carlos Fernandez-del Castillo; Dan G Duda Journal: Int J Radiat Oncol Biol Phys Date: 2014-05-24 Impact factor: 7.038
Authors: Jens Werner; Stephanie E Combs; Christoph Springfeld; Werner Hartwig; Thilo Hackert; Markus W Büchler Journal: Nat Rev Clin Oncol Date: 2013-04-30 Impact factor: 66.675
Authors: Francesco D'Angelo; Laura Antolino; Alessio Farcomeni; Dario Sirimarco; Andrea Kazemi Nava; Martina De Siena; Niccolò Petrucciani; Giuseppe Nigri; Stefano Valabrega; Paolo Aurello; Giovanni Ramacciato Journal: Med Oncol Date: 2017-04-08 Impact factor: 3.064