Shigeru Yamada1, Tadashi Kamada2, Daniel K Ebner3, Makoto Shinoto4, Kotaro Terashima5, Yuka Isozaki2, Shigeo Yasuda2, Hirokazu Makishima2, Hiroshi Tsuji2, Hirohiko Tsujii2, Tetsuro Isozaki6, Satoshi Endo6, Keiichi Takahashi7, Mitsugu Sekimoto8, Norio Saito9, Hisahiro Matsubara6. 1. Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan. Electronic address: s_yamada@nirs.go.jp. 2. Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan. 3. Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan; Brown University Alpert Medical School, Providence, Rhode Island. 4. Ion Beam Therapy Center, SAGA HIMAT Foundation, Saga, Japan. 5. Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 6. Graduate School of Medicine, Chiba University, Chiba, Japan. 7. Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome, Tokyo, Japan. 8. National Hospital Organization Osaka National Hospital, Osaka, Japan. 9. National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
Abstract
PURPOSE: Investigation of the treatment potential of carbon-ion radiation therapy in pelvic recurrence of rectal cancer. METHODS AND MATERIALS: A phase 1/2 dose escalation study was performed. One hundred eighty patients (186 lesions) with locally recurrent rectal cancer were treated with carbon-ion radiation therapy (CIRT) (phase 1/2: 37 and 143 patients, respectively). The relapse locations were 71 in the presacral region, 82 in the pelvic sidewalls, 28 in the perineum, and 5 near the colorectal anastomosis. A 16-fraction in 4 weeks dose regimen was used, with total dose ranging from 67.2 to 73.6 Gy(RBE); RBE-weighted absorbed dose: 4.2 to 4.6 Gy(RBE)/fraction. RESULTS: During phase 1, the highest total dose, 73.6 Gy(RBE), resulted in no grade >3 acute reactions in the 13 patients treated at that dose. Dose escalation was halted at this level, and this dose was used for phase 2, with no other grade >3 acute reactions observed. At 5 years, the local control and survival rates at 73.6 Gy(RBE) were 88% (95% confidence interval [CI], 80%-93%) and 59% (95% CI, 50%-68%), respectively. CONCLUSION: Carbon-ion radiation therapy may be a safe and effective treatment option for locally recurrent rectal cancer and may serve as an alternative to surgery.
PURPOSE: Investigation of the treatment potential of carbon-ion radiation therapy in pelvic recurrence of rectal cancer. METHODS AND MATERIALS: A phase 1/2 dose escalation study was performed. One hundred eighty patients (186 lesions) with locally recurrent rectal cancer were treated with carbon-ion radiation therapy (CIRT) (phase 1/2: 37 and 143 patients, respectively). The relapse locations were 71 in the presacral region, 82 in the pelvic sidewalls, 28 in the perineum, and 5 near the colorectal anastomosis. A 16-fraction in 4 weeks dose regimen was used, with total dose ranging from 67.2 to 73.6 Gy(RBE); RBE-weighted absorbed dose: 4.2 to 4.6 Gy(RBE)/fraction. RESULTS: During phase 1, the highest total dose, 73.6 Gy(RBE), resulted in no grade >3 acute reactions in the 13 patients treated at that dose. Dose escalation was halted at this level, and this dose was used for phase 2, with no other grade >3 acute reactions observed. At 5 years, the local control and survival rates at 73.6 Gy(RBE) were 88% (95% confidence interval [CI], 80%-93%) and 59% (95% CI, 50%-68%), respectively. CONCLUSION:Carbon-ion radiation therapy may be a safe and effective treatment option for locally recurrent rectal cancer and may serve as an alternative to surgery.
Authors: Amelia Barcellini; Viviana Vitolo; Lorenzo Cobianchi; Andrea Peloso; Alessandro Vanoli; Alfredo Mirandola; Angelica Facoetti; Maria Rosaria Fiore; Alberto Iannalfi; Barbara Vischioni; Francesco Cuccia; Sara Ronchi; Maria Bonora; Giulia Riva; Rachele Petrucci; Emma D'Ippolito; Francesca Dal Mas; Lorenzo Preda; Francesca Valvo Journal: In Vivo Date: 2020 May-Jun Impact factor: 2.155
Authors: Osama Mohamad; Brock J Sishc; Janapriya Saha; Arnold Pompos; Asal Rahimi; Michael D Story; Anthony J Davis; D W Nathan Kim Journal: Cancers (Basel) Date: 2017-06-09 Impact factor: 6.639