Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer

Journal Article · Thu Sep 01 04:00:00 EDT 2016 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2016.04.022· OSTI ID:22648785

Yamada, Shigeru ^[1]; Kamada, Tadashi ^[1]; Ebner, Daniel K. ^[1]; Shinoto, Makoto ^[2]; Terashima, Kotaro ^[3]; Isozaki, Yuka; Yasuda, Shigeo; Makishima, Hirokazu; Tsuji, Hiroshi; Tsujii, Hirohiko ^[1]; Isozaki, Tetsuro; Endo, Satoshi ^[4]; Takahashi, Keiichi ^[5]; Sekimoto, Mitsugu ^[6]; Saito, Norio ^[7]; Matsubara, Hisahiro ^[4]

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1. Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan)
2. Ion Beam Therapy Center, SAGA HIMAT Foundation, Saga (Japan)
3. Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)
4. Graduate School of Medicine, Chiba University, Chiba (Japan)
5. Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome, Tokyo (Japan)
6. National Hospital Organization Osaka National Hospital, Osaka (Japan)
7. National Cancer Center Hospital East, Kashiwa, Chiba (Japan)

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.

• OSTI ID: 22648785
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 96; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ABSORBED RADIATION DOSES
CARBON IONS
GY RANGE 01-10
GY RANGE 10-100
NEOPLASMS
PATIENTS
RADIOTHERAPY
RBE
RECTUM