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Title: Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer

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.

Authors:
 [1];  [1];  [1];  [2];  [3];  [4]; ; ; ; ;  [1]; ;  [5];  [6];  [7];  [8];  [5]
  1. Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan)
  2. (United States)
  3. Ion Beam Therapy Center, SAGA HIMAT Foundation, Saga (Japan)
  4. Graduate School of Medical Sciences, Kyushu University, Fukuoka (Japan)
  5. Graduate School of Medicine, Chiba University, Chiba (Japan)
  6. Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome, Tokyo (Japan)
  7. National Hospital Organization Osaka National Hospital, Osaka (Japan)
  8. National Cancer Center Hospital East, Kashiwa, Chiba (Japan)
Publication Date:
OSTI Identifier:
22648785
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 96; Journal Issue: 1; Other Information: Copyright (c) 2016 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ABSORBED RADIATION DOSES; CARBON IONS; GY RANGE 01-10; GY RANGE 10-100; NEOPLASMS; PATIENTS; RADIOTHERAPY; RBE; RECTUM

Citation Formats

Yamada, Shigeru, E-mail: s_yamada@nirs.go.jp, Kamada, Tadashi, Ebner, Daniel K., Brown University Alpert Medical School, Providence, Rhode Island, Shinoto, Makoto, Terashima, Kotaro, Isozaki, Yuka, Yasuda, Shigeo, Makishima, Hirokazu, Tsuji, Hiroshi, Tsujii, Hirohiko, Isozaki, Tetsuro, Endo, Satoshi, Takahashi, Keiichi, Sekimoto, Mitsugu, Saito, Norio, and Matsubara, Hisahiro. Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer. United States: N. p., 2016. Web. doi:10.1016/J.IJROBP.2016.04.022.
Yamada, Shigeru, E-mail: s_yamada@nirs.go.jp, Kamada, Tadashi, Ebner, Daniel K., Brown University Alpert Medical School, Providence, Rhode Island, Shinoto, Makoto, Terashima, Kotaro, Isozaki, Yuka, Yasuda, Shigeo, Makishima, Hirokazu, Tsuji, Hiroshi, Tsujii, Hirohiko, Isozaki, Tetsuro, Endo, Satoshi, Takahashi, Keiichi, Sekimoto, Mitsugu, Saito, Norio, & Matsubara, Hisahiro. Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer. United States. doi:10.1016/J.IJROBP.2016.04.022.
Yamada, Shigeru, E-mail: s_yamada@nirs.go.jp, Kamada, Tadashi, Ebner, Daniel K., Brown University Alpert Medical School, Providence, Rhode Island, Shinoto, Makoto, Terashima, Kotaro, Isozaki, Yuka, Yasuda, Shigeo, Makishima, Hirokazu, Tsuji, Hiroshi, Tsujii, Hirohiko, Isozaki, Tetsuro, Endo, Satoshi, Takahashi, Keiichi, Sekimoto, Mitsugu, Saito, Norio, and Matsubara, Hisahiro. Thu . "Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer". United States. doi:10.1016/J.IJROBP.2016.04.022.
@article{osti_22648785,
title = {Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer},
author = {Yamada, Shigeru, E-mail: s_yamada@nirs.go.jp and Kamada, Tadashi and Ebner, Daniel K. and Brown University Alpert Medical School, Providence, Rhode Island and Shinoto, Makoto and Terashima, Kotaro and Isozaki, Yuka and Yasuda, Shigeo and Makishima, Hirokazu and Tsuji, Hiroshi and Tsujii, Hirohiko and Isozaki, Tetsuro and Endo, Satoshi and Takahashi, Keiichi and Sekimoto, Mitsugu and Saito, Norio and Matsubara, Hisahiro},
abstractNote = {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.},
doi = {10.1016/J.IJROBP.2016.04.022},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 96,
place = {United States},
year = {Thu Sep 01 00:00:00 EDT 2016},
month = {Thu Sep 01 00:00:00 EDT 2016}
}