Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer

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• 作者：Shigeru Yamada ; MD ; PhD^&lowast ; ; ^{s_yamada@nirs.go.jp" class="auth_mail" title="E-mail the corresponding author} ; Tadashi Kamada ; MD ; PhD^&lowast ; ; Daniel K. Ebner ; BS^&lowast ; ; ^&dagger ; ; Makoto Shinoto ; MD^&Dagger ; ; Kotaro Terashima ; MD ; PhD^§ ; ; Yuka Isozaki ; MD ; PhD^&lowast ; ; Shigeo Yasuda ; MD ; PhD^&lowast ; ; Hirokazu Makishima ; MD ; PhD^&lowast ; ; Hiroshi Tsuji ; MD ; PhD^&lowast ; ; Hirohiko Tsujii ; MD ; PhD^&lowast ; ; Tetsuro Isozaki ; MD^‖ ; Satoshi Endo ; MD ; PhD^‖ ; Keiichi Takahashi ; MD ; PhD^¶ ; ; Mitsugu Sekimoto ; MD ; PhD^# ; Norio Saito ; MD ; PhD^&lowast ; &lowast ; ; Hisahiro Matsubara ; MD ; PhD^‖ ; for the Working Group on Locally Recurrent Rectal Cancer
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2016
• 出版时间：1 September 2016
• 年：2016
• 卷：96
• 期：1
• 页码：93-101
• 全文大小：679 K

文摘

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.