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: Shigeru Yamada, Tadashi Kamada, Daniel K Ebner, Makoto Shinoto, Kotaro Terashima, Yuka Isozaki, Shigeo Yasuda, Hirokazu Makishima, Hiroshi Tsuji, Hirohiko Tsujii, Tetsuro Isozaki, Satoshi Endo, Keiichi Takahashi, Mitsugu Sekimoto, Norio Saito, Hisahiro Matsubara, Working Group on Locally Recurrent Rectal Cancer
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 96 Issue 1 Pg. 93-101 (09 01 2016) ISSN: 1879-355X [Electronic] United States
• PMID: 27375166 (Publication Type: Clinical Trial, Phase I, Clinical Trial, Phase II, Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Chemical References

• Carbon

Topics

• Adult
• Aged
• Carbon
• Disease-Free Survival
• Dose-Response Relationship, Radiation
• Female
• Heavy Ion Radiotherapy (mortality, statistics & numerical data)
• Humans
• Japan (epidemiology)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (mortality, radiotherapy)
• Pelvic Neoplasms (mortality, prevention & control)
• Prevalence
• Radiation Dose Hypofractionation
• Rectal Neoplasms (mortality, radiotherapy)
• Risk Factors
• Survival Rate
• Treatment Outcome