A single institutional experience of combined carbon-ion radiotherapy and chemotherapy for unresectable locally advanced pancreatic cancer

Shinoto, Makoto; Terashima, Kotaro; Suefuji, Hiroaki; Matsunobu, Akira; Toyama, Shingo; Fukunishi, K.; Shioyama, Yoshiyuki

doi:10.1016/j.radonc.2018.08.026

Cited by 38 publications

(44 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Japan, 64 patients with unresectable pancreatic cancer were treated with 55.2 GyE in 12 fractions, with a median survival of 25.1 months and 2-year LC of 82%. Four patients had acute grade 3 toxicity (78).…”

Section: Pancreatic Cancermentioning

confidence: 98%

Carbon Ion Therapy: A Modern Review of an Emerging Technology

et al. 2020

View full text Add to dashboard Cite

Radiation therapy is one of the most widely used therapies for malignancies. The therapeutic use of heavy ions, such as carbon, has gained significant interest due to advantageous physical and radiobiologic properties compared to photon based therapy. By taking advantage of these unique properties, carbon ion radiotherapy may allow dose escalation to tumors while reducing radiation dose to adjacent normal tissues. There are currently 13 centers treating with carbon ion radiotherapy, with many of these centers publishing promising safety and efficacy data from the first cohorts of patients treated. To date, carbon ion radiotherapy has been studied for almost every type of malignancy, including intracranial malignancies, head and neck malignancies, primary and metastatic lung cancers, tumors of the gastrointestinal tract, prostate and genitourinary cancers, sarcomas, cutaneous malignancies, breast cancer, gynecologic malignancies, and pediatric cancers. Additionally, carbon ion radiotherapy has been studied extensively in the setting of recurrent disease. We aim to provide a comprehensive review of the studies of each of these disease sites, with a focus on the current trials using carbon ion radiotherapy.

show abstract

Section: Pancreatic Cancermentioning

confidence: 98%

Carbon Ion Therapy: A Modern Review of an Emerging Technology

et al. 2020

View full text Add to dashboard Cite

show abstract

“…As demonstrated in Shinoto, et al [68], more recently, validated the efficacy and safety of 55.2 GyE, demonstrating an increase in OS rates (2-year OS rose from 48% in 2016 to 53% in 2018) with acceptable late (3%) and acute (0%) grade 3 GI toxicities. The maximum tolerated dose was evaluated as safe, under the conditions of respiratory-gating and stringent selection criteria.…”

Section: Carbon Ionmentioning

confidence: 72%

“…In [68] C-ion studies could also be attributed to selection bias of patients as candidates were selected depending on the lesions contact with the GI tract. Selection bias of these results in Table 4 is difficult to translate to a wider population; improved eligibility criteria is therefore required for C-ion studies.…”

Section: Gaps In Particle Therapy For Pancreatic Cancermentioning

confidence: 99%

Clinical Limitations of Photon, Proton and Carbon Ion Therapy for Pancreatic Cancer

Dell’Oro

Short

Wilson

et al. 2020

Cancers

View full text Add to dashboard Cite

Introduction: Despite improvements in radiation therapy, chemotherapy and surgical procedures over the last 30 years, pancreatic cancer 5-year survival rate remains at 9%. Reduced stroma permeability and heterogeneous blood supply to the tumour prevent chemoradiation from making a meaningful impact on overall survival. Hypoxia-activated prodrugs are the latest strategy to reintroduce oxygenation to radioresistant cells harbouring in pancreatic cancer. This paper reviews the current status of photon and particle radiation therapy for pancreatic cancer in combination with systemic therapies and hypoxia activators. Methods: The current effectiveness of management of pancreatic cancer was systematically evaluated from MEDLINE® database search in April 2019. Results: Limited published data suggest pancreatic cancer patients undergoing carbon ion therapy and proton therapy achieve a comparable median survival time (25.1 months and 25.6 months, respectively) and 1-year overall survival rate (84% and 77.8%). Inconsistencies in methodology, recording parameters and protocols have prevented the safety and technical aspects of particle therapy to be fully defined yet. Conclusion: There is an increasing requirement to tackle unmet clinical demands of pancreatic cancer, particularly the lack of synergistic therapies in the advancing space of radiation oncology.

show abstract

“…Another potential reason for lower LC rates in our study is that we used CT and 18F-FDG-PET to detect local recurrence after C-ion RT. Notably, Shinoto et al [9][10] discovered dissimilarities in evaluations when using CT versus 18F-FDG-PET criteria, as the latter can assess tumour viability more reliably.…”

Section: Discussionmentioning

confidence: 99%

“…Promising outcomes have been reported in patients who received C-ion RT for radioresistant inoperable pancreatic cancers [8][9][10]. Shinoto et al [10] reported 2-year local control (LC) and overall survival (OS) rates of 82% and 53%, respectively, in 64 patients with LAPC who received C-ion RT. Ben-Josef et al [11] reported 2-year LC and OS rates of 59% and 30%, respectively, in 50 patients with LAPC who received intensity-modulated radiation (IMRT).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and feasibility of re-irradiation using carbon ions for pancreatic cancer that recurs after carbon-ion radiotherapy

Hagiwara

Yamada

Isozaki

et al. 2021

Clinical and Translational Radiation Oncology

Self Cite

View full text Add to dashboard Cite

Background and purpose: Patients who receive carbon-ion radiotherapy (C-ion RT) for primary pancreatic cancer may experience locoregional recurrence; however, the treatment options for such patients are limited. We aimed to investigate the feasibility and efficacy of carbon-ion re-irradiation for patients with pancreatic cancer who experienced recurrence after initial C-ion RT. Materials and methods: Twenty-one patients with recurrent pancreatic cancer who underwent repeat Cion RT between December 2010 and November 2016 at our institute were retrospectively evaluated. The sites of post-initial C-ion RT failure were in-field central in 16 patients (76.2%) and marginal in 5 (23.8%). The median doses of initial and repeat C-ion RT were both 52.8 Gy (relative biological effectiveness [RBE]). Thirteen patients (61.9%) received concurrent chemotherapy with re-irradiation, while 11 (52.4%) received adjuvant chemotherapy. Results: The median follow-up period after re-irradiation was 11 months. The 1-year local control, progression-free survival, and overall survival rates were 53.5%, 24.5%, and 48.7%, respectively. Toxicity data was obtained from the patients' charts. Only 1 patient (4.8%) developed grade 3 acute toxicities and none developed grade 3 late toxicities. Univariate analysis indicated that patients who received adjuvant chemotherapy had significantly improved local control rates compared with those who did not; the 1-year local control rates were 80.0% and 0.0%, respectively (P = 0.0469). Conclusion: Repeating C-ion RT may be a reasonable option with tolerable toxicity for patients with recurrent pancreatic cancers. Adjuvant chemotherapy appears to improve the local control rate. This is the first study to examine re-irradiation using C-ion for recurrent pancreatic cancer after initial C-ion RT.

show abstract

A single institutional experience of combined carbon-ion radiotherapy and chemotherapy for unresectable locally advanced pancreatic cancer

Cited by 38 publications

References 29 publications

Carbon Ion Therapy: A Modern Review of an Emerging Technology

Carbon Ion Therapy: A Modern Review of an Emerging Technology

Clinical Limitations of Photon, Proton and Carbon Ion Therapy for Pancreatic Cancer

Efficacy and feasibility of re-irradiation using carbon ions for pancreatic cancer that recurs after carbon-ion radiotherapy

Contact Info

Product

Resources

About