Application of Carbon Ion and Its Sensitizing Agent in Cancer Therapy: A Systematic Review

Abstract

Carbon ion radiation therapy (CIRT) is the most advanced radiation therapy (RT) available and offers new opportunities to improve cancer treatment and research. CIRT has a unique physical and biological advantage that allow them to kill tumor cells more accurately and intensively. So far, CIRT has been used in almost all types of malignant tumors, and showed good feasibility, safety and acceptable toxicity, indicating that CIRT has a wide range of development and application prospects. In addition, in order to improve the biological effect of CIRT, scientists are also trying to investigate related sensitizing agents to enhance the killing ability of tumor cells, which has attracted extensive attention. In this review, we tried to systematically review the rationale, advantages and problems, the clinical applications and the sensitizing agents of the CIRT. At the same time, the prospects of the CIRT in were prospected. We hope that this review will help researchers interested in CIRT, sensitizing agents, and radiotherapy to understand their magic more systematically and faster, and provide data reference and support for bioanalysis, clinical medicine, radiotherapy, heavy ion therapy, and nanoparticle diagnostics.

The rationale for a carbon ion radiation therapy facility in Australia

“…Various recent (2020-2023) reviews and other publications consider clinical applications, experience, trials and outcomes for CIRT, some overviewing most or all sites with varying levels of detail 3,4,27,36,38,42,62,[100][101][102] and others discussing single applications only. [103][104][105][106][107][108][109] In 2022, Pompos et al 36 succinctly summarised the clinical indications as: radiation resistant malignancies, such as ACC, mucosal melanoma, NSCLC, liver cancer, bone and soft tissue sarcoma; recurrent previously irradiated cancers (especially rectal cancer), advanced gynaecological malignancies, oesophageal cancer, pancreatic cancer and hypoxic malignancies.…”

“…The clinical efficacy of CIRT has been demonstrated for many tumours, both for toxicity reduction and for improved local control and survival. 3,4,27,38,42,62,[86][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102] However, all discussion recognises that direct high-level clinical evidence for CIRT benefit is limited, 117 since most clinical CIRT investigations are retrospective single arm studies. This is similar in principle to many PBT applications, although PBT phase III trial numbers are increasing.…”

“…Various recent (2020–2023) reviews and other publications consider clinical applications, experience, trials and outcomes for CIRT, some overviewing most or all sites with varying levels of detail 3,4,27,36,38,42,62,100–102 and others discussing single applications only 103–109 . In 2022, Pompos et al 36 .…”

Recent Advances in Metal-Based NanoEnhancers for Particle Therapy

“…The global cancer burden is expected to increase to 28.4 million new cancer diagnoses by 2040, which represents a 47% rise in number of cases from 2020 [ 2 ]. Radiotherapy (RT) has become one of the main treatment modalities for cancer over the past century with more than two-thirds of the patients receiving RT alone or along with combinations of other treatments [ 3 ]. During RT, the photon beam is mainly used to damage cancer cells without the need to perform surgical incisions on the patient body.…”

Charged Particle Irradiation for Pancreatic Cancer: A Systematic Review of In Vitro Studies

“…It can deliver equivalent doses to targets as photons would while sparing integral dose to organs at risk (OARs), which could potentially reduce toxicity ( 11 ). Compared with proton, carbon ion offers comparable physical characteristics ( 12 ), but has substantially different biological properties. Carbon ion is associated with an enhanced relative biological effectiveness (RBE) due to higher LET, which theoretically induce more direct DNA damage, and double-strand breaks (DSBs).…”