Carbon Ion Radiotherapy in Advanced Hypofractionated Regimens for Prostate Cancer: From 20 to 16 Fractions

Okada, Tohru; Tsuji, Hiroshi; Kamada, Tadashi; Akakura, Koichiro; Suzuki, Hiroyoshi; Shimazaki, Jun; Tsujii, Hirohiko

doi:10.1016/j.ijrobp.2012.01.072

Cited by 59 publications

(84 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reference MKM parametrization was selected in order to reproduce in vitro cell survival data extracted from the Particle Irradiation Data Ensemble (PIDE) database provided by the Gesellschaft für Schwerionenforschung (GSI) (Friedrich et al 2012b) and corresponding to a hypothetical tissue type with ratio R = α X /β X = 3 Gy for late responding tissues. We verified that with this parametrization we were able to reproduce a RBE = 3 in the distal part of the SOBP as reported in Okada et al (2012). The planning target volume (PTV) tolerance margins were adjusted until isodoses and PTV/bladder DVHs were similar to those reported in Mayahara et al (2007) and Okada et al (2012).…”

Section: Patient Model and Reference Treatment Planningsupporting

confidence: 69%

“…AIC ranking supports such a result, providing lower values for cMKM2 with respect to the cMKM1 (where β = β X > 0) (see table 4). These values could be due to the heterogeneous cohort included in the two studies, with one population more radiosensitive than the other, as reported in Okada et al (2012). Additional trials could improve the accuracy of predicted β value and its CI.…”

Section: Radiobiological Parametersmentioning

confidence: 98%

See 1 more Smart Citation

Direct evaluation of radiobiological parameters from clinical data in the case of ion beam therapy: an alternative approach to the relative biological effectiveness

et al. 2014

View full text Add to dashboard Cite

The relative biological effectiveness (RBE) concept is commonly used in treatment planning for ion beam therapy. Whether models based on in vitro/ in vivo RBE data can be used to predict human response to treatments is an open issue. In this work an alternative method, based on an effective radiobiological parameterization directly derived from clinical data, is presented. The method has been applied to the analysis of prostate cancer trials with protons and carbon ions.Prostate cancer trials with proton and carbon ion beams reporting 5 yearlocal control (LC5) and grade 2 (G2) or higher genitourinary toxicity rates (TOX) were selected from literature to test the method. Treatment simulations were performed on a representative subset of patients to produce dose and linear energy transfer distribution, which were used as explicative physical variables for the radiobiological modelling. Two models were taken into consideration: the microdosimetric kinetic model (MKM) and a linear model (LM). The radiobiological parameters of the LM and MKM were obtained by coupling them with the tumor control probability and normal tissue complication probability models to fit the LC5 and TOX data through likelihood maximization. The model ranking was based on the Akaike information criterion. Results showed large confidence intervals due to the limited variety of available treatment schedules. RBE values, such as RBE = 1.1 for protons in the treated volume, were derived as a by-product of the method, showing a consistency with current approaches. Carbon ion RBE values were also derived, showing lower values than those assumed for the original treatment planning in the target region, whereas higher values were found in the bladder. Most importantly, this work shows the possibility to infer the radiobiological parametrization for proton and carbon ion treatment directly from clinical data.

show abstract

Section: Patient Model and Reference Treatment Planningsupporting

confidence: 69%

Section: Radiobiological Parametersmentioning

confidence: 98%

Direct evaluation of radiobiological parameters from clinical data in the case of ion beam therapy: an alternative approach to the relative biological effectiveness

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Many of the reports originate from centers with much experience in particle therapy, mainly from Japan but are retrospective in nature and only very few cover a number of patients that will allow valid conclusions to be drawn [58, 59]. Prospective studies are usually of even smaller size [60].…”

Section: Hypofractionated Radiotherapy With Protons and Ionsmentioning

confidence: 99%

Hypofractionated radiotherapy for localized prostate cancer

Höcht¹,

Aebersold

Albrecht

et al. 2016

Strahlenther Onkol

View full text Add to dashboard Cite

AimThis article gives an overview on the current status of hypofractionated radiotherapy in the treatment of prostate cancer with a special focus on the applicability in routine use.MethodsBased on a recently published systematic review the German Society of Radiation Oncology (DEGRO) expert panel added additional information that has become available since then and assessed the validity of the information on outcome parameters especially with respect to long-term toxicity and long-term disease control.ResultsSeveral large-scale trials on moderate hypofractionation with single doses from 2.4–3.4 Gy have recently finished recruiting or have published first results suggestive of equivalent outcomes although there might be a trend for increased short-term and possibly even long-term toxicity. Large phase 3 trials on extreme hypofractionation with single doses above 4.0 Gy are lacking and only very few prospective trials have follow-up periods covering more than just 2–3 years.ConclusionUntil the results on long-term follow-up of several well-designed phase 3 trials become available, moderate hypofractionation should not be used in routine practice without special precautions and without adherence to the highest quality standards and evidence-based dose fractionation regimens. Extreme hypofractionation should be restricted to prospective clinical trials.

show abstract

“…The total irradiation dose was calculated on the basis of the past irradiation schedules. The past protocols of CIRT (63.0 GyE in 20 fractions in protocol 9904[2] and 57.6 GyE in 16 fractions in protocol 9904[3]) showed favourable outcomes with limited toxicity; the total dose of this clinical trial was estimated to be equivalent to the biological effect observed in the past protocols (Okada et al , 2012). Assuming the alpha–beta ratio of prostate cancer is 1.5–3.0 (Akimoto et al , 2005; Fowler, 2005; Khoo, 2005; Pollack et al , 2006), biologically effective dose when α/β =1.5 (BED 1.5 ) of 63.0 GyE/20 fr.…”

Section: Methodsmentioning

confidence: 99%

“…A new treatment schedule of 16 fractions over 4 weeks was initiated in 2003. This treatment schedule has also shown favourable outcomes and feasibility despite approximately half the duration compared with that of radiotherapy by photons (Okada et al , 2012). The possibility of shortening the treatment duration is one of the advantages of CIRT; however, it is also one of the challenges of CIRT (Tsujii et al , 2004).…”

mentioning

confidence: 99%

Phase I/II trial of definitive carbon ion radiotherapy for prostate cancer: evaluation of shortening of treatment period to 3 weeks

Nomiya¹,

Tsuji²,

Maruyama³

et al. 2014

Br J Cancer

View full text Add to dashboard Cite

Background:The purpose of this study was to evaluate the feasibility of a new shortened 3-week treatment schedule of carbon ion radiotherapy (CIRT) for prostate cancer.Methods:Beginning in May 2010, patients with T1b–T3bN0M0, histologically proven prostate adenocarcinoma were enrolled in the phase II trial of CIRT. Patients received 51.6 GyE in 12 fractions over 3 weeks (protocol 1002). The primary end point was defined as the incidence of late adverse events that were evaluated based on the Common Terminology Criteria for Adverse Events version 4.0. Biochemical failure was determined using the Phoenix definition (nadir +2.0 ng ml−1).Results:Forty-six patients were enrolled, and all patients were included in the analysis. The number of low-, intermediate-, and high-risk patients was 12 (26%), 9 (20%), and 25 (54%), respectively. The median follow-up period of surviving patients was 32.3 months. Two patients had intercurrent death without recurrence, and the remaining 44 patients were alive at the time of this analysis. In the analysis of late toxicities, grade 1 (G1) rectal haemorrhage was observed in 3 (7%) patients. The incidence of G1 haematuria was observed in 6 (13%) patients, and G1 urinary frequency was observed in 17 (37%) patients. No ⩾G2 late toxicities were observed. In the analysis of acute toxicities, 2 (4%) patients showed G2 urinary frequency, and no other G2 acute toxicities were observed.Conclusions:The new shortened CIRT schedule over 3 weeks was considered as feasible. The analysis of long-term outcome is warranted.

show abstract

Carbon Ion Radiotherapy in Advanced Hypofractionated Regimens for Prostate Cancer: From 20 to 16 Fractions

Cited by 59 publications

References 13 publications

Direct evaluation of radiobiological parameters from clinical data in the case of ion beam therapy: an alternative approach to the relative biological effectiveness

Direct evaluation of radiobiological parameters from clinical data in the case of ion beam therapy: an alternative approach to the relative biological effectiveness

Hypofractionated radiotherapy for localized prostate cancer

Phase I/II trial of definitive carbon ion radiotherapy for prostate cancer: evaluation of shortening of treatment period to 3 weeks

Contact Info

Product

Resources

About