Pelvic insufficiency fractures following carbon-ion radiotherapy for uterine carcinomas

Miyasaka, Yasuhiro; Okonogi, Noriyuki; Fukahori, Mai; Furuichi, Wataru; Wakatsuki, Masaru; Kato, Shingo; Ohno, Tatsuya; Nakano, Takashi; Tsuji, Hiroshi

doi:10.1016/j.radonc.2020.11.030

Cited by 5 publications

(3 citation statements)

References 30 publications

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“…However, because of the relatively short follow-up period, caution should be exercised regarding the possibility of increased toxicity, especially bladder and small intestine toxicity, in the future [ 41 ]. Insufficiency fracture is also an important factor that lowers the quality of life, and it has been reported following CIRT [ 42 , 43 ]. It is desirable to devise irradiation methods to prevent insufficiency fractures.…”

Section: Discussionmentioning

confidence: 99%

Preliminary result of combined treatment with scanning carbon-ion radiotherapy and image-guided brachytherapy for locally advanced cervical adenocarcinoma

Tsuchida,

Yoshida,

Shima

et al. 2024

Journal of Radiation Research

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Although there is growing evidence of the efficacy of carbon-ion radiotherapy (CIRT) for locally advanced cervical adenocarcinoma, reports on combined treatment with CIRT and image-guided brachytherapy (IGBT) are scarce. We retrospectively analyzed patients with International Federation of Gynecology and Obstetrics (2008) stage II–IVA locally advanced cervical adenocarcinoma who received combined scanning CIRT (sCIRT) and IGBT between April 2019 and March 2022. sCIRT consisted of whole-pelvic irradiation with 36 Gy (relative biological effectiveness [RBE]) in 12 fractions and subsequent local boost irradiation with 19.2 Gy (RBE) in 4 fractions. Three sessions of IGBT were administered after completion of sCIRT. Concurrent chemotherapy using weekly cisplatin (40 mg/m2/week) was also administered. Efficacy, toxicity and dose–volume parameters were analyzed. Fifteen patients were included in the analysis. The median follow-up period was 25 months. The 2-year overall survival, progression-free survival and local control rates were 92.3% (95% confidence interval [CI] = 77.8–100%), 52.5% (95% CI = 26.9–78.1%) and 84.8% (95% CI = 65.2–100%), respectively. Neither severe acute toxicity necessitating treatment cessation nor grade 3 or higher late toxicity were observed. The sigmoid D2cm3 of the patient who developed grade 2 late sigmoid hemorrhage was 65.6 Gy, which exceeded the standard deviation and target dose. The combination of sCIRT and IGBT for locally advanced cervical adenocarcinoma showed acceptable efficacy and safety. Further large-scale and long-term studies are warranted to confirm the efficacy and safety of this treatment.

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Section: Discussionmentioning

confidence: 99%

Preliminary result of combined treatment with scanning carbon-ion radiotherapy and image-guided brachytherapy for locally advanced cervical adenocarcinoma

Tsuchida,

Yoshida,

Shima

et al. 2024

Journal of Radiation Research

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“…As treatment outcomes for cervical cancer improve, the need to control late adverse events is an important clinical issue. Typical late adverse events after administering RT/CIRT for cervical cancer include rectal complications, bladder complications, and insufficiency bone fractures 6,17–20 . Secondary cancers are also an adverse event that deserves posttreatment attention.…”

Section: Introductionmentioning

confidence: 99%

“…Typical late adverse events after administering RT/CIRT for cervical cancer include rectal complications, bladder complications, and insufficiency bone fractures. 6 , 17 , 18 , 19 , 20 Secondary cancers are also an adverse event that deserves posttreatment attention. A previous study reported a significant 1.2‐fold (95 percent confidence interval [CI], 1.1–1.4) increased risk of developing secondary cancers in patients with cervical cancer treated with conventional definitive RT compared to the general population, equating to a 1.6‐percent excess risk per person per decade of follow‐up.…”

Section: Introductionmentioning

confidence: 99%

Secondary cancers after carbon‐ion radiotherapy and photon beam radiotherapy for uterine cervical cancer: A comparative study

et al. 2022

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Background There are limited studies on the risk of secondary cancers after carbon‐ion radiotherapy (CIRT). We assessed the incidence of secondary cancers in patients treated with CIRT for cervical cancer. We also evaluated the incidence of secondary cancers in patients who received standard photon radiotherapy (RT) throughout the same period. Methods This retrospective study included patients with cervical cancer who underwent curative RT at our hospital. All cancers discovered for the first time after RT were classified as secondary cancers. To compare the risk of secondary cancers among cervical cancer survivors to the general population, standardized incidence ratios (SIRs) were calculated. Results The analysis included a total of 197 and 417 patients in the CIRT and photon RT groups, respectively. The total person‐years during the observation period were 1052.4 in the CIRT group and 2481.5 in the photon RT group. The SIR for all secondary cancers was 1.1 (95% confidence interval [CI], 0.6–2.1) in the CIRT group and 1.4 (95% CI, 1.0–2.1) in the photon RT group. The 10‐year cumulative incidence of all secondary cancers was 9.5% (95% CI, 4.0–21.5) in the CIRT group and 9.4% (95% CI, 6.2–14.1) in the photon RT group. The CIRT and photon RT groups were not significantly different in incidence (p = 0.268). Conclusions The incidence of secondary cancers after CIRT for cervical cancer was similar to that after photon RT. Validation of our findings after long‐term observation is warranted.

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Whole-tumor histogram analysis of diffusion and perfusion metrics for noninvasive pediatric glioma grading

Kang

Lin

et al. 2023

Neuroradiology

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Pelvic insufficiency fractures following carbon-ion radiotherapy for uterine carcinomas

Cited by 5 publications

References 30 publications

Preliminary result of combined treatment with scanning carbon-ion radiotherapy and image-guided brachytherapy for locally advanced cervical adenocarcinoma

Preliminary result of combined treatment with scanning carbon-ion radiotherapy and image-guided brachytherapy for locally advanced cervical adenocarcinoma

Secondary cancers after carbon‐ion radiotherapy and photon beam radiotherapy for uterine cervical cancer: A comparative study

Whole-tumor histogram analysis of diffusion and perfusion metrics for noninvasive pediatric glioma grading

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