Phase I/II clinical trials of carbon ion therapy for prostate cancer

Akakura, Koichiro; Tsujii, Hirohiko; Morita, Shinroku; Tsuji, Hiroshi; Yagishita, Tsuguo; Isaka, Shigeo; Itô, Haruo; Akaza, Hideyuki; Hata, Makoto; Fujime, Μakoto; Harada, Masaoki; Shimazaki, Jun

doi:10.1002/pros.10328

Cited by 100 publications

(80 citation statements)

References 26 publications

(27 reference statements)

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“…77 The treatment schedule was 20 fractions 5 days a week with doses gradually increased from 54 GyE to 72 GyE in 10% increments. A recommended dose of 66 GyE emerged from this study.…”

Section: Light Ionsmentioning

confidence: 99%

Current status of radiotherapy with proton and light ion beams

Greco

Wolden

2007

Cancer

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Several model studies have shown potential clinical advantages with charged particles (protons and light ions) compared with 3D-conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) in many disease sites. The newly developed intensity-modulated proton therapy (IMPT) often yields superior dose distributions to photon IMRT, with the added advantage of a significant reduction in the volume of healthy normal tissues exposed to low-to-medium doses. Initially, the major emphasis in clinical research for proton and light ion therapy was dose escalation for inherently radioresistant tumors, or for lesions adjacent to critical normal structures that constrained the dose that could be safely delivered with conventional x-ray therapy. Since the advent of IMRT the interest in particle therapy has gradually shifted toward protocols aimed at morbidity reduction. Lately the emphasis has mostly been placed on the potential for reduced risk of radiation-induced carcinogenesis with protons. Compared with 3D-CRT, a 2-fold increase has been theoretically estimated with the use of IMRT due to the larger integral volumes. In the pediatric setting, due to a higher inherent susceptibility of tissues, the risk could be significant, and the benefits of protons have been strongly emphasized in the literature. There is a significant expansion of particle therapy facilities around the world. Increasing public awareness of the potential benefits of particle therapy and wider accessibility for patients require that treating physicians stay abreast of the clinical indications of this radiotherapy modality. The article reviews the available literature for various disease sites in which particle therapy has traditionally been considered to offer clinical advantages and to highlight current lines of clinical research. The issue of radiation-induced second malignancies is examined in the light of the controversial epidemiological evidence available. The cost-effectiveness of particle therapy is also discussed. Cancer 2007;109: 1227-38. 2007 American Cancer Society.KEYWORDS: radiotherapy, proton therapy, light ions, intensity modulated radiotherapy, second cancers. C harged particles (protons and light ions) have a finite range in tissues. The interaction probability to cause ionization increases as they lose velocity traversing through tissues, so that a peak of dose occurs at a depth proportional to the energy of each particle. Beyond this peak no further dose deposition occurs. This phenomenon was described by William Bragg over 100 years ago.1 The dose peak may be 'spread out' to achieve a plateau of uniform dose to precisely cover the target while sparing adjacent normal structures. Passively scattered beams of a certain aperture can be produced by means of range-shifting modulators of variable thickness providing spread-out Bragg peaks (SOBP) for clinical use. The recent introduction of the spot scanning method represents a major advance in particle therapy.2 In this method, small pencil beams of a certain

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“…77 The treatment schedule was 20 fractions 5 days a week with doses gradually increased from 54 GyE to 72 GyE in 10% increments. A recommended dose of 66 GyE emerged from this study.…”

Section: Light Ionsmentioning

confidence: 99%

Current status of radiotherapy with proton and light ion beams

Greco

Wolden

2007

Cancer

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“…In the latter, the clinical aim of maximizing damage in the tumor sites while minimizing damages to healthy surrounding tissue has lead to the use of protons and, more recently, carbon ions to provide high spatial-specifi c damage profi les [13][14][15][16][17][18]. In radiation or particle therapy there is a possibility that the particle interacts directly with critical components of the cell or with water.…”

Section: C-ion Therapymentioning

confidence: 99%

“…As these radicals are extremely reactive, the diffusion length must be within about 20Å from the target. Recently, good effective radiotoxic responses from C-ion tumor therapy was reported [14][15][16][17][18]. The high ionization densities within the Bragg peak make normal DNA enzymatic repair diffi cult in contrast to low LET (Linear Energy Transfer) electron, proton and photon irradiation [13].…”

Section: C-ion Therapymentioning

confidence: 99%

Primary radicals production from water fragmentation by heavy ions

Montenegro¹,

Luna²

2005

Braz. J. Phys.

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The importance of fragmentation of water molecules by heavy ions is discussed for several different physical environments, including tumor treatment, planetary sciences and fi ssion reactors. The characteristics of the fragmentation yields by electrons, protons and photons are presented and compared with fragmentation yields of water molecules by C 3+ and O 5+ ions at energies corresponding to the Bragg peak. It is shown that for low energy electron loss and high energy electron capture, the water molecules essentially blow-out, releasing a much larger fraction of O q+ ions as compared with electrons, protons and photons.

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“…Dada la relativamente alta dosis necesaria para controlar el cáncer de próstata, las células puede suponerse que serán relativamente radio-resistentes a los fotones de alta energía de los tratamientos convencionales. Haces con alta LET tales como los iones de carbono no sólo proporcionan la ventaja física de un perfil de dosis invertido (pico de Bragg), lo que permite un fuerte gradiente de dosis hacia la pared anterior del recto, sino que también ofrecen ventajas biológicas 36,37 . Los resultados prometedores obtenidos con la radioterapia de carbono necesitan confirmación en los ensayos clínicos controlados con gran número de pacientes que comparen el tratamiento de iones de carbono con IMRT con fotones de alta energía y tratamiento con protones teniendo también en cuenta la toxicidad y la calidad de vida.…”

Section: Cáncer De Próstataunclassified

Heavy particle radiation therapy

Lozares

Mañeru

Pellejero

2009

An Sist Sanit Navar

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RESUMENLas características de la radiación constituida por partículas pesadas la convierten en una herramienta muy útil para el uso terapéutico. Los protones, los núcleos de helio o los iones de carbono están siendo empleados con éxito en instalaciones radioterápicas de todo el mundo. En este trabajo se exponen los fundamentos físicos y tecnológicos que convierten a estas partículas en radiación adecuada para atacar los volúmenes blanco, así como las distintas maneras de administrar tratamientos. Posteriormente se describen las principales aplicaciones clínicas que muestran las ventajas terapéuticas en algunas de las patologías más empleadas en centros de protón y hadrón-terapia en la actualidad. En continuo estudio, el uso clínico de partículas pesadas se presenta como una vía de avance enormemente prometedora frente a las tecnologías clá-sicas, tanto en cobertura tumoral como en reducción de dosis en el tejido circundante.Palabras clave. Radioterapia. Partículas pesadas. Hadrón-terapia. Tumores. ABSTRACTThe characteristics of radiation formed by heavy particles make it a highly useful tool for therapeutic use. Protons, helium nuclei or carbon ions are being successfully employed in radiotherapy installations throughout the world. This article sets out the physical and technological foundations that make these radiation particles suitable for attacking white volume, as well as the different ways of administering treatment. Next, the main clinical applications are described, which show the therapeutic advantages in some of the pathologies most widely employed in proton and hadrontherapy centres at present. Under continuous study, the clinical use of heavy particles appears to be an enormously promising path of advance in comparison with classical technologies, both in tumour coverage and in reducing dosages in surrounding tissue.

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Phase I/II clinical trials of carbon ion therapy for prostate cancer

Abstract: The therapeutic techniques of carbon ion therapy have been established for patients with prostate cancer. Carbon ion therapy may exert excellent effect to the tissues of prostate cancer.

Cited by 100 publications

References 26 publications

Current status of radiotherapy with proton and light ion beams

Current status of radiotherapy with proton and light ion beams

Primary radicals production from water fragmentation by heavy ions

Heavy particle radiation therapy

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