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

Nomiya, Takuma; Tsuji, Hiroshi; Maruyama, Katsuya; Toyama, Shingo; Suzuki, Hiroyoshi; Akakura, Koichiro; Shimazaki, Jun; Nemoto, Kenji; Kamada, Tadashi; Tsujii, Hirohiko

doi:10.1038/bjc.2014.191

Cited by 49 publications

(71 citation statements)

References 43 publications

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“…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]. Data on proton therapy are more robust, and proton therapy in standard fractionation is in routine use in many centers for definitive treatment of prostate cancer and detailed information is available [38, 61].…”

Section: Hypofractionated Radiotherapy With Protons and Ionsmentioning

confidence: 99%

Hypofractionated radiotherapy for localized prostate cancer

Höcht¹,

Aebersold

Albrecht

et al. 2016

Strahlenther Onkol

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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.

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Section: Hypofractionated Radiotherapy With Protons and Ionsmentioning

confidence: 99%

Hypofractionated radiotherapy for localized prostate cancer

Höcht¹,

Aebersold

Albrecht

et al. 2016

Strahlenther Onkol

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“…Regarding the late grade 3 or greater morbidity, only one patient who was treated with 20 fractions suffered from GU complications, but no grade 4 or higher toxicity was observed . Recently, the results of a phase I/II prospective study to evaluate the feasibility of a more hypofractionated regimen using 51.6 GyE in 12 fractions for 3 weeks were reported from NIRS . A total of 46 patients (12 low‐risk, 9 intermediate‐risk and 25 high‐risk cases) were enrolled in that study.…”

Section: Clinical Results In Prostate Cancermentioning

confidence: 99%

“…Regarding acute toxicity, just two patients (4%) showed grade 2 urinary frequency, and no other acute grade 2 toxicities were observed. Regarding the late toxicities, no grade 2 or greater toxicities were observed in any patients within the median follow‐up period of 32 months . In addition, at the Ion Beam Therapy Center in Saga, Japan, a phase II prospective study using 51.6 GyE in 12 fractions for 3 weeks began in August 2013.…”

Section: Clinical Results In Prostate Cancermentioning

confidence: 99%

Particle radiotherapy for prostate cancer

Shioyama

Tsuji²,

Suefuji

et al. 2014

Int J of Urology

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Abbreviations & Acronyms 3DCRT = 3-dimensional conformal radiation therapy ADT = androgen deprivation therapy CGE = cobalt gray equivalent GI = gastrointestinal GU = genitourinary IMRT = intensity-modulated radiation therapy LBNL = Lawrence Berkeley National Laboratory LET = linear energy transfer NIRS = National Institute of Radiological Sciences RT = radiotherapy SBRT = stereotactic body radiotherapy Abstract: Recent advances in external beam radiotherapy have allowed us to deliver higher doses to the tumors while decreasing doses to the surrounding tissues. Dose escalation using high-precision radiotherapy has improved the treatment outcomes of prostate cancer. Intensity-modulated radiation therapy has been widely used throughout the world as the most advanced form of photon radiotherapy. In contrast, particle radiotherapy has also been under development, and has been used as an effective and non-invasive radiation modality for prostate and other cancers. Among the particles used in such treatments, protons and carbon ions have the physical advantage that the dose can be focused on the tumor with only minimal exposure of the surrounding normal tissues. Furthermore, carbon ions also have radiobiological advantages that include higher killing effects on intrinsic radioresistant tumors, hypoxic tumor cells and tumor cells in the G0 or S phase. However, the degree of clinical benefit derived from these theoretical advantages in the treatment of prostate cancer has not been adequately determined. The present article reviews the available literature on the use of particle radiotherapy for prostate cancer as well as the literature on the physical and radiobiological properties of this treatment, and discusses the role and the relative merits of particle radiotherapy compared with current photon-based radiotherapy, with a focus on proton beam therapy and carbon ion radiotherapy.

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“…To overcome this issue for the future, hypofractionation is a promising strategy, especially for prostate cancer treatment, based on radiobiological models . In fact, several studies of hypofractionated particle beam RT for prostate cancer have been carried out, and reported the same or lower incidences of adverse events as those seen with conventional photon beam RT using standard fractionation . Further confirmation of the feasibility and efficacy of hypofractionated particle beam RT will enable an increase in patient volume and reduction in the cost per patient.…”

Section: Future Prospectsmentioning

confidence: 99%

Particle therapy for prostate cancer: The past, present and future

et al. 2019

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Although prostate cancer control using radiotherapy is dose‐dependent, dose–volume effects on late toxicities in organs at risk, such as the rectum and bladder, have been observed. Both protons and carbon ions offer advantageous physical properties for radiotherapy, and create favorable dose distributions using fewer portals compared with photon‐based radiotherapy. Thus, particle beam therapy using protons and carbon ions theoretically seems suitable for dose escalation and reduced risk of toxicity. However, it is difficult to evaluate the superiority of particle beam radiotherapy over photon beam radiotherapy for prostate cancer, as no clinical trials have directly compared the outcomes between the two types of therapy due to the limited number of facilities using particle beam therapy. The Japanese Society for Radiation Oncology organized a joint effort among research groups to establish standardized treatment policies and indications for particle beam therapy according to disease, and multicenter prospective studies have been planned for several common cancers. Clinical trials of proton beam therapy for intermediate‐risk prostate cancer and carbon‐ion therapy for high‐risk prostate cancer have already begun. As particle beam therapy for prostate cancer is covered by the Japanese national health insurance system as of April 2018, and the number of facilities practicing particle beam therapy has increased recently, the number of prostate cancer patients treated with particle beam therapy in Japan is expected to increase drastically. Here, we review the results from studies of particle beam therapy for prostate cancer and discuss future developments in this field.

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

Cited by 49 publications

References 43 publications

Hypofractionated radiotherapy for localized prostate cancer

Hypofractionated radiotherapy for localized prostate cancer

Particle radiotherapy for prostate cancer

Particle therapy for prostate cancer: The past, present and future

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