Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer

Shigeru Yamada, Tadashi Kamada, Daniel K. Ebner, Makoto Shinoto, Kotaro Terashima, Yuka Isozaki, Shigeo Yasuda, Hirokazu Makishima, Hiroshi Tsuji, Hirohiko Tsujii, Tetsuro Isozaki, Satoshi Endo, Keiichi Takahashi, Mitsugu Sekimoto, Norio Saito, Hisahiro Matsubara

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Purpose Investigation of the treatment potential of carbon-ion radiation therapy in pelvic recurrence of rectal cancer. Methods and Materials A phase 1/2 dose escalation study was performed. One hundred eighty patients (186 lesions) with locally recurrent rectal cancer were treated with carbon-ion radiation therapy (CIRT) (phase 1/2: 37 and 143 patients, respectively). The relapse locations were 71 in the presacral region, 82 in the pelvic sidewalls, 28 in the perineum, and 5 near the colorectal anastomosis. A 16-fraction in 4 weeks dose regimen was used, with total dose ranging from 67.2 to 73.6 Gy(RBE); RBE-weighted absorbed dose: 4.2 to 4.6 Gy(RBE)/fraction. Results During phase 1, the highest total dose, 73.6 Gy(RBE), resulted in no grade >3 acute reactions in the 13 patients treated at that dose. Dose escalation was halted at this level, and this dose was used for phase 2, with no other grade >3 acute reactions observed. At 5 years, the local control and survival rates at 73.6 Gy(RBE) were 88% (95% confidence interval [CI], 80%-93%) and 59% (95% CI, 50%-68%), respectively. Conclusion Carbon-ion radiation therapy may be a safe and effective treatment option for locally recurrent rectal cancer and may serve as an alternative to surgery.

Original languageEnglish
Pages (from-to)93-101
Number of pages9
JournalInternational Journal of Radiation Oncology Biology Physics
Volume96
Issue number1
DOIs
Publication statusPublished - Sep 1 2016

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Heavy Ion Radiotherapy
Rectal Neoplasms
radiation therapy
cancer
Recurrence
dosage
carbon
Confidence Intervals
Perineum
ions
Survival Rate
confidence
grade
Therapeutics
intervals
surgery
lesions

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

Yamada, S., Kamada, T., Ebner, D. K., Shinoto, M., Terashima, K., Isozaki, Y., ... Matsubara, H. (2016). Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer. International Journal of Radiation Oncology Biology Physics, 96(1), 93-101. https://doi.org/10.1016/j.ijrobp.2016.04.022

Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer. / Yamada, Shigeru; Kamada, Tadashi; Ebner, Daniel K.; Shinoto, Makoto; Terashima, Kotaro; Isozaki, Yuka; Yasuda, Shigeo; Makishima, Hirokazu; Tsuji, Hiroshi; Tsujii, Hirohiko; Isozaki, Tetsuro; Endo, Satoshi; Takahashi, Keiichi; Sekimoto, Mitsugu; Saito, Norio; Matsubara, Hisahiro.

In: International Journal of Radiation Oncology Biology Physics, Vol. 96, No. 1, 01.09.2016, p. 93-101.

Research output: Contribution to journalArticle

Yamada, S, Kamada, T, Ebner, DK, Shinoto, M, Terashima, K, Isozaki, Y, Yasuda, S, Makishima, H, Tsuji, H, Tsujii, H, Isozaki, T, Endo, S, Takahashi, K, Sekimoto, M, Saito, N & Matsubara, H 2016, 'Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer', International Journal of Radiation Oncology Biology Physics, vol. 96, no. 1, pp. 93-101. https://doi.org/10.1016/j.ijrobp.2016.04.022
Yamada, Shigeru ; Kamada, Tadashi ; Ebner, Daniel K. ; Shinoto, Makoto ; Terashima, Kotaro ; Isozaki, Yuka ; Yasuda, Shigeo ; Makishima, Hirokazu ; Tsuji, Hiroshi ; Tsujii, Hirohiko ; Isozaki, Tetsuro ; Endo, Satoshi ; Takahashi, Keiichi ; Sekimoto, Mitsugu ; Saito, Norio ; Matsubara, Hisahiro. / Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer. In: International Journal of Radiation Oncology Biology Physics. 2016 ; Vol. 96, No. 1. pp. 93-101.
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abstract = "Purpose Investigation of the treatment potential of carbon-ion radiation therapy in pelvic recurrence of rectal cancer. Methods and Materials A phase 1/2 dose escalation study was performed. One hundred eighty patients (186 lesions) with locally recurrent rectal cancer were treated with carbon-ion radiation therapy (CIRT) (phase 1/2: 37 and 143 patients, respectively). The relapse locations were 71 in the presacral region, 82 in the pelvic sidewalls, 28 in the perineum, and 5 near the colorectal anastomosis. A 16-fraction in 4 weeks dose regimen was used, with total dose ranging from 67.2 to 73.6 Gy(RBE); RBE-weighted absorbed dose: 4.2 to 4.6 Gy(RBE)/fraction. Results During phase 1, the highest total dose, 73.6 Gy(RBE), resulted in no grade >3 acute reactions in the 13 patients treated at that dose. Dose escalation was halted at this level, and this dose was used for phase 2, with no other grade >3 acute reactions observed. At 5 years, the local control and survival rates at 73.6 Gy(RBE) were 88{\%} (95{\%} confidence interval [CI], 80{\%}-93{\%}) and 59{\%} (95{\%} CI, 50{\%}-68{\%}), respectively. Conclusion Carbon-ion radiation therapy may be a safe and effective treatment option for locally recurrent rectal cancer and may serve as an alternative to surgery.",
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