Pancreatic cancer is the fifth leading cause of cancer death and is considered to be one of the most lethal cancers in Japan.Complete surgical resection is the only curative treatment. Even if curative resection is performed, the disease usually recurs, and 5-year survival rates are less than 20%. Chemotherapy or chemoradiotherapy is selected as a standard treatment for unresectable pancreatic cancer. However, since pancreatic cancer is often resistant to chemotherapy and radiotherapy, the local control and survival rates are very low. We conducted a phase I/II clinical trial using carbon ion radiotherapy (C-ion RT) for patients with operable and locally advanced pancreatic cancer. This was delivered preop- eratively in 8 fractions over 2 weeks, was well tolerated, and resulted in excellent local control and survival rates. C-ion RT for patients with locally advanced pancreatic cancer was also well tolerated, even when concomitantly administered with the highest dose of gemcitabine (1,000 mg/m2), and likewise resulted in a good survival rate. In this chapter, we discuss current treatment methods and the results of C-ion RT for pancreatic cancer at the National Institute of Radiological Sciences.
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