Feasibility and Safety of Repeated Carbon Ion Radiotherapy for Locally Advanced Unresectable Pancreatic Cancer
by
, , ,
Masahiko Okamoto
1,*
,
Shintaro Shiba
1,
Shohei Okazaki
1,
Yuhei Miyasaka
1,
Kei Shibuya
1,
Hiroki Kiyohara
2 and
Tatsuya Ohno
1 1
Gunma University Heavy-ion Medical Center, Gunma University Graduate School of Medicine, Gunma 371-0811, Japan
2
Japanese Red Cross Maebashi Hospital, Gunma 371-0811, Japan
*
Author to whom correspondence should be addressed.
Cancers 2021, 13(4), 665; https://doi.org/10.3390/cancers13040665
Submission received: 6 January 2021
/
Revised: 1 February 2021
/
Accepted: 3 February 2021
/
Published: 7 February 2021
(This article belongs to the Special Issue Cancer Radiotherapy)
Simple Summary
Despite the effectiveness of carbon ion radiotherapy (CIRT) for locally advanced unresectable pancreatic cancer (URPC), isolated local recurrence after CIRT is a therapeutic challenge. Herein, we aimed to evaluate the feasibility and safety of a second course of CIRT for locally recurrent URPC in 10 patients. One patient developed grade 3 diarrhea immediately after the second CIRT; no other grade 3 or higher adverse events were induced by CIRT. The estimated 1-year overall survival rate and local control rate after the second CIRT were 48% and 67%, respectively. Repeated CIRT is feasible with acceptable toxicity for selected patients with locally advanced URPC after CIRT.
Abstract
Purpose: The feasibility and safety of re-irradiation with carbon ion beams for locally recurrent unresectable pancreatic cancer (URPC) after carbon ion radiotherapy (CIRT) was evaluated. Methods: Medical records from patients with re-irradiated URPC who were treated with CIRT between November 2017 and February 2019 were reviewed. Inclusion criteria were (1) isolated local recurrence after CIRT, (2) URPC, and (3) tumor located at least 3 mm from the gastrointestinal tract. The first and second CIRT irradiation doses were 55.2 Gy (relative biological effectiveness) in 12 fractions. Results: Ten patients met the inclusion criteria. The median follow-up period was 25.5 months (range, 16.0–69.1) after the first CIRT and 8.9 months (range, 6.4–18.9) after the second CIRT. The median interval between the initial CIRT and the local recurrence was 15.8 months (range, 8.0–50.1). One patient developed grade 3 diarrhea immediately after the second CIRT; no other grade 3 or higher adverse events were attributed to CIRT. The estimated 1-year overall survival, local control, and progression-free survival rates after the second CIRT were 48%, 67%, and 34%, respectively. Conclusion: Repeated CIRT is feasible with acceptable toxicity for selected patients with locally advanced URPC after CIRT.
