Carbon-Ion Radiotherapy Combined with Concurrent Chemotherapy for Locally Advanced Pancreatic Cancer: A Retrospective Case Series Analysis
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Eligibility
2.2. Carbon-Ion Radiotherapy
2.3. Treatment Planning
2.4. Chemotherapy
2.5. Evaluation and Follow-Up
2.6. Statistical Analysis
3. Results
3.1. Patient Characteristics
3.2. Survival and LC Rate
3.3. Toxicities
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Structure | Constraints |
---|---|
Stomach, Duodenum | Max dose < 45 Gy; volume receive more than 30 Gy < 10 cm3 |
Spinal cord | Max dose < 30 Gy |
Liver | Volume received more than 20 Gy < 35% |
Kidney | Volume received more than 20 Gy < 50% of each kidney |
Patient Characteristics | Value | |
---|---|---|
Age (years) | median (range) | 68 (44–79) |
Sex | male/female | 30:14 |
Tumor location | head/body | 17:27 |
Tumor to GI tract distance (mm) | median (range) | 3 (0–24) |
N stage | N0:N1 | 36:8 |
Neoadjuvant CT | multi agent/single/none | 35:2:7 |
NAC regimen | GnP/FFX/GEM/GEM + TGO/TGO | 29:5:1:1:1 |
NAC duration (days) | median (range) | 88 (31–343) |
Concurrent CT | GEM:TGO | 26:18 |
Adjuvant CT | multi agent/single | 27:17 |
AC regimen | GnP/FFX/GEM/GEM + TGO/TGO | 23:3:7:1:10 |
Factor | Category | Number | 95% CI of mOS (Month) | p-Value |
---|---|---|---|---|
Age | ≥70 <70 | 16 28 | 17.5–32.2 40.1–60.5 | 0.038 |
Sex | Male Female | 30 14 | 30.4–43.3 20.0–47.9 | 0.069 |
Tumor location | Head Body | 17 27 | 19.8–33.4 36.6–58.1 | 0.169 |
CA19-9 at CIRT | ≥150 (ng/mL) <150 (ng/mL) | 11 33 | 12.7–24.0 39.6–59.1 | 0.001 |
Concurrent CT | GEM TGO | 26 18 | 29.3–43.4 25.8–51.1 | 0.436 |
Neoadjuvant CT | Single agent Multiple agents None | 2 35 7 | 23.4–23.4 29.7–41.0 6.0–55.9 | 0.406 |
NAC duration | ≥100 days <100 days None | 16 21 7 | 24.3–42.5 28.4–42.8 6.0–55.9 | 0.449 |
Adjuvant CT | Single agent Multiple agents | 17 27 | 21.6–46.4 32.1–45.0 | 0.077 |
Tumor to GI distance | ≥3 mm <3 mm | 28 16 | 30.1–51.8 26.6–41.9 | 0.555 |
Factor | Category | Number | 95% CI of mLC (Month) | p-Value |
---|---|---|---|---|
Age | ≥70 y.o <70 y.o | 16 28 | 38.4–56.2 33.1–64.9 | 0.390 |
Tumor location | Head Body | 17 27 | NIA * 35.4–63.5 | 0.122 |
CA19-9 at CIRT | ≥150 (U/mL) <150 (U/mL) | 11 33 | 28.3–49.9 40.3–67.4 | 0.551 |
Concurrent CT | GEM TGO | 26 18 | 36.5–52.2 33.7–69.5 | 0.857 |
Tumor to GI distance | ≥3 mm <3 mm | 28 16 | 34.5–66.8 31.8–54.1 | 0.878 |
Tumor diameter | ≥30 mm <30 mm | 33 11 | 48.8–70.7 26.3–54.7 | 0.603 |
GTV D95 | ≥52.8 Gy <52.8 Gy | 30 14 | 56.3–74.1 16.3–46.1 | 0.015 |
Adjuvant CT | Single agent Multiple agents | 17 27 | 31.9–66.8 36.5–45.9 | 0.079 |
Acute Toxicity | |||||
---|---|---|---|---|---|
Adverse event | Grade 0–1 | Grade 2 | Grade 3 | Grade 4–5 | |
Upper GI tract | 40 | 4 | 0 | 0 | |
Lower GI tract | 42 | 2 | 0 | 0 | |
Biliary tract | 41 | 3 | 0 | 0 | |
Dermatitis | 44 | 0 | 0 | 0 | |
Nausea | 40 | 4 | 0 | 0 | |
GEM | Leukopenia | 6 | 11 | 9 | 0 |
Thrombocytopenia | 18 | 2 | 6 | 0 | |
TGO | Leukopenia | 14 | 3 | 1 | 0 |
Thrombocytopenia | 18 | 0 | 0 | 0 | |
Late toxicity | |||||
Adverse event | Grade 0–1 | Grade 2 | Grade 3 | Grade 4–5 | |
Upper GI tract | 41 | 2 | 1 | 0 | |
Lower GI tract | 41 | 3 | 0 | 0 | |
Biliary tract | 39 | 2 | 3 | 0 | |
Dermatitis | 44 | 0 | 0 | 0 |
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Okamoto, M.; Shiba, S.; Kobayashi, D.; Miyasaka, Y.; Okazaki, S.; Shibuya, K.; Ohno, T. Carbon-Ion Radiotherapy Combined with Concurrent Chemotherapy for Locally Advanced Pancreatic Cancer: A Retrospective Case Series Analysis. Cancers 2023, 15, 2857. https://doi.org/10.3390/cancers15102857
Okamoto M, Shiba S, Kobayashi D, Miyasaka Y, Okazaki S, Shibuya K, Ohno T. Carbon-Ion Radiotherapy Combined with Concurrent Chemotherapy for Locally Advanced Pancreatic Cancer: A Retrospective Case Series Analysis. Cancers. 2023; 15(10):2857. https://doi.org/10.3390/cancers15102857
Chicago/Turabian StyleOkamoto, Masahiko, Shintaro Shiba, Daijiro Kobayashi, Yuhei Miyasaka, Shohei Okazaki, Kei Shibuya, and Tatsuya Ohno. 2023. "Carbon-Ion Radiotherapy Combined with Concurrent Chemotherapy for Locally Advanced Pancreatic Cancer: A Retrospective Case Series Analysis" Cancers 15, no. 10: 2857. https://doi.org/10.3390/cancers15102857