Search

To evaluate the safety and efficacy of carbon-ion radiotherapy (CIRT) for cholangiocarcinoma via a multicenter retrospective study. Clinical data were collected from patients with cholangiocarcinoma who had received CIRT at one of four treating institutions in Japan. Of 56 eligible patients, none received surgery for cholangiocarcinoma before or after CIRT. The primary endpoint was overall survival (OS). Based on the tumor site, the 56 cases were categorized as intrahepatic cholangiocarcinoma (IHC) (n=27) or perihilar cholangiocarcinoma (PHC) (n=29). In all patients, the median tumor size was 37 (range, 15‒110) mm, and the most commonly prescribed dose was 76 Gy (relative biological effectiveness) in 20 fractions. The median survival was 14.8 (range, 2.1-129.2) months, and the 1- and 2-year OS rates were 69.7% and 40.9%, respectively. The median survival times of the patients with IHC and those with PHC were 23.8 and 12.6 months, respectively. Both univariate and multivariate analyses revealed that cholangitis pre-CIRT and Child‒Pugh class B were significant prognostic factors for an unfavorable OS. Of four patients who died of liver failure, one with IHC was suspected to have radiation-induced liver disease because of newly developed ascites, and died at 4.3 months post-CIRT. Grade 3 CIRT-related bile duct stenosis was observed in one IHC case. No other CIRT-related severe adverse events, including gastrointestinal events, were observed. These results suggest that CIRT yields relatively favorable treatment outcomes, especially for patients with IHC, and acceptable toxicities were observed in patients with cholangiocarcinoma who did not receive surgery.

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 radio-resistant 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.

To determine the long-term results of carbon ion radiation therapy (C-ion RT) in patients with choroidal melanoma, and to assess the usefulness of CT-based 2-port irradiation in reducing the risk of neovascular glaucoma (NVG).

Therapeutic outcome of hypofractionated conformal carbon ion radiotherapy towards localized prostate cancer was investigated. We analyzed the biochemical relapse-free rate of 1,084 cases which were observed for 6 months or more after carbon ion radiotherapy at the time of February 2011, also we analyzed survival rate, and the incidence of toxicity,. 5-year biochemical relapse-free rete of whole cases was 90.6%. The Gleason score, PSA value and clinical stage were the significant prognostic factor of relapse-free rate. The difference of relapse-free rate by method of fractionation (20 fractions and 16 fractions) was not found. None but one out of 1,005 cases who were followed up at least 1 year developed grade 3 lower urological impairment, and incidences of grade 2 were 5.6% in lower urinary tract and 2.3% in the rectum, respectively. Furthermore, in the 16 fractions, the toxicity incidence was lower than 20 fractions. Accordingly, hypofractionation made it possible to reduce the toxicity incidence without reducing the relapse-free rate., NIRS-KFSHRC Joint Symposium on Carbon Ion Radiotherapy and Radiation Emergency Medicine

Therapeutic outcome of hypofractionated conformal carbon ion radiotherapy towards localized prostate cancer was investigated. We analyzed the biochemical relapse-free rate of 1,084 cases which were observed for 6 months or more after carbon ion radiotherapy at the time of February 2011, also we analyzed survival rate, and the incidence of toxicity. 5-year biochemical relapse-free rate of whole cases was 90.6%. The Gleason score, PSA value and clinical stage were the significant prognostic factor of relapse-free rate. The difference of relapse-free rate by method of fractionation (20 fractions and 16 fractions) was not found. None but one out of 1,005 cases who were followed up at least 1 year developed grade 3 lower urological impairment, and incidences of grade 2 were 5.6% in lower urinary tract and 2.3% in the rectum, respectively. Furthermore, in the 16 fractions, the toxicity incidence was lower than 20 fractions. Accordingly, hypofractionation made it possible to reduce the toxicity incidence without reducing the relapse-free rate., New Frontiers in Cancer Treatment