Phase 1 trial of preoperative, short-course carbon-ion radiotherapy for patients with resectable pancreatic cancer

Authors

  • Makoto Shinoto MD,

    Corresponding author
    1. Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan
    2. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
    • Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, 4-9-1, Anagawa, Inage-ku, Chiba, 263-8555 Japan

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    • Fax: (011) 81-43-256-6506

  • Shigeru Yamada MD, PhD,

    1. Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan
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  • Shigeo Yasuda MD, PhD,

    1. Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan
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  • Hiroshi Imada MD, PhD,

    1. Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan
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  • Yoshiyuki Shioyama MD, PhD,

    1. Department of Heavy Particle Therapy and Radiation Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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  • Hiroshi Honda MD, PhD,

    1. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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  • Tadashi Kamada MD, PhD,

    1. Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan
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  • Hirohiko Tsujii MD, PhD,

    1. Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan
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  • Hiromitsu Saisho MD, PhD,

    1. Department of Internal Medicine and Clinical Oncology, Kaken Hospital, Chemotherapy Research Institute, Chiba, Japan
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  • Working Group for Pancreas Cancer

    1. Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan
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Abstract

BACKGROUND:

The authors evaluated the tolerance and efficacy of carbon-ion radiotherapy (CIRT) as a short-course, preoperative treatment and determined the recommended dose needed to reduce the risk of postoperative local recurrence without excess injury to normal tissue.

METHODS:

Patients radiographically defined with potentially resectable pancreatic cancer were eligible. A preoperative, short-course, dose-escalation study was performed with fixed 8 fractions in 2 weeks. The dose of irradiation was increased by 5% increments from 30 grays equivalents (GyE) to 36.8 GyE. Surgery was to be performed 2 to 4 weeks after the completion of CIRT.

RESULTS:

The study enrolled 26 patients. At the time of restaging after CIRT, disease progression with distant metastasis or refusal ruled out 5 patients from surgery. Twenty-one of 26 patients (81%) patients underwent surgery. The pattern of initial disease progression was distant metastasis in 17 patients (65%) and regional recurrence in 2 patients (8%). No patients experienced local recurrence. The 5-year survival rates for all 26 patients and for those who underwent surgery were 42% and 52%, respectively.

CONCLUSIONS:

Preoperative, short-course CIRT followed by surgery is feasible and tolerable without unacceptable morbidity. Cancer 2013. © 2012 American Cancer Society.

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