Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan.
Cancer. 2013 Jan 1;119(1):45-51. doi: 10.1002/cncr.27723. Epub 2012 Jun 28.
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.
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.
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.
Preoperative, short-course CIRT followed by surgery is feasible and tolerable without unacceptable morbidity.
作者评估了碳离子放疗（CIRT）作为短程术前治疗的耐受性和疗效，并确定了降低术后局部复发风险而不增加正常组织损伤的推荐剂量。
影像学定义为可切除的胰腺癌患者符合条件。进行了术前短程剂量递增研究，2 周内固定 8 个分数。照射剂量从 30 格雷当量（GyE）增加 5%递增至 36.8 GyE。CIRT 完成后 2 至 4 周进行手术。
该研究纳入了 26 名患者。在 CIRT 后重新分期时，由于疾病进展伴远处转移或拒绝手术，排除了 5 名患者。26 名患者中的 21 名（81%）接受了手术。初始疾病进展模式为远处转移 17 例（65%）和区域复发 2 例（8%）。无患者发生局部复发。所有 26 名患者和接受手术的患者的 5 年生存率分别为 42%和 52%。
术前短程 CIRT 加手术是可行的，且耐受性良好，没有不可接受的发病率。
