Yamada Shigeru, Kamada Tadashi, Ebner Daniel K, Shinoto Makoto, Terashima Kotaro, Isozaki Yuka, Yasuda Shigeo, Makishima Hirokazu, Tsuji Hiroshi, Tsujii Hirohiko, Isozaki Tetsuro, Endo Satoshi, Takahashi Keiichi, Sekimoto Mitsugu, Saito Norio, Matsubara Hisahiro
Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
Int J Radiat Oncol Biol Phys. 2016 Sep 1;96(1):93-101. doi: 10.1016/j.ijrobp.2016.04.022. Epub 2016 Apr 23.
Investigation of the treatment potential of carbon-ion radiation therapy in pelvic recurrence of rectal cancer.
A phase 1/2 dose escalation study was performed. One hundred eighty patients (186 lesions) with locally recurrent rectal cancer were treated with carbon-ion radiation therapy (CIRT) (phase 1/2: 37 and 143 patients, respectively). The relapse locations were 71 in the presacral region, 82 in the pelvic sidewalls, 28 in the perineum, and 5 near the colorectal anastomosis. A 16-fraction in 4 weeks dose regimen was used, with total dose ranging from 67.2 to 73.6 Gy(RBE); RBE-weighted absorbed dose: 4.2 to 4.6 Gy(RBE)/fraction.
During phase 1, the highest total dose, 73.6 Gy(RBE), resulted in no grade >3 acute reactions in the 13 patients treated at that dose. Dose escalation was halted at this level, and this dose was used for phase 2, with no other grade >3 acute reactions observed. At 5 years, the local control and survival rates at 73.6 Gy(RBE) were 88% (95% confidence interval [CI], 80%-93%) and 59% (95% CI, 50%-68%), respectively.
Carbon-ion radiation therapy may be a safe and effective treatment option for locally recurrent rectal cancer and may serve as an alternative to surgery.
研究碳离子放射治疗在直肠癌盆腔复发中的治疗潜力。
进行了一项1/2期剂量递增研究。180例（186个病灶）局部复发性直肠癌患者接受了碳离子放射治疗（CIRT）（1/2期分别为37例和143例患者）。复发部位为骶前区71处、盆腔侧壁82处、会阴28处、结直肠吻合口附近5处。采用4周内16次分割的剂量方案，总剂量范围为67.2至73.6 Gy（RBE）；RBE加权吸收剂量：4.2至4.6 Gy（RBE）/分割。
在1期，最高总剂量73.6 Gy（RBE）在接受该剂量治疗的13例患者中未导致3级以上急性反应。剂量递增在此水平停止，该剂量用于2期，未观察到其他3级以上急性反应。5年时，73.6 Gy（RBE）的局部控制率和生存率分别为88%（95%置信区间[CI]，80%-93%）和59%（95%CI，50%-68%）。
碳离子放射治疗可能是局部复发性直肠癌的一种安全有效的治疗选择，可作为手术的替代方法。
