Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan.
National Institutional of Radiological Sciences Hospital, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
Radiother Oncol. 2019 Mar;132:236-240. doi: 10.1016/j.radonc.2018.10.007. Epub 2018 Oct 22.
We investigated the efficacy and safety of carbon-ion radiotherapy (C-ion RT) for locally recurrent rectal cancer (LRRC).
Data from patients with LRRC treated with C-ion RT from November 2003 to December 2014 at three institutions were retrospectively analyzed. The endpoints of this clinical trial were overall survival (OS), local control (LC), and acute/late toxicity.
A total of 224 patients' data were collected. The prescribed dose was 70.4 Gy (relative biological effectiveness [RBE]-weighted absorbed dose) or 73.6 Gy (RBE) in 16 fractions. The median follow-up period from the initiation of C-ion RT was 62 months (range 6-169 months). The OS rates were 73% (95% confidence interval [CI], 67%-79%) at 3 years and 51% (95%CI 44%-58%) at 5 years. The LC rates were 93% (95%CI 88%-96%) at 3 years, and 88% (95%CI 82%-93%) at 5 years. Grade 3 acute toxicity was observed in three patients: gastrointestinal toxicity (n = 1) and pelvic infection (n = 2). Grade 3 late toxicity was observed in 12 patients: skin reaction (n = 2), gastrointestinal toxicity (n = 2), neuropathy (n = 1), and pelvic infection (n = 7). There was no grade 4 or 5 acute or late toxicity.
This first multi-institutional analysis of C-ion RT for LRRC indicated relatively favorable outcomes with limited toxicities.
我们研究了碳离子放射疗法（C-ion RT）治疗局部复发性直肠癌（LRRC）的疗效和安全性。
回顾性分析了 2003 年 11 月至 2014 年 12 月期间在三所机构接受 C-ion RT 治疗的 LRRC 患者的数据。该临床试验的终点为总生存率（OS）、局部控制率（LC）和急性/迟发性毒性。
共收集了 224 例患者的数据。处方剂量为 70.4 Gy（相对生物效应[RBE]加权吸收剂量）或 73.6 Gy（RBE），共 16 个分次。从开始 C-ion RT 到中位随访时间为 62 个月（范围为 6-169 个月）。3 年时 OS 率为 73%（95%置信区间[CI]，67%-79%），5 年时为 51%（95%CI 44%-58%）。3 年时 LC 率为 93%（95%CI 88%-96%），5 年时为 88%（95%CI 82%-93%）。有 3 例患者发生 3 级急性毒性：胃肠道毒性（n=1）和骨盆感染（n=2）。12 例患者发生 3 级迟发性毒性：皮肤反应（n=2）、胃肠道毒性（n=2）、神经病变（n=1）和骨盆感染（n=7）。无 4 级或 5 级急性或迟发性毒性。
这是首次多机构分析 C-ion RT 治疗 LRRC 的结果，表明疗效较好，毒性有限。
