Okamoto Masahiko, Shiba Shintaro, Okazaki Shohei, Miyasaka Yuhei, Shibuya Kei, Kiyohara Hiroki, Ohno Tatsuya
Gunma University Heavy-ion Medical Center, Gunma University Graduate School of Medicine, Gunma 371-0811, Japan.
Japanese Red Cross Maebashi Hospital, Gunma 371-0811, Japan.
Cancers (Basel). 2021 Feb 7;13(4):665. doi: 10.3390/cancers13040665.
The feasibility and safety of re-irradiation with carbon ion beams for locally recurrent unresectable pancreatic cancer (URPC) after carbon ion radiotherapy (CIRT) was evaluated.
Medical records from patients with re-irradiated URPC who were treated with CIRT between November 2017 and February 2019 were reviewed. Inclusion criteria were (1) isolated local recurrence after CIRT, (2) URPC, and (3) tumor located at least 3 mm from the gastrointestinal tract. The first and second CIRT irradiation doses were 55.2 Gy (relative biological effectiveness) in 12 fractions.
Ten patients met the inclusion criteria. The median follow-up period was 25.5 months (range, 16.0-69.1) after the first CIRT and 8.9 months (range, 6.4-18.9) after the second CIRT. The median interval between the initial CIRT and the local recurrence was 15.8 months (range, 8.0-50.1). One patient developed grade 3 diarrhea immediately after the second CIRT; no other grade 3 or higher adverse events were attributed to CIRT. The estimated 1-year overall survival, local control, and progression-free survival rates after the second CIRT were 48%, 67%, and 34%, respectively.
Repeated CIRT is feasible with acceptable toxicity for selected patients with locally advanced URPC after CIRT.
评估碳离子束再照射用于碳离子放疗（CIRT）后局部复发不可切除胰腺癌（URPC）的可行性和安全性。
回顾了2017年11月至2019年2月间接受CIRT再照射的URPC患者的病历。纳入标准为：（1）CIRT后孤立性局部复发；（2）URPC；（3）肿瘤距胃肠道至少3毫米。首次和第二次CIRT照射剂量均为55.2 Gy（相对生物效应），分12次给予。
10例患者符合纳入标准。首次CIRT后的中位随访期为25.5个月（范围16.0 - 69.1个月），第二次CIRT后的中位随访期为8.9个月（范围6.4 - 18.9个月）。初始CIRT与局部复发之间的中位间隔为15.8个月（范围8.0 - 50.1个月）。1例患者在第二次CIRT后立即出现3级腹泻；无其他3级或更高级别的不良事件归因于CIRT。第二次CIRT后估计的1年总生存率、局部控制率和无进展生存率分别为48%、67%和34%。
对于CIRT后局部晚期URPC的特定患者，重复CIRT是可行的，且毒性可接受。
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