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

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.

• Authors: Makoto Shinoto, Shigeru Yamada, Shigeo Yasuda, Hiroshi Imada, Yoshiyuki Shioyama, Hiroshi Honda, Tadashi Kamada, Hirohiko Tsujii, Hiromitsu Saisho, Working Group for Pancreas Cancer
• Journal: Cancer (Cancer) Vol. 119 Issue 1 Pg. 45-51 (Jan 01 2013) ISSN: 1097-0142 [Electronic] United States
• PMID: 22744973 (Publication Type: Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 American Cancer Society.

Topics

• Adult
• Aged
• Female
• Heavy Ion Radiotherapy (adverse effects)
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy (methods)
• Neoplasm Recurrence, Local (prevention & control)
• Pancreatic Neoplasms (pathology, radiotherapy, surgery)
• Radiotherapy Dosage
• Radiotherapy, Adjuvant (methods)
• Survival Rate