Carbon Ion Radiation Therapy with Concurrent Gemcitabine for Patients with Locally Advanced Pancreatic Cancer

Makoto Shinoto, Shigeru Yamada, Kotaro Terashima, Shigeo Yasuda, Yoshiyuki Shioyama, Hiroshi Honda, Tadashi Kamada, Hirohiko Tsujii, Hiromitsu Saisho, Takehide Asano, Taketo Yamaguchi, Hodaka Amano, Takeshi Ishihara, Masayuki Otsuka, Masamichi Matsuda, Osamu Kainuma, Akihiro Funakoshi, Junji Furuse, Toshio Nakagori, Takuji OkusakaHiroshi Ishii, Tatsuya Nagakawa, Shinichiro Takahashi, Shoichi Hishinuma, Masafumi Nakamura, Hirofumi Saito, Kiyoshi Ohara, Shinichi Ohkawa, Masahiro Hiraoka

Research output: Contribution to journalArticlepeer-review

99 Citations (Scopus)


Purpose To determine, in the setting of locally advanced pancreatic cancer, the maximum tolerated dose of carbon ion radiation therapy (C-ion RT) and gemcitabine dose delivered concurrently and to estimate local effect and survival. Methods and Materials Eligibility included pathologic confirmation of pancreatic invasive ductal carcinomas and radiographically unresectable disease without metastasis. Concurrent gemcitabine was administered on days 1, 8, and 15, and the dose levels were escalated from 400 to 1000 mg/m2 under the starting dose level (43.2 GyE) of C-ion RT. The dose levels of C-ion RT were escalated from 43.2 to 55.2 GyE at 12 fractions under the fixed recommended gemcitabine dose determined. Results Seventy-six patients were enrolled. Among the 72 treated patients, dose-limiting toxicity was observed in 3 patients: grade 3 infection in 1 patient and grade 4 neutropenia in 2 patients. Only 1 patient experienced a late grade 3 gastric ulcer and bleeding 10 months after C-ion RT. The recommended dose of gemcitabine with C-ion RT was found to be 1000 mg/m2. The dose of C-ion RT with the full dose of gemcitabine (1000 mg/m2) was safely increased to 55.2 GyE. The freedom from local progression rate was 83% at 2 years using the Response Evaluation Criteria in Solid Tumors. The 2-year overall survival rates in all patients and in the high-dose group with stage III (≥45.6 GyE) were 35% and 48%, respectively. Conclusions Carbon ion RT with concurrent full-dose gemcitabine was well tolerated and effective in patients with unresectable locally advanced pancreatic cancer.

Original languageEnglish
Pages (from-to)498-504
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Issue number1
Publication statusPublished - May 1 2016

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


Dive into the research topics of 'Carbon Ion Radiation Therapy with Concurrent Gemcitabine for Patients with Locally Advanced Pancreatic Cancer'. Together they form a unique fingerprint.

Cite this