TY - JOUR
T1 - Carbon Ion Radiation Therapy with Concurrent Gemcitabine for Patients with Locally Advanced Pancreatic Cancer
AU - Shinoto, Makoto
AU - Yamada, Shigeru
AU - Terashima, Kotaro
AU - Yasuda, Shigeo
AU - Shioyama, Yoshiyuki
AU - Honda, Hiroshi
AU - Kamada, Tadashi
AU - Tsujii, Hirohiko
AU - Saisho, Hiromitsu
AU - Asano, Takehide
AU - Yamaguchi, Taketo
AU - Amano, Hodaka
AU - Ishihara, Takeshi
AU - Otsuka, Masayuki
AU - Matsuda, Masamichi
AU - Kainuma, Osamu
AU - Funakoshi, Akihiro
AU - Furuse, Junji
AU - Nakagori, Toshio
AU - Okusaka, Takuji
AU - Ishii, Hiroshi
AU - Nagakawa, Tatsuya
AU - Takahashi, Shinichiro
AU - Hishinuma, Shoichi
AU - Nakamura, Masafumi
AU - Saito, Hirofumi
AU - Ohara, Kiyoshi
AU - Ohkawa, Shinichi
AU - Hiraoka, Masahiro
N1 - Funding Information:
This study was supported by the Research Project with Heavy Ions at the National Institute of Radiological Sciences-Heavy Ion Medical Accelerator in Chiba.
Publisher Copyright:
© 2016 Elsevier Inc.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ijrobp.2015.12.362
DO - 10.1016/j.ijrobp.2015.12.362
M3 - Article
C2 - 26883565
AN - SCOPUS:84957644663
SN - 0360-3016
VL - 95
SP - 498
EP - 504
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 1
ER -
