The role of carbon ion radiotherapy for unresectable locally recurrent rectal cancer: a single institutional experience
- PDF / 721,210 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 39 Downloads / 193 Views
RESEARCH
Open Access
The role of carbon ion radiotherapy for unresectable locally recurrent rectal cancer: a single institutional experience Xin Cai1,2†, Yueyao Du3†, Zheng Wang1,2, Ping Li1,2, Zhan Yu1,2, Qing Zhang1,2* and Zhen Zhang2,4*
Abstract Background: Treatment for locally recurrent rectal cancer after surgery is still a challenge. With the physical and biological advantages, carbon-ion radiotherapy (CIRT) could be a choice for these patients. The purpose of this study was to investigate the efficacy and safety of CIRT for unresectable locally recurrent rectal cancer in Chinese patients. Methods: Date from 25 patients with unresectable locally recurrent rectal cancer treated by CIRT from July 2015 to April 2019 were analyzed retrospectively. The endpoints of this study were overall survival (OS), local control (LC) and acute and late toxicity. Results: With the median follow-up of 19.6 (range 5.1–52.5) months, data of all 25 patients were collected. Median prescribed dose for tumor was 72Gy (relative biologic efficacy (RBE)) (range 48–75.6Gy (RBE)). The LC rates at 1 and 2 years were 90.4 and 71.8%. Overall LC at 1- and 2-year were 76.2 and 30.5% for 9 patients whose prescribed tumor doses of CIRT< 66 Gy (RBE), 100 and 100% for 16 patients whose prescribed doses of CIRT≥66 Gy (RBE). Patients received ≥66 Gy (RBE) had obviously better LC rates than those received < 66 Gy (RBE) (P = 0.001). The OS rates at 1 and 2 years were 82.9 and 65.1%, respectively. No acute toxicity over grade 2 was observed, grade 3 late toxicity were observed in 3 patients: gastrointestinal toxicity (n = 1), neuropathy (n = 1), pelvic infection (n = 1). No Grade 4 or higher toxicity was observed. Conclusion: Our study shows that CIRT is effective for unresectable locally recurrent rectal cancer patients with acceptable toxicity. Keywords: Carbon-ion, Rectal cancer, Pelvic radiation, Local recurrence, Particle therapy
Introduction Local recurrence (LR) presents a challenge after combined modality treatment for rectal cancer. Although multiple strategies including total mesorectal excision (TME), radiation therapy as well as chemotherapy has been shown to improve clinical outcomes, it remains a significant problem * Correspondence: [email protected]; [email protected] † Xin Cai and Yueyao Du contributed equally to this work. 1 Department of Radiation Oncology, Shanghai Proton and Heavy Ion Center, 4365 Kang Xin Road, Shanghai 201321, China 2 Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, 4365 Kang Xin Road, Shanghai 201321, China Full list of author information is available at the end of the article
in practice [1, 2], and about 4–15% of the patients with rectal cancer will suffer from LR [3–7]. Several studies have shown that LRs after definitive surgery occur in the central or posterior pelvis, with the presacral-perineal space being identified as the primary site of recurrence. Salvage surgical therapy remains the mainstay for these LR lesions, offering the best chance for cure. Howe
Data Loading...
