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. 2023 May 22;15(10):2857.
doi: 10.3390/cancers15102857.

Carbon-Ion Radiotherapy Combined with Concurrent Chemotherapy for Locally Advanced Pancreatic Cancer: A Retrospective Case Series Analysis

Masahiko Okamoto  1   2 , Shintaro Shiba  1   3 , Daijiro Kobayashi  1   2 , Yuhei Miyasaka  1 , Shohei Okazaki  1   4 , Kei Shibuya  1   2 , Tatsuya Ohno  1   2
Affiliations

Carbon-Ion Radiotherapy Combined with Concurrent Chemotherapy for Locally Advanced Pancreatic Cancer: A Retrospective Case Series Analysis

Masahiko Okamoto et al. Cancers (Basel). .

Abstract

Systemic chemotherapy has significantly improved in recent years. In this study. the clinical impact of carbon-ion radiotherapy (CIRT) with concurrent chemotherapy for locally advanced unresectable pancreatic cancer (URPC) was evaluated.

Methods: Patients with URPC who were treated with CIRT between January 2016 and December 2020 were prospectively registered and analyzed. The major criteria for registration were (1) diagnosed as URPC on imaging; (2) pathologically diagnosed adenocarcinoma; (3) no distant metastasis; (4) Eastern Cooperative Oncology Group performance status of 0-2; (5) tumors without gastrointestinal tract invasion; and (6) available for concurrent chemotherapy. Patients who received neoadjuvant chemotherapy (NAC) for more than one year prior to CIRT were excluded.

Results: Forty-four patients met the inclusion criteria, and thirty-seven received NAC before CIRT. The median follow-up period of living patients was 26.0 (6.0-68.6) months after CIRT. The estimated two-year overall survival, local control, and progression-free survival rates after CIRT were 56.6%, 76.1%, and 29.0%, respectively. The median survival time of all patients was 29.6 months after CIRT and 34.5 months after the initial NAC.

Conclusion: CIRT showed survival benefits for URPC even in the multiagent chemotherapy era.

Keywords: carbon ion radiotherapy; heavy-ion radiotherapy; locally advanced pancreatic cancer; pancreatic cancer; particle beam radiotherapy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Dose distribution of a typical case. The prescribed dose was 55.2 Gy in 12 fractions. Color wash structures indicate gross tumor volume (red) and clinical target volume (cyan).
Figure 2
Figure 2
Survival rate after the initial day of (a) CIRT and (b) start of initial treatment (NAC (n = 37), CIRT (n = 7)). The survival rate was calculated by Kaplan–Meier methods. OS: overall survival rate, LC: local control rate, PFS: progression free survival.
See this image and copyright information in PMC

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