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. 2023 Dec 30;9(4):101432.
doi: 10.1016/j.adro.2023.101432. eCollection 2024 Apr.

Carbon Ion Radiation Therapy for Nonmetastatic Castration-Resistant Prostate Cancer: A Retrospective Analysis

Yuhei Miyasaka  1   2 , Hidemasa Kawamura  1   2 , Hiro Sato  1   2 , Nobuteru Kubo  1   2 , Hiroyuki Katoh  3 , Hitoshi Ishikawa  4 , Hiroshi Matsui  2   5 , Yoshiyuki Miyazawa  5 , Kazuto Ito  5 , Kazuhiro Suzuki  2   5 , Tatsuya Ohno  1   2
Affiliations

Carbon Ion Radiation Therapy for Nonmetastatic Castration-Resistant Prostate Cancer: A Retrospective Analysis

Yuhei Miyasaka et al. Adv Radiat Oncol. .

Abstract

Purpose: Treatment outcomes of definitive photon radiation therapy for nonmetastatic castration-resistant prostate cancer (nmCRPC) are reportedly unsatisfactory. Carbon ion radiation therapy (CIRT) has shown favorable tumor control in various malignancies, including radioresistant tumors. Therefore, we retrospectively evaluated the clinical outcomes of CIRT for nmCRPC.

Methods and materials: Patients with nmCRPC (N0M0) treated with CIRT at a total dose of 57.6 Gy (relative biologic effectiveness) in 16 fractions or 51.6 Gy (relative biologic effectiveness) in 12 fractions were included. The castration-resistant status received a diagnosis based on prostate-specific antigen kinetics showing a monotonic increase during primary androgen deprivation therapy or the need to change androgen deprivation therapy. Clinical factors associated with patient prognosis were explored. Twenty-three consecutive patients were identified from our database. The median follow-up period was 63.6 months (range, 14.1-120).

Results: Seven patients developed biochemical relapse, 6 had clinical relapse, and 4 died of the disease. The 5-year overall survival, local control rate, biochemical relapse-free survival, and clinical relapse-free survival were 87.5%, 95.7%, 70.3%, and 75.7%, respectively. One patient with diabetes mellitus requiring insulin injections and taking antiplatelet and anticoagulant drugs developed grade 3 hematuria and bladder tamponade after CIRT. None of the patients developed grade 4 or worse toxicity.

Conclusions: The present findings indicate the acceptable safety and favorable efficacy of CIRT, encouraging further research on CIRT for nmCRPC.

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Conflict of interest statement

Kazuhiro Suzuki has potential financial conflicts of interest due to consultancies in Takeda Pharmaceutical, Astellas Pharma, Daiichi-Sankyo, AstraZeneca, Sanofi, Janssen, and Bayer and grants received from Takeda Pharmaceutical, Astellas Pharma, and Daiichi-Sankyo. Tatsuya Ohno has potential financial conflicts of interest due to research funding from Hitachi Ltd Hiroyuki Katoh has potential financial conflicts of interest due to research funding from Toshiba Energy Systems & Solutions Corporation.

Figures

Figure 1
Figure 1
Kaplan-Meir curves in 23 patients. (A) Overall survival (equal to prostate cancer-specific survival), (B) local control, (C) biochemical relapse-free survival, and (D) clinical relapse-free survival. The gray regions show 95% confidence intervals. Abbreviation: CIRT = carbon ion radiation therapy.
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