Multi-institutional Study of Carbon-ion Radiotherapy for Locally Advanced Pancreatic Cancer: Japan Carbon-ion Radiation Oncology Study Group (J-CROS) Study 1403 Pancreas
Multi-institutional Study of Carbon-ion Radiotherapy for Locally Advanced Pancreatic Cancer: Japan Carbon-ion Radiation Oncology Study Group (J-CROS) Study 1403 Pancreas
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DOI：
10.1016/j.ijrobp.2018.04.057
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发表时间：
2018-08-01
影响因子：
7
通讯作者：
Kamada, Tadashi
中科院分区：
文献类型：
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作者：
Kawashiro, Shohei;Yamada, Shigeru;Kamada, Tadashi
目的：本多机构研究的目的是评估局部晚期胰腺癌（LAPC.Methods and Materials）的碳离子放射治疗（C-ion RT）的疗效和安全性：回顾性分析了2012年4月至2014年12月在3个机构接受C-ion RT治疗的LAPC患者。经病理学证实的胰腺浸润性导管腺癌患者合格。处方剂量为52.8戈伊（相对生物学有效性加权吸收剂量; RBE）或55.2戈伊（RBE）分12次。评估总生存期（OS）、无远处转移生存期（DMFS）、局部复发（LR）和毒性反应。胰头肿瘤30例（42%），胰体或胰尾肿瘤42例（58%）。五十六例患者（78%）接受同期化疗。1年时的OS率为73%（95%置信区间[CI]，62%-84%），2年时为46%（95% CI，31%-61%），中位OS为21.5个月（95% CI，11.8-31.2个月）。1年和2年DMFS率分别为41%（95% CI，29%-52%）和28%（95% CI，16%-40%）。LR的1年和2年累积发生率分别为16%（95% CI，9%-26%）和24%（95% CI，14%-36%）。19例患者（26%）发生了3级或4级急性血液学毒性。2例患者（3%）出现3级厌食。在1例患者（1%）中观察到晚期胃肠道（GI）3级毒性。没有患者发展晚期4级或5级toxicity.Conclusions：第一个多机构分析的C-离子RT LAPC显示相对有利的结果与有限的毒性，特别是肿瘤不接近胃肠道。(C)2018爱思唯尔公司All rights reserved.
Purpose: The aim of this multi-institutional study was to evaluate the efficacy and safety of carbon-ion radiotherapy (C-ion RT) for locally advanced pancreatic cancer (LAPC).Methods and Materials: Patients with LAPC treated with C-ion RT from April 2012 to December 2014 at 3 institutions were retrospectively analyzed. Patients with pathologically-confirmed invasive ductal adenocarcinoma of the pancreas were eligible. The prescribed dose was 52.8 Gy (relative biological effectiveness weighted absorbed dose; RBE) or 55.2 Gy (RBE) in 12 fractions. Overall survival (OS), distant metastasis-free survival (DMFS), local recurrence (LR), and toxicity were evaluated.Results: In total, 72 patients were included in this study. Tumors in the head of the pancreas were seen in 30 patients (42%), while those in the body or tail of the pancreas were seen in 42 patients (58%). Fifty-six patients (78%) received concurrent chemotherapy. The OS rates were 73% (95% confidence interval [CI], 62%-84%) at 1 year, and 46% (95% CI, 31%-61%) at 2 years with a median OS of 21.5 months (95% CI, 11.8-31.2 months). The 1- and 2-year DMFS rates were 41% (95% CI, 29%-52%) and 28% (95% CI, 16%-40%), respectively. The 1- and 2-year cumulative incidences of LR were 16% (95% CI, 9%-26%) and 24% (95% CI, 14%-36%), respectively. Nineteen patients (26%) experienced acute grade 3 or 4 hematological toxicities. Two patients (3%) had grade 3 anorexia. Late gastrointestinal (GI) grade 3 toxicity was observed in 1 patient (1%). No patients developed late grade 4 or 5 toxicity.Conclusions: The first multi-institutional analysis of C-ion RT for LAPC indicated relatively favorable outcomes with limited toxicities, especially for tumors not in close proximity to GI tract. (C) 2018 Elsevier Inc. All rights reserved.