Gastrointestinal Cancer

PV QA 1 - Poster Viewing Q&A 1

SU_16_2162 - Re-irradiation using carbon-ion beams for isolated recurrent tumor.

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Re-irradiation using carbon-ion beams for isolated recurrent tumor.
K. Shirai1,2, T. Ohno2, J. I. Saitoh2, M. Okamoto2, H. Katoh2, K. Murata2, H. Kawamura2, A. Musha2, T. Mizukami2, T. Abe2, and T. Nakano2; 1Department of Radiology, Saitama Medical Center, Jichi Medical University, Saitama, Japan, 2Gunma University Heavy Ion Medical Center, Maebashi, Japan

Purpose/Objective(s): Local recurrent tumors after radiotherapy are radio-resistant tumors, and carbon-ion is expected to overcome the refractory disease. We performed prospective study to evaluate the efficacy and safety of re-irradiation using carbon-ion radiotherapy for isolated recurrent tumor.

Materials/Methods: The inclusion criteria were as follows: clinically proven recurrent tumor; measurable tumor by CT or MRI; Age >=16, performance status 0-2; isolated tumor at previously irradiated site; and life expectancy more than 6 months. The exclusion criteria were as follows: tumor invasion to gastrointestinal tract or major blood vessel; uncontrolled infection; early recurrent tumor less than 3 months; and severe concomitant diseases. The primary end-point was the 1-year local control rate, and the secondary end-points included the overall survival rate and adverse events. Local control and overall survival rates were statistically calculated by the Kaplan-Meier method and log-rank tests. A P value < 0.05 was defined as a statistical significance. Acute and late adverse events were evaluated according to the Common Terminology Criteria for Adverse Events, version 4.0. This study was reviewed and approved by our Institutional Review Board (No. 1108).

Results: Between December 2013 and March 2016, 22 patients were enrolled in this prospective study. All patients were re-irradiated carbon-ion radiotherapy with radical intent. The median age was 67 years old (range: 17-89), and number of male patients was 13 (59%). There were 7 patients with rectal cancer, 4 with sarcoma, 4 with lung cancer, and 3 with hepatic cell carcinoma, and 4 with other tumors. The median follow-up time was 26 months. Eight patients developed local recurrence, and the 1- and 2-year local control rates were 71% and 60%, respectively. Eight patients died of the cancers and 2 died of other disease. The 1- and 2 year overall survival rates were 76% and 67%, respectively. There were no acute adverse events grade ≧3. There were 4 patients with late adverse events grade ≧3, including 3 patients with grade 3 urinary tract obstruction requiring ureteral stent and 1 with skin ulcer and upper limb disability. There were no late adverse events grade ≧4.

Conclusion: Re-irradiation of carbon-ion radiotherapy with radical intent were safely performed with tolerable toxicities for the selected patients. The re-irradiation has the potential to improve the treatment for isolated local recurrent tumor, and the further investigations are required to confirm the therapeutic efficacy. UMIN000014513.

Author Disclosure: K. Shirai: None. T. Ohno: None. M. Okamoto: None. H. Katoh: None. H. Kawamura: None. T. Abe: None.

Katsuyuki Shirai, MD, PhD

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