Carbon-ion radiotherapy for locally advanced cervical cancer with bladder invasion

Abstract

The purpose of this study was to evaluate the efficacy and toxicities of carbon-ion radiotherapy (C-ion RT) for locally advanced cervical cancer with bladder invasion by a subset analysis of pooled data from eight prospective clinical trials at the National Institute of Radiological Sciences. Between June 1995 and January 2014, 29 patients with locally advanced cervical cancer with bladder invasion were identified. The median age was 56 years old (range 31–79 years old). The median tumor size at diagnosis on magnetic resonance imaging was 6.7 cm (range 3.5–11.0 cm). Histologically, 20 patients had squamous cell carcinoma and 9 had adenocarcinoma. C-ion RT was performed as a dose-escalation study in the initial trials. All patients received prophylactic whole-pelvic or extended-field irradiation and local boost. The total dose to the cervical tumor was 52.8–74.4 Gy (relative biological effectiveness) in 20 or 24 fractions. Weekly cisplatin (40 mg/m2/week, five cycles) was concurrently given to four patients. The median follow-up of all patients was 28.6 months (range 8.8–238.6 months). Grade 2 or higher late complications in the bladder were observed in eight patients, with seven developing vesicovaginal fistula. Six patients had Grade 2 or higher complications in the rectosigmoid colon. The 3-year overall survival rate was 47%, the 3-year local control rate was 66%, and the 3-year disease-free survival rate was 28%. In this study, C-ion RT showed favorable local control with reasonable toxicities, but the results were still unsatisfactory. We have the expectation of improvement of therapeutic effects by using C-ion RT with concurrent chemotherapy.

Locally advanced cervical cancer with bladder invasion: clinical outcomes and predictive factors for vesicovaginal fistulae

“…CCBI is infrequent and data are scarce, generally showing poor prognosis and high local failure rates. This study with 71 patients, although retrospective, is to date the largest monocentric cohort assessing the clinical outcomes in this population, and one of the first examining prognostic factors associated with VVF [ 15 , 2 , 3 , 16 , 17 ]. Patient prognosis was poor, with median OS and DFS of 27.3 and 15.8 months, respectively.…”

Inhibition of Wnt signalling pathway by XAV939 enhances radiosensitivity in human cervical cancer HeLa cells

“…Accumulating evidence suggests that 12 C 6þ irradiation has been widely used in the treatment of a variety of cancers, such as pancreatic cancer [11], non-small cell lung cancer [12], locally advanced cervical cancer, prostate carcinoma [13] and breast cancer [14]. What is more, in the stage IVA patients of cervical carcinoma, 12 C 6þ beam radiotherapy has respectively shown a 3-year local control and overall survival rate of 66% and 47%, indicating that it can be applied to locally advanced cervical cancer [15]. Thus far, it is estimated that more than 16,000 patients have received 12 C 6þ treatment.…”

Adenoid Cystic Carcinoma of Bartholin’s Gland: What Is the Best Approach?

“…Overall, Japanese studies showed an excellent efficacy of CIRT with concurrent chemotherapy in women receiving prophylactic extended-field CIRT with higher local control for higher total dose (>70 Gy [relative biological effectiveness [RBE]]) and a better local control rate for large tumors compared with concurrent chemoradiotherapy with photons. Encouraging results were also shown for locally advanced adenocarcinoma [63][64][65][66][67][68][69].…”