Dosimetric analysis of upper gastrointestinal ulcer after carbon-ion radiotherapy for pancreatic cancer

Shinoto, Makoto; Shioyama, Yoshiyuki; Matsunobu, Akira; Okamoto, Kei; Suefuji, Hiroaki; Toyama, Shingo; Honda, Hiroshi; Kudo, Sho

doi:10.1016/j.radonc.2016.04.040

Cited by 28 publications

(27 citation statements)

References 20 publications

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“…The C-ion RT technique was performed using approximately the same approach as reported previously [13, 14]. In brief, a set of 2 to 5 mm thick noncontrast-enhanced computed tomography (CT) images was obtained under respiratory gating for treatment planning purposes.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Risk Factors for Vertebral Compression Fracture after Carbon-Ion Radiotherapy for Primary Spinal and Paraspinal Sarcoma

Matsumoto

Shinoto

Setsu

et al. 2017

BioMed Research International

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Background and Purpose Carbon-ion radiotherapy (C-ion RT) was effective therapy for inoperable spinal and paraspinal sarcomas. However, a significant adverse event following radiotherapies is vertebral compression fractures (VCFs). In this study, we investigated the incidence of and risk factors for post-C-ion RT VCFs in patients with spinal or paraspinal sarcomas. Material and Methods Thirty consecutive patients with spinal or paraspinal sarcomas treated with C-ion RT were retrospectively reviewed. Various clinical parameters and the Spinal Instability Neoplastic Score (SINS) were used to evaluate the risk factors for post-C-ion RT VCFs. Results The overall incidence of VCFs was 23% (median time: 7 months). Patients with VCFs showed a markedly higher SINS score (median value, 9 points) than those without VCF (5 points). The area under the receiver operating characteristic curve for the SINS score was 0.88, and the optimum SINS cut-off score was 8 points. The cumulative incidence of VCFs at 1 year was 9% for patients with a SINS score under 8 points, versus 80% for those with a SINS score of 8 points or higher (p < 0.0001). Conclusions In patients with a SINS score of 8 points or higher, referral to a spine surgeon for stabilization and multidisciplinary discussion is appropriate.

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Section: Methodsmentioning

confidence: 99%

Evaluation of Risk Factors for Vertebral Compression Fracture after Carbon-Ion Radiotherapy for Primary Spinal and Paraspinal Sarcoma

Matsumoto

Shinoto

Setsu

et al. 2017

BioMed Research International

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“…The 2-year survival was 48% with excellent tolerability at this dose level [91]. Gastric ulceration was uncommon after CIRT for these patients [169]. The NIRS group also tested CIRT as a pre-operative strategy for potentially resectable pancreatic cancer in 8 fractions over 2 weeks.…”

Section: Clinical Experiences With Cirtmentioning

confidence: 99%

Carbon Ion Radiotherapy: A Review of Clinical Experiences and Preclinical Research, with an Emphasis on DNA Damage/Repair

Mohamad

Sishc

Saha

et al. 2017

Cancers

148

130

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Compared to conventional photon-based external beam radiation (PhXRT), carbon ion radiotherapy (CIRT) has superior dose distribution, higher linear energy transfer (LET), and a higher relative biological effectiveness (RBE). This enhanced RBE is driven by a unique DNA damage signature characterized by clustered lesions that overwhelm the DNA repair capacity of malignant cells. These physical and radiobiological characteristics imbue heavy ions with potent tumoricidal capacity, while having the potential for simultaneously maximally sparing normal tissues. Thus, CIRT could potentially be used to treat some of the most difficult to treat tumors, including those that are hypoxic, radio-resistant, or deep-seated. Clinical data, mostly from Japan and Germany, are promising, with favorable oncologic outcomes and acceptable toxicity. In this manuscript, we review the physical and biological rationales for CIRT, with an emphasis on DNA damage and repair, as well as providing a comprehensive overview of the translational and clinical data using CIRT.

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“…Several publications have analysed GI OAR dose-volumes in chemoradiotherapy for pancreatic cancer (Table 3) [11] and found stomach V20Gy was the best predictor of acute toxicity, while duodenum V40Gy and V45Gy were o elated spe ifi all ith a ato i al da age. 'e e tl Shi oto et al ha e pu lished a al sis of carbon-ion chemoradiotherapy dose-volume parameters, though the values themselves may not be directly comparable with those from photon radiotherapy [28]. It is worth noting that in our analysis we failed to show associations of GI toxicity with duodenum dose-volume, despite other studies having shown evidence of a relationship [29].…”

Section: Discussionmentioning

confidence: 59%

Stomach Dose–Volume Predicts Acute Gastrointestinal Toxicity in Chemoradiotherapy for Locally Advanced Pancreatic Cancer

et al. 2018

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Dosimetric analysis of upper gastrointestinal ulcer after carbon-ion radiotherapy for pancreatic cancer

Abstract: The incidence of GI ulcer after C-ion RT was very low with the dose constraint of D2cm3 <46Gy (RBE). To further minimize the risk of GI ulcer, V10-30 should also be reduced.

Cited by 28 publications

References 20 publications

Evaluation of Risk Factors for Vertebral Compression Fracture after Carbon-Ion Radiotherapy for Primary Spinal and Paraspinal Sarcoma

Evaluation of Risk Factors for Vertebral Compression Fracture after Carbon-Ion Radiotherapy for Primary Spinal and Paraspinal Sarcoma

Carbon Ion Radiotherapy: A Review of Clinical Experiences and Preclinical Research, with an Emphasis on DNA Damage/Repair

Stomach Dose–Volume Predicts Acute Gastrointestinal Toxicity in Chemoradiotherapy for Locally Advanced Pancreatic Cancer

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