Landscape of Carbon Ion Radiotherapy in Prostate Cancer: Clinical Application and Translational Research

Abstract

Carbon ion radiotherapy (CIRT) is a useful and advanced technique for prostate cancer. This study sought to investigate the clinical efficacy and translational research for prostate cancer with carbon ion radiotherapy. We integrated the data from published articles, clinical trials websites, and our data. The efficacy of CIRT for prostate cancer was assessed in terms of overall survival, biochemical recurrence-free survival, and toxicity response. Up to now, clinical treatment of carbon ion radiotherapy has been carried in only five countries. We found that carbon ion radiotherapy induced little genitourinary and gastrointestinal toxicity when used for prostate cancer treatment. To some extent, it led to improved outcomes in overall survival, biochemical recurrence-free survival than conventional radiotherapy, especially for high-risk prostate cancer. Carbon ion radiotherapy brought clinical benefits for prostate cancer patients, and quality of life assessment indicated that CIRT affected patients to a lesser extent. Potential biomarkers from our omics-based study could be used to predict the efficacy of prostate cancer with CIRT. Carbon ion radiotherapy brought clinical benefits for prostate cancer patients. The omics-based translational research may provide insights into individualized therapy.

Radiation induced therapeutic effects in cancerous and tumor cells: A review

“…84 Carbon ion therapy (CIRT) is a useful method that provides clinical benefit to prostate cancer patients. 85 The diagnostic method is magnetic resonance imaging (MRI) using intraprostatic gold fiducial markers (GFM). 86 Modern radiotherapy techniques of intensity-modulated radiotherapy are used to modify risk.…”

The rationale for a carbon ion radiation therapy facility in Australia

“…Various recent (2020-2023) reviews and other publications consider clinical applications, experience, trials and outcomes for CIRT, some overviewing most or all sites with varying levels of detail 3,4,27,36,38,42,62,[100][101][102] and others discussing single applications only. [103][104][105][106][107][108][109] In 2022, Pompos et al 36 succinctly summarised the clinical indications as: radiation resistant malignancies, such as ACC, mucosal melanoma, NSCLC, liver cancer, bone and soft tissue sarcoma; recurrent previously irradiated cancers (especially rectal cancer), advanced gynaecological malignancies, oesophageal cancer, pancreatic cancer and hypoxic malignancies. For these, XRT and PBT are often not able to deliver sufficient target dose without undue probability of severe toxicity to organs-at-risk.…”

“…Various recent (2020–2023) reviews and other publications consider clinical applications, experience, trials and outcomes for CIRT, some overviewing most or all sites with varying levels of detail 3,4,27,36,38,42,62,100–102 and others discussing single applications only 103–109 . In 2022, Pompos et al 36 .…”

Value of carbon-ion radiotherapy for early stage non-small cell lung cancer

“…Currently, Japan is the country with the largest number of CIRT facilities, followed by Germany and China. Since 1994, the NIRS has been using carbon ions to treat tumors, and some clinical trials involving CIRT for the treatment of lung cancer are conducted in the institution [29] . For example, the first protocol (9303), which began in October 1994, and ended in August 1998.…”

“…The second one is the Gunma Heavy Ion Medical Center (GHMC), which is the first university hospital with a CIRT facility in Japan. For its clinical use, carbon-ion beams were selected based on preclinical experiments, while the past experiments with particle radiotherapy also played a pivotal role in the curative treatment of tumors [29] . It became apparent that it was necessary to carry out dose escalation studies for CIRT according to the differential effect and described toxicity-risk reduction of the surrounding healthy tissue.…”