Multi-institutional Retrospective Analysis of Carbon-ion Radiotherapy for Patients with Locally Advanced Adenocarcinoma of the Uterine Cervix

Abstract

The clinical significance of carbon-ion radiotherapy (CIRT) for adenocarcinoma (AC) of the uterine cervix has been assessed in several single-institutional studies. To validate the significance, we conducted a multi-institutional survey of CIRT for locally advanced AC (LAAC) of the uterine cervix. We retrospectively analyzed the clinical outcomes of patients with stage IIB–IVA LAAC of the uterine cervix who underwent chemo-CIRT or CIRT alone between April 2010 and April 2016. Patients received 74.4 Gy (relative biological effectiveness [RBE]) in 20 fractions of CIRT or 55.2 Gy (RBE) in 16 fractions of CIRT plus 3 sessions of brachytherapy. Patients aged ≤70 years with adequate bone marrow and organ function were administered cisplatin weekly (40 mg/m2 per week for up to 5 weeks). Fifty-five patients were enrolled in this study. The median follow-up period was 67.5 months. The 5-year overall survival (OS) and local control (LC) rates were 68.6% and 65.2%, respectively. Multivariate analysis showed that the initial tumor response within 6 months was significantly associated with LC and OS. The present study represents promising outcomes of CIRT or chemo-CIRT for LAAC of the uterine cervix, especially in the cases showing initial rapid regression of the tumor.

Secondary cancers after carbon‐ion radiotherapy and photon beam radiotherapy for uterine cervical cancer: A comparative study

“…Even with CCRT, including 3D‐IGBT, the clinical results for adenocarcinoma of the uterine cervix remain poor 12–14 . In comparison, CIRT showed favorable clinical outcomes for uterine cervix adenocarcinoma, and those results were validated in a recent multi‐institutional study 15–17 …”

“…As treatment outcomes for cervical cancer improve, the need to control late adverse events is an important clinical issue. Typical late adverse events after administering RT/CIRT for cervical cancer include rectal complications, bladder complications, and insufficiency bone fractures 6,17–20 . Secondary cancers are also an adverse event that deserves posttreatment attention.…”

Evaluation of X-ray and carbon-ion beam irradiation with chemotherapy for the treatment of cervical adenocarcinoma cells on 2D and 3D cultures

“…C-ion radiotherapy has also been used to treat cervical adenocarcinoma. Relatively good results have been reported compared to cisplatin-based concurrent chemoradiotherapy, which is established as a standard treatment, and image-guided brachytherapy [6,7]. In addition, clinical trials are ongoing to combine C-ion radiotherapy with cisplatin or image-guided brachytherapy for locally advanced cervical cancer [8,9].…”