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  • [Sci Rep.] Comparison of clinical outcomes between carbon ion radiotherapy and X-ray radiotherapy for reirradiation in locoregional recurrence of rectal cancer

    National Institutes for Quantum Science and Technology, 연세의대 / 정승연, Hirotoshi Takiyama*, 금웅섭*

  • 출처
    Sci Rep.
  • 등재일
    2022 Feb 3
  • 저널이슈번호
    12(1):1845. doi: 10.1038/s41598-022-05809-4.
  • 내용

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    Abstract
    Carbon ion radiotherapy (CIRT) has garnered interest for the treatment of locoregional rectal cancer recurrence. No study has compared CIRT and X-ray radiotherapy (XRT) for reirradiation (reRT) in such cases. We analyzed and compared the clinical outcomes such as local control, overall survival, and late toxicity rate between CIRT and XRT, for treating locoregional rectal cancer recurrence. Patients with rectal cancer who received reRT to the pelvis by CIRT or XRT from March 2005 to July 2019 were included. The CIRT treatment schedule was 70.4 Gy (relative biological effectiveness) in 16 fractions. For the XRT group, the median reRT dose was 50 Gy (range 25-62.5 Gy) with a median of 25 fractions (range 3-33). Thirty-five and 31 patients received CIRT and XRT, respectively. Tumour and treatment characteristics such as recurrence location and chemotherapy treatment differed between the two groups. CIRT showed better control of local recurrence (adjusted hazard ratio [HR] 0.17; p = 0.002), better overall survival (HR 0.30; p = 0.004), and lower severe late toxicity rate (HR 0.15; p = 0.015) than XRT. CIRT was effective for treating locoregional rectal cancer recurrence, with high rates of local control and survival, and a low late severe toxicity rate.

     

     

    Affiliations

    Seung Yeun Chung #  1   2 , Hirotoshi Takiyama #  3 , Jae Hyun Kang  4 , Jee Suk Chang  1 , Byung Soh Min  4 , Hiroshi Tsuji  3 , Shigeru Yamada #  5 , Woong Sub Koom #  6
    1 Department of Radiation Oncology, Yonsei Colorectal Cancer Clinic, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
    2 Department of Radiation Oncology, Ajou University School of Medicine, Suwon, Korea.
    3 Department of Radiation Oncology, QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inageku, Chiba, 263-8555, Japan.
    4 Department of Surgery, Yonsei Colorectal Cancer Clinic, Yonsei University College of Medicine, Seoul, Korea.
    5 Department of Radiation Oncology, QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inageku, Chiba, 263-8555, Japan. yamada.shigeru@qst.go.jp.
    6 Department of Radiation Oncology, Yonsei Colorectal Cancer Clinic, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea. mdgold@yuhs.ac.
    # Contributed equally.

  • 편집위원

    재발 위치가 presacral recurrence (51%) in CIRT vs. non-presacral, regional, nodal in XRT로 차이가 있고, CIRT군에서는 bowel or bladder가 가까울 경우 spacer를 삽입해서 보다 안전한 dose escalation이 가능하였으므로 연구 결과를 carbon과 x-ray의 차이로 해석하기는 어렵지만, 두 나라의 두 기관에서 비교 연구를 시행한 것으로 다양한 정보를 제공합니다.

    2022-03-18 10:48:27

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