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01-12-2020 | Prostate Cancer | Research

Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer

Authors: Yosuke Takakusagi, Hiroyuki Katoh, Kio Kano, Wataru Anno, Keisuke Tsuchida, Nobutaka Mizoguchi, Itsuko Serizawa, Daisaku Yoshida, Tadashi Kamada

Published in: Radiation Oncology | Issue 1/2020

Abstract

Background

Carbon-ion radiotherapy (CIRT) for prostate cancer was initiated at Kanagawa Cancer Center in 2015. The present study analyzed the preliminary clinical outcomes of CIRT for prostate cancer.

Methods

The clinical outcomes of 253 patients with prostate cancer who were treated with CIRT delivered using the spot scanning method between December 2015 and December 2017 were retrospectively analyzed. The irradiation dose was set at 51.6 Gy (relative biological effectiveness) delivered in 12 fractions over 3 weeks. Biochemical relapse was defined using the Phoenix definition. Toxicities were assessed according to CTCAE version 4.0. Results: The median patient age was 70 (47–86) years. The median follow-up duration was 35.3 (4.1–52.9) months. According to the D’Amico classification system, 8, 88, and 157 patients were classified as having low, intermediate, and high risks, respectively. Androgen deprivation therapy was administered in 244 patients. The biochemical relapse-free rate in the low-, intermediate-, and high-risk groups at 3 years was 87.5, 88.0, and 97.5%, respectively (P = 0.036). Grade 2 acute urinary toxicity was observed in 12 (4.7%) patients. Grade 2 acute rectal toxicity was not observed. Grade 2 late urinary toxicity and grade 2 late rectal toxicity were observed in 17 (6.7%) and 3 patients (1.2%), respectively. Previous transurethral resection of the prostate was significantly associated with late grade 2 toxicity in univariate analysis. The predictive factor for late rectal toxicity was not detected.

Conclusion

The present study demonstrated that CIRT using the spot scanning method for prostate cancer produces favorable outcomes.

Bray F, Ferlay J, Soerjomataram Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.PubMedCrossRef

Scherr D, Swindle PW, Scardino PT. National Comprehensive Cancer Network guidelines for the management of prostate cancer. Urology. 2003;61:14–24.PubMedCrossRef

Hernandez DJ, Nielsen ME, Han M, Partin AW. Contemporary evaluation of the D’amico risk classification of prostate cancer. Urology. 2007;70:931–5.PubMedCrossRef

Sanguineti G, Cavey ML, Endres EJ, Brandon GG, Bayouth JE. Is IMRT needed to spare the rectum when pelvic lymph nodes are part of the initial treatment volume for prostate cancer? Int J Radiat Oncol Biol Phys. 2006;64:151–60.PubMedCrossRef

Lyons JA, Kupelian PA, Mohan DS, Reddy CA, Klein EA. Importance of high radiation doses (72 Gy or greater) in the treatment of stage T1–T3 adenocarcinoma of the prostate. Urology. 2000;55(1):85–90.PubMedCrossRef

Kupelian PA, Mohan DS, Lyons J, Klein EA, Reddy CA. Higher than standard radiation doses (72 Gy) with or without androgen deprivation in the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys. 2000;46(3):567–74.PubMedCrossRef

Kupelian PA, Buchsbaum JC, Reddy CA, Klein EA. Radiation dose response in patients with favorable localized prostate cancer (stage T1–T2, biopsy Gleason < or = 6, and pretreatment prostate-specific antigen < or =10). Int J Radiat Oncol Biol Phys. 2001;50(3):621–5.PubMedCrossRef

Akakura K, Tsujii H, Morita S, Tsuji H, Yagishita T, Isaka S, Ito H, Akaza H, Hata M, Fujime M, Harada M, Shimazaki J. Phase I/II clinical trials of carbon ion therapy for prostate cancer. Prostate. 2004;58(3):252–8.PubMedCrossRef

Kanai T, Endo M, Minohara S, Miyahara N, Koyama-ito H, Tomura H, Matsufuji N, Futami Y, Fukumura A, Hiraoka T, Furusawa Y, Ando K, Suzuki M, Soga F, Kawachi K. Biophysical characteristics of HIMAC clinical irradiation system for heavy-ion radiation therapy. Int J Radiat Oncol Biol Phys. 1999;44:201–10.PubMedCrossRef

10.

Kanai T, Matsufuji N, Miyamoto T, Mizoe J, Kamada T, Tsuji H, Kato H, Baba M, Tsujii H. Examination of GyE system for HIMAC carbon therapy. Int J Radiat Oncol Biol Phys. 2006;64:650–6.PubMedCrossRef

11.

Schulz-Ertner D, Tsujii H. Particle radiation therapy using proton and heavier ion beams. J Clin Oncol. 2007;25:953–64.PubMedCrossRef

12.

Ishikawa H, Tsuji H, Kamada T, Akakura K, Suzuki H, Shimazaki J, Tsujii H. Carbon-ion radiation therapy for prostate cancer. Int J Urol. 2012 Apr;19(4):296–305.PubMedCrossRef

13.

Nomiya T, Tsuji H, Kawamura H, Ohno T, Toyama S, Shioyama Y, Nakayama Y, Nemoto K, Tsujii H, Kamada T. A multi-institutional analysis of prospective studies of carbon-ion radiotherapy for prostate cancer: a report from the Japan carbon-ion radiation oncology study group (J-CROS). Radiother Oncol. 2016;121(2):288–93.PubMedCrossRef

14.

Nakayama Y, Minohara S, Nonaka T, Nomiya T, Kusano Y, Takeshita E, Mizoguchi N, Hagiwara Y. The ion-beam radiation oncology Center in Kanagawa (i-ROCK) carbon ion Facility at the Kanagawa Cancer Center. Int J Part Ther. 2016 Winter;2(3):478–80.PubMedPubMedCentralCrossRef

15.

Tsujii H, Kamada T, Shirai T, Noda K, Tsuji H, Karasawa K. Carbon-ion radiotherapy. Springer: Japan; 2014. p. 53–64.CrossRef

16.

Minohara S, Fukuda S, Kanematsu N, Takei Y, Furukawa T, Inaniwa T, Matsufuji N, Mori S, Noda K. Recent innovations in carbon-ion radiotherapy. J Radiat Res. 2010;51(4):385–92.PubMedCrossRef

17.

Ute L. Ion Beam Therapy. Heidelbelg: Springer; 2012. p. 45–59.

18.

Weber U, Becher W, Kraft G. Depth scanning for a conformal ion beam treatment of deep seated tumours. Phys Med Biol. 2000;45(12):3627–41.PubMedCrossRef

19.

Pedroni E, Bacher R, Blattmann H, Böhringer T, Coray A, Lomax A, Lin S, Munkel G, Scheib S, Schneider U. The 200-MeV proton therapy project at the Paul Scherrer Institute: conceptual design and practical realization. Med Phys. 1995;22(1):37–53.PubMedCrossRef

20.

Chu WT, Ludewigt BA, Renner TR. Instrumentation for treatment of cancer using proton and light-ion beams. Rev Sci Instrum. 1993;64:2055–122.CrossRef

21.

D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, Tomaszewski JE, Renshaw AA, Kaplan I, Beard CJ, Wein A. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998;280(11):969–74.PubMedCrossRef

22.

Kawamura H, Kubo N, Sato H, Mizukami T, Katoh H, Ishikawa H, Ohno T, Matsui H, Ito K, Suzuki K, Nakano T. Group for Genitourinary Tumors at Gunma University Heavy Ion Medical Center. Moderately hypofractionated carbon ion radiotherapy for prostate cancer; a prospective observational study “GUNMA0702”. BMC Cancer. 2020;20(1):75.PubMedPubMedCentralCrossRef

23.

Kasuya G, Ishikawa H, Tsuji H, Haruyama Y, Kobashi G, Ebner DK, Akakura K, Suzuki H, Ichikawa T, Shimazaki J, Makishima H, Nomiya T, Kamada T. Tsujii H; working Group for Genitourinary Tumors. Cancer-specific mortality of high-risk prostate cancer after carbon-ion radiotherapy plus long-term androgen deprivation therapy. Cancer Sci. 2017;108(12):2422–9.PubMedPubMedCentralCrossRef

24.

Tsuji H, Yanagi T, Ishikawa H, Kamada T, Mizoe JE, Kanai T, Morita S, Tsujii H. Hypofractionated radiotherapy with carbon ion beams for prostate cancer. Int J Radiat Oncol Biol Phys. 2005;63:1153–60.PubMedCrossRef

25.

Ishikawa H, Tsuji H, Kamada T, Yanagi T, Mizoe JE, Kanai T, Morita S, Wakatsuki M, Shimazaki J, Tsujii H. Carbon ion radiation therapy for prostate cancer: results of a prospective phase II study. Radiother Oncol. 2006;81:57–64.PubMedCrossRef

26.

Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, Sandler H. Defining biochemical failure following radio therapy with clinically localized prostate cancer:recommendations of the RTOG- ASTRO Phoenix consensus conference. Int J Radiation Oncol Biol Phys. 2006;65:965–74.CrossRef

27.

Hanks GE. Conformal radiotherapy for prostate cancer. Ann Med. 2000;32(1):57–63.PubMedCrossRef

28.

Vargas C, Martinez A, Kestin LL, Yan D, Grills I, Brabbins DS, Lockman DM, Liang J, Gustafson GS, Chen PY, Vicini FA, Wong JW. Dose-volume analysis of predictors for chronic rectal toxicity after treatment of prostate cancer with adaptive image-guided radiotherapy. Int J Radiat Oncol Biol Phys. 2005;62(5):1297–308.PubMedCrossRef

29.

Pollack A, Zagars GK, Starkschall G, Antolak JA, Lee JJ, Huang E, von Eschenbach AC, Kuban DA, Rosen I. Prostate cancer radiation dose response: results of the M. D. Anderson phase III randomized trial. Int J Radiat Oncol Biol Phys. 2002;53(5):1097–105.PubMedCrossRef

30.

Zelefsky MJ, Cowen D, Fuks Z, Shike M, Burman C, Jackson A, Venkatramen ES, Leibel SA. Long term tolerance of high dose three-dimensional conformal radiotherapy in patients with localized prostate carcinoma. Cancer. 1999;85(11):2460–8.PubMedCrossRef

31.

Sveistrup J, af Rosenschöld PM, Deasy JO, Oh JH, Pommer T, Petersen PM, Engelholm SA. Improvement in toxicity in high risk prostate cancer patients treated with image-guided intensity-modulated radiotherapy compared to 3D conformal radiotherapy without daily image guidance. Radiat Oncol. 2014;9(1):44.PubMedPubMedCentralCrossRef

32.

Michalski JM, Yan Y, Watkins-Bruner D, Bosch WR, Winter K, Galvin JM, Bahary JP, Morton GC, Parliament MB, Sandler HM. Preliminary toxicity analysis of 3-dimensional conformal radiation therapy versus intensity modulated radiation therapy on the high-dose arm of the radiation therapy oncology group 0126 prostate cancer trial. Int J Radiat Oncol Biol Phys. 2013;87(5):932–8.PubMedCrossRef

33.

Kupelian PA, Willoughby TR, Reddy CA, Klein EA, Mahadevan A. Hypofractionated intensity-modulated radiotherapy (70 Gy at 2.5 Gy per fraction) for localized prostate cancer: Cleveland Clinic experience. Int J Radiat Oncol Biol Phys. 2007;68(5):1424–30.PubMedCrossRef

34.

Coen JJ, Bae K, Zietman AL, Patel B, Shipley WU, Slater JD, Rossi CJ. Acute and late toxicity after dose escalation to 82 GyE using conformal proton radiation for localized prostate cancer: initial report of American College of Radiology Phase II study 03–12. Int J Radiat Oncol Biol Phys. 2011;81:1005–9.PubMedCrossRef

35.

Iwata H, Ishikawa H, Takagi M, Okimoto T, Murayama S, Akimoto T, Wada H, Arimura T, Sato Y, Araya M, Mizoe JE, Gosho M, Nakamura K, Shirato H, Sakurai H. Long-term outcomes of proton therapy for prostate cancer in Japan: a multi-institutional survey of the Japanese radiation oncology study group. Cancer Med. 2018;7(3):677–89.PubMedPubMedCentralCrossRef

36.

Ishikawa H, Tsuji H, Kamada T, Hirasawa N, Yanagi T, Mizoe JE, Akakura K, Suzuki H, Shimazaki J, Tsujii H. Risk factors of late rectal bleeding after carbon-ion therapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2006;66(4):1084–91.

37.

Byrne K, Hruby G, Kneebone A, Whalley D, Guo L, McCloud P, Eade T. Late genitourinary toxicity outcomes in 300 prostate cancer patients treated with dose-escalated image-guided intensity-modulated radiotherapy. Clin Oncol (R Coll Radiol). 2017;29(9):617–25.CrossRef

38.

Kalakota K, Liauw SL. Toxicity after external beam radiotherapy for prostate cancer: an analysis of late morbidity in men with diabetes mellitus. Urology. 2013;81(6):1196–201.PubMedCrossRef

39.

Ishikawa H, Tsuji H, Kamada T, Hirasawa N, Yanagi T, Mizoe JE, Akakura K, Suzuki H, Shimazaki J, Nakano T, Tsujii H. Adverse effects of androgen deprivation therapy on persistent genitourinary complications after carbon-ion radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys. 2008;72(1):78–84.PubMedCrossRef

40.

Nomiya T, Tsuji H, Toyama S, Maruyama K, Nemoto K, Tsujii H, Kamada T. Management of high-risk prostate cancer: radiation therapy and hormonal therapy. Cancer Treat Rev. 2013;39(8):872–8.PubMedCrossRef

41.

Hausterman K, Fowler JF. A comment on proliferation rates in human prostate cancer. Int J Radiat Oncol Biol Phys. 2000;48(1):303.PubMedCrossRef

42.

Aluwini S, Pos F, Schimmel E, Krol S, van der Toorn PP, de Jager H, Alemayehu WG, Heemsbergen W, Heijmen B, Incrocci L. Hypofractionated versus conventionally fractionated radiotherapy for patients with prostate cancer (HYPRO): late toxicity results from a randomised, non-inferiority, phase 3 trial. Lancet Oncol. 2016;17(4):464–74.PubMedCrossRef

43.

Dearnaley D, Syndikus I, Mossop H, Khoo V, Birtle A, Bloomfield D, Graham J, Kirkbride P, Logue J, Malik Z, Money-Kyrle J, O'Sullivan JM, Panades M, Parker C, Patterson H, Scrase C, Staffurth J, Stockdale A, Tremlett J, Bidmead M, Mayles H, Naismith O, South C, Gao A, Cruickshank C, Hassan S, Pugh J, Griffin C, Hall E, CHHiP Investigators. Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncol. 2016;17(8):1047–60.PubMedPubMedCentralCrossRef

44.

Catton CN, Lukka H, Gu CS, Martin JM, Supiot S, Chung PWM, Bauman GS, Bahary JP, Ahmed S, Cheung P, Tai KH, Wu JS, Parliament MB, Tsakiridis T, Corbett TB, Tang C, Dayes IS, Warde P, Craig TK, Julian JA, Levine MN. Randomized trial of a Hypofractionated radiation regimen for the treatment of localized prostate Cancer. J Clin Oncol. 2017;35(17):1884–90.PubMedCrossRef

45.

Takakusagi Y, Kawamura H, Okamoto M, Kaminuma T, Kubo N, Mizukami T, Sato H, Onishi M, Ohtake N, Sekihara T, Nakano T. Long-term outcome of hypofractionated intensity-modulated radiotherapy using TomoTherapy for localized prostate cancer: a retrospective study. PLoS One. 2019;14(2):e0211370.PubMedPubMedCentralCrossRef

46.

Zilli T, Franzese C, Bottero M, Giaj-Levra N, Förster R, Zwahlen D, Koutsouvelis N, Bertaut A, Blanc J, Roberto D'agostino G, Alongi F, Guckenberger M, Scorsetti M, Miralbell R. Single fraction urethra-sparing prostate cancer SBRT: phase I results of the ONE SHOT trial. Radiother Oncol. 2019;139:83–6.PubMedCrossRef

47.

Alongi F, Fiorentino A, De Bari B. SBRT and extreme hypofractionation: a new era in prostate cancer treatments? Rep Pract Oncol Radiother. 2015;20(6):411–6.PubMedCrossRef

48.

Nicosia L, Mazzola R, Rigo M, Figlia V, Giaj-Levra N, Napoli G, Ricchetti F, Corradini S, Ruggieri R, Alongi F. Moderate versus extreme hypofractionated radiotherapy: a toxicity comparative analysis in low- and favorable intermediate-risk prostate cancer patients. J Cancer Res Clin Oncol. 2019;145(10):2547–54.PubMedCrossRef

49.

Burchardt W, Skowronek J. Time to PSA rise differentiates the PSA bounce after HDR and LDR brachytherapy of prostate cancer. J Contemp Brachytherapy. 2018;10(1):1–9.PubMedPubMedCentralCrossRef

50.

Crook J, Gillan C, Yeung I, Austen L, McLean M, Lockwood G. PSA kinetics and PSA bounce following permanent seed prostate brachytherapy. Int J Radiat Oncol Biol Phys. 2007;69:426–33.PubMedCrossRef

51.

Caloglu M, Ciezki J. Prostate-specific antigen bounce after prostate brachytherapy: review of a confusing phenomenon. Urology. 2009;74:1183–90.PubMedCrossRef

Title: Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer
Authors: Yosuke Takakusagi
Hiroyuki Katoh
Kio Kano
Wataru Anno
Keisuke Tsuchida
Nobutaka Mizoguchi
Itsuko Serizawa
Daisaku Yoshida
Tadashi Kamada
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Prostate Cancer
Prostate Cancer
Radiotherapy
Transurethral Prostate Resection
Published in: Radiation Oncology / Issue 1/2020
Electronic ISSN: 1748-717X
DOI: https://doi.org/10.1186/s13014-020-01575-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Preliminary result of carbon-ion radiotherapy using the spot scanning method for prostate cancer

Abstract

Background

Methods

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Conclusion

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