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01-04-2022 | Particle Therapy | Original Article

Carbon ion radiotherapy as definitive treatment in locally recurrent pancreatic cancer

Authors: Dr. Jakob Liermann, MD, Prof. Edgar Ben-Josef, Mustafa Syed, Prof. Juergen Debus, Prof. Klaus Herfarth, Dr. Patrick Naumann

Published in: Strahlentherapie und Onkologie | Issue 4/2022

Abstract

Purpose

Data on management of locally recurrent pancreatic cancer (LRPC) after primary resection are limited. Recently, surprisingly high overall survival rates were reported after irradiation with carbon ions. Here, we report on our clinical experience using carbon ion radiotherapy as definitive treatment in LRPC at the Heidelberg Ion-Beam Therapy Center (HIT).

Methods

Between 2015 and 2019, we treated 13 patients with LRPC with carbon ions with a median total dose of 48 Gy (RBE) in 12 fractions using an active raster-scanning technique at a rotating gantry. No concomitant chemotherapy was administered. Overall survival, local control, and toxicity rates were evaluated 18 months after the last patient finished radiotherapy.

Results

With a median follow-up time of 9.5 months, one patient is still alive (8%). Median OS was 12.7 months. Ten patients (77%) developed distant metastases. Additionally, one local recurrence (8%) and two regional tumor recurrences (15%) were observed. The estimated 1‑year local control and locoregional control rates were 87.5% and 75%, respectively. During radiotherapy, we registered one gastrointestinal bleeding CTCAE grade III (8%) due to gastritis. The bleeding was sufficiently managed with conservative therapy. No further higher-grade acute or late toxicities were observed.

Conclusion

We demonstrate high local control rates in a rare cohort of LRPC patients treated with carbon ion radiotherapy. The observed median overall survival rate was not improved compared to historical in-house data using photon radiotherapy. This is likely due to a high rate of distant tumor progression, highlighting the necessity of additional chemotherapy.

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Title: Carbon ion radiotherapy as definitive treatment in locally recurrent pancreatic cancer
Authors: Dr. Jakob Liermann, MD
Prof. Edgar Ben-Josef
Mustafa Syed
Prof. Juergen Debus
Prof. Klaus Herfarth
Dr. Patrick Naumann
Publication date: 01-04-2022
Publisher: Springer Berlin Heidelberg
Keywords: Particle Therapy
Radiotherapy
Pancreatic Cancer
Pancreatic Cancer
Cytostatic Therapy
Published in: Strahlentherapie und Onkologie / Issue 4/2022
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-021-01827-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Carbon ion radiotherapy as definitive treatment in locally recurrent pancreatic cancer

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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