@article{b1067db00f604c80a0f7121f7454a423,
title = "Single fraction carbon ion radiotherapy for colorectal cancer liver metastasis: A dose escalation study",
abstract = "Prognosis is usually grim for those with liver metastasis from colorectal cancer (CRC) who cannot receive resection. Radiation therapy can be an option for those unsuitable for resection, with carbon ion radiotherapy (CIRT) being more effective and less toxic than X-ray due to its physio-biological characteristics. The objective of this study is to identify the optimal dose of single fraction CIRT for colorectal cancer liver metastasis. Thirty-one patients with liver metastasis from CRC were enrolled in the present study. Twenty-nine patients received a single-fraction CIRT, escalating the dose from 36 Gy (RBE) in 5% to 10% increments until unacceptable incidence of dose-limiting toxicity was observed. Dose-limiting toxicity was defined as grade ≥3 acute toxicity attributed to radiotherapy. The prescribed doses were as follows: 36 Gy (RBE) (3 cases), 40 Gy (2 cases), 44 Gy (4 cases), 46 Gy (6 cases), 48 Gy (3 cases), 53 Gy (8 cases) and 58 Gy (3 cases). Dose-limiting toxicity was not observed, but late grade 3 liver toxicity due to biliary obstruction was observed in 2 patients at 53 Gy (RBE). Both cases had lesions close to the hepatic portal region, and, therefore, the dose was escalated to 58 Gy (RBE), limited to peripheral lesions. The 3-year actuarial overall survival rate of all 29 patients was 78%, and the median survival time was 65 months. Local control improved significantly at ≥53 Gy (RBE), with a 3-year actuarial local control rate of 82%, compared to 28% in lower doses. Treatment for CRC liver metastasis with single-fraction CIRT appeared to be safe up to 58 Gy (RBE) as long as the central hepatic portal region was avoided.",
keywords = "carbon ion therapy, colorectal cancer, dose escalation study, liver metastasis, particle therapy",
author = "{the Liver Cancer Working Group} and Hirokazu Makishima and Shigeo Yasuda and Yuka Isozaki and Goro Kasuya and Naomi Okada and Masaru Miyazaki and Osama Mohamad and Naruhiro Matsufuji and Shigeru Yamada and Hiroshi Tsuji and Tadashi Kamada and Shigeki Arii and Ikuo Udagawa and Masaak Ebara and Takehito Otsubo and Kiyoshi Ohara and Takuji Okusaka and Fumihiko Kanai and Fukuo Kondo and Akiko Saito and Yoshiaki Shimizu and Kenichi Takayasu and Jyunji Furuse and Hiroshi Yamamoto and Osamu Yokosuka and Hiroyuki Yoshidome and Hirohiko Tsujii and Takehide Asano and Ohkohchi Nobuhiro and Masaharu Yoshikawa and Takaaki Ikari and Hirotoshi Kato and Hiroshi Shimada",
note = "Funding Information: This work was supported by the Research Project for Heavy Ions at the National Institute of Radiological Sciences, Japan. We wish to express our deep appreciation to the late Dr Masao Ohto, the principal investigator of the Liver Cancer Working Group, as well as Funding Information: This work was supported by the Research Project for Heavy Ions at the National Institute of Radiological Sciences, Japan. We wish to express our deep appreciation to the late Dr Masao Ohto, the principal investigator of the Liver Cancer Working Group, as well as all the members. This group was organized to evaluate and revise clinical trials conducted at NIRS. The current members are as follows (affiliations at the time of participation): Masaru Miyazaki (Chiba University); Shigeki Arii (Hamamatsu Rosai Hospital); Ikuo Udagawa (Chiba Rosai Hospital); Masaak Ebara (Matsudo City Hospital); Takehito Otsubo (St. Mariannna University); Kiyoshi Ohara (Tsuchiura Kyodo General Hospital); Takuji Okusaka, (National Cancer Center Hospital); Fumihiko Kanai (Chiba University); Fukuo Kondo (Teikyo University Hospital); Akiko Saito, (Tokyo Women's Medical University Hospital); Yoshiaki Shimizu, (Narita Red Cross Hospital); Kenichi Takayasu, (National Cancer Center Hospital); Jyunji Furuse, (Kyorin University); Hiroshi Yamamoto, (Chiba Cancer Center); Osamu Yokosuka, (Chiba University); Hiroyuki Yoshidome, (Japanese Red Cross Saitama); Shigeo Yasuda, (NIRS); Hirohiko Tsujii, (NIRS); Tadashi Kamada, (NIRS); Takehide Asano, (Teikyo University Hospital); Ohkohchi Nobuhiro, (University of Tsukuba); Masaharu Yoshikawa, (Chiba University); Takaaki Ikari, (Cancer Institute Hospital); Hirotoshi Kato, (NIRS); Hiroshi Shimada, (Yokohama City University). Publisher Copyright: {\textcopyright} 2018 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.",
year = "2019",
month = jan,
doi = "10.1111/cas.13872",
language = "English (US)",
volume = "110",
pages = "303--309",
journal = "Cancer science",
issn = "1347-9032",
publisher = "Wiley-Blackwell",
number = "1",
}