scholarly journals Mixed Photon and Carbon-Ion Beam Radiotherapy in the Management of Non-Metastatic Nasopharyngeal Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Jiyi Hu ◽  
Qingting Huang ◽  
Jing Gao ◽  
Weixu Hu ◽  
Jing Yang ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Local Control ◽  
Ion Beam ◽  
Cervical Lymphadenopathy ◽  
Heavy Ion ◽  
Toxicity Profile ◽  
Carbon Ion ◽  
Regional Control ◽  
Mixed Treatment

BackgroundCarbon-ion radiotherapy (CIRT) may further increase the therapeutic ratio for patients with newly diagnosed nasopharyngeal carcinoma (NPC). The purpose of the current study is to examine the effectiveness and toxicity profile of photon-based intensity-modulated radiotherapy (IMRT) plus CIRT boost in a relatively large cohort of NPC patients.MethodsIn the current study, non-metastatic NPC patients treated with IMRT plus CIRT boost at Shanghai Proton and Heavy Ion Center between June, 2015 and June, 2018 were included. Overall survival (OS), progression-free survival (PFS), local control, regional control, and distant control were calculated with Kaplan–Meier method. Acute and late toxicities were graded using CTCAE 4.03.ResultsA total of 69 patients were included in the analysis. Among those, 74% of the patients had locoregionally advanced (stage III/IV) disease, and 92.8% had cervical lymphadenopathy. With a median follow-up of 31.9 months, the 3-year OS, PFS, local control, regional control, and distant control rates were 94.9, 85.2, 96.9, 98.4, and 89.7%, respectively. Mixed treatment of IMRT with CIRT boost was well tolerated. Severe acute toxicities induced by radiation therapy were observed in only two patients (dermatitis). No severe radiation-induced late toxicity was observed at the time of analysis. Univariable analysis showed N2/3 disease was correlated with an inferior distant control (p = 0.040).ConclusionMixed treatment of IMRT plus CIRT boost provides an excellent disease control and a favorable toxicity profile for patients with non-metastatic NPC. Further follow-up is necessary to evaluate the long-term survivals and toxicities more accurately.

scholarly journals Bimodal Radiotherapy with Active Raster-Scanning Carbon Ion Radiotherapy and Intensity-Modulated Radiotherapy in High-Risk Nasopharyngeal Carcinoma Results in Excellent Local Control

Cancers ◽  
2019 ◽  
Vol 11 (3) ◽  
pp. 379 ◽  
Author(s):  
Sati Akbaba ◽  
Thomas Held ◽  
Kristin Lang ◽  
Tobias Forster ◽  
Philippe Federspil ◽  
...  
Keyword(s):  
High Risk ◽  
Nasopharyngeal Carcinoma ◽  
Local Control ◽  
Intensity Modulated Radiotherapy ◽  
Carbon Ion ◽  
Raster Scanning ◽  
Intensity Modulated ◽  
Grade 3 ◽  
Tumor Remission

Background: In this analysis, we aimed to present the first results of carbon ion radiotherapy (CIRT), which is known for its conformal dose distribution and increased biological effectiveness in the treatment of high-risk nasopharyngeal carcinoma (NPC). Methods: We retrospectively analyzed twenty-six consecutive patients who had been treated at our center with CIRT for high-risk NPC between 2009 and 2018. Carbon ion (C12) boost was applied in a bimodal setting combined with intensity-modulated radiotherapy (IMRT) base plan. The median cumulative total dose was 74 Gy (RBE), and patients with inoperable (n = 17, 65%) or incompletely resected (n = 7, 27%) tumors were included in the analysis. Overall, 81% received concomitant chemotherapy (n = 21). Results: The median follow-up time was 40 months (range 10–97 months) for all patients. At the last follow-up, 92% of the patients were still alive. We could identify excellent tumor response with complete tumor remission (CR) in 60% (n = 15/25), partial tumor remission (PR) in 20% (n = 5/25), and stable disease (SD) in 12% (n = 3/25) of the patients according to the RECIST (Response Evaluation Criteria in Solid Tumors) criteria. Despite unfavorable tumor characteristics, only one patient showed a locally in-field recurrence after 56 months (4%) and another patient a locoregional recurrence in the unilateral cervical lymph nodes after 21 months (4%). The 2-year local control (LC), distant progression-free survival (DPFS), and overall survival (OS) were 95%, 93%, and 100% and the estimated 5-year LC, DPFS, and OS were 90%, 86%, and 86%, respectively. Overall, treatment was tolerated well with 20% acute and 16% chronic grade 3 side effects. No toxicity greater than grade 3 occurred. Conclusion: Bimodal radiotherapy including IMRT and active raster-scanning CIRT for high-risk nasopharyngeal cancer is a safe treatment method resulting in moderate toxicity and excellent local control. A larger patient number and longer follow-up time would be necessary to strengthen the current findings.

scholarly journals Accelerated Hypofractionated Active Raster-Scanned Carbon Ion Radiotherapy (CIRT) for Laryngeal Malignancies: Feasibility and Safety

Cancers ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 388 ◽  
Author(s):  
Sati Akbaba ◽  
Kristin Lang ◽  
Thomas Held ◽  
Olcay Bulut ◽  
Matthias Mattke ◽  
...  
Keyword(s):  
Local Control ◽  
Lung Metastases ◽  
Ion Beam ◽  
Progression Free Survival ◽  
Carbon Ion Radiotherapy ◽  
Carbon Ions ◽  
Carbon Ion ◽  
Swallowing Problems ◽  
Grade 3

(1) Background: The authors present the first results of active raster-scanned carbon ion radiotherapy (CIRT) for radioresistant laryngeal malignancies regarding efficacy and toxicity. (2) Methods: 15 patients with laryngeal adenoid cystic carcinoma (ACC; n = 8; 53.3%) or chondrosarcoma (CS; n = 7; 46.7%) who underwent radiotherapy with carbon ions (C12) at the Heidelberg Ion Beam Therapy Center (HIT) between 2013 and 2018 were identified retrospectively and analyzed for local control (LC), overall survival (OS), and distant progression-free survival using the Kaplan–Meier method. CIRT was applied either alone (n = 7, 46.7%) or in combination with intensity modulated radiotherapy (IMRT) (n = 8, 53.3%). The toxicity was assessed according to the Common Toxicity Terminology Criteria for Adverse Events (CTCAE) v4.03. (3). Results: the median follow-up was 24 months (range 5–61 months). Overall, the therapy was tolerated very well. No grade >3 acute and chronic toxicity could be identified. The most reported acute grade 3 side effects were acute dysphagia (n = 2; 13%) and acute odynophagia (n = 3; 20%), making supportive nutrition via gastric tube (n = 2; 13.3%) and via high caloric drinks (n = 1; 6.7%) necessary due to swallowing problems (n = 4; 27%). Overall, chronic grade 3 toxicity in the form of chronic hoarseness occurred in 7% of the patients (n = 1; 7%). At the last follow-up, all the patients were alive. No local or locoregional recurrence could be identified. Only one patient with laryngeal ACC developed lung metastases three years after the first diagnosis. (4) Conclusions: the accelerated hypofractionated active raster-scanned carbon ion radiotherapy for radioresistant laryngeal malignancies is feasible in practice with excellent local control rates and moderate acute and late toxicity. Further follow-ups are necessary to evaluate the long-term clinical outcome.

scholarly journals The Effect of Argon and Carbon Ion After Heavy Ion Beam Irradiation of Toraja Local Rice

2019 ◽  
Vol 305 ◽  
pp. 012055
Author(s):  
S Rinaldi ◽  
M Riadi ◽  
Rafiuddin ◽  
AR Trisnawaty ◽  
M M Putra ◽  
...  
Keyword(s):  
Ion Beam ◽  
Heavy Ion ◽  
Beam Irradiation ◽  
Ion Beam Irradiation ◽  
Carbon Ion ◽  
Heavy Ion Beam

Efficacy and Safety of Carbon Ion Radiotherapy in Bone and Soft Tissue Sarcomas

2002 ◽  
Vol 20 (22) ◽  
pp. 4466-4471 ◽  
Author(s):  
Tadashi Kamada ◽  
Hirohiko Tsujii ◽  
Hiroshi Tsuji ◽  
Tsuyoshi Yanagi ◽  
Jun-etsu Mizoe ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Total Dose ◽  
Local Control ◽  
Dose Escalation ◽  
Soft Tissue Sarcomas ◽  
Carbon Ion Radiotherapy ◽  
Skin Reactions ◽  
Carbon Ion ◽  
Acute Skin Reactions

PURPOSE: To evaluate the tolerance for and effectiveness of carbon ion radiotherapy in patients with unresectable bone and soft tissue sarcomas. PATIENTS AND METHODS: We conducted a phase I/II dose escalation study of carbon ion radiotherapy. Fifty-seven patients with 64 sites of bone and soft tissue sarcomas not suited for resection received carbon ion radiotherapy. Tumors involved the spine or paraspinous soft tissues in 19 patients, pelvis in 32 patients, and extremities in six patients. The total dose ranged from 52.8 to 73.6 gray equivalent (GyE) and was administered in 16 fixed fractions over 4 weeks (3.3 to 4.6 GyE/fraction). The median tumor size was 559 cm3 (range, 20 to 2,290 cm3). The minimum follow-up was 18 months. RESULTS: Seven of 17 patients treated with the highest total dose of 73.6 GyE experienced Radiation Therapy Oncology Group grade 3 acute skin reactions. Dose escalation was then halted at this level. No other severe acute reactions (grade > 3) were observed in this series. The overall local control rates were 88% and 73% at 1 year and 3 years of follow-up, respectively. The median survival time was 31 months (range, 2 to 60 months), and the 1- and 3-year overall survival rates were 82% and 46%, respectively. CONCLUSION: Carbon ion radiotherapy seems to be a safe and effective modality in the management of bone and soft tissue sarcomas not eligible for surgical resection, providing good local control and offering a survival advantage without unacceptable morbidity.

scholarly journals Evaluation of Toraja (Indonesia) local aromatic rice mutant developed using heavy-ion beam irradiation

2021 ◽  
Vol 22 (8) ◽  
Author(s):  
Andi Muliarni Okasa ◽  
Rinaldi Sjahril ◽  
Muhammad Riadi ◽  
Meta Mahendradatta ◽  
Tadashi Sato ◽  
...  
Keyword(s):  
Ion Beam ◽  
Heavy Ion ◽  
Phenotypic Traits ◽  
Aromatic Rice ◽  
Beam Irradiation ◽  
Ion Beam Irradiation ◽  
Carbon Ion ◽  
Rice Mutant ◽  
Heavy Ion Beam ◽  
Argon Ion

Abstract. Okasa AM, Sjahril R, Riadi M, Mahendradatta M, Sato T, Toriyama K, Ishii K, Hayashi Y, Abe T. 2021. Evaluation of Toraja (Indonesia) local aromatic rice mutant developed using heavy-ion beam irradiation. Biodiversitas 22: 3474-3481. The aromatic local Toraja rice "Pare Bau" has a good grain quality and aroma. However, it has some disadvantages, including a late heading and low yield for a modern farming system. This study aims to evaluate and select early heading as well as high yield mutant lines induced by heavy-ion beam irradiation. Furthermore, dry seeds of Pare Bau were irradiated with Argon-ion (300 keV/?m) and Carbon-ion (30 keV/?m) at RI-beam factory, RIKEN Nishina Center, Japan. The germination percentages of the M1 seeds were 49% for Pare Bau irradiated with Argon-ion (PB-A), 53% for Pare Bau irradiated with Carbon-ion (PB-C), and 70% for the Control. The 13 PB-A and 13 PB-C M1 plants were selected, and the seeds were sampled in the paddy field of Hasanuddin University (20 m asl.), Makassar. During the following planting season, the M2 generation plant was examined in Enrekang District (650 m asl.), South Sulawesi, Indonesia. Based on the early heading and a larger number of panicles, the 18 PB-A and one PB-C M3 line were selected from a total of 404 M2 survival plants. The selected lines and control were grouped into seven clusters based on the quantitative phenotypic traits, indicating the existence of genetic variability. The plant yield was significantly correlated with plant height, the number of tillers, the number of panicles, as well as grain weight per panicle, which showed that these traits are good criteria for selection.

scholarly journals Dose Escalated Carbon Ion Radiotherapy for Localized Prostate Cancer in Shanghai Proton and Heavy Ion Center: Toxicity and Efficacy Outcomes At Two Years.

2021 ◽  
Author(s):  
Ping Li ◽  
Zhengshan Hong ◽  
Yongqiang Li ◽  
Xiaomao Guo ◽  
Shen Fu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Late Toxicity ◽  
Heavy Ion ◽  
Carbon Ion Radiotherapy ◽  
Localized Prostate Cancer ◽  
Cancer Specific Survival ◽  
Free Survival ◽  
Carbon Ion ◽  
Spot Scanning

Abstract Purpose: The purpose of this study was to prospectively analyze the safety and feasibility of spot scanning carbon ion radiotherapy (CIRT) for patients with localized prostate cancer.Methods: 118 localized prostate cancer patients treated with spot scanning CIRT at Shanghai Proton and Heavy Ion Center (SPHIC) were enrolled in this dose escalated study. The dose was gradually increased from 59.2GyE to 65.6GyE in 16 fractions. The primary endpoint was the acute and late toxicities. Secondary endpoints were biochemical relapse free survival (bRFS), distant metastasis free survival (DMFS), prostate cancer-specific survival (PCSS), and overall survival (OS).Results: The median follow-up time was 30.2 months (4.8-62.7 months). Acute grade 1 and 2 genitourinary (GU) toxicities were 15.3% and 18.6%, while acute grade 1 and 2 gastrointestinal (GI) toxicities were 2.5% and 0%, respectively. Late grade 1 and 2 GU toxicities were 4.2% and 1.7%, respectively. No late GI toxicity were observed. There were no cases of severe acute or late toxicity (≥grade 3). The significant association was not found between the factors and the acute GU toxicities except for CTV volume (p=0.031) on multivariate analysis. The 2-year bRFS, DMFS, PCSS, OS were 100%, 100%, 100% and 98.8%, respectively.Conclusion: The 2 years’ outcomes are encouraging, providing additional and useful information on the feasibility and safety of spot scanning CIRT for prostate cancer. Long term follow-up and prospective multi-institutional data are warranted to reinforce the role of CIRT in the management of localized prostate cancer.Trial registration: Clinicaltrial, NCT02739659. Registered 15 April 2016

The Effects of Heavy Ion Particles on Human Megakaryocytopoiesis and Thrombopoiesis.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4156-4156
Author(s):  
Ikuo Kashiwakura ◽  
Kenji Takahashi ◽  
Satoru Monzen ◽  
Kiyomi Eguchi-Kasai ◽  
Tsutomu Toki ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Ion Beam ◽  
Heavy Ion ◽  
X Rays ◽  
Dna Double Strand Breaks ◽  
Nuclear Facilities ◽  
Plasma Clot ◽  
Carbon Ion ◽  
X Ray ◽  
Carbon Ion Beam

Abstract Heavy ion particles provide unique properties in radiotherapy. However, they have also been shown to pose high risks for both work at nuclear facilities and astronauts participating in space missions. In a previous study, we demonstrated that in radio-sensitive megakaryocyte progenitor cells, namely colony-forming unit megakaryocytes (CFU-Meg), a degree of X-ray-induced damage was prevented by post-treatment with several cytokines. In this study, we analyzed the effects of heavy ion particles on megakaryocytopoiesis and thrombopoiesis. The CD34+ CFU-Meg were isolated from human placental and umbilical cord blood using a magnetic isolation kit and then were exposed to a carbon ion beam (LET=50 KeV/mm). They were cultured in a serum free medium supplemented with a thrombopoietin (TPO) alone or a combination of TPO plus other cytokines including stem cell factor, interleukin-3 (IL-3) and Flt3-ligand. The number of CFU-Meg was calculated by a plasma clot technique. The differentiation into megakaryocytes (CD41+) and the release of platelets (CD42a+) in a liquid culture were both analyzed by flow cytometry. The increase of gamma-H2AX, a marker of DNA double-strand breaks (DSBs) was also detected by flow cytometry. The sensitivity of CFU-Meg to a carbon ion beam was found to be extremely high and could not be lowered by any type of cytokines unlike X-rays. However, treatment with TPO plus IL-3 potentially induced megakaryocytopoiesis and thrombopoiesis at 14 days after the exposure to a carbon ion beam at 2 Gy. The cytokine treatment enhanced the induction of gamma-H2AX in X-ray-irradiated CD34+ CFU-Meg but not in a carbon ion beam-irradiated one. These results show that not only the downregulation of death signals, but also the repair of DSBs was less strongly promoted by cytokines in CFU-Meg exposed to a carbon ion beam than X-rays. Different treatments therefore are required to protect against megakaryocytopoiesis and thrombopoiesis damage by heavy ion particles.

scholarly journals Dose escalation via brachytherapy boost for nasopharyngeal carcinoma in the era of intensity-modulated radiation therapy and combined chemotherapy

2017 ◽  
Vol 58 (5) ◽  
pp. 654-660 ◽  
Author(s):  
Hsing-Lung Chao ◽  
Shao-Cheng Liu ◽  
Chih-Cheng Tsao ◽  
Kuen-Tze Lin ◽  
Steve P Lee ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Nasopharyngeal Carcinoma ◽  
Local Control ◽  
Dose Escalation ◽  
Intensity Modulated Radiation Therapy ◽  
Intracavitary Brachytherapy ◽  
Intensity Modulated ◽  
Brachytherapy Boost ◽  
Chemoradiation Treatment

ABSTRACT To investigate if dose escalation using intracavitary brachytherapy (ICBT) improves local control for nasopharyngeal carcinoma (NPC) in the era of intensity-modulated radiation therapy (IMRT) and concurrent chemoradiation treatment (CCRT). We retrospectively analyzed 232 patients with Stage T1–3 N0–3 M0 NPC who underwent definitive IMRT with or without additional ICBT boost between 2002 and 2013. For most of the 124 patients who had ICBT boost, the additional brachytherapy was given as 6 Gy in 2 fractions completed within 1 week after IMRT of 70 Gy. CCRT with or without adjuvant chemotherapy was used for 176 patients, including 88 with and 88 without ICBT boost, respectively. The mean follow-up time was 63.1 months. The 5-year overall survival and local control rates were 81.5% and 91.5%, respectively. ICBT was not associated with local control prediction (P = 0.228). However, in a subgroup analysis, 75 T1 patients with ICBT boost had significantly better local control than the other 71 T1 patients without ICBT boost (98.1% vs 85.9%, P = 0.020), despite having fewer patients who had undergone chemotherapy (60.0% vs 76.1%, P = 0.038). Multivariate analysis showed that both ICBT (P = 0.029) and chemotherapy (P = 0.047) influenced local control for T1 patients. Our study demonstrated that dose escalation with ICBT can improve local control of the primary tumor for NPC patients with T1 disease treated with IMRT, even without chemotherapy.

scholarly journals Proteomic analysis of effects by x-rays and heavy ion in HeLa cells

2014 ◽  
Vol 48 (2) ◽  
pp. 142-154 ◽  
Author(s):  
Zhitong Bing ◽  
Guanghui Yang ◽  
Yanan Zhang ◽  
Fengling Wang ◽  
Caiyong Ye ◽  
...  
Keyword(s):  
Cell Line ◽  
Hela Cells ◽  
Biological Effects ◽  
Ion Beam ◽  
Heavy Ion ◽  
X Rays ◽  
Stable Isotope Labelling ◽  
Carbon Ion ◽  
Cell Line Hela ◽  
Line Hela

Abstract Background. Carbon ion therapy may be better against cancer than the effects of a photon beam. To investigate a biological advantage of carbon ion beam over X-rays, the radioresistant cell line HeLa cells were used. Radiationinduced changes in the biological processes were investigated post-irradiation at 1 h by a clinically relevant radiation dose (2 Gy X-ray and 2 Gy carbon beam). The differential expression proteins were collected for analysing biological effects. Materials and methods. The radioresistant cell line Hela cells were used. In our study, the stable isotope labelling with amino acids (SILAC) method coupled with 2D-LC-LTQ Orbitrap mass spectrometry was applied to identity and quantify the differentially expressed proteins after irradiation. The Western blotting experiment was used to validate the data. Results. A total of 123 and 155 significantly changed proteins were evaluated with treatment of 2 Gy carbon and X-rays after radiation 1 h, respectively. These deregulated proteins were found to be mainly involved in several kinds of metabolism processes through Gene Ontology (GO) enrichment analysis. The two groups perform different response to different types of irradiation. Conclusions. The radioresistance of the cancer cells treated with 2 Gy X-rays irradiation may be largely due to glycolysis enhancement, while the greater killing effect of 2 Gy carbon may be due to unchanged glycolysis and decreased amino acid metabolism.

scholarly journals Carbon ion radiotherapy as definitive treatment in locally recurrent pancreatic cancer

2021 ◽  
Author(s):  
Jakob Liermann ◽  
Edgar Ben-Josef ◽  
Mustafa Syed ◽  
Juergen Debus ◽  
Klaus Herfarth ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Local Control ◽  
Ion Beam ◽  
Carbon Ion Radiotherapy ◽  
Definitive Treatment ◽  
Carbon Ions ◽  
Carbon Ion ◽  
Recurrent Pancreatic Cancer ◽  
Locally Recurrent

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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