title: Phase 1 trial of preoperative, short-course carbon-ion radiotherapy for patients with resectable pancreatic cancer.
abstract: BACKGROUND
  The authors evaluated the tolerance and efficacy of carbon-ion radiotherapy (CIRT) as a short-course, preoperative treatment and determined the recommended dose needed to reduce the risk of postoperative local recurrence without excess injury to normal tissue.
  
  
  METHODS
  Patients radiographically defined with potentially resectable pancreatic cancer were eligible. A preoperative, short-course, dose-escalation study was performed with fixed 8 fractions in 2 weeks. The dose of irradiation was increased by 5% increments from 30 grays equivalents (GyE) to 36.8 GyE. Surgery was to be performed 2 to 4 weeks after the completion of CIRT.
  
  
  RESULTS
  The study enrolled 26 patients. At the time of restaging after CIRT, disease progression with distant metastasis or refusal ruled out 5 patients from surgery. Twenty-one of 26 patients (81%) patients underwent surgery. The pattern of initial disease progression was distant metastasis in 17 patients (65%) and regional recurrence in 2 patients (8%). No patients experienced local recurrence. The 5-year survival rates for all 26 patients and for those who underwent surgery were 42% and 52%, respectively.
  
  
  CONCLUSIONS
  Preoperative, short-course CIRT followed by surgery is feasible and tolerable without unacceptable morbidity.
authors: Hospital of Research Center for Charged Particle Therapy, National Institute of Radiological Sciences. Chiba, Japan. shinoto@nirs.go.jp
authors: Makoto
authors: M
authors: Shinoto
authors: Shigeru
authors: S
authors: Yamada
authors: Shigeo
authors: S
authors: Yasuda
authors: Hiroshi
authors: H
authors: Imada
authors: Yoshiyuki
authors: Y
authors: Shioyama
authors: Hiroshi
authors: H
authors: Honda
authors: Tadashi
authors: T
authors: Kamada
authors: Hirohiko
authors: H
authors: Tsujii
authors: Hiromitsu
authors: H
authors: Saisho
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D063193:Heavy Ion Radiotherapy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000379:methods; D015996:Survival Rate