title: Carbon-Ion Radiation Therapy for Pelvic Recurrence of Rectal Cancer.
abstract: Investigation of the treatment potential of carbon-ion radiation therapy in pelvic recurrence of rectal cancer.
  
  
  
  A phase 1/2 dose escalation study was performed. One hundred eighty patients (186 lesions) with locally recurrent rectal cancer were treated with carbon-ion radiation therapy (CIRT) (phase 1/2: 37 and 143 patients, respectively). The relapse locations were 71 in the presacral region, 82 in the pelvic sidewalls, 28 in the perineum, and 5 near the colorectal anastomosis. A 16-fraction in 4 weeks dose regimen was used, with total dose ranging from 67.2 to 73.6 Gy(RBE); RBE-weighted absorbed dose: 4.2 to 4.6 Gy(RBE)/fraction.
  
  
  
  During phase 1, the highest total dose, 73.6 Gy(RBE), resulted in no grade >3 acute reactions in the 13 patients treated at that dose. Dose escalation was halted at this level, and this dose was used for phase 2, with no other grade >3 acute reactions observed. At 5 years, the local control and survival rates at 73.6 Gy(RBE) were 88% (95% confidence interval [CI], 80%-93%) and 59% (95% CI, 50%-68%), respectively.
  
  
  
  Carbon-ion radiation therapy may be a safe and effective treatment option for locally recurrent rectal cancer and may serve as an alternative to surgery.
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan. Electronic address: s_yamada@nirs.go.jp.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kamada
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan; Brown University Alpert Medical School, Providence, Rhode Island.
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Ebner
authors.affiliation: Ion Beam Therapy Center, SAGA HIMAT Foundation, Saga, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinoto
authors.affiliation: Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Terashima
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Isozaki
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yasuda
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Makishima
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tsuji
authors.affiliation: Research Center Hospital for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Tsujii
authors.affiliation: Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Isozaki
authors.affiliation: Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Endo
authors.affiliation: Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: National Hospital Organization Osaka National Hospital, Osaka, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Sekimoto
authors.affiliation: National Cancer Center Hospital East, Kashiwa, Chiba, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Saito
authors.affiliation: Graduate School of Medicine, Chiba University, Chiba, Japan.
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Matsubara
mesh_terms: D000328:Adult; D000368:Aged; D002244:Carbon; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D005260:Female; D063193:Heavy Ion Radiotherapy / Q000401:mortality* / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000532:radiotherapy*; D010386:Pelvic Neoplasms / Q000401:mortality / Q000517:prevention & control; D015995:Prevalence; D000069473:Radiation Dose Hypofractionation; D012004:Rectal Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D002244:Carbon