Respiration-gated fast-rescanning carbon-ion radiotherapy.
Phase-controlled rescanning of the carbon-ion beam offers fast and precise dose application with decreased irradiation of normal tissue. However, organ movement with respiration remains a unique challenge. Technological development has enabled the simultaneous application of beam-energy-modulated markerless phase-controlled rescanning with respiration gating, allowing scanning treatment of respiration-mobile tumors with carbon. A total of 10 patients with tumors in the liver or lung were treated in a feasibility study at our facility using this combination. At a median of 10.5 months, follow-up examination including computed tomography/magnetic resonance imaging revealed no grade 2+ acute adverse effects with this new therapy. Two patients with complex disease experienced local recurrence, which may be improved with increased dose delivery. One patient died of unrelated causes. All other patients are alive with good control at the time of writing. Though long-term observation is pending, these are promising initial results for use of the carbon-beam phase-controlled rescanning method in respiration-mobile disease.
Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology , Chiba, Japan.|Brown University Alpert Medical School , Providence, RI, USA.
Daniel K
DK
Ebner
Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology , Chiba, Japan tsuji.hiroshi@qst.go.jp.
Hiroshi
H
Tsuji
Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology , Chiba, Japan.
Shigeo
S
Yasuda
Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology , Chiba, Japan.
Naoyoshi
N
Yamamoto
Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology , Chiba, Japan.
Shinichiro
S
Mori
Hospital of the National Institute of Radiological Sciences, National Institutes of Quantum and Radiological Science and Technology , Chiba, Japan.
Tadashi
T
Kamada
D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D056973:Four-Dimensional Computed Tomography; D063193:Heavy Ion Radiotherapy / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008168:Lung / Q000000981:diagnostic imaging; D008175:Lung Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local; D012119:Respiration; D012871:Skin Diseases / Q000209:etiology; D015996:Survival Rate
carbon-ion radiotherapy; clinical trial; respiration gating; scanning method