Journal Article Carbon-ion radiotherapy for inoperable endometrial carcinoma

Irie, Daisuke  ,  Okonogi, Noriyuki  ,  Wakatsuki, Masaru  ,  Kato, Shingo  ,  Ohno, Tatsuya  ,  Karasawa, Kumiko  ,  Kiyohara, Hiroki  ,  Kobayashi, Daijiro  ,  Tsuji, Hiroshi  ,  Nakano, Takashi  ,  Kamada, Tadashi  ,  Shozu, Makio

2018-03 , Oxford University Press
This is a pooled analysis to evaluate the toxicity and efficacy of carbon-ion radiotherapy (C-ion RT) for inoperableendometrial carcinoma. Eligible patients had previously untreated Stage I–III endometrial carcinoma without paraaorticlymph node metastasis. Total dose to the tumor was 62.4–74.4 Gy [relative biological effectiveness (RBE)]in 20 fractions, and the dose to the gastrointestinal tract was limited to <60 Gy (RBE). Intracavitary brachytherapywas not combined in the present study. Fourteen patients with endometrial carcinoma were analyzed. Ten of the14 patients were judged medically inoperable, and the others refused surgery. The numbers of patients withStage I, II and III disease were 1, 9 and 4, respectively. Tumor size was 3.8–13.8 cm in maximum diameter.Median follow-up periods for all patients and surviving patients were 50 months (range, 12–218 months) and 78months (range, 23–218 months), respectively. Two of three patients receiving 62.4–64.8 Gy (RBE) had localrecurrence whereas none of 11 patients receiving 68.0 Gy (RBE) or more had local recurrence. Three patientsdeveloped distant metastases and one of them also had local recurrence. The 5-year local control, progression-freesurvival, overall survival, and cause-specific survival rates were 86%, 64%, 68% and 73%, respectively. No patientdeveloped Grade 3 or higher acute or late toxicity. The present study showed that C-ion RT alone could be a safeand curative treatment modality for inoperable endometrial carcinoma.

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