[en] The determination of optical parameter type in x-ray pelvimetry was performed on 59 subjects using Fuji computed radiography (FCR). Excellent measurable images were obtained at GT (type A), RT (type P), GA (1.6) and RN (2.0). To reduce maternal and fetal exposure to radiation, the doses were progressively decreased to 50%, 25%, 12.5%, 6.3%, that of conventional screen/film system. One-eighth per cent of conventional radiation dose was minimum for FCR at which measurable images could be obtained. Thereby drastically reducing the radiological exposure to both mother and fetus was possible to obtain measurable images in FCR. (author)

[en] The Heavy Ion Medical Accelerator in Chiba (HIMAC) is the world's first heavy ion accelerator complex dedicated to medical use in a hospital environment. Heavy ions have superior depth-dose distribution and greater cell-killing capability than other forms of radiation. In June 1996, clinical research for the treatment of bone and soft tissue sarcomas was begun using carbon ions generated by the HIMAC. As of February 2010, a total of 507 patients with bone and soft tissue sarcoma were enrolled in these clinical trials. Most of the patients had locally advanced and/or medically inoperable sarcomas. The clinical trials revealed that carbon ion radiotherapy provided definite local control and offered a survival advantage without unacceptable morbidity for patients with bone and soft tissue sarcomas that were hard to cure using other modalities. (author)

[en] Highlights: • We analyzed 64 LAPC patients treated with C-ion RT at single institution. • The median survival time and 2-year OS were 25.1 months and 53%. • Only four patients experienced acute grade 3 toxicities. • C-ion RT for LAPC showed relatively favorable outcome and limited toxicity. - Abstract: PurposeThe aim of this study was to evaluate the efficacy and safety of carbon-ion radiotherapy (C-ion RT) for unresectable locally advanced pancreatic cancer (LAPC).

[en] The purpose of this study was to evaluate the therapeutic outcomes and late toxicities in patients treated by high-dose-rate brachytherapy (HDR-BT) with external beam radiotherapy (EBRT) for localized or locally advanced prostate cancer. From May 2004 to September 2008, 86 men were treated by HDR-BT with EBRT for localized or locally advanced prostate cancer at the National Hospital Organization Kyushu Medical center. The median EBRT and HDR-BT doses were 40 Gy and 30 Gy, respectively. With a median follow-up of 24 months, the 3-year overall, disease specific, and biochemical relapse-free survival rates in all patients were 97.3%, 100%, and 83.6% respectively. The 3-year biochemical relapse-free survival rate of the patients categorized to low or intermediate risk group (91.8%) was significantly better than that of the patients categorized to the high risk group (74.3%) (p=0.042). There was no significant difference of biochemical relapse-free survival regarding to the other clinical factors (age, T-stage, Gleason score, initial prostate-specific antigen level, neoadjuvant hormone therapy, and total dose of EBRT and HDR-BT). Late Grade2 and Grade3 gastrointestinal toxicities were observed in 8 patients (9.3%) and 2 patients (2.3%), respectively. Late Grade2 genitourinary toxicities were observed in 12 patients (13.9%). There was no patient suffered from late Grade3 or greater genitourinary toxicities. HDR-BT with EBRT can be safe and effective for localized or locally advanced prostate cancer. (author)

[en] Purpose: The aim of this study was to clarify the incidence, clinical risk factors, and dose–volume relationship of upper gastrointestinal (GI) ulcer after carbon-ion radiotherapy (C-ion RT) for pancreatic cancer. Materials and methods: Fifty-eight pancreatic cancer patients were treated with C-ion RT from April 2014 to December 2015. The total dose was 55.2 Gy (RBE) in 12 fractions. D_2cm3 of GI tracts were restricted under 46 Gy (RBE); RBE-weighted absorbed dose. The association between dosimetric parameters (V_10–50, D_max, D_1cm3, D_2cm3) and GI ulcer was examined using Spearman’s correlation. The incidence of GI ulcer was compared between the two groups divided by the cutoff value. Results: Twelve patients (21%) experienced gastric ulcer including only one (2%) grade 3 ulcer. There was no grade 4/5 toxicity or duodenal ulcer. V_10–30 was significantly associated with gastric ulcer. The 1-year estimated risk of gastric ulcer for the determined cutoff values were 51% vs. 10% (V₁₀, ⩾102 cm³ or less), 42% vs. 9% (V₂₀, ⩾24 cm³ or less), 34% vs. 4% (V₃₀, ⩾6 cm³ or less). Conclusions: The incidence of GI ulcer after C-ion RT was very low with the dose constraint of D_2cm3 <46 Gy (RBE). To further minimize the risk of GI ulcer, V_10–30 should also be reduced.

[en] Highlights: • The first multicentre study to evaluate carbon ion radiotherapy for sacral chordoma. • The largest cohort of patients among the reports published to date. • Demonstrating high local control and low toxicity rates. • The results of a pioneering institution in Japan were replicated by this study. Usefulness of carbon ion radiotherapy (CIRT) for sacral chordoma has been reported from single institutions. We conducted a retrospective nationwide multicentre study to evaluate the clinical outcomes of CIRT for sacral chordoma in Japan.

[en] 

Purpose

To evaluate the clinical outcome of combination of carbon-ion radiotherapy with separation surgery (CIRT-SS) in patients with primary spinal/paraspinal sarcoma (PSPS) and epidural spinal cord compression (ESCC).

Methods

CIRT-SS was performed in 11 consecutive patients. Patients treated in the primary and salvage settings were categorized into Group A (n = 8) and Group B (n = 3), respectively. Clinical results and imaging findings were collected, with a particular focus on ESCC grade, treatment-associated adverse events (AEs), and the locoregional control (LRC) rate and overall survival (OS).

Results

The median follow-up period from the start of CIRT-SS was 25 months (7–57 months). ESCC was improved by SS in all cases. No patients exhibited radiation-induced myelopathy (RIM), but three developed Grade 3 vertebral compression fracture (VCF) during follow-up. Locoregional recurrences were observed in four patients [Group A: 1 (12.5%), Group B: 3 (100%)]. Over the entire follow-up period, three patients developed distant metastases and two patients died. The 2-year LRC rate and OS were 70% and 80%, respectively.

Conclusion

CIRT-SS in the primary setting achieved acceptable LRC and OS without RIM in patients with PSPS and with ESCC. VCF was the most frequent AE associated with CIRT-SS.

[en] Carbon-ion radiation therapy (CIRT) for advanced non–small-cell lung cancer (NSCLC) has not been well studied to date. This paper aimed to analyze a retrospective multicenter survey for detecting problems with the use of CIRT for Stage II and III NSCLC (7th UICC TNM Staging System). Inclusion was restricted to patients with Stage II and III NSCLC who received CIRT from November 2003 to December 2014. We gathered the data from three CIRT operating centers on July 2015. Patients with radiotherapy history, patients with cancers other than lung cancer, and those receiving palliative therapies were excluded. The patient characteristics, prescribed dose/fraction, survival rates, and adverse effects were analyzed. The total number of patients was 64 (male: 49, female: 15). Of these, 53 patients were medically inoperable. The median age was 76 years (range 46–91), and the median follow-up period was 18.5 months (range 3.2–121.5). The clinical staging consisted of 10 Stage IIA, 30 Stage IIB, 23 Stage IIIA and 1 Stage IIIB. The median prescribed dose was 72.0 Gy (RBE) (range 52.8–72.0) in 16 fractions (range 4–16). The 2-year overall survival, progression-free survival, and local control rates were 62.2% [confidence interval (CI): 47.5–76.9], 42.3% (CI: 28.8–55.8) and 81.8% (CI: 69.9–94.0), respectively. There were no higher than Grade 2 adverse effects observed. CIRT for inoperable Stage II and III NSCLC could be implemented without severe adverse effects, but the clinical staging (including lymph node status) was inhomogeneous. In addition, the prescribed dose and fractionation were not standardized. Further data accumulation and a multiple centers prospective trial for evaluating clinical stage–based results are required.