@inproceedings{oai:repo.qst.go.jp:00054396,
 author = {Shinoto, Makoto and Yamada, Shigeru and Yasuda, Shigeo and Imada, Hiroshi and Kamada, Tadashi and Tsujii, Hirohiko and 篠藤 誠 and 山田 滋 and 安田 茂雄 and 今田 浩史 and 鎌田 正 and 辻井 博彦},
 book = {International Journal of Radiation Oncology Biology Physics},
 issue = {2},
 month = {},
 note = {Purpose/Objective(s):Complete surgical resection is the only curative treatment for pancreatic cancer. Even if a curative resection is performed, the disease usually recurs, and the half of the failure pattern is local recurrence. We examined the effect of short course preoperative carbon-ion radiotherapy (CIRT) in terms of reducing the rate of local recurrence in patients undergoing resection for adenocarcinoma of the pancreas.
Materials/Methods: Patients with radiographically resectable pancreatic cancer were enrolled from October 2003 to July 2010. Eligibility included no CT involvement of celiac artery or SMA; adequate renal, hepatic and hematopoietic function; and ECOG PS 0-2. CIRT was given once daily, 4 days a week, for a fixed 8 fractions in 2 weeks. The dose was set to 30.0GyE and escalated to 36.8GyE at 5% increments with 5 levels. Treatment volumes included the location of the primary tumor and regional lymph nodes and retroperitoneal area. Surgery was performed 2-4 weeks after completion of CIRT.
Results: Twenty-eight patients were enrolled on study. Twenty-five patients are eligible for this analysis. Five patients were treated at each of dose levels 1-2. Three patients were at dose level 3. Six patients were at each of dose levels 4-5. Twenty-one patients (84%) underwent resection. Reasons for no resections were: metastatic disease-3 and refusal-1 those were at dose levels 1-2. Although grade 3/4 toxicities were noted in 2 patients (liver abscess-1, PV thrombus-1), both of them were unrelated directly to CIRT. Median follow-up time is 13.9 months (range, 3.2-73.1). There has been on local failure in postoperative patients. Metastatic failure has occurred in 17 out of 25 patients (68%). Five-year survival rates in all patients and postoperative patients are 39% and 48%, respectively.
Conclusions: Short course preoperative CIRT seems to be a safe and effective modality in the management of resectable pancreatic cancer, providing satisfactory local control and offering a survival advantage without unacceptable morbidity.},
 title = {Efficacy  and  Safety of Short Course Carbon-ion Radiotherapy for Patients with Preoperative Pancreatic Cancer},
 volume = {82},
 year = {2011}
}