Table 3.
Clinical outcome in prostate cancer patients treated with carbon ion radiotherapy.
| Authors | Year | No. of patients | Radiation therapy | Median of follow-up | Clinical outcome |
|---|---|---|---|---|---|
| Akakura et al. (34) | 2004 | 96 | Carbon ion | 47 months | 5-year OS: 87.7%; cause-specific survival: 94.9%; clinical recurrence-free survival: 90%; bRFS: 82.6%; local control: 98.5% |
| 54-72 GyE/20 fractions | No grade 3 or worse acute toxicity | ||||
| Grade 1, 2, 3 late GI toxicity: 12, 6, 4 cases, respectively | |||||
| Grade 1, 2, 3 late GU toxicity: 28, 5, 6 cases, respectively | |||||
| Tsuji et al. (35) | 2005 | 201 | Carbon ion | NA | 5-year OS 89.2%; bRFS 83.2%; local control 100% |
| 54-72 GyE/20 fractions | Grade 2 GI and GU toxicity: 1% and 6% | ||||
| 66 GyE/20 fractions | No Grade 3 or higher GI and GU toxicities | ||||
| Ishikawa et al. (36) | 2006 | 175 | Carbon ion | 46 months | 4-year OS and bRFS: 91% and 87% |
| 66 GyE/20 fractions | 4-year bRFS in low-risk and high-risk group: 87% and 88% | ||||
| Grade 2 late GI and GU toxicity: 2% and 5% | |||||
| No Grade 3 or higher toxicities | |||||
| Okada et al. (37) | 2012 | 740 | Carbon ion | 59.3 months | 5-year OS and bRFS: 95.2% and 89.7% |
| 63 or 66 GyE /20 fractions |
Grade 1 and 2 late GI toxicity: 14% and 2.4% | ||||
| 57.6GyE/16 fractions | Grade 1, 2 and 3 late GU toxicity: 43.1%, 7.8% and 0.2% | ||||
| GU toxicity with 57.6 GyE/16 fractions was lower than 63 or 66 GyE/20 fractions | |||||
| Nomiya et al. (38) | 2014 | 46 | Carbon ion | 32.3 months | Grade1 late toxicity of rectal hemorrhage: 7% |
| 51.6GyE/12 fractions | Grade1 late toxicity of hematuria: 13% | ||||
| Grade1late toxicity of urinary frequency: 37% | |||||
| No ≥Grade 2 late toxicities | |||||
| Grade2 acute toxicity of urinary frequency: 4% | |||||
| No other grade 2 acute toxicities | |||||
| Nomiya et al. (39) | 2016 | 2157 | Carbon ion | 43 months in NIRS | 5-year bRFS in low-, intermediate-, and high-risk patients: 92%, 89%, 92% |
| 63 or 66 GyE/20 fractions | 23 months in GHMC | 5-year CSS in low-, intermediate-, and high-risk patients: 100%, 100%, 99% | |||
| 57.6GyE/16 fractions | 7 months in HIMAT | 5-year LCR in low-, intermediate-, and high-risk patients: 98%, 96%, 99% | |||
| 51.6GyE/12 fractions | 29 months in all surviving patients | 5-year OS in low-, intermediate-, and high-risk patients: 100%, 99%, 96% | |||
| Grade 2 late GU and GI toxicities: 4.6% and 0.4% | |||||
| No Grade 3 or higher late toxicities | |||||
| Habl et al. (40) | 2016 | 91 | Proton (arm A, n=46) | 22.3 months | Grade 1 cystitis: 34.1% (39.1% in A; 28.9% in B) |
| Carbon ion (arm B, n=45) |
Grade 2 cystitis: 17.6% (21.7% in A; 13.3% in B) | ||||
| 66 GyE/20 fractions | Grade 1 radiation proctitis: 12.1% (13.0% in A; 11.1% in B) | ||||
| Grade 2 radiation proctitis: 5.5% (8.7% in A; 2.2% in B). | |||||
| Grade 3 radiation proctitis: 2.2% (4.3% in A; 0% in B) | |||||
| Grade 1 diarrhea: 58.2% (60.9% in A; 55.6% in B) | |||||
| Grade 2 diarrhea: 4.4% (8.7% in A; 0% in B) | |||||
| Kasuya et al. (41) | 2017 | 608 | Carbon ion | 88.4 months | 5-/10-year PCa-specific mortality rates were 1.5%/4.3% |
| 63 or 66 GyE /20 fractions |
|||||
| 57.6 GyE/16 fractions | |||||
| Zhang et al. (42) | 2019 | 64 | Carbon ion | 19 months | Grade 1 acute GU toxicity: 20.3% |
| 59.2-60.8 GyE /16 fractions |
Grade 2 acute GU toxicity: 10.9% | ||||
| 66 GyE/24 fractions | Grade 1 late GU toxicity: 3.1% | ||||
| Grade 2 late GU toxicity: 1.6% | |||||
| No acute or late GI toxicity | |||||
| Takakusagi et al. (43) | 2020 | 253 | Carbon ion | 35.3 months | 3-year bRFS in low-, intermediate-, and high-risk patients: 87.5%, 88%, 97.5% |
| 51.6GyE/12 fractions | Grade 2 acute urinary toxicity: 4.7% | ||||
| No grade 2 acute rectal toxicity | |||||
| Grade 2 late GU and GI: 6.7% and 1.2% | |||||
| Kawamura et al. (44) | 2020 | 304 | Carbon ion | 60 months | 5-year bRFS, OS, local control: 92.7%, 96.6%, 98.4% |
| 57.6GyE/16 fractions | 5-year bRFS in low-, intermediate-, and high-risk patients: 91.7%, 93.4%, 92% | ||||
| Late grade 2 GU and GI: 9% and 0.3% | |||||
| Late grade 3 GU and GI: 0.3% and 0% | |||||
| No grade 3 or great acute toxicity | |||||
| Sato et al. (45) | 2021 | 256 | Carbon ion | 7 years | 5-year bRFS in low-, intermediate-, and high-risk patients: 95.1%, 90.9%, 91.1% |
| 51.6GyE/12 fractions | Late grade 2 GU and GI: 6.3% and 0.4% | ||||
| No grade 3 or higher toxicities | |||||
OS, overall survival; bRFS, biochemical recurrence-free survival; CSS, cause-specific survival; LCR, local control rate; GI, Gastrointestinal; GU, genitourinary; NA, not available; NIRS, National Institute of Radiological Sciences; GHMC, Gunma University Heavy Ion Medical Center; HIMAT, Ion Beam Therapy Center, SAGA HIMAT Foundation.