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Clin Oncol (R Coll Radiol). 2018 May;30(5):317-329. doi: 10.1016/j.clon.2018.01.006.

Clinical Indications for Carbon Ion Radiotherapy.

Author information

1
University of Texas - Southwestern Medical Center, Department of Radiation Oncology, Dallas, Texas, USA; Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
2
Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
3
Trento Institute for Fundamental Physics and Applications (TIFPA), National Institute of Nuclear Physics (INFN), University of Trento, Povo, Trento, Italy; Department of Physics, University Federico II, Monte S. Angelo, Naples, Italy. Electronic address: Marco.Durante@tifpa.infn.it.

Abstract

Compared with photon and proton therapy, carbon ion radiotherapy (CIRT) offers potentially superior dose distributions, which may permit dose escalation with the potential for improved sparing of adjacent normal tissues. CIRT has increased biological effectiveness leading to increased tumour killing compared with other radiation modalities. Here we review these biophysical properties and provide a comprehensive evaluation of the current clinical evidence available for different tumour types treated with CIRT. We suggest that patient selection for CIRT should move away from the traditional viewpoint, which confines use to deep-seated hypoxic tumours that are adjacent to radiosensitive structures. A more integrated translational approach is required for the future as densely ionising C-ions elicit a distinct signal response pathway compared with sparsely ionising X-rays. This makes CIRT a biologically distinct treatment compared with conventional radiotherapy.

KEYWORDS:

Carbon ion; RBE; high LET; indications; radiation; radiotherapy

PMID:
29402598
DOI:
10.1016/j.clon.2018.01.006
[Indexed for MEDLINE]

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