Carbon-ion Radiotherapy for Oligometastatic Colorectal Cancer in the Liver or Lung

SHINTARO SHIBA; KEI SHIBUYA; MASAHIKO OKAMOTO; NAOKO OKANO; NOBUTERU KUBO; TAKUYA KAMINUMA; HIRO SATO; SHOHEI OKAZAKI; YUHEI MIYASAKA; HIDEMASA KAWAMURA; TATSUYA OHNO

doi:10.21873/anticanres.14967

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Figure 1.
A 65-year-old female with oligometastic sigmoid colon cancer in the liver treated with carbon-ion radiotherapy. A: Contrast-enhanced magnetic resonance imaging in hepatocyte phase before treatment. Yellow arrow shows the tumor with tumor washout. B: 2-Deoxy-2-[¹⁸F]fluoro-D-glucose (FDG) positron-emission tomography before treatment. Yellow arrow shows the tumor with abnormal FDG uptake. C: Dose distribution on axial computed tomographic images. The area within the red outline is the gross tumor volume. The 95% (red), 90% (orange), 80% (yellow), 65% (green), 50% (blue), and 20% (purple) isodose curves are highlighted (100% was 60 Gy relative biological effectiveness). D: Contrast-enhanced magnetic resonance imaging in hepatic phase 3 months after treatment. Contrast-enhanced deterioration is observed at the site of the carbon-ion beam path and no recurrence or residual tumor evident (green arrow). E: FDG positron-emission tomography 12 months after treatment. FDG uptake was reduced compared to that before treatment (green arrow).
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Figure 2.
A 58-year-old male with oligometastic colorectal cancer in lung treated with carbon-ion radiotherapy. A: Plain computed tomography (CT) before treatment. Yellow arrow shows the tumor with contrast enhancement. B: 2-Deoxy-2-[¹⁸F]fluoro-D-glucose (FDG) positron-emission tomography before treatment. Yellow arrow shows the tumor with abnormal FDG uptake. C: Dose distribution on axial CT images. The area within the red outline is the gross tumor volume. The 95% (red), 90% (orange), 80% (yellow), 65% (green), 50% (blue), and 20% (purple) isodose curves are highlighted [100% was 60 Gy (relative biological effectiveness)]. D: Plain CT 12 months after treatment. No recurrence or residual tumor evident (green arrow). E: FDG positron-emission tomography 12 months after treatment. FDG uptake was reduced compared to that before treatment (green arrow).
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Figure 3.
Kaplan–Meier curves of overall survival (OS) (A), local control (LC) (B) and progression-free survival (C) for the whole patient cohort, patients with liver metastases, and those with lung metastases.