Skip to main content
Log in

The Effects of Carbon Ion Irradiation Revealed by Excised Perforated Intestines as a Late Morbidity for Uterine Cancer Treatment

  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

Clinical trials of carbon ion therapy have been performed due to the advantages of high-dose energy delivery with precise localization control to targeted organs and strong cell-killing activities to cancers. Perforated intestines as a late morbidity after carbon ion radiotherapy for uterine cancers were examined to reveal the biological characteristics of carbon ion for future applications for the treatment of gastrointestinal cancers.

Methods

Between June 1995 and December 2004, 94 patients with carcinoma of the uterine cervix or corpus were treated with carbon ion therapy. Among them, 9 patients (9.6%) developed major late gastrointestinal (GI) complications. Four out of 9 patients had intestinal perforations excised operatively at our institute. The postoperative clinical courses and histopathological findings of the excised intestine were investigated.

Results

Carbon ion irradiation severely damaged smooth muscle layers by coagulation necrosis as well as atrophy of the intestinal epithelium and middle-sized arterial thromboses of the intestines. After evaluating late complications, the dose constraints on the GI tracts were set under 60 GyE to prevent major complications. Thereafter, the incidence of major GI complications markedly decreased.

Conclusion

Our findings demonstrated the characteristic histopathological effects of carbon ion radiotherapy and thus are expected to facilitate future additional applications of carbon ion radiotherapy for the treatment of gastrointestinal cancers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. M Imamura S Sawada M Kasahara-Imamura K Harima K Harada (2002) ArticleTitleSynergistic cell-killing effect of a combination of hyperthermia and heavy ion beam irradiation: in expectation of a breakthrough in the treatment of refractory cancers (review) Int J Mol Med 9 11–8 Occurrence Handle11744989 Occurrence Handle1:CAS:528:DC%2BD38XlvF2rtQ%3D%3D

    PubMed  CAS  Google Scholar 

  2. I Asakawa H Yoshimura A Takahashi K Ohnishi H Nakagawa I Ota et al. (2002) ArticleTitleRadiation-induced growth inhibition in transplanted human tongue carcinomas with different p53 gene status Anticancer Res 22 2037–43 Occurrence Handle12174881 Occurrence Handle1:CAS:528:DC%2BD38XmsF2lsbg%3D

    PubMed  CAS  Google Scholar 

  3. Y Iwadate J Mizoe Y Osaka A Yamaura H Tsujii (2001) ArticleTitleHigh linear energy transfer carbon radiation effectively kills cultured glioma cells with either mutant or wild-type p53 Int J Radiat Oncol Biol Phys 50 803–8 Occurrence Handle11395250 Occurrence Handle1:CAS:528:DC%2BD3MXktVOiurw%3D Occurrence Handle10.1016/S0360-3016(01)01514-0

    Article  PubMed  CAS  Google Scholar 

  4. T Ofuchi M Suzuki Y Kase K ando K Isono T Ochiai (1999) ArticleTitleChromosome breakage and cell lethality in human hepatoma cells irradiated with X rays and carbon-ion beams J Radiat Res 40 125–33 Occurrence Handle10494144 Occurrence Handle1:STN:280:DyaK1Mvitl2itQ%3D%3D Occurrence Handle10.1269/jrr.40.125

    Article  PubMed  CAS  Google Scholar 

  5. TW Griffin (Eds) (1992) Particle-beam radiation therapy. Principles and practice of radiation oncology EditionNumber2nd ed. Lippincott Philadelphia

    Google Scholar 

  6. H Tsujii J Mizoe T Kamada (2002) Experiences of carbon ion radiotherapy at NIRS HD Kogelnik P Lukas Sedlmayer (Eds) Progress in radio-oncology VII Monduzzi Editore Bologna 393–405

    Google Scholar 

  7. D Schulz-Ertner A Nikoghosyan O Jakel T Haberer G Kraft M Scholz et al. (2003) ArticleTitleFeasibility and toxicity of combined photon and carbon ion radiotherapy for locally advanced adenoid cystic carcinomas Int J Radiat Oncol Biol Phys 56 391–8 Occurrence Handle12738314 Occurrence Handle10.1016/S0360-3016(02)04511-X

    Article  PubMed  Google Scholar 

  8. T Kamada H Tsujii H Tsuji T Yanagi JE Mizoe T Miyamoto et al. (2002) ArticleTitleWorking Group for the Bone and Soft Tissue Sarcomas. Efficacy and safety of carbon ion radiotherapy in bone and soft tissue sarcomas J Clin Oncol 20 4466–71 Occurrence Handle12431970 Occurrence Handle1:CAS:528:DC%2BD38XosFCjs7Y%3D Occurrence Handle10.1200/JCO.2002.10.050

    Article  PubMed  CAS  Google Scholar 

  9. T Miyamoto N Yamamoto H Nishimura M Koto H Tsujii J Mizoe et al. (2003) ArticleTitleCarbon ion radiotherapy for stage I non-small cell lung cancer Radiother Oncol 66 127–40 Occurrence Handle12648784 Occurrence Handle10.1016/S0167-8140(02)00367-5

    Article  PubMed  Google Scholar 

  10. K Kadono T Homma K Kamahara M Nakayama H Satoh K Sekizawa et al. (2002) ArticleTitleEffect of heavy-ion radiotherapy on pulmonary function in stage I non-small cell lung cancer patients Chest 122 1925–32 Occurrence Handle12475828 Occurrence Handle1:CAS:528:DC%2BD3sXlsF2hsQ%3D%3D Occurrence Handle10.1378/chest.122.6.1925

    Article  PubMed  CAS  Google Scholar 

  11. H Nishimura T Miyamoto N Yamamoto M Koto K Sugimura H Tsujii (2003) ArticleTitleRadiographic pulmonary and pleural changes after carbon ion irradiation Int J Radiat Oncol Biol Phys 55 861–6 Occurrence Handle12605963 Occurrence Handle10.1016/S0360-3016(02)04495-4

    Article  PubMed  Google Scholar 

  12. T Nakano M Suzuki A Abe Y Suzuki S Morita J Mizoe et al. (1999) ArticleTitleThe phase I/II clinical study of carbon ion therapy for cancer of the uterine cervix Cancer J Sci Am 5 362–9 Occurrence Handle10606478 Occurrence Handle1:STN:280:DC%2BD3c%2Fnt1Cqtg%3D%3D

    PubMed  CAS  Google Scholar 

  13. T Nakano S Kato T Ohno H Tsujii S Sato K Fukuhisa et al. (2005) ArticleTitleLong-term results of high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of the uterine cervix Cancer 103 92–101 Occurrence Handle15540233 Occurrence Handle10.1002/cncr.20734

    Article  PubMed  Google Scholar 

  14. Tsujii H, Kamada T, Mizoe J, et al. 10 years' history of heavy ion radiotherapy at national institute of radiological sciences. NIRS-M-177, HIMAC-093 (Chiba, NIRS), 2004:3–18

  15. N Yamamoto T Miyamoto H Nishimura M Koto H Tsujii H Ohwada et al. (2003) ArticleTitlePreoperative carbon ion radiotherapy for non-small cell lung cancer with chest wall invasion — pathological findings concerning tumor response and radiation induced lung injury in the resected organs Lung Cancer 42 87–95 Occurrence Handle14512192 Occurrence Handle10.1016/S0169-5002(03)00243-5

    Article  PubMed  Google Scholar 

  16. M Berthrong LF Fajardo (1981) ArticleTitleRadiation injury in surgical pathology. Part II. Alimentary tract (review) Am J Surg Pathol 5 153–78 Occurrence Handle7013506 Occurrence Handle1:STN:280:Bi6C1c7lt1Q%3D Occurrence Handle10.1097/00000478-198103000-00006

    Article  PubMed  CAS  Google Scholar 

  17. N Leupin J Curschmann H Kranzbuhler CA Maurer JA Laissue L Mazzucchelli (2002) ArticleTitleAcute radiation colitis in patients treated with short-term preoperative radiotherapy for rectal cancer Am J Surg Pathol 26 498–504 Occurrence Handle11914629 Occurrence Handle10.1097/00000478-200204000-00013

    Article  PubMed  Google Scholar 

  18. Fajardo LF, Berthrong M, Anderson RE (editors). Radiation pathology. New York: Oxford University Press; 2001

  19. PC O'Brien (2001) ArticleTitleRadiation injury of the rectum (review) Radiother Oncol 60 1–14 Occurrence Handle11410298 Occurrence Handle10.1016/S0167-8140(01)00378-4

    Article  PubMed  Google Scholar 

  20. H Nishimura T Miyamoto N Yamamoto M Koto K Sugimura H Tsujii (2003) ArticleTitleRadiographic pulmonary and pleural changes after carbon ion irradiation Int J Radiat Oncol Biol Phys 55 861–6 Occurrence Handle12605963 Occurrence Handle10.1016/S0360-3016(02)04495-4

    Article  PubMed  Google Scholar 

  21. T Arai T Nakano S Morita (1992) ArticleTitleHigh-dose-rate remote afterloading intracavitary radiation therapy for cancer of the uterine cervix. A 20-year experience Cancer 69 175–80 Occurrence Handle1727661 Occurrence Handle1:STN:280:By2D1cbotl0%3D Occurrence Handle10.1002/1097-0142(19920101)69:1<175::AID-CNCR2820690129>3.0.CO;2-B

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Matsushita, K., Ochiai, T., Shimada, H. et al. The Effects of Carbon Ion Irradiation Revealed by Excised Perforated Intestines as a Late Morbidity for Uterine Cancer Treatment. Surg Today 36, 692–700 (2006). https://doi.org/10.1007/s00595-006-3231-8

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-006-3231-8

Key words

Navigation