Novel Carbon Ion and Proton Partial Irradiation of Recurrent Unresectable Bulky Tumors (Particle-PATHY): Early Indication of Effectiveness and Safety

Slavisa Tubin*, Piero Fossati, Antonio Carlino, Giovanna Martino, Joanna Gora, Markus Stock, Eugen Hug

*Corresponding author for this work

Research output: Journal article (peer-reviewed)Journal article

7 Citations (Scopus)

Abstract

Background: We present the early results of a novel partial bulky-tumor irradiation using particles for patients with recurrent unresectable bulky tumors who failed previous state-of-the-art treatments. Methods: First, eleven consecutive patients were treated from March 2020 until December 2021. The targeted Bystander Tumor Volume (BTV) was created by subtracting 1 cm from Gross Tumor Volume (GTV) surface. It reflected approximately 30% of the central GTV volume and was irradiated with 30–45 Gy RBE (Relative Biological Effectiveness) in three consecutive fractions. The Peritumoral Immune Microenvironment (PIM) surrounding the GTV, containing nearby tissues, blood-lymphatic vessels and lymph nodes, was considered an organ at risk (OAR) and protected by highly conservative constraints. Results: With the median follow up of 6.3 months, overall survival was 64% with a median survival of 6.7 months; 46% of patients were progression-free. The average tumor volume regression was 61% from the initial size. The symptom control rate was 91%, with an average increase of the Karnofsky Index of 20%. The abscopal effect has been observed in 60% of patients. Conclusions: Partial bulky-tumor irradiation is an effective, safe and well tolerated treatment for patients with unresectable recurrent bulky disease. Abscopal effects elucidate an immunogenic pathway contribution. Extensive tumor shrinkage in some patients might permit definitive treatment—otherwise previously impossible.

Original languageEnglish
Article number2232
JournalCancers
Volume14
Issue number9
DOIs
Publication statusPublished - 29 Apr 2022
Externally publishedYes

Keywords

  • abscopal effect
  • bystander effect
  • carbon ions
  • partial tumor irradiation
  • particles

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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