The Role of Carbon Ion Therapy in the Changing Oncology Landscape-A Narrative Review of the Literature and the Decade of Carbon Ion Experience at the Italian National Center for Oncological Hadrontherapy

Ester Orlandi, Amelia Barcellini*, Barbara Vischioni, Maria Rosaria Fiore, Viviana Vitolo, Alberto Iannalfi, Maria Bonora, Agnieszka Chalaszczyk, Rossana Ingargiola, Giulia Riva, Sara Ronchi, Francesca Valvo, Piero Fossati, Mario Ciocca, Alfredo Mirandola, Silvia Molinelli, Andrea Pella, Guido Baroni, Marco Giuseppe Pullia, Angelica FacoettiRoberto Orecchia, Lisa Licitra, Gianluca Vago, Sandro Rossi

*Corresponding author for this work

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

Abstract

BACKGROUND: Currently, 13 Asian and European facilities deliver carbon ion radiotherapy (CIRT) for preclinical and clinical activity, and, to date, 55 clinical studies including CIRT for adult and paediatric solid neoplasms have been registered. The National Center for Oncological Hadrontherapy (CNAO) is the only Italian facility able to accelerate both protons and carbon ions for oncological treatment and research.

METHODS: To summarise and critically evaluate state-of-the-art knowledge on the application of carbon ion radiotherapy in oncological settings, the authors conducted a literature search till December 2022 in the following electronic databases: PubMed, Web of Science, MEDLINE, Google Scholar, and Cochrane. The results of 68 studies are reported using a narrative approach, highlighting CNAO's clinical activity over the last 10 years of CIRT.

RESULTS: The ballistic and radiobiological hallmarks of CIRT make it an effective option in several rare, radioresistant, and difficult-to-treat tumours. CNAO has made a significant contribution to the advancement of knowledge on CIRT delivery in selected tumour types.

CONCLUSIONS: After an initial ramp-up period, CNAO has progressively honed its clinical, technical, and dosimetric skills. Growing engagement with national and international networks and research groups for complex cancers has led to increasingly targeted patient selection for CIRT and lowered barriers to facility access.

Original languageEnglish
Article number5068
JournalCancers
Volume15
Issue number20
DOIs
Publication statusPublished - 20 Oct 2023

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