BACKGROUND The efficacy of carbon-ion radiotherapy (C-ion RT) for lymph node (LN) oligo-recurrence has only been evaluated in limited single-center studies. We aimed to investigate the benefit of C-ion RT for LN oligo-recurrence in a large multi-center study. METHODS Patients who received C-ion RT between December 1996 and December 2015 at 4 participating facilities and who met the following eligibility criteria were included: (i) histological or clinical diagnosis of LN recurrence; (ii) controlled primary lesion; (iii) no recurrence other than LN; (iv) LN recurrence involved in a single lymphatic site; and (v) age ≥ 20 years. RESULTS A total of 323 patients were enrolled. Median follow-up period was 34 months for surviving patients. The most common dose fractionation of C-ion RT was 48.0 Gy (relative biological effectiveness) in 12 fractions. Forty-seven patients had a history of RT at the recurrent site. The 2-year local control (LC) and overall survival (OS) rates after C-ion RT were 85% and 63%, respectively. Only 1 patient developed grade-3 toxicity. Factors such as LN diameter, histology, and history of previous RT did not correlate with LC. Smaller diameters (< 30 mm) and numbers (≤ 3) of LN metastases as well as longer disease-free intervals post-primary therapy (≥ 16 months) were associated with significantly better OS. CONCLUSIONS C-ion RT for LN oligo-recurrence appeared to be effective and safe. C-ion RT may provide a survival benefit to patients with LN oligo-recurrence, particularly to those with few LN metastases, smaller LN diameters, and longer disease-free intervals.

中文翻译：

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碳离子放射疗法治疗淋巴结低聚复发：日本碳离子放射肿瘤学研究小组（J-CROS）进行的多机构研究。

背景技术仅在有限的单中心研究中评估了碳离子放射疗法（C-ion RT）对淋巴结（LN）少发复发的功效。我们旨在在大型多中心研究中研究C离子RT对LN寡聚复发的益处。方法1996年12月至2015年12月在4个参与机构接受C-ion RT且符合以下资格标准的患者包括：（i）LN复发的组织学或临床诊断；（ii）受控原发灶；（iii）除LN外，没有其他重复发生；（iv）LN复发涉及单个淋巴部位；（v）年龄≥20岁。结果总共招募了323名患者。存活患者的中位随访期为34个月。C离子RT的最常见剂量分级为12个馏分中的48.0 Gy（相对生物学有效性）。47位患者在复发部位有RT病史。C-离子放疗后的2年局部对照（LC）和总生存（OS）率分别为85％和63％。只有1名患者出现3级毒性。LN直径，组织学和先前的RT病史等因素与LC无关。LN转移的直径较小（<30 mm）和数量（≤3）以及在初次治疗后（≥16个月）无病间隔时间较长，与OS显着改善相关。结论C-离子RT用于LN寡聚复发似乎是有效和安全的。C离子RT可为LN寡聚复发的患者提供生存益处，尤其是对于那些LN转移少，LN直径较小和无病间隔时间较长的患者。C-离子放疗后的2年局部对照（LC）和总生存（OS）率分别为85％和63％。只有1名患者出现3级毒性。LN直径，组织学和先前的RT病史等因素与LC无关。LN转移的直径较小（<30 mm）和数量（≤3）以及在初次治疗后（≥16个月）无病间隔时间较长，与OS显着改善相关。结论C离子RT用于LN寡聚复发似乎是有效和安全的。C离子RT可为LN寡聚复发的患者提供生存益处，尤其是对于那些LN转移少，LN直径较小和无病间隔时间较长的患者。C-离子放疗后的2年局部对照（LC）和总生存（OS）率分别为85％和63％。只有1名患者出现3级毒性。LN直径，组织学和先前的RT病史等因素与LC无关。LN转移的直径较小（<30 mm）和数量（≤3）以及在初次治疗后（≥16个月）无病间隔时间较长，与OS显着改善相关。结论C-离子RT用于LN寡聚复发似乎是有效和安全的。C离子RT可为LN寡聚复发的患者提供生存益处，尤其是对于那些LN转移少，LN直径较小和无病间隔时间较长的患者。先前的放疗史与LC无关。LN转移的直径较小（<30 mm）和数量（≤3）以及在初次治疗后（≥16个月）无病间隔时间较长，与OS显着改善相关。结论C-离子RT用于LN寡聚复发似乎是有效和安全的。C离子RT可为LN寡聚复发的患者提供生存益处，尤其是对于那些LN转移少，LN直径较小和无病间隔时间较长的患者。既往RT史与LC无相关性。LN转移的直径较小（<30 mm）和数量（≤3）以及在初次治疗后（≥16个月）无病间隔时间较长，与OS显着改善相关。结论C-离子RT用于LN寡聚复发似乎是有效和安全的。C离子RT可为LN寡聚复发的患者提供生存益处，尤其是对于那些LN转移少，LN直径较小和无病间隔时间较长的患者。