Carbon-Ion Radiotherapy for Prostate Cancer in Hemodialysis Patients

Background/Aim: Although the safety and efficacy of carbon ion radiation therapy (CIRT) are well established, its toxicity in the treatment of prostate cancer in patients undergoing hemodialysis has not been well determined. To evaluate this toxicity/safety, we retrospectively analyzed cases of patients with prostate cancer who had undergone CIRT. Patients and Methods: The cases of 13 hemodialysis patients with localized or locally invasive prostate cancer who underwent CIRT at the Japanese Ion Beam Therapy Center, SAGA HIMAT Foundation between November 2013 and May 2023 were investigated. CIRT was delivered using either passive scattering or scanning techniques, with a total dose of 51.6 Gy (RBE) delivered in 12 fractions for all cases. Toxicity was assessed and analyzed based primarily on CTCAE version 5.0. Results: In the acute phase, Grade 1 genitourinary (GU) toxicity was observed in three patients, and Grade 2 GU toxicity was observed in two patients. In the late phase, Grade 1 gastrointestinal toxicity was observed in one patient. No Grade 3 or higher toxicities were observed. Nine patients achieved recurrence-free survival. One patient experienced clinical recurrence. Conclusion: CIRT for prostate cancer can be safely administered even in hemodialysis patients, and its toxicities were within acceptable limits. Our findings suggest that CIRT has potential as a treatment option for this patient population.