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Recently, surprisingly high overall survival rates were reported after irradiation with carbon ions. Here, we report on our clinical experience using carbon ion radiotherapy as definitive treatment in LRPC at the Heidelberg Ion-Beam Therapy Center (HIT).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Between 2015 and 2019, we treated 13\u00a0patients with LRPC with carbon ions with a\u00a0median total dose of 48\u202fGy (RBE) in 12\u00a0fractions using an active raster-scanning technique at a\u00a0rotating gantry. No concomitant chemotherapy was administered. Overall survival, local control, and toxicity rates were evaluated 18\u00a0months after the last patient finished radiotherapy.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>With a\u00a0median follow-up time of 9.5\u00a0months, one patient is still alive (8%). Median OS was 12.7\u00a0months. Ten patients (77%) developed distant metastases. Additionally, one local recurrence (8%) and two regional tumor recurrences (15%) were observed. The estimated 1\u2011year local control and locoregional control rates were 87.5% and 75%, respectively. During radiotherapy, we registered one gastrointestinal bleeding CTCAE grade\u00a0III (8%) due to gastritis. The bleeding was sufficiently managed with conservative therapy. No further higher-grade acute or late toxicities were observed.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>We demonstrate high local control rates in a\u00a0rare cohort of LRPC patients treated with carbon ion radiotherapy. The observed median overall survival rate was not improved compared to historical in-house data using photon radiotherapy. This is likely due to a\u00a0high rate of distant tumor progression, highlighting the necessity of additional chemotherapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00066-021-01827-9","type":"journal-article","created":{"date-parts":[[2021,8,5]],"date-time":"2021-08-05T07:02:51Z","timestamp":1628146971000},"page":"378-387","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Carbon ion radiotherapy as definitive treatment in locally recurrent pancreatic cancer"],"prefix":"10.1007","volume":"198","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1445-1940","authenticated-orcid":false,"given":"Jakob","family":"Liermann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgar","family":"Ben-Josef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Syed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juergen","family":"Debus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Herfarth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Naumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,8,5]]},"reference":[{"issue":"1","key":"1827_CR1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.14740\/wjon1166","volume":"10","author":"P Rawla","year":"2019","unstructured":"Rawla\u00a0P, Sunkara\u00a0T, Gaduputi\u00a0V (2019) Epidemiology of pancreatic cancer: global trends, etiology and risk factors. 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Cancer 119(1):45\u201351. https:\/\/doi.org\/10.1002\/cncr.27723","journal-title":"Cancer"}],"container-title":["Strahlentherapie und Onkologie"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-021-01827-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00066-021-01827-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00066-021-01827-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,22]],"date-time":"2022-03-22T14:04:48Z","timestamp":1647957888000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00066-021-01827-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,5]]},"references-count":28,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["1827"],"URL":"https:\/\/doi.org\/10.1007\/s00066-021-01827-9","relation":{},"ISSN":["0179-7158","1439-099X"],"issn-type":[{"value":"0179-7158","type":"print"},{"value":"1439-099X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,5]]},"assertion":[{"value":"30 December 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 August 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"J.\u00a0Debus received grants from Viewray Incorporated, The Clinical Research Institute GmbH (CRI), Accuray International Sarl, RaySearch Laboratories AB, Vision RT Limited, Merck Seono GmbH, Astellas Pharma GmbH, Astra Zeneca GmbH, Siemens Healthcare GmbH, Solution Akademie GmbH, Egomed PLC Surrey Research Park, Quintiles GmbH, Pharmaceutical Research Associates GmbH, Boehringer Ingelheim Pharma GmbH&CoKG, PTW-Freiburg Dr. Pychlau GmbH, Nanobiotix SA, Accuray Incorporated, Bristol-Myer Squibb GmbH&CoKG aA, and Merck KHG aA. As chairman of HIRO (Heidelberg Institute of Radiation Oncology, Heidelberg, Germany) and a managing director of the NCT (National Center for Tumor Diseases) Heidelberg, Germany, J.\u00a0Debus is responsible for collaborations with a multitude of companies and institutions. Juergen Debus is CEO of the HIT Betriebs-GmbH and a member of the board of trustees of the Physikalisch-Technische Bundesanstalt (PTB). He attended advisory board meetings of MERCK KGaA (Darmstadt). J.\u00a0Liermann, E.\u00a0Ben-Josef, M.\u00a0Syed, K.\u00a0Herfarth, and P.\u00a0Naumann declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The presented study is in accordance with the ethical standards of the institutional research committee (ethics committee of the University of Heidelberg, Germany, S\u2011688\/2020) and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}