Safety and Efficacy of Carbon Ion and Proton Therapies for Pancreatic Cancer: A Systematic Review and Meta-analysis

Objective To evaluate the safety and efficacy of carbon ion and proton therapies for pancreatic cancer (PaC). Methods The databases were electronically searched to collect the studies about the carbon ion and proton therapies for PaC from inception to June 2019. Two reviewers independently screened literature and extracted data. A Meta-analysis was performed by STATA 12.0 and MetaAnalyst Beta 3.13 software. Results A total of 8 studies involving 459 PaC patients were included. The incidence of grade 2, 3 and 5 gastrointestinal (GI) ulcer toxicities in PaC patients treated with carbon ion and proton therapies were 7%, 2% and 0; the incidence of grade 2, 3 and 4 anorexia toxicities were 6%, 3.2% and 0; the 1- and 2-year OS rates were 77% and 45%; the 2-year local control (LC), 1-year freedom from local progression (FFLP) and 1-year local recurrence(LR) rates were 81%, 88% and 15%. The incidence of grade 2, 3, 2-3 GI ulcer toxicities in carbon ion and proton therapies for PaC were 6.8%, 1.5%, 9.2% and 3.5%, 8.3%, 6.1% (P < 0.05); and the 1- and 2-year OS were 77.1%, 44.4% and 77.6%, 49.7% (P > 0.05). Conclusion Carbon ion and proton therapies for PaC are safe and effective; and the security and effectiveness of the two methods are similar.