High-Dose Carbon Ion Reirradiation for Recurrent Pelvic Sarcomas: A Retrospective Analysis of Oncologic Outcomes in a Referral Center

Why clinicians should know about it

• Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (paper of the day, 27 August 2026): High‑dose carbon ion reirradiation shows safety and efficacy

Abstract

PURPOSE: This study aims to evaluate the safety and efficacy of high-dose carbon ion reirradiation (CIR) in patients with recurrent pelvic sarcomas. METHODS AND MATERIALS: This retrospective study included 46 patients treated with high-dose CIR for locoregional recurrences of pelvic sarcomas between 2013 and 2023 at the National Center for Oncological Hadrontherapy, Pavia, Italy. Clinical outcomes, toxicity, and cumulative doses were analyzed. RESULTS: The median prescribed total dose of CIR was 60 GyRBE (range, 45-73.6 GyRBE). The maximum cumulative equivalent dose in 2 Gy fractions to the target volume reached 284 Gy, with a median of 153 Gy. The median follow-up was 32.5 months. The 1-, 2-, and 3-year locoregional progression-free survival rates were 79.1%, 43.9%, and 25.1%, respectively, with a mean time to locoregional relapse of 18.9 months. The 1-, 2-, and 3-year overall survival rates were 100%, 93.9%, and 83.1%, respectively. At last follow-up, grade 3 neuropathy occurred in 6.5% of the patients, grade 3 anorectal dysfunction in 8.7%, and grade 3 skin toxicity in 6.5%. CONCLUSIONS: High-dose CIR is a feasible salvage strategy for recurrent pelvic sarcoma, offering promising outcomes and manageable toxicity in carefully selected patients. Prospective studies are warranted to refine dose-response models and validate long-term efficacy.

Abstract as published, via PubMed.