• Christin Glowa, Peter Peschke, Stephan Brons, Jürgen Debus, and Christian P Karger.
• Department of Radiation Oncology and Radiotherapy, University Hospital Heidelberg, Germany; Department of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany; Heidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany. Electronic address: c.glowa@dkfz.de.
• Radiother Oncol. 2019 Apr 1; 133: 120-124.

ObjectiveTo quantify the impact of tumor-associated resistance factors on local tumor control after split doses of carbon (12C-) ions or photons in an experimental prostate tumor model.Material And MethodsThree sublines (AT1, H, HI) of syngeneic rat prostate tumors (R3327) differing in growth rate, differentiation and hypoxic status were irradiated with split doses of either 12C-ions or 6MV photons. Dose-response curves were determined for the endpoint local tumor control within 300 days. The relative biological effectiveness (RBE) of 12C-ions was calculated from the TCD50-values (dose at 50% control probability) of photons and 12C-ions.ResultsExperimental findings demonstrated: (i) The RBE was highest for the least differentiated AT1-tumor (2.39 ± 0.16 (AT1) vs 2.06 ± 0.11 (H) and 2.03 ± 0.17 (HI)). (ii) TCD50-values between the three tumor sublines differed much less for 12C-ions (26.0-37.9 Gy) than for photons (53.7-90.6 Gy). (iii) While the slope of the dose-response curves for photons and 12C-ions were very similar for the AT1- and H-tumors, the histologically heterogeneous HI-tumor showed a shallow dose-response curve for photons, which is transformed into a steep dose-response curve after 12C-ion irradiation.ConclusionThe response to carbon ion irradiations is much less dependent on biological differences between and within the tumor-sublines. Tumors showing a high resistance against photon treatments, also exhibit the largest RBE for carbon ions. Carbon ions could therefore be of clinical advantage for the treatment of tumors with known resistance factors against photons.Copyright © 2018 Elsevier B.V. All rights reserved.

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