{
  "abstract": "Aim: Carbon‐ion radiotherapy (CIRT) provides superior dose distribution and higher biological effectiveness than conventional X‐ray radiotherapy and has emerged as a promising component of multidisciplinary treatment for advanced pancreatic ductal adenocarcinoma (PDAC). However, evidence regarding surgical resection after CIRT remains limited. In this study, we aimed to evaluate the feasibility, histopathological therapeutic response, and oncological outcomes of pancreatic resection after CIRT‐based multimodal treatment.\n\nMethods: We retrospectively analyzed 12 patients with borderline resectable pancreatic cancer with arterial involvement (BR‐A) or unresectable locally advanced PDAC (UR‐LA), who underwent surgical resection following CIRT at our institution between January 2016 and June 2025. The surgical outcomes, perioperative morbidity, pathological therapeutic responses, and survival outcomes were assessed.\n\nResults: Surgical resection after CIRT was feasible in all patients. The procedures included pancreaticoduodenectomy (n = 5), distal pancreatectomy (n = 2), and distal pancreatectomy with celiac axis resection (n = 5). R0 resection was achieved in 11 patients (92%) and no pathological lymph node metastasis was identified. A marked histopathological response (Evans Grades III–IV) was observed in 83% of patients. No local recurrences were observed in the CIRT irradiation field. The 3‐year progression‐free survival and overall survival (OS) rates calculated from treatment initiation were 74.1% and 79.5%, respectively, whereas the corresponding 3‐year recurrence‐free survival and OS rates calculated from surgical resection were 47.6% and 50.8%, respectively.\n\nConclusions: Surgical resection following CIRT‐based multimodal treatment is feasible and safe, achieving a favorable histopathological response and durable local control in selected patients with PDAC with arterial involvement.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Hepatobiliary and Pancreatic Surgery, Department of General Surgical Science Gunma University Graduate School of Medicine Maebashi Gunma Japan",
    "Department of Radiation Oncology Gunma University Graduate School of Medicine Maebashi Gunma Japan",
    "Gunma University Heavy Ion Medical Center Maebashi Gunma Japan",
    "Clinical Department of Pathology Gunma University Hospital Maebashi Gunma Japan",
    "Department of Radiation Oncology, International Medical Center Saitama Medical University Saitama Japan"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kenichiro Araki",
      "orcid": "0000-0002-5438-4551"
    },
    {
      "affs": [
        0
      ],
      "name": "Norio Kubo",
      "orcid": "0000-0003-2624-2529"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Yuhei Miyasaka"
    },
    {
      "affs": [
        3
      ],
      "name": "Hayato Ikota",
      "orcid": "0009-0006-0289-314X"
    },
    {
      "affs": [
        0
      ],
      "name": "Ryo Muranushi"
    },
    {
      "affs": [
        0
      ],
      "name": "Mariko Tsukagoshi",
      "orcid": "0000-0003-3748-9615"
    },
    {
      "affs": [
        0
      ],
      "name": "Takamichi Igarashi",
      "orcid": "0000-0001-9077-2052"
    },
    {
      "affs": [
        1,
        2,
        4
      ],
      "name": "Masahiko Okamoto"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Tatsuya Ohno",
      "orcid": "0000-0002-6703-3144"
    },
    {
      "affs": [
        0
      ],
      "name": "Ken Shirabe",
      "orcid": "0000-0002-7173-7945"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2x7qzbc9441w5.bib",
  "cited_by": 0,
  "doi": "10.1002/ags3.70259",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13429861/",
  "id": "2x7qzbc9441w5",
  "issns": [
    "2475-0328"
  ],
  "landing_url": "https://doi.org/10.1002/ags3.70259",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Article"
    ],
    [
      "openalex",
      "2730|Pancreatic and Hepatic Oncology Research"
    ]
  ],
  "openalex": "W7172201305",
  "pdf_url": null,
  "pmcid": "PMC13429861",
  "pmid": "42548785",
  "published": "2026-08-02",
  "publisher": "Wiley",
  "ris": "https://research.draconitic.com/paper/2x7qzbc9441w5.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:23:28Z",
      "native_id": "PMC13429861",
      "source": "pmc",
      "url": "https://doi.org/10.1002/ags3.70259"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Pancreatic and Hepatic Oncology Research",
      "subfield": "oncology"
    }
  ],
  "title": "Impact of Histopathological Response on Outcomes After Surgical Resection Following Carbon‐Ion Radiotherapy for Pancreatic Cancer With Arterial Involvement",
  "title_text": "Impact of Histopathological Response on Outcomes After Surgical Resection Following Carbon‐Ion Radiotherapy for Pancreatic Cancer With Arterial Involvement",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:20:56Z",
  "url": "https://research.draconitic.com/paper/2x7qzbc9441w5",
  "venue": "Annals of Gastroenterological Surgery",
  "versions": []
}