A Technique of Partial Breast Irradiation Utilizing Proton Beam Radiotherapy: Comparison with Conformal X-Ray Therapy

Bush, David A.; Slater, Jerry D.; Garberoglio, Carlos A.; Yuh, Grace E.; Hocko, Janet M.; Slater, James M.

doi:10.1097/ppo.0b013e318046354b

Cited by 61 publications

(34 citation statements)

References 28 publications

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“…Compared with conventional X-rays and electron beams, it was found that partial breast irradiation using PBT was safer, more effective and technically feasible; furthermore, it may provide satisfactory target coverage and improve normal tissue sparing. Moreover, compared with intracavitary and interstitial brachytherapy, PBT was found to be more cost-effective (45)(46)(47)(48)(49)(50)(51)(52)(53)(54).…”

Section: Pbt For Different Cancersmentioning

confidence: 99%

The evolution of proton beam therapy: Current and future status (Review)

et al. 2017

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Abstract. Proton beam therapy (PBT) has been increasingly used in a variety of cancers due to its excellent physical properties and superior dosimetric parameters. PBT may improve patient survival by improving the local tumor treatment rate while reducing injury to normal organs, which may result in fewer radiation-induced adverse effects. However, the significant cost of establishing and maintaining proton facilities cannot be overlooked. In addition, there has been significant controversy regarding routine application of this treatment in certain types of cancer. The challenges of PBT in the future mainly include the lack of basic clinical trials, unclear biological effects, immature imaging technology and miniaturization of imaging guidance. Overcoming these limitations may promote the rapid development of PBT. We herein provide an overview of the existing literature on the efficacy and toxicity of common oncological applications of proton beam therapy.

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Section: Pbt For Different Cancersmentioning

confidence: 99%

The evolution of proton beam therapy: Current and future status (Review)

et al. 2017

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“…60- 62 Kozak et al 63 reported significant acute skin toxicity when a single-field proton beam per fraction was used. However, this issue was resolved in more recent phase II trials that used multiple fields per day.…”

Section: Breast Cancermentioning

confidence: 99%

Promise and Pitfalls of Heavy-Particle Therapy

Mitin

Zietman

2014

JCO

114

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Proton beam therapy, the most common form of heavy-particle radiation therapy, is not a new invention, but it has gained considerable public attention because of the high cost of installing and operating the rapidly increasing number of treatment centers. This article reviews the physical properties of proton beam therapy and focuses on the up-to-date clinical evidence comparing proton beam therapy with the more standard and widely available radiation therapy treatment alternatives. In a cost-conscious era of health care, the hypothetical benefits of proton beam therapy will have to be supported by demonstrable clinical gains. Proton beam therapy represents, through its scale and its cost, a battleground for the policy debate around managing expensive technology in modern medicine.

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“…Proton therapy has been proposed after mastectomy [52] , in patients with bilateral implants [53] , and as accelerated partial breast irradiation (PBI) [54][55][56][57] . It seems unlikely that PBT could be widely used in breast cancer and it is predictable that it will find selective use in specific clinical scenarios in which the patient's anatomy poses cardiac or pulmonary risks with the use of conventional XRT.…”

Section: Breast Cancermentioning

confidence: 99%

The actual Interest in Radiotherapy for the Utilization of Proton Beam, Highlighting Physics Basis, Technology and Common Clinical Indications

Amichetti

2016

Journal of Tumor

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. Since that years, commercial entities began to build cyclotrons and synchrotrons for clinical purposes. Over the last 10 years, PBT has gathered more interest in the scientific community and more media and patient attention and is now flourishing in the US and abroad. As of December, 2015, 57 proton therapy centers are in operation worldwide, others are under construction and many more in a planning phase [3] . Most patients who have been treated with heavy-particle therapy were treated with protons: PTCOG (Particle Therapy Co-Operative Group) reports that between 1954 and 2014, 137 000 patients globally received part or all of their radiation therapy with particles, and in particular 86% of them with protons [4] . The generation of these particles and the building of dedicated centers, however, requires large investments and operational costs and big infrastructure. Only relatively few studies have demonstrated the effectiveness of proton therapy and the effects are surrounded with uncertainty [5] being the cost-effectiveness still the core of the controversy around the use of PBT. ABSTRACTManaging expensive technology is a debated issue in modern radiation oncology. Proton beam therapy (PBT) represents, considering its cost and its foreseen benefits, a typical case of discussion waiting for more robust results demonstrating the presumable clinical gains against the available radiation therapy (XRT) treatment alternatives based on the use of photons. The treatment with particles utilizes many different beams (neutrons, protons, pions, or helium, neon, argon, and carbon ions) that represent a distinct entity respect conventional XRT which uses photons. PBT is the most common form of heavy-particle radiation therapy used so far; it is not a new invention, being its clinical use proposed in a seminal article by R. Wilson in 1946 [1] and the first patients treated in 1954 at the Lawrence Berkeley National Laboratory in California [2] . Since cyclotron or synchrotron, used to accelerate protons to therapeutic energies, were used primarily for research in particle or nuclear physics, the initial clinical activity in proton therapy was carried out in research facilities and the use of protons in clinical practice has grown slowly for several years in non-clinical setting. More than fifty years later, after a long period of seminal work in a limited number of Institutions, PBT has gained public attention in recent years because of the rapidly increasing number of centers around the world, regardless of their high cost. Hospital-based proton beam facilities have been in operation since 1990 after the opening of the first dedicated clinical center at Loma Linda Medical

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A Technique of Partial Breast Irradiation Utilizing Proton Beam Radiotherapy: Comparison with Conformal X-Ray Therapy

Cited by 61 publications

References 28 publications

The evolution of proton beam therapy: Current and future status (Review)

The evolution of proton beam therapy: Current and future status (Review)

Promise and Pitfalls of Heavy-Particle Therapy

The actual Interest in Radiotherapy for the Utilization of Proton Beam, Highlighting Physics Basis, Technology and Common Clinical Indications

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