Clinical Effectiveness of Hypofractionated Proton Beam Therapy for Liver Metastasis From Breast Cancer

Kim, Tae Hyun; Lee, Keun Seok; Sim, Sung Hoon; Kim, Yeon-Joo; Kim, Dae Yong; Chae, Hee Dong; Lee, Eun-Gyeong; Han, Jai Hong; Jung, Sung Eun; Lee, Seeyoun; Han, Kang; Lee, Eun Sook

doi:10.3389/fonc.2021.783327

Cited by 8 publications

(7 citation statements)

References 43 publications

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“…27 Regarding PBT outcomes, the 1-and 3year OS rates were 88-94.1% and 71.7-73%, respectively, with a median survival time of 39.3 months. 10,11 The summary of clinical results of local treatment for liver metastasis in breast cancer patients is shown in Table 3. A study of prognostic factors predicting survival from rst recurrence in patients with metastatic breast cancer reported that i) size of primary tumor, ii) axillary lymph node status, iii) hormonal receptor status, iv) adjuvant radiotherapy, v) disease free interval, and vi) number of recurrence site were prognostic factors.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, there are few studies that can provide su cient evidence for the treatment of liver metastasis. There are no reports of CIBT, and there are only two reports of PBT on liver metastasis from breast cancer 10,11 In Japan, a nationwide multicenter cohort study on PT was started in May 2016 for all facilities that performed PBT and/or CIBT.…”

Section: Introductionmentioning

confidence: 99%

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The Japanese nationwide cohort data of proton beam therapy for liver oligometastasis in breast cancer patients

Fukumitsu¹,

Numajiri

Ogino³

et al. 2023

Preprint

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Purpose: A nationwide multicenter cohort study on particle therapy was launched by the Japanese Society for Radiation Oncology in Japan in May 2016. We analyzed the outcome of proton beam therapy (PBT) for liver oligometastasis in breast cancers. Methods: Cases in which PBT was performed at all Japanese proton therapy facilities between May 2016 and February 2019 were enrolled. The patients were selected based on the following criteria: the primary cancer was controlled, liver recurrence without extrahepatic tumors, and no more than three liver lesions. Results: Fourteen females with a median age of 57 (range, 44–73) years and twenty-two lesions were included. The median lesion size, fraction size, and biological effective dose (BED)10 were 44 (20–130) mm, 6.6 (2-8) gray (Gy) (relative biological effectiveness [RBE])/fraction (fr), and 109.6 (52.7-115.2) Gy, respectively. The median follow-up period was 22.8 (4-54) months. The 1-, 2-, and 3-year local control (LC) rates of liver metastasis from breast cancer were 100% for all. The 1-, 2-, and 3-year overall survival rates were 85.7%, 62.5%, and 62.5%, respectively. The 1-, 2-, and 3-year progression free survival (PFS) rates were 50.0%, 33.3%, and 16.7%, respectively. The median PFS time was 16 months. Only one patient did not complete PBT due to current disease progression. One patient had grade 3 radiation-induced dermatitis. None of the patients experienced radiation-induced liver failure during the acute or late phase. Conclusions: Owing to the low incidence of adverse events and the high LC rate, PBT appears to be a feasible option for liver oligometastasis in breast cancers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Japanese nationwide cohort data of proton beam therapy for liver oligometastasis in breast cancer patients

Fukumitsu¹,

Numajiri

Ogino³

et al. 2023

Preprint

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“…64 A maximum dose of 60 The median progression-free survival (PFS) and OS of 7.9 months and 39.3 months without grade 3 or higher events. 66…”

Section: Discussionmentioning

confidence: 99%

American Radium Society Appropriate Use Criteria for the use of liver‐directed therapies for nonsurgical management of liver metastases: Systematic review and guidelines

Hallemeier

Sharma

Anker

et al. 2023

Cancer

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The liver is a common site of cancer metastases. Systemic therapy is widely accepted as the standard treatment for liver metastases (LM), although select patients with liver oligometastases may be candidates for potentially curative liver resection. Recent data support the role of nonsurgical local therapies such as ablation, external beam radiotherapy, embolization, and hepatic artery infusion therapy for management of LM. Additionally, for patients with advanced, symptomatic LM, local therapies may provide palliative benefit. The American Radium Society gastrointestinal expert panel, including members representing radiation oncology, interventional radiology, surgical oncology, and medical oncology, performed a systemic review and developed Appropriate Use Criteria for the use of nonsurgical local therapies for LM. Preferred Reporting Items for Systematic reviews and Meta‐Analyses methodology was used. These studies were used to inform the expert panel, which then rated the appropriateness of various treatments in seven representative clinical scenarios through a well‐established consensus methodology (modified Delphi). A summary of recommendations is outlined to guide practitioners on the use of nonsurgical local therapies for patients with LM.

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“…The PBT procedures have been described in detail in previous reports [ 26 , 27 , 31 , 32 , 33 , 34 , 35 ]. Patients were immobilized in the supine position with a customized vacuum cushion and underwent contrast-enhanced four-dimensional CT imaging under gating of respiration.…”

Section: Methodsmentioning

confidence: 99%

“…The gross tumor volume (GTV) was defined in average intensity projection CT images at exhalation (gated) phases (i.e., 30% of the entire respiration cycle in each patient) based on available imaging studies, including liver dynamic CT and/or MRI. The internal target volume (ITV) and organs at risk (OARs) were defined to account for the extent and movement of the GTV and each OAR at the exhalation (gated) phases, and the clinical target volume was defined as the ITV with no additional margins [ 25 , 27 , 31 , 32 , 34 , 36 ]. The planning target volume (PTV) was defined as the ITV plus a 5–7 mm margin in all directions.…”

Section: Methodsmentioning

confidence: 99%

Clinical Efficacy of Hypofractionated Proton Beam Therapy for Intrahepatic Cholangiocarcinoma

Kim

Woo

Lee

et al. 2022

Cancers

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Forty-seven patients with intrahepatic cholangiocarcinoma (IHCC) who received proton beam therapy (PBT) were analyzed to evaluate the clinical efficacy and safety of hypofractionated PBT in patients with inoperable or recurrent IHCC. The median prescribed dose of PBT was 63.3 GyE (range: 45–80 GyE) in 10 fractions, and the median duration of follow-up in all the patients was 18.3 months (range: 2.4–89.9 months). Disease progression occurred in 35 of the 47 (74.5%) patients; local, intrahepatic, and extrahepatic progression occurred in 5 (10.6%), 20 (42.6%), and 29 (61.7%) patients, respectively. The 2-year freedom from local progression (FFLP), progression-free survival (PFS), overall survival (OS) rates, and median time of OS were 86.9% (95% confidence interval [CI], 74.4–99.4%), 16.8% (95% CI, 4.3–29.3%), 42.7% (95% CI, 28.0–57.4%), and 21.9 months (95% CI, 16.2–28.3 months), respectively; grade ≥ 3 adverse events were observed in four (8.5%) patients. In selected patients with localized disease (no viable tumors outside of the PBT sites), the median time of OS was 33.8 months (95% CI, 5.4–62.3). These findings suggest that hypofractionated PBT is safe and could offer a high rate of FFLP and promising OS in patients with inoperable or recurrent IHCC.

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Clinical Effectiveness of Hypofractionated Proton Beam Therapy for Liver Metastasis From Breast Cancer

Cited by 8 publications

References 43 publications

The Japanese nationwide cohort data of proton beam therapy for liver oligometastasis in breast cancer patients

The Japanese nationwide cohort data of proton beam therapy for liver oligometastasis in breast cancer patients

American Radium Society Appropriate Use Criteria for the use of liver‐directed therapies for nonsurgical management of liver metastases: Systematic review and guidelines

Clinical Efficacy of Hypofractionated Proton Beam Therapy for Intrahepatic Cholangiocarcinoma

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