Proton beam versus photon beam dose to the heart and left anterior descending artery for left-sided breast cancer

Lin, Lilie L.; Vennarini, Sabina; Dimofte, Andreea; Ravanelli, Daniele; Shillington, Katie J.; Karmakar, Saswati; Tochner, Zelig; Both, Stefan; Freedman, Gary M.

doi:10.3109/0284186x.2015.1011756

Cited by 80 publications

(57 citation statements)

References 22 publications

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“…The results of this comparison showed that proton treatments could improve target coverage and reduce normal tissue burden and the integral dose in both gated and free breathing patients. These results are comparable with and add to those from recent similar studies that only investigated whole breast treatments (Mast et al 2014, Lin et al 2015.…”

Section: Discussionsupporting

confidence: 81%

“…Investigating the potential of the technique for proton therapy was the subject of one study in this thesis (Paper IV) as few studies have investigated this aspect of proton therapy (Mast et al 2014, Lin et al 2015. The more general impact of the breathing motion on dose distributions from proton radiotherapy has been addressed in another study in this thesis (Paper V).…”

Section: Respiratory Gatingmentioning

confidence: 99%

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Radiation burden from modern radiation therapy techniques including proton therapy for breast cancer treatment - clinical implications

Flejmer¹

2016

Linköping University Medical Dissertations

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Section: Discussionsupporting

confidence: 81%

Section: Respiratory Gatingmentioning

confidence: 99%

Radiation burden from modern radiation therapy techniques including proton therapy for breast cancer treatment - clinical implications

Flejmer¹

2016

Linköping University Medical Dissertations

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“…Numerous dosimetric studies clearly support the advantage of PBT at improving target coverage while simultaneously decreasing dose to the heart, coronary vessels, lungs and contralateral normal tissue compared with photon advanced planning techniques. These advantages are evident whether the target is partial breast, whole breast/chest wall or breast/chest wall and regional lymph nodes (Table 1) [20,[37][38][39][40][41][42][43]. A recent paper assessed the potential absolute gains with PBT compared with photon therapy in patients with left-sided breast cancer requiring comprehensive nodal irradiation.…”

Section: Second Malignancymentioning

confidence: 99%

“…Dosimetric studies do support a potential benefit of PBT in reduction of heart, cardiac substructure and lung doses [41,64]. Patients with bilateral breast cancer, unfavorable anatomy and left-sided disease may be most likely to benefit from this approach (Figure 2).…”

Section: Clinical Applications For Pbt In Breast Cancermentioning

confidence: 99%

Proton Therapy for Breast Cancer: Progress & Pitfalls

Corbin

Mutter

2018

Breast Cancer Manag.

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Practice points• Proton therapy is under investigation for early stage and locally advanced breast cancer.• Due to unique physical properties, proton therapy reduces the dose to the heart, lungs, skin, muscle, and bone and is therefore hypothesized to reduce side effects from treatment.• Proton therapy may also enable improved target coverage in some breast cancer patients.• Due to its highly conformal nature, proton therapy requires careful attention to target volume delineation and implementation of strategies to mitigate uncertainties in setup and delivery.• Proton therapy for breast cancer is rapidly evolving with improvements in techniques for treatment delivery and optimizing of dose and fractionation schedules.• Research is ongoing to determine whether proton therapy improves treatment outcomes and quality of life compared with conventional photon techniques.As the number of patients cured from breast cancer increases with improvements in multidisciplinary care, emphasis on reducing late toxicities of treatment has increased, in order to improve long-term quality of life. Proton beam therapy (PBT) is a form of radiotherapy that uses particles with unique physical properties that enable treatment delivery with minimal dose deposition beyond the treatment target. Therefore, PBT has emerged as an exciting radiotherapy modality for breast cancer due to the ability to minimize exposure to the heart, lungs, muscle, and bone. Herein, we review the rationale for PBT in breast cancer, potential clinical applications, and the available clinical data supporting its use. We also address some of the technical and logistical challenges and areas of ongoing research that will ultimately establish the role for PBT for breast cancer in the years ahead.First draft submitted: 5 January 2018; Accepted for publication: 13 March 2018; Published online: 13 April 2018Keywords: breast cancer • cardiotoxicity • heart • particle therapy • pencil-beam scanning • proton therapy • radiation therapyBreast cancer accounts for 30% of new cancer diagnoses in women [1]. Although breast cancer remains the second leading cause of cancer death among women, advances in detection and treatment have resulted in improved outcomes, with 5-year expected survival of 90% [1]. Radiation therapy (RT) is indicated in the management of the majority of women with breast cancer [2]. For early stage breast cancer, breast irradiation following lumpectomy is an essential component of breast conserving therapy, lowering the risk of recurrence and improving breast cancer specific survival [3,4]. Recently published clinical trials also support the oncologic value of regional nodal irradiation (RNI) in some women with high risk node negative or axillary nodal metastases [5,6]. In addition, women with locally advanced breast cancer benefit from RT to the chest wall and regional lymph nodes, delivered in the post mastectomy setting [7]. While RT is widely utilized and improves breast cancer treatment outcomes, RT is also associated with late effects including cardi...

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“…The sparing effects of proton radiotherapy on critical organs is particularly apparent in cases of left-sided BC where using IMPT, as compared with IMRT, allowed a 20-fold reduction of heart dose and for the left anterior descendens (LAD) artery region (a lower arm of the left coronary artery), which is a critical structure in the development of late cardiac complications [67,[75][76][77][78][79][80]. Such findings are indicative of a potential benefit in using proton radiotherapy for adjuvant radiotherapy of BC patients, especially when risk factors for cardiac complications are present [80].…”

Section: Breast Cancer (Bc)mentioning

confidence: 99%

Proton radiotherapy for treating the most common carcinomas

Sas-Korczyńska

Jakubowicz²,

Reinfuss³

2017

Nowotwory. Journal of Oncology

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A literature review is presented on proton radiotherapy when used for treating the most common carcinoma types such as cancer of the lung, breast and prostate. This is based on analytic parameters of dosimetry and clinical outcomes (efficacy and toxicity), along with studies on cost-effectiveness as compared to those achieved by conventional photon radiotherapy. NOWOTWORY J Oncol 2016; 66, 5: 396-402

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Proton beam versus photon beam dose to the heart and left anterior descending artery for left-sided breast cancer

Abstract: (2015) Proton beam versus photon beam dose to the heart and left anterior descending artery for left-sided breast cancer, Acta Oncologica, 54:7,

Cited by 80 publications

References 22 publications

Radiation burden from modern radiation therapy techniques including proton therapy for breast cancer treatment - clinical implications

Radiation burden from modern radiation therapy techniques including proton therapy for breast cancer treatment - clinical implications

Proton Therapy for Breast Cancer: Progress & Pitfalls

Proton radiotherapy for treating the most common carcinomas

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