Selection criteria for early breast cancer patients in the DBCG proton trial – The randomised phase III trial strategy

Stick, Line Bjerregaard; Lorenzen, Ebbe Laugaard; Yates, Esben Svitzer; Anandadas, C.; Andersen, Karen; Aristei, Cynthia; Byrne, O.; Hol, S.; Jensen, I.; Kirby, Anna M.; Kirova, Youlia; Marrazzo, L.; Matías-Pérez, A.; Nielsen, Mette Marie Bruun; Nissen, Henrik Dahl; Oliveros, S.; Verhoeven, K.; Vikström, Johan; Offersen, Birgitte Vrou

doi:10.1016/j.ctro.2021.01.012

Cited by 23 publications

(11 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…With breathing adaption, 3D-CRT and tangential IMRT fields also had higher potential for sparing the heart compared to a partial VMAT technique [21]. These conclusions were recently validated in another study showing that the 3D-CRT in many situations is to be preferred [28].…”

Section: Discussionmentioning

confidence: 90%

Dose constraints for whole breast radiation therapy based on the quality assessment of treatment plans in the randomised Danish breast cancer group (DBCG) HYPO trial

Thomsen

Berg

Zimmermann

et al. 2021

Clinical and Translational Radiation Oncology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 90%

Dose constraints for whole breast radiation therapy based on the quality assessment of treatment plans in the randomised Danish breast cancer group (DBCG) HYPO trial

Thomsen

Berg

Zimmermann

et al. 2021

Clinical and Translational Radiation Oncology

View full text Add to dashboard Cite

show abstract

“…In the DBCG Proton trial ( ClinicalTrials.gov number, NCT04291378) [ 40 ], breast cancer patients are randomized between photon radiation therapy and proton therapy. Full target coverage is a prerequisite and patients may be included if exposure to the heart or lungs exceeds a prespecified threshold with photon therapy [ 41 ]. After randomization, the optimal proton and photon plans are made (including possible target compromises as deemed optimal by treating physician).…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced Toxicity Risks in Photon Versus Proton Therapy for Synchronous Bilateral Breast Cancer

Stick

Bentzen

Kamby

et al. 2022

International Journal of Particle Therapy

Self Cite

View full text Add to dashboard Cite

Purpose This study compares photon and proton therapy plans for patients with synchronous bilateral early breast cancer and estimates risks of early and late radiation-induced toxicities. Materials and Methods Twenty-four patients with synchronous bilateral early breast cancer receiving adjuvant radiation therapy using photons, 3-dimensional conformal radiation therapy or volumetric modulated arc therapy, were included and competing pencil beam scanning proton therapy plans were created. Risks of dermatitis, pneumonitis, acute esophageal toxicity, lung and breast fibrosis, hypothyroidism, secondary lung and esophageal cancer and coronary artery events were estimated using published dose-response relationships and normal tissue complication probability (NTCP) models. Results The primary clinical target volume V95% and/or nodal clinical target volume V90% were less than 95% in 17 photon therapy plans and none of the proton plans. Median NTCP of radiation dermatitis ≥ grade 2 was 18.3% (range, 5.4-41.7) with photon therapy and 58.4% (range, 31.4-69.7) with proton therapy. Median excess absolute risk (EAR) of secondary lung cancer at age 80 for current and former smokers was 4.8% (range, 0.0-17.0) using photons and 2.7% (range, 0.0-13.6) using protons. Median EAR of coronary event at age 80, assuming all patients have preexisting cardiac risk factors, was 1.0% (range, 0.0-5.6) with photons and 0.2% (range, 0.0-1.3) with protons. Conclusion Proton therapy plans improved target coverage and reduced risk of coronary artery event and secondary lung cancer while increasing the risk of radiation dermatitis.

show abstract

“…In one striking example from Europe of modern radiotherapy cases, authors re-planned treatments without allowing target compromise. The estimated portion of breast cancer patients with excess doses to either the heart or the lung was 22%, suggesting that clinicians compromise target coverage in about 1 in 5 patients [ 18 ]. Particle therapy may be especially valuable among left-sided patients receiving regional nodal irradiation (RNI), wherein the IMN are a target structure and are located immediately adjacent to the heart, as well as in young women, and those with pre-existing cardiac risk factors [ 5 , 19 ].…”

Section: Proton Therapy: Rationale and Specific Clinical Indicationsmentioning

confidence: 99%

“…The Mayo Clinic MC1631 trial comparing 15 versus 25 fractions for 88 women undergoing post-mastectomy radiotherapy with or without reconstruction completed accrual and is pending publication. Additional multi-institutional clinical trials in the United Kingdom and Denmark using moderate hypofractionation with proton therapy for the treatment of regional lymph nodes will further refine the role of proton therapy in this setting [ 18 , 50 ].…”

Section: Hypofractionationmentioning

confidence: 99%

Particle Therapy for Breast Cancer

Kowalchuk

Corbin

Jimenez

2022

Cancers

View full text Add to dashboard Cite

Particle therapy has received increasing attention in the treatment of breast cancer due to its unique physical properties that may enhance patient quality of life and reduce the late effects of therapy. In this review, we will examine the rationale for the use of proton and carbon therapy in the treatment of breast cancer and highlight their potential for sparing normal tissue injury. We will discuss the early dosimetric and clinical studies that have been pursued to date in this domain before focusing on the remaining open questions limiting the widespread adoption of particle therapy.

show abstract

Selection criteria for early breast cancer patients in the DBCG proton trial – The randomised phase III trial strategy

Abstract: Highlights We establish selection criteria for the randomised DBCG Proton Trial. DBCG proton selection criteria: mean heart dose ≥ 4 Gy and/or lung V17Gy/V20Gy ≥ 37%. ~1 in 5 patients undergoing loco-regional radiotherapy will be eligible for the trial.

Cited by 23 publications

References 37 publications

Dose constraints for whole breast radiation therapy based on the quality assessment of treatment plans in the randomised Danish breast cancer group (DBCG) HYPO trial

Dose constraints for whole breast radiation therapy based on the quality assessment of treatment plans in the randomised Danish breast cancer group (DBCG) HYPO trial

Radiation-Induced Toxicity Risks in Photon Versus Proton Therapy for Synchronous Bilateral Breast Cancer

Particle Therapy for Breast Cancer

Contact Info

Product

Resources

About