scholarly journals Treatment interruptions affect biochemical failure rates in prostate cancer patients treated with proton beam therapy: Report from the multi-institutional proton collaborative group registry

2020 ◽  
Vol 25 ◽  
pp. 94-101
Author(s):  
James E. Han ◽  
John Chang ◽  
Lane Rosen ◽  
William Hartsell ◽  
Henry Tsai ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Biochemical Failure ◽  
Collaborative Group ◽  
Failure Rates ◽  
Treatment Interruptions

Proton beam therapy for liver cancer is well tolerated: Outcomes from the Proton Collaborative Group REG001-09 trial.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 389-389
Author(s):  
Michael David Chuong ◽  
Smith Apisarnthanarax ◽  
William F. Hartsell ◽  
Gary L. Larson ◽  
Henry K. Tsai ◽  
...  
Keyword(s):  
Liver Cancer ◽  
Cancer Patients ◽  
Proton Beam ◽  
Liver Tumors ◽  
Proton Beam Therapy ◽  
Median Number ◽  
Tumor Burden ◽  
Collaborative Group ◽  
Delivery Technique

389 Background: The liver is one of the most radiosensitive organs, making radiation therapy (RT) for liver tumors extremely challenging. RT is appropriate only for a minority of liver patients with limited tumor burden; a reduction in the prescribed radiation dose may be needed to lower the probability of radiation-induced liver disease especially in the presence of cirrhosis. Proton beam therapy (PBT) delivers less dose to the liver than photon therapy and is expected to reduce toxicity while also permitting safe dose escalation for some patients with liver tumors. Methods: The Proton Collaborative Group REG001-09 trial (NCT01255748) prospectively collects data for PBT patients with a variety of cancer types. To better understand treatment details and outcomes associated with liver PBT, patients enrolled on the PCG registry trial from 5 institutions who received liver PBT for any cancer between 2012 and 2016 were analyzed. Results: A total of 43 liver cancer patients were included, most with hepatocellular carcinoma (48.8%) or cholangiocarcinoma (25.6%). The vast majority did not have surgery at any time (86%). Most were treatment naive prior to PBT; 2 previously had RT and 8 had prior chemotherapy (mostly cholangiocarcinoma patients). The median total prescribed PBT dose was 58.05 Gy(RBE) (range 21.7-67.5). The median number of prescribed fractions was 15 (range 12-37). PBT was delivered to only the liver in 90.7% of patients; inclusion of lymph nodes was rare. Uniform scanning was used in 26 (72.1%) and pencil beam scanning in 2 patients (4.7%); the delivery technique used for the remaining patients was unknown (23.2%). With median follow up of 4.4 months (range 1.3-17.9), 3 patients (7%) had an intrahepatic recurrence, 2 patients (4.6%) developed distant metastasis, and 10 patients (23.3%) died. No grade 3 or higher toxicity was reported although 17 patients (39.5%) had grade 2 toxicity predominantly fatigue, anorexia, nausea, or vomiting. Conclusions: Although longer follow up is needed to assess late toxicities as well as disease control, early outcomes from the PCG registry trial for liver cancer patients shows that predominantly hypofractionated PBT has a very favorable acute toxicity profile.

Completion time in prostate cancer treated with proton beam therapy: Do interruptions matter?

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e17553-e17553
Author(s):  
Shaakir Hasan ◽  
Lane Rosen ◽  
Henry Tsai ◽  
Christopher Sinesi ◽  
George E Laramore ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Completion Time ◽  
Characteristic Curve ◽  
Proton Beam Therapy ◽  
Collaborative Group ◽  
Kaplan Meier ◽  
Treatment Interruptions ◽  
Risk Patients ◽  
Prostate Cancers

e17553 Background: The association between completion time of proton therapy(PT) in prostate cancer and biochemical control is unknown. Methods: We queried the multi-institutional, prospectively collected, proton collaborative group registry for prostate cases treated definitively with PT. Kaplan meier methodology was used for biochemical failure free (bFF) rates and multivariable regression analyses (MVA) were used to identify correlates of treatment interruptions (TI) and bF. Results: After exclusion, 2794 men with 693 low, 869 favorable intermediate, 627 unfavorable intermediate, and 605 high risk prostate cancers had available data. The median age was 68 years(40-92), 90% were white and 8% were black. Androgen deprivation therapy (ADT) was given to 676 patients, 312 treatments were hypofractionated, and median EQD2 dose = 75(74-86) GyE1.5. Kaplan-meier median follow-up was 79 months. In total 900 patients (32%) had at least one TI. Shorter treatments (HR = 0.95 per day, P < 0.01) and high risk (HR = 0.72, P < 0.04) cases were less likely to have Tis on MVA. There was no difference in 5-year bFF rate with (92.7) and without (93.1%) TIs. In a subset of only high risk patients treated with ADT (n = 385), the 5-year bFF was 83% without TIs and 75% with TIs (HR = 2.10, P = 0.06). This discrepancy was significant with multivariable binomial regression (HR = 2.36, P = 0.03), and the bF difference was greatest when > 5 treatment days were missed per receiver operating characteristic curve. Conclusions: Largely, there was no correlation between TIs and bF in prostate cancer treated with PT, however completion time may play a more significant role in high risk disease.

scholarly journals Long-term Clinical Outcomes in Favorable Risk Prostate Cancer Patients Receiving Proton Beam Therapy

2021 ◽  
Author(s):  
Alicia Bao ◽  
Andrew R. Barsky ◽  
Russell Maxwell ◽  
Justin E. Bekelman ◽  
Stefan Both ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Control ◽  
Proton Beam ◽  
Proportional Hazards ◽  
Proton Beam Therapy ◽  
Cox Proportional Hazards ◽  
Biochemical Failure ◽  
Distant Failure ◽  
Regional Failure

Abstract Purpose Long-term data regarding the disease control outcomes of proton beam therapy (PBT) for patients with favorable risk intact prostate cancer (PC) are limited. Herein, we report our institution's long-term disease control outcomes in PC patients with clinically localized disease who received PBT as primary treatment. Methods One hundred sixty-six favorable risk PC patients who received definitive PBT to the prostate gland at our institution from 2010 to 2012 were retrospectively assessed. The outcomes studied were biochemical failure-free survival (BFFS), biochemical failure, local failure, regional failure, distant failure, PC-specific survival, and overall survival. Patterns of failure were also analyzed. Multivariate Cox proportional hazards modeling was used to estimate independent predictors of BFFS. Results The median length of follow-up was 8.3 years (range, 1.2–10.5 years). The majority of patients had low-risk disease (58%, n = 96), with a median age of 64 years at the onset of treatment. Of 166 treated men, 13 (7.8%), 8 (4.8%), 2 (1.2%) patient(s) experienced biochemical failure, local failure, regional failure, respectively. Regional failure was seen in an obturator lymph node in 1 patient and the external iliac lymph nodes in the other. None of the patients experienced distant failure. There were 5 (3.0%) deaths, none of which were due to PC. The 5- and 8-year BFFS rate were 97% and 92%, respectively. None of the clinical disease characteristics or treatment-related factors assessed were associated with BFFS on multivariate Cox proportional hazards modeling (all P &gt; .05). Conclusion Disease control rates reported in our assessment of PBT were similar to those reported in previous clinically localized intact PC analyses, which used intensity-modulated radiotherapy, three-dimensional conformal radiotherapy, or radical prostatectomy as definitive therapy. In addition, BFFS rates were similar, if not improved, to previous PBT studies.

scholarly journals Is an Endorectal Balloon Beneficial for Rectal Sparing After Spacer Implantation in Prostate Cancer Patients Treated With Hypofractionated Intensity-modulated Proton Beam Therapy? A Dosimetric and Radiobiological Comparison Study

2021 ◽  
Author(s):  
Dalia Ahmad Khalil ◽  
Jörg Wulff ◽  
Danny Jazmati ◽  
Dirk Geismar ◽  
Christian Bäumer ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Seminal Vesicle ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Rectal Toxicity ◽  
P Values ◽  
Intensity Modulated ◽  
Late Rectal Toxicity ◽  
Dose Levels

Abstract BackgroundThe aim of this study is to examine the dosimetric influence of endorectal balloons (ERB) in rectal sparing in prostate cancer patients with implanted hydrogel rectum spacers treated with dose escalated/hypofractionated intensity modulated proton beam therapy (IMPT). MethodsTen patients with localised prostate cancer included in the ProRegPros study and treated at our centre were invastigated in this study. All patients underwent a placement of hydrogel rectum spacers before planning. Two planning CTs (with and without 120 cm3 fluid-filled ERB) were acquired for each patient. Dose prescription was set according to the used simultaneous integrated boost strategy with 72 Gray (Gy)/2.4 Gy/5 x weekly to prostate+1 cm of the seminal vesicle, and 60 Gy/2 Gy/5 x weekly to prostate+2 cm of the seminal vesicle. Planning with two lateral-opposed IMPT beams was performed in both CTs. Rectal dosimetry values including dose-volume statistics and normal tissue complication probability (NTCP) in both plans were compared (non-ERB plans vs. ERB plans).ResultsFor ERB plans compared to non-ERB, the reductions were 8.51 ± 5.25 Gy (RBE) (p= 0.000) and 15.76 ± 11.11Gy (P= 0.001) for the mean and the median rectal dose, respectively. No significant reductions in rectal volumes receiving high dose levels were found. The use of ERB resulted in significant reduction in rectal volume receiving 50 Gy (RBE), 40 Gy (RBE), 30 Gy (RBE), 20 Gy (RBE), and 10 Gy (RBE) with P values of 0.034, 0.008, 0.003, 0.001, and 0.001, respectively. For the anterior rectum, no differences between ERB and non-ERB plans were observed. For the posterior rectum, ERB reduced rectal volumes received 30 Gy (RBE), 20 Gy (RBE), and 10 Gy (RBE) with P values of 0.019, 0.003, and 0.001, respectively. No significant reductions in mean or median rectal toxicity (Late rectal bleeding ≥2, necrosis/stenosis, and Late rectal toxicity ≥ 3) were observed when using the ERB according to NTCP models.ConclusionThe ERB reduced rectal volumes exposed to intermediate/low dose levels. However, no significant reduction in rectal volumes receiving high/intermediate doses could be observed. No benefit but also no disadvantage of the ERB for late rectal toxicity was found according to available NTCP models.

Sign in / Sign up

Export Citation Format

Share Document