scholarly journals Proton Beam Therapy Versus Conformal Photon Radiation Therapy for Childhood Craniopharyngioma: Multi-institutional Analysis of Outcomes, Cyst Dynamics, and Toxicity

2014 ◽  
Vol 90 (2) ◽  
pp. 354-361 ◽  
Author(s):  
Andrew J. Bishop ◽  
Brad Greenfield ◽  
Anita Mahajan ◽  
Arnold C. Paulino ◽  
M. Fatih Okcu ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Proton Beam ◽  
Institutional Analysis ◽  
Proton Beam Therapy ◽  
Photon Radiation

scholarly journals Outcomes and Toxicities of Proton and Photon Radiation Therapy for Testicular Seminoma

2020 ◽  
Vol 7 (2) ◽  
pp. 11-20
Author(s):  
Dario Pasalic ◽  
Surendra Prajapati ◽  
Ethan B. Ludmir ◽  
Chad Tang ◽  
Seungtaek Choi ◽  
...  
Keyword(s):  
At Risk ◽  
Radiation Therapy ◽  
Survival Rate ◽  
Proton Beam ◽  
Organs At Risk ◽  
Proton Beam Therapy ◽  
Photon Radiation ◽  
Secondary Malignancies ◽  
Testicular Seminoma

Abstract Purpose To determine the clinical outcomes and toxicities of proton beam therapy (PBT) versus 3D-conformal photon radiation therapy (XRT) in patients with testicular seminoma. Materials and Methods This observational study evaluated consecutive patients with testicular seminoma who were treated with inguinal orchiectomy and radiation therapy at a single, tertiary, high-volume center in 2008-19. Acute toxicity was scored with the Common Terminology Criteria for Adverse Events V 4.0. Organs at risk were contoured retrospectively by 2 investigators. Recurrences and secondary malignancies were based on routine follow-up imaging, either computed tomography or magnetic resonance imaging. Results Fifty-five patients were treated with radiation therapy, 11 in the PBT-arm and 44 in the XRT-arm, with a median follow-up interval of 61 months (interquartile range [IQR]: 32-79 months). Acute treatment-related diarrhea, grade 1 to 2, was more common among XRT-treated patients (0% vs 29.5%, P = .039), and dermatitis, grade 1, was more likely among PBT-treated patients (27.3% vs 2.3%, P = .004). Dosimetrically, PBT-treated patients, relative to XRT-treated patients, had lower dose to organs at risk including the kidney, bladder, femoral head, spinal cord, bowel, pancreas, and stomach. The 5-year overall survival rate was 100% and disease-free survival rate was 96.4% for all patients. Two patients, all in the XRT-arm, had disease recurrence: 1 in the pelvis and 1 in the lung. Three patients, all in the XRT-arm, were diagnosed with a secondary malignancy: 1 in-field pancreaticoblastoma, 1 in-field colon adenocarcinoma, and a stage IV T-cell lymphoma. Conclusion Proton beam therapy for testicular seminoma resulted in excellent clinical outcomes and was associated with lower rates of acute diarrhea but higher rates of acute dermatitis. Proton beam therapy resulted in no in-field secondary malignancies and a more favorable dosimetric profile for organs at risk relative to XRT. Reduced dose to organs at risk, such as the kidneys, may result in long-term improvement in function.

scholarly journals Radiation Induced Cavernomas in the Treatment of Pediatric Medulloblastoma: Comparative Study Between Proton and Photon Radiation Therapy

2021 ◽  
Vol 11 ◽  
Author(s):  
S. Joy Trybula ◽  
Mark W. Youngblood ◽  
Hanna R. Kemeny ◽  
Jeffrey R. Clark ◽  
Constantine L. Karras ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Proton Beam ◽  
Surgical Resection ◽  
Proton Beam Therapy ◽  
Photon Radiation ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Significant Difference ◽  
Radiation Induced

Radiation induced cavernomas among children with medulloblastoma are common following external beam radiation (XRT) treatment with either photon or proton beams. However, with the increased utilization of proton beam therapy over the last decade we sought to determine if there was any difference in the development or natural history of these cavernous malformations (CM) or CM-like lesions. We performed a retrospective analysis of 79 patients from 2003 to 2019 who had undergone resection of medulloblastoma and subsequent XRT (30 photon or 49 proton beam therapy). The average age of patients at radiation treatment was 8.7 years old. Average follow up for patients who received photon beam therapy was 105 months compared to 56.8 months for proton beam therapy. A total of 68 patients (86.1%) developed post-radiation CMs, including 26 photon and 42 proton patients (86.7% and 85.7% respectively). The time to cavernoma development was significantly different, with a mean of 40.2 months for photon patients and 18.2 months for proton patients (p = 1.98 x 10-4). Three patients, one who received photon and two who received proton beam radiation, required surgical resection of a cavernoma. Although CM or CM-like lesions are detected significantly earlier in patients after receiving proton beam therapy, there appears to be no significant difference between the two radiation therapy modalities in the development of significant CM requiring surgical resection or intervention other than continued follow up and surveillance.

scholarly journals Dosimetric advantages of proton beam therapy compared to intensity-modulated radiation therapy for retroperitoneal chordoma

Rare Tumors ◽  
2019 ◽  
Vol 11 ◽  
pp. 203636131987851 ◽  
Author(s):  
Nathan Y Yu ◽  
Sujay A Vora
Keyword(s):  
Radiation Therapy ◽  
Proton Beam ◽  
Intensity Modulated Radiation Therapy ◽  
Proton Beam Therapy ◽  
Intensity Modulated ◽  
Spot Scanning ◽  
Prescription Dose ◽  
Biological Effectiveness ◽  
Primary Bone ◽  
Rare Diagnosis

Retroperitoneal chordomas are exceedingly rare and account for less than 5% of all primary bone malignancies. Their etiology remains unknown. We report a rare case of an extravertebral chordoma of the retroperitoneum in a 71-year-old man treated with surgical resection and post-operative spot-scanning proton beam therapy. We describe how to safely treat a retroperitoneal target to a prescription dose over 70 Gy (relative biological effectiveness) with spot-scanning proton beam therapy and also report a dosimetric comparison of spot-scanning proton beam therapy versus intensity-modulated radiation therapy. This case not only highlights a rare diagnosis of an extravertebral retroperitoneal chordoma but it also draws attention to the dosimetric advantages of proton beam therapy and illustrates a promising radiotherapeutic option for retroperitoneal targets.

scholarly journals Promise and Pitfalls of Heavy-Particle Therapy

2014 ◽  
Vol 32 (26) ◽  
pp. 2855-2863 ◽  
Author(s):  
Timur Mitin ◽  
Anthony L. Zietman
Keyword(s):  
Radiation Therapy ◽  
Proton Beam ◽  
Heavy Particle ◽  
Proton Beam Therapy ◽  
Modern Medicine ◽  
Particle Therapy ◽  
Policy Debate ◽  
Public Attention ◽  
Particle Radiation ◽  
Number Of Treatment

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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