Predicted Rate of Secondary Malignancies Following Adjuvant Proton Versus Photon Radiation Therapy for Thymoma

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.

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Proton Radiation Therapy and the Incidence of Secondary Malignancies

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2007.07.324 ◽

2007 ◽

Vol 69 (3) ◽

pp. S178-S179 ◽

Cited By ~ 4

Author(s):

C.S. Chung ◽

T. Yock ◽

J. Johnson ◽

B. Esty ◽

N. Tarbell

Keyword(s):

Radiation Therapy ◽

Secondary Malignancies ◽

Proton Radiation ◽

Proton Radiation Therapy

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EXTERNAL-BEAM RADIATION THERAPY INCREASES THE RATE OF SECONDARY MALIGNANCIES RELATIVE TO RADICAL PROSTATECTOMY IN MEN WITH PROSTATE CANCER

European Urology Supplements ◽

10.1016/s1569-9056(08)60186-4 ◽

2008 ◽

Vol 7 (3) ◽

pp. 117

Author(s):

N. Suardi ◽

C. Jeldres ◽

P. Perrotte ◽

L.F. Da Pozzo ◽

M. Raber ◽

...

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Radical Prostatectomy ◽

External Beam Radiation Therapy ◽

External Beam Radiation ◽

External Beam ◽

Secondary Malignancies ◽

Beam Radiation

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National Cancer Database Analysis of Proton Versus Photon Radiation Therapy in Non-Small Cell Lung Cancer

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2016.10.001 ◽

2017 ◽

Vol 97 (1) ◽

pp. 128-137 ◽

Cited By ~ 52

Author(s):

Kristin A. Higgins ◽

Kelli O'Connell ◽

Yuan Liu ◽

Theresa W. Gillespie ◽

Mark W. McDonald ◽

...

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Small Cell ◽

Photon Radiation ◽

National Cancer Database ◽

Small Cell Lung ◽

Database Analysis

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A case report of total skin photon radiation therapy for cutaneous epitheliotropic lymphoma in a dog

BMC Veterinary Research ◽

10.1186/s12917-019-2105-4 ◽

2019 ◽

Vol 15 (1) ◽

Author(s):

Michael A. Deveau ◽

Megan Sutton ◽

Courtney Baetge ◽

Alison B. Diesel

Keyword(s):

Veterinary Medicine ◽

Radiation Therapy ◽

Treatment Time ◽

Treatment Interruption ◽

Photon Radiation ◽

Beam Radiation ◽

Palliative Intent ◽

Time Commitment ◽

Cutaneous Lymphomas ◽

Grade 3

Abstract Background Total skin electron beam radiation therapy (TSEBT) is an effective treatment for primary diffuse cutaneous lymphomas in humans. While several techniques exist, they all require significant commitment of staff time and resources. In veterinary medicine, canine-specific techniques and strategies have been adapted and delivered but deemed not “realistically” clinically implementable given the time commitment of over 2.5 h plus per fraction or have been relegated to palliative intent. Leveraging these technologies of helical tomotherapy and 3D printing, we developed and clinically implemented a radiotherapeutic treatment strategy for the management of medically refractory diffuse cutaneous lymphoma in the dog. Case presentation A 13.5-year-old female spayed Bichon Frise presented to the Oncology service at Texas A&M University, College of Veterinary Medicine due to the progression of diffuse cutaneous epitheliotropic lymphoma (CEL) that had failed medical management. Twenty-seven gray were delivered to the patient with a treatment time requirement under 40 min including real time monitoring of anesthesia during setup and treatment. A partial response was noticeable after four fractions and the tumor completely regressed progressively over the entire treated area by the end of therapy. A grade 1 lethargy, fatigue, weight loss, and oral mucositis and grade 2 alopecia, nail/claw changes, pruritus, scaling, anorexia, and diarrhea were noted during treatment. Additionally, a grade 3 thrombocytopenia developed after fraction eight requiring a treatment interruption of 6 weeks and prescription modification prior to treatment continuation and completion. From the beginning of total skin photon radiation therapy (TSPT) treatment until the time of the patient was euthanized unrelated to cutaneous epitheliotropic lymphoma (123 days), only one new lesion on the head was identified and confirmed by histopathology within the treated fields. Conclusions The proposed technique is an acceptable alternative to TSEBT that is actually clinically implementable within a palliative or definitive setting and clinical constraints, however further testing and refinement is needed to reduce hematological complications and to confirm and expand on preliminary findings.

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Robustness of Clonogenic Assays as a Biomarker for Cancer Cell Radiosensitivity

International Journal of Molecular Sciences ◽

10.3390/ijms20174148 ◽

2019 ◽

Vol 20 (17) ◽

pp. 4148 ◽

Cited By ~ 7

Author(s):

Toshiaki Matsui ◽

Endang Nuryadi ◽

Shuichiro Komatsu ◽

Yuka Hirota ◽

Atsushi Shibata ◽

...

Keyword(s):

Radiation Therapy ◽

Cell Lines ◽

Cancer Cell ◽

Predictive Biomarkers ◽

Photon Radiation ◽

Published Data ◽

Gold Standard Method ◽

Clonogenic Assays ◽

Survival Endpoints ◽

Number Of Publications

Photon radiation therapy is a major curative treatment for cancer. However, the lack of robust predictive biomarkers for radiosensitivity precludes personalized radiation therapy. Clonogenic assays are the gold standard method for measuring the radiosensitivity of cancer cells. Although a large number of publications describe the use of clonogenic assays to measure cancer cell radiosensitivity, the robustness of results from different studies is unclear. To address this, we conducted a comprehensive detailed literature search of 256 common cancer cell lines and identified the eight cell lines most-frequently examined for photon sensitivity using clonogenic assays. Survival endpoints and experimental parameters from all 620 relevant experiments were compiled and analyzed. We found that the coefficients of variation for SF2 (surviving fraction after 2 Gy irradiation) and for D10 (dose that yields a surviving fraction of 10%) were below 30% for all cell lines, indicating that SF2 and D10 have acceptable inter-assay precision. These data support further analysis of published data on clonogenic assays using SF2 and D10 as survival endpoints, which facilitates robust identification of biological profiles representative of cancer cell sensitivity to photons.

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