Predicted Cardiac and Second Cancer Risks in Hodgkin Lymphoma Patients Treated With Advanced Proton Beam Therapy Compared to Photon Radiation Therapy

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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Dosimetric comparison between proton beam therapy and photon radiation therapy for locally advanced esophageal squamous cell carcinoma

Radiation Oncology ◽

10.1186/s13014-018-0966-5 ◽

2018 ◽

Vol 13 (1) ◽

Cited By ~ 12

Author(s):

Yasuhiro Hirano ◽

Masakatsu Onozawa ◽

Hidehiro Hojo ◽

Atsushi Motegi ◽

Sadatomo Zenda ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Radiation Therapy ◽

Esophageal Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Proton Beam ◽

Squamous Cell ◽

Locally Advanced ◽

Proton Beam Therapy ◽

Photon Radiation ◽

Dosimetric Comparison

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

Frontiers in Oncology ◽

10.3389/fonc.2021.760691 ◽

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.

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Dosimetric comparison between proton beam therapy and photon radiation therapy for locally advanced non-small cell lung cancer

Japanese Journal of Clinical Oncology ◽

10.1093/jjco/hyw108 ◽

2016 ◽

Vol 46 (11) ◽

pp. 1008-1014 ◽

Cited By ~ 3

Author(s):

Chen-Ta Wu ◽

Atsushi Motegi ◽

Kana Motegi ◽

Kenji Hotta ◽

Ryosuke Kohno ◽

...

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Small Cell Lung Cancer ◽

Proton Beam ◽

Cell Lung Cancer ◽

Locally Advanced ◽

Proton Beam Therapy ◽

Small Cell ◽

Photon Radiation ◽

Small Cell Lung

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RONC-04. RE-IRRADIATION AFTER TREATMENT OF MEDULLOBLASTOMA; RELAPSED CASES AND SECOND CANCER CASES

Neuro-Oncology ◽

10.1093/neuonc/noaa222.777 ◽

2020 ◽

Vol 22 (Supplement_3) ◽

pp. iii456-iii457

Author(s):

Toshinori Soejima ◽

Nobutoshi Fukumitsu ◽

Yusuke Demizu ◽

Masayuki Mima ◽

Takeshi Suzuki ◽

...

Keyword(s):

Radiation Therapy ◽

Brain Tumor ◽

Proton Beam ◽

Organs At Risk ◽

Gamma Knife Radiosurgery ◽

Proton Beam Therapy ◽

Late Complications ◽

Second Cancer ◽

Reduce Radiation Dose

Abstract PURPOSE Late complications such as brainstem necrosis are great concern of re-irradiation for brain tumor. Proton beam therapy can reduce radiation dose of organs at risk such as brainstem, so is expected to reduce late complications. PATIENTS AND METHODS Patients with medulloblastoma treated with re-irradiation from January 2015 to February 2019 at the Kobe Children’s Hospital and the Kobe Proton Center were reviewed. There were three cases of relapsed medulloblastoma and three cases of second cancer (glioblastomas). RESULTS In relapsed cases, all three cases treated with 12 Gy in 8 fractions cranio-spinal irradiation followed by gamma knife radiosurgery (one) or 28.8 Gy (RBE) in 16 fractions of proton beam therapy (two). Follow-up periods were 8 to 19 months (median 12 months) and all three cases survived without relapse. In second cancer cases, all three cases were treated with 40.05 Gy per 15 fractions of radiation therapy (2 cases were treated with photon and one case with proton). However, all cases relapsed and two cases died of disease. CONCLUSION Twelve Gy in 8 fractions cranio-spinal irradiation followed by 28.8 Gy (RBE) in 16 fractions of proton beam therapy is thought to be useful for the relapsed case. Re-irradiation for second cancer was disappointing and further study is warranted.

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Radiation Therapy (Hypofractionated Proton Beam Therapy or IMRT) for the Treatment of Recurrent, Oligometastatic Prostate Cancer Following Primary Localized Treatment

Case Medical Research ◽

10.31525/ct1-nct04190446 ◽

2019 ◽

Author(s):

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Proton Beam ◽

Proton Beam Therapy ◽

Oligometastatic Prostate Cancer ◽

Localized Treatment

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

Rare Tumors ◽

10.1177/2036361319878518 ◽

2019 ◽

Vol 11 ◽

pp. 203636131987851 ◽

Cited By ~ 1

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.

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