scholarly journals 455 Proton Beam Therapy in Rectal Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Fok ◽  
S Toh ◽  
J E Maducolil ◽  
H Fowler ◽  
R Clifford ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Proton Beam ◽  
Organs At Risk ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Significant Risk ◽  
Proton Beam Therapy ◽  
Recurrent Rectal Cancer ◽  
Pelvic Bone ◽  
Dosimetric Data

Abstract Introduction Radiotherapy for locally advanced rectal cancer is conventionally performed using photon-based radiotherapy (PBR), carrying significant risk of toxicity to organs at risk (OAR). Proton beam therapy (PBT) potentially delivers equivalent dosimetric radiation to the targeted tissue with improved sparing of OAR. We aimed to compare dosimetric irradiation of OAR for PBT versus PBR in patients with rectal cancer and assess any oncological outcomes. Method An extensive electronic literature search was performed from inception till April 2020 and subsequent meta-analysis performed. Results Six articles met the inclusion criteria. Dosimetric data of irradiation delivered to OAR for PBT and PBR were calculated for the same patients. PBT had significantly less irradiated small bowel compared to 3DCRT and IMRT, (MD -16.95, 95% CI [-24.03, -9.88], p < 0.00001) and (MD -6.96, 95% CI [-12.99, -0.94], p = 0.02) respectively. Similar results were observed for bladder and pelvic bone marrow. Two studies reported clinical and oncological results for PBT in recurrent rectal cancer with overall survival reported as 43% and 68%. Conclusions Dosimetric treatment plans have less irradiation of OAR for rectal cancer with PBT compared to PBR. There is a need for further research in PBT and rectal cancer, as promising results have been shown in recurrent rectal cancer.

Proton beam therapy in rectal cancer: A systematic review and meta-analysis

2021 ◽  
pp. 101638
Author(s):  
Matthew Fok ◽  
Steven Toh ◽  
Jeremy Maducolil ◽  
Hayley Fowler ◽  
Rachael Clifford ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Proton Beam ◽  
Meta Analysis ◽  
Proton Beam Therapy

Effect and safety of proton beam therapy for locally recurrent rectal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 743-743
Author(s):  
Yusuke Ogi ◽  
Tomohiro Yamaguchi ◽  
Yusuke Kinugasa ◽  
Akio Shiomi ◽  
Hiroyasu Kagawa ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Proton Beam ◽  
Survival Rates ◽  
Proton Beam Therapy ◽  
Local Control Rate ◽  
Recurrent Rectal Cancer ◽  
Lateral Lymph Node ◽  
Free Survival ◽  
Locally Recurrent Rectal Cancer ◽  
Locally Recurrent

743 Background: The first choice of treatment for locally recurrent rectal cancer is surgical resection. However, the operation is often difficult with high perioperative risk. For surgically unfit cases, proton beam therapy (PBT) is proposed as the treatment option. However, its efficacy for locally recurrent rectal cancer remains unclear. Therefore, this study aimed to evaluate the efficacy and safety of PBT for locally recurrent rectal cancer. Methods: A total of 23 patients with locally recurrent rectal cancer who received PBT were retrospectively evaluated, from November 2005 to July 2014. Patients with single lesion, who refuse the radical surgical therapy, or who were considered unfit for the operation were included in this study. All patients were treated with 2.8Gy relative biological effectiveness (RBE)/fraction. Twenty-five irradiations were performed, with a total irradiation of 70Gy RBE. Unfit for operation criteria include invasion to the vertebra higher than the third sacrum or lateral lymph node recurrence after a lateral lymph node dissection. To assess the safety of PBT, adverse events were evaluated by using the Common Terminology Criteria for Adverse Effects (CTCAE version4.0). To assess the efficacy, the overall and relapse-free survival rates and local control rate were evaluated. Results: Sixteen patients were unfit for operation, and seven refused surgery. Three patients experienced Grade 3 late adverse events in the CTCAE (two ileum fistula and one urinary tract obstruction). The median follow-up time was 28.9 months. The 5-year overall and relapse-free survival rates were 47.6% and 20.2%, respectively. Fifteen patients (65.2%) showed distant metastasis or regrowth at the locally recurrent site. The 5-year local control rate was 39.0%. Ten patients (43.4%) showed regrowth at the proton beam irradiation site. Conclusions: PBT was relatively effective for locally recurrent rectal cancer with manageable adverse effects. Therefore, PBT may be considered as the therapeutic option for selected locally recurrent rectal cancer patients.

scholarly journals Double-barrelled wet colostomy formation after pelvic exenteration for locally advanced or recurrent rectal cancer

2016 ◽  
Vol 18 (11) ◽  
pp. O427-O431 ◽  
Author(s):  
A. L. A. Bloemendaal ◽  
R. Kraus ◽  
N. C. Buchs ◽  
F. C. Hamdy ◽  
R. Hompes ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Pelvic Exenteration ◽  
Locally Advanced ◽  
Recurrent Rectal Cancer

Range optimization for target and organs at risk in dynamic adaptive passive scattering proton beam therapy – A proof of concept

2018 ◽  
Vol 56 ◽  
pp. 66-73
Author(s):  
Shunsuke Moriya ◽  
Hidenobu Tachibana ◽  
Kenji Hotta ◽  
Naoki Nakamura ◽  
Takeji Sakae ◽  
...  
Keyword(s):  
At Risk ◽  
Proton Beam ◽  
Organs At Risk ◽  
Proton Beam Therapy ◽  
Proof Of Concept ◽  
Passive Scattering

scholarly journals Proton Beam Therapy for Local Recurrence of Rectal Cancer

2021 ◽  
Vol 41 (7) ◽  
pp. 3589-3595
Author(s):  
YUICHI HIROSHIMA ◽  
HITOSHI ISHIKAWA ◽  
MOTOHIRO MURAKAMI ◽  
MASATOSHI NAKAMURA ◽  
SHOSEI SHIMIZU ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Recurrence Of Rectal Cancer

Proton Beam Therapy for Locally Advanced Head and Neck Tumors

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Saad Sheikh ◽  
Michael Z. Kharouta ◽  
Rajesh Pidikiti ◽  
Nicholas J. Damico ◽  
Serah Choi ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Beam ◽  
Locally Advanced ◽  
Proton Beam Therapy ◽  
Head And Neck Tumors ◽  
Advanced Head ◽  
Neck Tumors

scholarly journals Pathological Complete Response Following Different Neoadjuvant Treatment Strategies for Locally Advanced Rectal Cancer: A Systematic Review and Meta-analysis

2020 ◽  
Vol 27 (11) ◽  
pp. 4319-4336 ◽  
Author(s):  
S. Hoendervangers ◽  
J. P. M. Burbach ◽  
M. M. Lacle ◽  
M. Koopman ◽  
W. M. U. van Grevenstein ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Pathological Complete Response ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Treatment Strategies ◽  
Complete Response ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer

Abstract Background Pathological complete response (pCR) following neoadjuvant treatment for locally advanced rectal cancer (LARC) is associated with better survival, less local recurrence, and less distant failure. Furthermore, pCR indicates that the rectum may have been preserved. This meta-analysis gives an overview of available neoadjuvant treatment strategies for LARC and analyzes how these perform in achieving pCR as compared with the standard of care. Methods Pubmed, Embase, and Cochrane Central bibliographic databases were searched. Randomized controlled trials in which patients received neoadjuvant treatment for MRI-staged nonmetastatic resectable LARC were included. The primary outcome was pCR, defined as ypT0N0. A meta-analysis of studies comparing an intervention with standard fluoropyrimidine-based chemoradiation (CRT) was performed. Results Of the 17 articles included in the systematic review, 11 were used for the meta-analysis. Addition of oxaliplatin to fluoropyrimidine-based CRT resulted in significantly more pCR compared with fluoropyrimidine-based CRT only (OR 1.46), but at the expense of more ≥ grade 3 toxicity. Other treatment strategies, including consolidation/induction chemotherapy and short-course radiotherapy (SCRT), did not improve pCR rates. None of the included trials reported a benefit in local control or OS. Five-year DFS was significantly worse after SCRT-delay compared with CRT (59% vs. 75.1%, HR 1.93). Conclusions All included trials fail to deliver high-level evidence to show an improvement in pCR compared with standard fluoropyrimidine-based CRT. The addition of oxaliplatin might result in more pCR but at the expense of more toxicity. Furthermore, this benefit does not translate into less local recurrence or improved survival.

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