RT-4 Treatment outcome of proton beam therapy for glioblastoma

Abstract Introduction: Proton beam therapy enables high dose irradiation for tumors while reducing the dose to surrounding normal tissue due to the sharp energy peak called the Bragg peak. We retrospectively analyzed the efficacy of the high dose radiotherapeutic strategy using proton beam for glioblastoma (GBM) in our institution. Methods: Twenty-nine patients with newly diagnosed GBM who underwent high dose proton beam therapy concomitant with temozolomide were investigated. All patients received hyperfractionated concomitant radiotherapy consisting of X-ray radiotherapy (50.4Gy in 28 fractions) and proton beam therapy (46.2Gy [RBE] in 28 fractions). The survival outcome and adverse events were analyzed. Results: The median overall survival time and progression free survival time for all 29 patients were 31.0 months (95%CI, 25.9–36.1) and 11.0 months (95%CI, 7.8–14.2), respectively. No significant survival difference according to the MGMT methylation status was shown. Failure patterns after proton beam therapy included 17 cases of local recurrence, 3 cases of distant recurrence, and 5 cases of dissemination. Although there was no significant difference in time to recurrence according to the failure pattern, there was a tendency of longer survival in the local recurrence group. Regarding adverse events, radiation necrosis was observed in 8 cases (including 2 asymptomatic cases). The median time to onset of necrosis after radiation was 18.2 months (95%CI, 10.3–26.2). There were 5 cases of long survivor over 5 years out of 29 cases (17.2%). Of these, 4 cases developed radiation necrosis. Conclusions: Our results indicate that high dose proton beam therapy of 96.6Gy (RBE) prolonged survival in selected GBM patients. Particularly in long survivors, special attention and effective treatment to radiation necrosis is a remaining problem.

Download Full-text

RT-02 POTENTIAL OF PROTON BEAM THERAPY FOR THE TREATMENT OF GLIOBLASTOMA

Neuro-Oncology Advances ◽

10.1093/noajnl/vdz039.094 ◽

2019 ◽

Vol 1 (Supplement_2) ◽

pp. ii21-ii21

Author(s):

Masahide Matsuda ◽

Eiichi Ishikawa ◽

Masashi Mizumoto ◽

Hidehiro Kohzuki ◽

Narushi Sugii ◽

...

Keyword(s):

Local Recurrence ◽

Adverse Events ◽

Survival Time ◽

Proton Beam ◽

Radiation Necrosis ◽

Proton Beam Therapy ◽

High Dose ◽

Failure Patterns ◽

Survival Difference ◽

Significant Difference

Abstract INTRODUCTION Recently, proton beam therapy has attracted increasing interest in the Japanese neuro-oncological field because of the insurance approval for pediatric brain tumor, chordoma, and chondrosarcoma. We have developed the high dose radiotherapeutic strategy using proton beam for malignant glioma in our institution since long before. Here we retrospectively analyzed the efficacy of this treatment strategy. METHODS Thirty-four patients with newly diagnosed GBM who underwent high dose proton beam therapy were investigated. All patients received hyperfractionated concomitant radiotherapy consisting of X-ray radiotherapy (50.4Gy in 28 fractions) and proton beam therapy (46.2Gy [RBE] in 28 fractions). Concurrent chemotherapy consisted of ACNU in the early 6 cases or TMZ in the late 28 cases. The survival outcome and adverse events were analyzed. RESULTS The median overall survival time and progression free survival time for all 34 patients were 35.7 months (95%CI, 28.1–43.4) and 11.2 months (95%CI, 6.8–15.7), respectively. No significant survival difference according to the chemotherapy regimen was shown. Failure patterns after proton beam therapy include 19 cases of local recurrence, 3 cases of distant recurrence, and 5 cases of dissemination. Although there was no significant difference in time to recurrence according to the failure pattern, there was a tendency of longer survival in the local recurrence group. As for adverse events, symptomatic radiation necrosis was observed in 9 cases. The median time to onset of necrosis after radiation was 18.2 months (95%CI, 10.2–26.2). There were 8 cases of long survivors over 5 years out of 34 cases (23.5%). Of these, 6 cases developed symptomatic radiation necrosis. CONCLUSIONS Our results indicate that high dose proton beam therapy of 96.6Gy (RBE) prolonged survival in selected GBM patients. With appropriate patient selection and potent treatment for radiation necrosis, high dose proton beam therapy has a great potential to improve survival in GBM patients.

Download Full-text

Long‐term outcomes of high‐dose (74 GyE ) proton beam therapy with concurrent chemotherapy for stage III nonsmall‐cell lung cancer

Thoracic Cancer ◽

10.1111/1759-7714.13896 ◽

2021 ◽

Author(s):

Kayoko Ohnishi ◽

Hitoshi Ishikawa ◽

Kensuke Nakazawa ◽

Toshihiro Shiozawa ◽

Yutaro Mori ◽

...

Keyword(s):

Lung Cancer ◽

Proton Beam ◽

Cell Lung Cancer ◽

Nonsmall Cell Lung Cancer ◽

Proton Beam Therapy ◽

Concurrent Chemotherapy ◽

Stage Iii ◽

High Dose ◽

Long Term Outcomes

Download Full-text

ML-23 The outcome of malignant lymphoma of the central nervous system in a single institution

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa143.079 ◽

2020 ◽

Vol 2 (Supplement_3) ◽

pp. ii18-ii18

Author(s):

Kiyonori Kuwahara ◽

Shigeo Ohba ◽

Kazuyasu Matsumura ◽

Saeko Higashiguchi ◽

Daijiro Kojima ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Adverse Events ◽

Malignant Lymphoma ◽

Survival Time ◽

Progression Free Survival ◽

Treatment Method ◽

The Other ◽

High Dose ◽

Other Hand

Abstract Background: Although high dose-methotrexate therapy has been performed for primary central nervous system malignant lymphoma (PCNSL), R-MPV (rituximab, methotrexate (MTX), procarbazine and vincristine) therapy is currently the first line therapy for (PCNSL) in our hospital. This study examines the results of R-MPV therapy comparing with past treatment. Method/Subjects: Thirty-seven patients treated at our hospital from 2009 to 2020 were included. Overall survival time, progression free survival time, and toxicities were evaluated. Results: The average age of patients was 65.7 years. Patients included 21 males and 16 females. Thirty-six patients were diagnosed DLBCL by resected brain tumor tissues, and one was diagnosed DLBCL by vitreous biopsy. As initial treatment, rituximab±HD-MTX therapy (R±MTX group) was performed in 20 cases, HD-MTX therapy plus radiation (R±MTX+RT group) was performed in 12 cases, and RMPV therapy was performed in 5 cases (R-MPV group). Median OS of all cases was 69 months and median PFS was 38 months. Median OS was 69 months in R±MTX group and could not be calculated in R±MTX+RT, and R-MPV groups. Median PFS was 16 months and 56 months in R±MTX group and R±MTX+RT, respectively, and could not be calculated in the R-MPV group. Although the R-MPV group had a short follow-up period, the results were considered to be comparable to those of the R±MTX+RT group. On the other hand, grade 3/4 adverse events occurred in 50%, 25%, and 100%, respectively. Conclusion: R-MPV therapy may delay the timing of radiation and reduce the amount of radiation. On the other hand, the frequency of adverse events is high, and more strict management of treatment is required.

Download Full-text

909 POSTER Updated results of high dose proton beam therapy (PBT) for stage I non-small cell lung cancer (NSCLC)

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(07)70548-7 ◽

2007 ◽

Vol 5 (4) ◽

pp. 121-122 ◽

Cited By ~ 1

Author(s):

K. Nihei ◽

T. Ogino ◽

M. Onozawa ◽

H. Nishimura

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Proton Beam ◽

Cell Lung Cancer ◽

Proton Beam Therapy ◽

Small Cell ◽

Stage I ◽

High Dose ◽

Small Cell Lung

Download Full-text

Proton Beam Therapy for Local Recurrence of Rectal Cancer

Anticancer Research ◽

10.21873/anticanres.15147 ◽

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

Download Full-text

OC-0514: radiation necrosis after proton beam therapy - when and where does it happen?

Radiotherapy and Oncology ◽

10.1016/s0167-8140(17)30954-4 ◽

2017 ◽

Vol 123 ◽

pp. S271 ◽

Cited By ~ 2

Author(s):

S. Harrabi ◽

C. Gudden ◽

S. Adeberg ◽

N. Bougatf ◽

T. Haberer ◽

...

Keyword(s):

Proton Beam ◽

Radiation Necrosis ◽

Proton Beam Therapy

Download Full-text

Proton beam therapy: perspectives on the National Health Service England clinical service and research programme

British Journal of Radiology ◽

10.1259/bjr.20190873 ◽

2020 ◽

Vol 93 (1107) ◽

pp. 20190873 ◽

Cited By ~ 3

Author(s):

Neil G Burnet ◽

Ranald I Mackay ◽

Ed Smith ◽

Amy L Chadwick ◽

Gillian A Whitfield ◽

...

Keyword(s):

Dna Damage ◽

National Health Service ◽

Health Service ◽

Proton Beam ◽

National Health ◽

Proton Beam Therapy ◽

Systematic Evaluation ◽

High Dose ◽

X Rays ◽

The Uk

The UK has an important role in the evaluation of proton beam therapy (PBT) and takes its place on the world stage with the opening of the first National Health Service (NHS) PBT centre in Manchester in 2018, and the second in London coming in 2020. Systematic evaluation of the role of PBT is a key objective. By September 2019, 108 patients had started treatment, 60 paediatric, 19 teenagers and young adults and 29 adults. Obtaining robust outcome data is vital, if we are to understand the strengths and weaknesses of current treatment approaches. This is important in demonstrating when PBT will provide an advantage and when it will not, and in quantifying the magnitude of benefit. The UK also has an important part to play in translational PBT research, and building a research capability has always been the vision. We are perfectly placed to perform translational pre-clinical biological and physical experiments in the dedicated research room in Manchester. The nature of DNA damage from proton irradiation is considerably different from X-rays and this needs to be more fully explored. A better understanding is needed of the relative biological effectiveness (RBE) of protons, especially at the end of the Bragg peak, and of the effects on tumour and normal tissue of PBT combined with conventional chemotherapy, targeted drugs and immunomodulatory agents. These experiments can be enhanced by deterministic mathematical models of the molecular and cellular processes of DNA damage response. The fashion of ultra-high dose rate FLASH irradiation also needs to be explored.

Download Full-text