Acute toxicity profile of patients with low-grade gliomas and meningiomas receiving proton therapy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e12508-e12508
Author(s):  
Genevieve Maquilan ◽  
Surbhi Grover ◽  
Michelle Alonso-Basanta ◽  
Robert A. Lustig
Keyword(s):  
Proton Beam ◽  
Proton Therapy ◽  
Radiation Treatment ◽  
Treatment Protocol ◽  
Proton Beam Therapy ◽  
University Of Pennsylvania ◽  
Low Grade ◽  
Beam Radiation ◽  
Low Grade Gliomas ◽  
Starting Point

e12508 Background: Quality of life is not often studied but is an important outcome to measure when evaluating types of radiation treatment. This study attempts to provide data on the treatment effects of proton beam therapy on patients with low grade gliomas and meningiomas, using the National Cancer Institute Common Terminology Criteria (CTCAE) version 4.0 to analyze the severity and frequency of symptoms experienced acutely during and after radiotherapy. Methods: 23 patients diagnosed with low grade gliomas or meningiomas were enrolled in a prospective proton beam radiation treatment protocol (NCT01024907) and were treated and followed between April 2010 and August 2011 in the University of Pennsylvania Radiation Oncology Department. Patients received 54 Gy [relative biologic effectiveness (RBE)] in 1.8 Gy (RBE) per fraction and were assessed at the time of consult, weekly during treatment, and followed up at 1, 3, 6, and 9 months after treatment. Symptoms were graded based on the CTCAE version 4.0. Results: At week 1 of treatment, 4/23 patients experienced Grade 1 anorexia. At week 3, 5/23 patients had Grade 1 nausea, 10/23 patients had Grade 1 headaches, and 1/23 patients had a Grade 3 headache. At the end of treatment at week 6, 13/23 patients had Grade 1 fatigue, 6/23 patients had Grade 2 fatigue, 3/23 patients had Grade 1 nausea, 4/23 patients had Grade 1 headaches, 7/23 patients had Grade 1 insomnia, and 1/23 patients had Grade 2 insomnia. At the 1-month follow-up, 3/23 patients had Grade 1 fatigue, 1/23 patients had Grade 2 fatigue, 2/23 patients had Grade 1 anorexia, 1/23 patients had a Grade 1 headache, and 2/23 patients had Grade 1 insomnia. No patients were reported to have experienced vomiting at any of the 4 time points. Conclusions: Proton therapy has a favorable side effect profile--most patients experienced mild fatigue, headaches, and insomnia that largely resolved by one month after treatment. This study provides a useful starting point for larger-scale studies which could directly compare the acute side effects of proton and conventional radiotherapy.

scholarly journals Mid-treatment magnetic resonance imaging in pediatric intracranial low-grade gliomas treated with proton beam therapy

2017 ◽  
Vol 56 (9) ◽  
pp. 1243-1247
Author(s):  
Radhika Sreeraman Kumar ◽  
Ronny L. Rotondo ◽  
Julie A. Bradley ◽  
Tamara Vern-Gross ◽  
Soon Huh ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Low Grade ◽  
Resonance Imaging ◽  
Low Grade Gliomas

scholarly journals Feasibility of Proton Beam Therapy as a Rescue Therapy in Heavily Pre-Treated Retinoblastoma Eyes

Cancers ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 1862
Author(s):  
Eva Biewald ◽  
Tobias Kiefer ◽  
Dirk Geismar ◽  
Sabrina Schlüter ◽  
Anke Manthey ◽  
...  
Keyword(s):  
Proton Beam ◽  
Rescue Therapy ◽  
Therapeutic Option ◽  
Proton Beam Therapy ◽  
External Beam Radiation ◽  
Time Interval ◽  
Beam Radiation ◽  
Primary Tumors ◽  
Increased Risk

Despite the increased risk of subsequent primary tumors (SPTs) external beam radiation (EBRT) may be the only therapeutic option to preserve a retinoblastoma eye. Due to their physical properties, proton beam therapy (PBT) offers the possibility to use the effectiveness of EBRT in tumor treatment and to decisively reduce the treatment-related morbidity. We report our experiences of PBT as rescue therapy in a retrospectively studied cohort of 15 advanced retinoblastoma eyes as final option for eye-preserving therapy. The average age at the initiation of PBT was 35 (14–97) months, mean follow-up was 22 (2–46) months. Prior to PBT, all eyes were treated with systemic chemotherapy and a mean number of 7.1 additional treatments. Indication for PBT was non-feasibility of intra-arterial chemotherapy (IAC) in 10 eyes, tumor recurrence after IAC in another 3 eyes and diffuse infiltrating retinoblastoma in 2 eyes. Six eyes (40%) were enucleated after a mean time interval of 4.8 (1–8) months. Cataract formation was the most common complication affecting 44.4% of the preserved eyes, yet 77.8% achieved a visual acuity of >20/200. Two of the 15 children treated developed metastatic disease during follow-up, resulting in a 13.3% metastasis rate. PBT is a useful treatment modality as a rescue therapy in retinoblastoma eyes with an eye-preserving rate of 60%. As patients are at lifetime risk of SPTs consistent monitoring is mandatory.

SU-E-T-491: A FLUKA Monte Carlo Computational Model of a Scanning Proton Beam Therapy Nozzle at IU Proton Therapy Center

2012 ◽  
Vol 39 (6Part17) ◽  
pp. 3818-3818 ◽  
Author(s):  
V Moskvin ◽  
C Cheng ◽  
V Anferov ◽  
D Nichiporov ◽  
Q Zhao ◽  
...  
Keyword(s):  
Monte Carlo ◽  
Computational Model ◽  
Proton Beam ◽  
Proton Therapy ◽  
Proton Beam Therapy ◽  
Therapy Center

scholarly journals Proton Beam Therapy and Continuous Intra-Arterial Chemotherapy for Polymorphous Low-Grade Adenocarcinoma in the Hard Palate

2013 ◽  
Vol 6 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Chiyoko Makita ◽  
Tatsuya Nakamura ◽  
Kanako Takayama ◽  
Akinori Takada ◽  
Nobukazu Fuwa ◽  
...  
Keyword(s):  
Proton Beam ◽  
Hard Palate ◽  
Proton Beam Therapy ◽  
Low Grade

scholarly journals The management of clival chordomas: an Italian multicentric study

2020 ◽  
pp. 1-10
Author(s):  
Luigi Maria Cavallo ◽  
Diego Mazzatenta ◽  
Elena d’Avella ◽  
Domenico Catapano ◽  
Marco Maria Fontanella ◽  
...  
Keyword(s):  
Proton Beam ◽  
Doppler Ultrasound ◽  
Previous Treatment ◽  
Proton Beam Therapy ◽  
Extent Of Resection ◽  
National Study ◽  
Surgical Morbidity ◽  
Endoscopic Endonasal ◽  
Beam Radiation ◽  
Multicentric Study

OBJECTIVEIn the last 2 decades, the endoscopic endonasal approach in the treatment of clival chordomas has evolved to be a viable strategy to achieve maximal safe resection of this tumor. Here, the authors present a multicentric national study, intending to analyze the evolution of this approach over a 20-year time frame and its contribution in the treatment of clival chordomas.METHODSClival chordoma cases surgically treated between 1999 and 2018 at 10 Italian neurosurgical departments were included in this retrospective study. Clinical, radiological, and surgical findings, adjuvant therapy, and outcomes were evaluated and compared according to classification in the treatment eras from 1999 to 2008 and from 2009 to 2018.RESULTSOne hundred eighty-two surgical procedures were reviewed, with an increase in case load since 2009. The endoscopic endonasal transclival approach (EETA) was performed in 151 of 182 cases (83.0%) and other approaches were performed in 31 cases (17%). There was an increment in the use of EETA, neuronavigation, and Doppler ultrasound after 2008. The overall postoperative complication rate was 14.3% (26 of 182 cases) consisting of 9 CSF leaks (4.9%), 7 intracranial hemorrhages (3.8%), 5 cases of meningitis (2.7%), and 5 cerebral ischemic injuries (2.7%). Gross-total resection (GTR) was achieved in 93 of 182 cases (51.1%). Extent of resection (EOR) improved in the second era of the study. Signs and/or symptoms at presentation worsened in 27 cases (14.8%), and the Katz Index worsened in 10 cases (5.5%). Previous treatment, dural involvement, EETA, and intraoperative Doppler ultrasound correlated with GTR. Patients received adjuvant proton beam radiation in 115 of 182 cases (63.2%), which was administered more in the latter era. Five-year progression-free survival (PFS) and overall survival (OS) were 62.3% and 73.5%, respectively. GTR, EETA, proton beam therapy, and the chondroid subtype correlated with a better survival rate. The mean follow-up was 62 months.CONCLUSIONSThrough multicentric data collection, this study encompasses the largest series in the literature of clival chordomas surgically treated through an EETA. An increase in the use of this approach was found among Italian neurosurgical departments together with an improved extent of resection over time. The satisfactory rate of GTR was marked by low surgical morbidity and the preservation of patient quality of life. Surgical outcome was reinforced, in terms of PFS and OS, by the use of proton beam therapy, which was increasingly performed along the period of study.

scholarly journals PS1 - 183 Recommendations for the Referral of Patients from Proton Beam Therapy, an Alberta Health Services Report: A Model for Canada?

2016 ◽  
Vol 43 (S4) ◽  
pp. S11-S11
Author(s):  
S. Patel ◽  
X. Kostaras ◽  
M. Parliament ◽  
I.A. Olivotto ◽  
R. Nordal ◽  
...  
Keyword(s):  
Health Services ◽  
Proton Beam ◽  
Proton Therapy ◽  
Proton Beam Therapy ◽  
Sufficient Evidence ◽  
Draft Report ◽  
Term Survival ◽  
Travel Abroad ◽  
Alberta Health

Proton beam therapy (PBT) offers compelling advantages in physical dose distribution compared to photon therapy. There are increasing numbers of gantry-based proton facilities worldwide but no such facilities exist in Canada. To access PBT, Canadian patients must travel abroad for treatment at high cost. In the face of limited access, this report seeks to provide recommendations for the selection of patients most likely to benefit from PBT and suggests an out-of-country referral process. METHODS: A systematic literature search for studies between January 1990 and May 2014 evaluating clinical outcomes after PBT. A draft report was developed through review of evidence, externally reviewed, and approved by the Alberta Health Services Cancer Care Proton Therapy Guidelines steering committee. RESULTS: Proton therapy is often used to treat tumours close to radiosensitive tissues, and children at risk of developing significant late effects of radiation therapy (RT). Local control rates with PBT appear similar to or, in some cases, higher than photon RT in uncontrolled and retrospective studies. Randomized trials comparing equivalent doses of PBT and photon RT are not available. SUMMARY: Referral for PBT is recommended for patients being treated with curative intent, with an expectation for long-term survival, and who are able and willing to travel abroad to a proton facility. Commonly accepted indications for referral include chordoma and chondrosarcoma, intraocular melanoma, and solid tumours in children and adolescents occurring in patients with greatest risk of long-term sequelae. Current data do not provide sufficient evidence to recommend routine referral of patients with most head and neck, breast, lung, gastrointestinal tract, and pelvic cancers including prostate cancer. It is recommended that all referrals be considered by a multidisciplinary team to select appropriate cases.

A pilot study of proton beam theary for mucosal melanoma of the head and neck

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17042-e17042
Author(s):  
S. Zenda ◽  
M. Kawashima ◽  
R. Kohno ◽  
S. Arahira ◽  
T. Nishio ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Beam ◽  
Proton Therapy ◽  
Progression Free Survival ◽  
Late Toxicity ◽  
Distant Metastases ◽  
Proton Beam Therapy ◽  
Mucosal Melanoma ◽  
Cervical Lymph Nodes ◽  
Number Of Patients

e17042 Background: The aim of this study is to clarify the clinical profile of proton beam therapy for mucosal melanoma of the head and neck. Methods: Patients with mucosal melanoma of the head and neck fulfilling the following criteria were enrolled: histologically confirmed malignant melanoma; N0 and M0 disease. Proton therapy was delivered three times a week with planned total dose of 60 GyE in 15 fractions. Results: From January 2004 through January 2007, thirteen patients were enrolled in this study. Patients’ characteristics were as follows: median age, 75 years (range, 56 to 79); male/female, 7/6; T1/2/3/4/rec, 3/2/0/7/1. All could receive the full dose of proton therapy. The most common acute toxicities were mucositis (grade 3: 15%) and dermatitis (grade 2: 15%). One patient had unilateral impairment of visual acuity possibly related with treatment. Initial local control rate was 77.0% (10/13, 95%CI: 46.2–95.0%). With median follow up period of 33.7 months, median progression free survival was 18.9 months and median survival time was not reached. 2-year overall survival rate was 69.7% (95%CI: 31.6–86.1%). Most frequent site of first failure was cervical lymph nodes outside of PTV. Four patients died of disease; cachexia caused by distant metastases in three and carotid blowout because of nodal disease in one. Conclusions: Proton beam therapy for mucosal melanoma of the head and neck achieved favorable results in this limited number of patients, although further investigation about late toxicity is needed. Now, the phase II study of this treatment is ongoing. No significant financial relationships to disclose.

Radiation induced contrast enhancement after proton beam therapy in patients with low grade glioma – how safe are protons?

2021 ◽  
Author(s):  
Semi B. Harrabi ◽  
Bastian von Nettelbladt ◽  
Clemens Gudden ◽  
Sebastian Adeberg ◽  
Katharina Seidensaal ◽  
...  
Keyword(s):  
Contrast Enhancement ◽  
Proton Beam ◽  
Proton Beam Therapy ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Radiation Induced

scholarly journals Multimodal Imaging and Clinicopathologic Correlation in Primary Uveal Lymphoma

2016 ◽  
Vol 7 (1) ◽  
pp. 39-43
Author(s):  
Brandon Erickson ◽  
Dimosthenis Mantopoulos ◽  
Lynn Schoenfield ◽  
Colleen M. Cebulla
Keyword(s):  
Retinal Detachment ◽  
Multimodal Imaging ◽  
Radiation Treatment ◽  
B Cell Lymphoma ◽  
Needle Aspiration ◽  
Good Prognosis ◽  
External Beam Radiation ◽  
Low Grade ◽  
Beam Radiation ◽  
Primary Uveal Lymphoma

Purpose: We report a rare case of primary uveal lymphoma and characterize it using histopathology and multimodal imaging. Patient and Methods: A 41-year-old male presented with a 2-year history of increasingly blurry vision in his right eye and no systemic symptoms. Examination revealed a retinal detachment and mass lesion in the right eye. Radiologic and histologic testing was performed. Results: Multimodal imaging localized the lesion to the choroid, and fine needle aspiration biopsy diagnosed the lesion as a low-grade B-cell lymphoma. The patient was treated with external beam radiation, resulting in regression of the mass and resolution of the retinal detachment. Conclusions: Primary uveal lymphoma is a rare, usually indolent tumor that carries a good prognosis. In this case, we show that primary uveal lymphoma has distinct findings via histopathology and multimodal imaging, and that imaging after radiation treatment documents disease regression.

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