Clinical Results of Proton Beam Therapy for Esophageal Cancer: Multicenter Retrospective Study in Japan

There are few reports about the clinical results of proton beam therapy for esophageal cancer in a large population. The purpose of this study was to evaluate the clinical results of proton beam therapy for esophageal cancer in a large population using a multicentered database. Between January 2009 and December 2013, patients newly diagnosed with esophageal cancer and who had received proton beam therapy were retrospectively recruited from a database of four proton beam therapy centers in Japan. Two hundred and two patients (including 90 inoperable patients) fulfilled the inclusion criteria, and 100 patients (49.5%) had stage III/IV cancer (Union for International Cancer Control 8th). The 3-year and 5-year overall survival rate was 66.7% and 56.3%, respectively. The five-year local control rate was 64.4%. There were two patients with grade three pericardial effusion (1%) and a patient with grade three pneumonia (0.5%). No grade 4 or higher cardiopulmonary toxicities were observed (Common Terminology Criteria for Adverse Events version 4.0). This study suggests that proton beam therapy for esophageal cancer was not inferior in efficacy and had lower rates of toxicities in comparison to photon radiotherapy. Therefore, proton beam therapy can serve as an alternate treatment for patients with esophageal cancer.

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Clinical results of proton beam therapy for twenty older patients with esophageal cancer

Radiology and Oncology ◽

10.1515/raon-2015-0034 ◽

2015 ◽

Vol 49 (4) ◽

pp. 371-378 ◽

Cited By ~ 5

Author(s):

Takashi Ono ◽

Tatsuya Nakamura ◽

Yusuke Azami ◽

Hisashi Yamaguchi ◽

Yuichiro Hayashi ◽

...

Keyword(s):

Esophageal Cancer ◽

Proton Beam ◽

Older Patients ◽

Dose Range ◽

Proton Beam Therapy ◽

Clinical Results ◽

Local Control Rate ◽

High Dose ◽

X Ray ◽

Node Metastases

Abstract Background. In an aging society, increasing number of older patients are diagnosed with esophageal cancer. The purpose of this study was to assess the clinical efficacy and safety of proton beam therapy for older patients with esophageal cancer. Patients and methods. Older patients (age: ≥ 65 years) newly diagnosed with esophageal cancer between January 2009 and June 2013 were enrolled in this study. All patients underwent either proton beam therapy alone or proton beam therapy with initial X-ray irradiation. Toxicities were evaluated using the Common Terminology Criteria for Adverse Events version 4.0. Results. Twenty patients were eligible for this study and all completed the treatment. The median age was 78 years (range: 65–89 years) and the median follow-up time was 26.5 months (range: 6–62 months). Seven patients had lymph node metastases and 10 had stage II/III cancer. The median dose of proton beam therapy was 72.6 Gy relative biological dose effectiveness (RBE) (range: 66–74.8 Gy [RBE]) for proton beam therapy alone and 33 Gy (RBE) (range: 30.8–39.6 Gy [RBE]; total dose range: 66.8–75.6 Gy [RBE]) for proton beam therapy with initial X-ray irradiation. The 2-year overall survival rate was 81.8% (95% confidence interval [CI]: 62.4%–100%), and the 2-year local control rate was 89.4% (95% CI: 75.5%–100%). Grade 2 or 3 toxicities occurred in some cases; however, no grade 4 or 5 toxicity was observed. Conclusions. High-dose (66–75.6 Gy [RBE]) proton beam therapy without chemotherapy was an efficacious and safe treatment for older patients with esophageal cancer.

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Clinical Results of Proton-Beam Therapy for Locoregionally Advanced Esophageal Cancer

Strahlentherapie und Onkologie ◽

10.1007/s00066-010-2079-4 ◽

2010 ◽

Vol 186 (9) ◽

pp. 482-488 ◽

Cited By ~ 34

Author(s):

Masashi Mizumoto ◽

Shinji Sugahara ◽

Hidetsugu Nakayama ◽

Haruko Hashii ◽

Akira Nakahara ◽

...

Keyword(s):

Esophageal Cancer ◽

Proton Beam ◽

Proton Beam Therapy ◽

Clinical Results ◽

Advanced Esophageal Cancer

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Clinical Results of Proton Beam Therapy for Esophageal Cancer at the University of Tsukuba

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2005.07.282 ◽

2005 ◽

Vol 63 ◽

pp. S163-S164

Author(s):

S. Sugahara ◽

K. Tokuuye ◽

A. Nakahara ◽

H. Igaki ◽

M. Hata ◽

...

Keyword(s):

Esophageal Cancer ◽

Proton Beam ◽

Proton Beam Therapy ◽

Clinical Results ◽

The University

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Improving Outcomes for Esophageal Cancer using Proton Beam Therapy

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2015.11.043 ◽

2016 ◽

Vol 95 (1) ◽

pp. 488-497 ◽

Cited By ~ 36

Author(s):

Michael D. Chuong ◽

Christopher L. Hallemeier ◽

Salma K. Jabbour ◽

Jen Yu ◽

Shahed Badiyan ◽

...

Keyword(s):

Esophageal Cancer ◽

Proton Beam ◽

Proton Beam Therapy

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The Radiobiological Effects of Proton Beam Therapy: Impact on DNA Damage and Repair

Cancers ◽

10.3390/cancers11070946 ◽

2019 ◽

Vol 11 (7) ◽

pp. 946 ◽

Cited By ~ 15

Author(s):

Eirini Terpsi Vitti ◽

Jason L Parsons

Keyword(s):

Dna Damage ◽

Dna Repair ◽

Proton Beam ◽

Bragg Peak ◽

Proton Beam Therapy ◽

High Energy ◽

High Let ◽

Repair Pathways ◽

Radiobiological Effects ◽

Photon Radiotherapy

Proton beam therapy (PBT) offers significant benefit over conventional (photon) radiotherapy for the treatment of a number of different human cancers, largely due to the physical characteristics. In particular, the low entrance dose and maximum energy deposition in depth at a well-defined region, the Bragg peak, can spare irradiation of proximal healthy tissues and organs at risk when compared to conventional radiotherapy using high-energy photons. However, there are still biological uncertainties reflected in the relative biological effectiveness that varies along the track of the proton beam as a consequence of the increases in linear energy transfer (LET). Furthermore, the spectrum of DNA damage induced by protons, particularly the generation of complex DNA damage (CDD) at high-LET regions of the distal edge of the Bragg peak, and the specific DNA repair pathways dependent on their repair are not entirely understood. This knowledge is essential in understanding the biological impact of protons on tumor cells, and ultimately in devising optimal therapeutic strategies employing PBT for greater clinical impact and patient benefit. Here, we provide an up-to-date review on the radiobiological effects of PBT versus photon radiotherapy in cells, particularly in the context of DNA damage. We also review the DNA repair pathways that are essential in the cellular response to PBT, with a specific focus on the signaling and processing of CDD induced by high-LET protons.

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Effectiveness of Proton Beam Therapy on Liver Metastases of Esophageal Cancer: Report of a Case

International Surgery ◽

10.9738/intsurg-d-13-00188.1 ◽

2015 ◽

Vol 100 (1) ◽

pp. 180-184 ◽

Cited By ~ 3

Author(s):

Hiroto Muroi ◽

Masanobu Nakajima ◽

Hitoshi Satomura ◽

Masakazu Takahashi ◽

Yasushi Domeki ◽

...

Keyword(s):

Positron Emission Tomography ◽

Esophageal Cancer ◽

Lymph Nodes ◽

Liver Metastases ◽

Proton Beam ◽

Primary Tumor ◽

Proton Beam Therapy ◽

Emission Tomography ◽

Mediastinal Lymph Nodes ◽

Positron Emission

Abstract A 53-year-old man with multiple liver metastasis of esophageal cancer underwent four courses of chemotherapy. After four courses of chemotherapy, positron emission tomography showed progressive disease. Because it was difficult to control the cancer only by chemotherapy, we performed proton beam therapy (PBT) combined with chemotherapy. The irradiated parts were the primary tumor, liver metastases (S2/S4/S6), and mediastinal lymph nodes. The primary tumor including the mediastinal lymph nodes and the S2/S4/S6 metastases received proton beam irradiation at a total dose of 68.2 Gy in 31 fractions and 66.0 Gy in 30 fractions, respectively, according to tumor location. This resulted in a complete response as shown by positron emission tomography. In our experience, PBT exerted a curative effect on liver metastases of esophageal cancer. It is thought that PBT may be effective in the treatment of esophageal cancer. This is the first report about PBT for liver metastases of esophageal cancer.

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