Reirradiation for recurrent malignant brain tumor with radiotherapy or proton beam therapy

Mizumoto, Masashi; Okumura, Toshiyuki; Ishikawa, Eiichi; Yamamoto, Tetsuya; Takano, Shingo; Matsumura, Akira; Oshiro, Yoshiko; Ishikawa, Hitoshi; Sakurai, Hideyuki; Tsuboi, Koji

doi:10.1007/s00066-013-0390-6

Cited by 47 publications

(31 citation statements)

References 18 publications

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“…The inherent physical properties of PBRT, which allow for the sparing of previously irradiated normal tissue, are particularly important for minimizing toxicity for patients treated for brain tumors and other head and neck malignancies [21,22]. Representative plans of 2 patients with isodose lines are depicted in Figure 3.…”

Section: Discussionmentioning

confidence: 99%

Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-institutional Report on Feasibility and Early Outcomes

Chang

Romesser

Scher

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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Purpose/Objectives-Re-irradiation (re-RT) is the only potentially curative treatment option for patients with locally recurrent head and neck cancer (HNC). Given the significant morbidity with head and neck re-irradiation, interest in proton beam radiotherapy (PBRT) has increased. Herein, we report the first multi-institutional clinical experience using curative intent PBRT for re-RT in recurrent HNC.Materials/Methods-A retrospective analysis of ongoing prospective data registries from 2-hybrid community practice and academic proton centers was conducted. Patients with recurrent HNC who had at least one prior course of definitive intent external beam RT were included. Acute and late toxicities were assessed by the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0 and by the Radiation Therapy Oncology Group late radiation morbidity scoring system, respectively. The cumulative incidence of locoregional failure was calculated with death as a competing risk. The actuarial twelve-month freedom from distant metastasis (FFDM) and overall survival (OS) rates were calculated with the Kaplan-Meier method.Results-Ninety-two consecutive patients were treated with curative intent re-RT with PBRT between 2011 and 2014. Median follow-up among surviving patients was 13.3 months and among all patients was 10.4 months (interquartile range, 5.3-17.5 months). The median time between last * Corresponding author: Nancy Y. Lee, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, telephone: 212-639-3341, fax: 212-639-2417, leen2@mskcc.org. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptRT and PBRT was 34.4 months. There were 76 patients with one prior RT course and 16 with two or more courses. Median PBRT dose was 60.6 Gy (RBE). Eighty-five percent of patients had prior HNC RT for an oropharynx primary and 39% had salvage surgery prior to re-RT. The cumulative incidence of locoregional failure at 12-months, with death as a competing risk, was 25.1%. Actuarial 12-month FFDM and OS were 84.0% and 65.2%, respectively.Acute grade ≥3 toxicities included mucositis (9.9%), dysphagia (9.1%), esophagitis (9.1%), and dermatitis (3.3%). There was one death during PBRT secondary to disease progression. Grade 3 or greater late skin and dysphagia toxicity were noted in 6 (8.7%) and 4 (7.1%) of patients, respectively. Two patients had grade 5 toxicity secondary to treatment-related bleeding.Conclusions-Proton beam re-irradiation of the head and neck can provide effective ...

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Section: Discussionmentioning

confidence: 99%

Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-institutional Report on Feasibility and Early Outcomes

Chang

Romesser

Scher

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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“…Clinical trials are ongoing that evaluate dose escalation with protons or carbon. 95,96 RADIOIMMUNOTHERAPY Antibodies and radionuclides Radioimmunotherapy (RIT) with monoclonal antibodies (mAb) labelled with therapeutic radionuclides are promising candidates to be applied alone or in combination with radio(chemo)therapy to improve treatment outcomes. The application of mAb is restricted by factors such as the high interstitial pressure inside the tumour, limited blood supply, inhomogeneous or inconstant expression of antigens, necrosis or fibrosis as physiological barriers, formation of immune complexes, catabolism of immunoglobulins, the blood-brain barrier and possible unfavourable biodistribution of the mAb leading to radiation burden in normal tissue.…”

Section: Particle Therapymentioning

confidence: 99%

Glioblastoma multiforme: emerging treatments and stratification markers beyond new drugs

Neubeck¹,

Seidlitz²,

Kitzler³

et al. 2015

BJR

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Glioblastoma multiforme (GBM) is the most common primary brain tumour in adults. The standard therapy for GBM is maximal surgical resection followed by radiotherapy with concurrent and adjuvant temozolomide (TMZ). In spite of the extensive treatment, the disease is associated with poor clinical outcome. Further intensification of the standard treatment is limited by the infiltrating growth of the GBM in normal brain areas, the expected neurological toxicities with radiation doses .60 Gy and the dose-limiting toxicities induced by systemic therapy. To improve the outcome of patients with GBM, alternative treatment modalities which add low or no additional toxicities to the standard treatment are needed. Many Phase II trials on new chemotherapeutics or targeted drugs have indicated potential efficacy but failed to improve the overall or progression-free survival in Phase III clinical trials. In this review, we will discuss contemporary issues related to recent technical developments and new metabolic strategies for patients with GBM including MR (spectroscopy) imaging, (amino acid) positron emission tomography (PET), amino acid PET, surgery, radiogenomics, particle therapy, radioimmunotherapy and diets.

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“…Des études doivent être réalisées pour permettre une escalade de dose. Un essai de phase III est en cours aux États-Unis afin de comparer à doses équivalentes (50,4 Gy) une irradiation par protons et une RCMI par photons (NCT01512589, objectif primaire : survie sans progression) dans les cancers de l'estomac et de l'oesophage relevant d'une radiothérapie, non métastatiques.…”

Section: Carcinomes Oesophagiens/estomacunclassified

État des lieux et perspectives de la protonthérapie

Doyen

Bondiau

Bénézery

et al. 2015

Cancer/Radiothérapie

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Reirradiation for recurrent malignant brain tumor with radiotherapy or proton beam therapy

Cited by 47 publications

References 18 publications

Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-institutional Report on Feasibility and Early Outcomes

Proton Beam Reirradiation for Recurrent Head and Neck Cancer: Multi-institutional Report on Feasibility and Early Outcomes

Glioblastoma multiforme: emerging treatments and stratification markers beyond new drugs

État des lieux et perspectives de la protonthérapie

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