Acute toxicities after proton beam therapy following breast‐conserving surgery for breast cancer: Multi‐institutional prospective PCG registry analysis

Abstract

Radiotherapy (RT) after breast-conserving surgery (BCS) for breast cancer improves breast cancer mortality and decreases recurrence. 1 However, the benefit of adjuvant breast RT is partially offset by nonbreast morbidity caused by dose to normal structures, including the heart. 2 Various techniques and technologies are used to minimize the dose to surrounding normal structures including deep inspiration breath-hold, intensity-modulated radiation therapy, and proton beam therapy (PBT). 3 Adjuvant whole-breast RT can be delivered with photons or PBT. PBT offers unique dosimetric advantages, such as improved target and internal mammary nodal (IMN) coverage, 4,5 decreased lung dose, 6,7 and decreased heart dose. 6,7 However, PBT has some disadvantages including decreased patient access, 8 increased cost, 9 and higher rates of acute radiation dermatitis (RD). 10 We report a prospectively evaluated multi-institutional cohort of patients who received adjuvant whole-breast PBT after BCS for breast cancer. 2 | ME THODS The Proton Collaborative Group (PCG) REG001-09 trial is an IRBapproved, multi-institutional prospective registry of patients treated with PBT. Between 2012 and 2016, 82 patients underwent BCS followed by PBT to the whole breast at seven participating institutions.

Reirradiation for Locoregional Recurrent Breast Cancer

“…In the present study, we report favorable LRFS and OS following re-irradiation for locoregional recurrent breast cancer, similar to other cohorts [7,14,15,17,19,20,27]. Particularly, high rates of disease control were seen among curative intent patients undergoing complete surgical excision followed Proton therapy for breast cancer offers enhanced ability to spare non-target tissue, including the heart and lungs [24,[28][29][30][31][32][33], which is of particular importance and interest for re-irradiation. Reirradiation with PBT has been reported in multiple disease sites, including in CNS, head and neck, gynecological, gastrointestinal, and lung tumors [34][35][36][37][38][39][40][41].…”

Dosimetric Correlation of Acute Radiation Dermatitis in Patients With Breast Cancer Undergoing Hypofractionated Proton Beam Therapy Using Pencil Beam Scanning

“…In comparison to non-PBS, PBS has the advantage of skin dose-sparing [ 7 8 ]. Table 5 displays the incidences of grade 2–3 dermatitis after PBT [ 3 4 5 23 24 25 26 27 28 29 30 31 32 33 34 ]. In patients who received conventional fractionated PBT without PBS, the rates of grade 2–3 dermatitis ranged from 71% to 100% (median, 82%).…”

Patient-reported outcomes version of the common terminology criteria for adverse events and quality-of-life linear analogue self-assessment in breast cancer patients receiving radiation therapy: single-institution prospective registry

“…Higher BMI has been shown to be associated with worse quality of life in other cancers [ 22 , 23 ]. Similarly, higher BMI has also been shown to correlate to worse physician reported adverse events [ 24 , 25 ]. In a study of breast cancer survivors, Anbari et al used the validated 36-Item Short Form Health Survey to compare quality of life to changes in BMI which showed that a BMI change corresponded to 5 of the 8 domains [ 26 ].…”