Comparative Outcomes After Definitive Chemoradiotherapy Using Proton Beam Therapy Versus Intensity Modulated Radiation Therapy for Esophageal Cancer: A Retrospective, Single-Institutional Analysis

Xi, Mian; Cai, Xu; Liao, Zhongxing; Chang, Joe Y.; Gomez, Daniel R.; Jeter, Melenda; Cox, James D.; Komaki, Ritsuko; Mehran, Reza J.; Blum, Mariela A.; Hofstetter, Wayne L.; Maru, Dipen M.; Bhutani, Manoop S.; Lee, Jeffrey H.; Weston, Brian; Ajani, Jaffer A.; Lin, Steven H.

doi:10.1016/j.ijrobp.2017.06.2450

Cited by 85 publications

(103 citation statements)

References 29 publications

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“…This demonstration of potentially decreased toxicities in a range of sites supports the predictions from dosimetric modelling and the wide international acceptance of this rationale for PT use in specific indications. The review supports the use of PBT for H&N tumours, 10,11 paediatrics, 15,18,21,22 CNS, 30 GIT 33,34 and ocular tumours, 39,41 and CIT for sarcoma, 23 in line with international recommendations 69,70 and consistent with our earlier review. 6 Future clinical trials must take into account technological advancement in PT including its evolving delivery techniques, image guidance availability and sophistication of planning algorithms.…”

Section: Resultssupporting

confidence: 84%

“…One retrospectively analysed patients who received definitive chemoradiation with either PBT (N = 132) or IMRT (N = 211). 34 Grade 3-4 toxicities occurred more frequently in patients treated with IMRT than PBT (45% vs. 37.9%, P = 0.192), as did grade 5 toxicities (4 versus 1 patient, P = 0.653). A greater proportion of elderly patients (≥67 years) received PBT than IMRT (70.5% vs. 38.4%, P < 0.001) which may have been a confounding factor for treatment tolerability.…”

Section: Gastrointestinal Tract (Git) (Appendix S5)mentioning

confidence: 91%

“…Of the 18 studies examining toxicity in GIT tumours, one was of level II RCT evidence 33 and two were comparative cohort studies. 34,35 The RCT by Bush et al 33 compared PBT (N = 33) with transarterial chemoembolisation (TACE) (N = 36) for hepatocellular carcinoma (HCC). Hospitalisation secondary to treatment-related complications was significantly increased in the TACE group (4.6 vs 0.73 days, P < 0.001), 33 demonstrating that PBT could be a safer alternative to TACE for HCC.…”

Section: Gastrointestinal Tract (Git) (Appendix S5)mentioning

confidence: 99%

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Particle therapy toxicity outcomes: A systematic review

Hwang

Gorayski

et al. 2020

J Med Imag Rad Onc

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Owing to its physical properties, particle therapy (PT), including proton beam therapy (PBT) and carbon ion therapy (CIT), can enhance the therapeutic ratio in radiation therapy. The major factor driving PT implementation is the reduction in exit and integral dose compared to photon plans, which is expected to translate to reduced toxicity and improved quality of life. This study extends the findings from a recent systematic review by the current authors which concentrated on tumour outcomes for PT, to now examine toxicity as a separate focus. Together, these reviews provide a comprehensive collation of the evidence relating to PT outcomes in clinical practice. Three major databases were searched by two independent researchers, and evidence quality was classified according to the National Health and Medical Research Council evidence hierarchy. One hundred and seventy-nine studies were included. Most demonstrated acceptable and favourable toxicity results. Comparative evidence reported reduced morbidities and improvement in quality of life in head and neck, paediatrics, sarcomas, adult central nervous system, gastrointestinal, ocular and prostate cancers compared to photon radiotherapy. This suggestion for reduced morbidity must be counterbalanced by the overall low quality of evidence. A concerted effort in the design of appropriate comparative clinical trials is needed which takes into account integration of PT's pace of technological advancements, including evolving delivery techniques, image guidance availability and sophistication of planning algorithms.

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Section: Resultssupporting

confidence: 84%

Section: Gastrointestinal Tract (Git) (Appendix S5)mentioning

confidence: 91%

Section: Gastrointestinal Tract (Git) (Appendix S5)mentioning

confidence: 99%

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Particle therapy toxicity outcomes: A systematic review

Hwang

Gorayski

et al. 2020

J Med Imag Rad Onc

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“…Proton therapy resulted in significantly better OS (P= 0.01), PFS (P= 0.0001), and locoregional failure-free survival (P = 0.041) in multivariate analysis. In stage III disease, 5-year OS (34.6% vs. 25.0%, P = 0.038) and PFS (33.5% vs. 13.2%, P = 0.005) rates were higher in the proton therapy group, while there were no significant differences in survival for Stage I/II patients [48].…”

Section: Gastrointestinal Tumorsmentioning

confidence: 88%

Proton therapy: the current status of the clinical evidences

2019

Precis Future Med

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Proton therapy has the potential advantages of better conformal planning and higher biological effect than photon therapy (X-ray) for targeting tumor tissues. While the energy of a photon passes through the target, the energy of a proton is deposited at a certain depth, which in turn is negligible beyond this stopping point (i.e., the "Bragg peak"). In addition, the proton beam has a 10% higher biological effect in the same dose than the photon beam. Recent technological advances have led to wide use of proton therapy in clinical practice. To date, more than 170,000 patients have received proton therapy. Although clinical experience with proton therapy is increasing now, only approximately 1% of all radiation therapy recipients receive proton therapy and prospective randomized studies involving large sample populations remain very limited yet. The aim of this review is to describe the physical and biological properties of proton therapy and discusses the clinical evidence supporting proton therapy in various disease sites.

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“…И снова, ретроспективное исследование из MDACC вышло с изначальным предположением, что протоны уменьшают легочную и гастроинтестинальную токсичность по сравнению с IMRT (еще раз: при сопоставлении ретроспективных данных). Не только токсичность, но даже и показатели выживаемости ретроспективно выглядели лучше при сравнении протонов с IMRT [43,44].…”

Section: тимур митин: станет ли вскоре вся лучевая терапия протонной?unclassified

Back to the XXIII Russian oncology congress: will radiotherapy soon become entirely the proton one?

2020

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The article presents two opinions regarding proton radiation therapy, its physical basis, dosimetric specifics and clinical efficacy in comparison with more traditional photon irradiation, as well as the authors» opinions concerning the expanding indications for proton therapy and the rationale for opening new centers for proton treatment in the world. This review has become a continuation of the discussion session on proton therapy held at the XXIII Russian Oncology Congress in November 2019.

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Comparative Outcomes After Definitive Chemoradiotherapy Using Proton Beam Therapy Versus Intensity Modulated Radiation Therapy for Esophageal Cancer: A Retrospective, Single-Institutional Analysis

Cited by 85 publications

References 29 publications

Particle therapy toxicity outcomes: A systematic review

Particle therapy toxicity outcomes: A systematic review

Proton therapy: the current status of the clinical evidences

Back to the XXIII Russian oncology congress: will radiotherapy soon become entirely the proton one?

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