Is there any benefit to particles over photon radiotherapy?

Goossens, Martine; Bulcke, Marc Van den; Gevaert, Thierry; Meheus, Lydie; Verellen, Dirk; Cosset, Jean‐Marc; Storme, Guy

doi:10.3332/ecancer.2019.982

Cited by 8 publications

(7 citation statements)

References 42 publications

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“…Significant disadvantages are the much higher capital and running costs and the necessity for technically advanced facilities designed to optimise patient treatment. In addition, there is a paucity of clinical outcome data supporting the use of protons over other types of radiotherapy for a number of potential treatment indications (2). Despite the theoretical advantages of proton beam treatments and its introduction into clinical practice in the 1950s, it is currently used in less than 1% of all tumours undergoing radiotherapy across all disciplines of oncology (1,3).…”

Section: Introductionmentioning

confidence: 99%

Proton beam radiotherapy for choroidal and ciliary body melanoma in the UK—national audit of referral patterns of 1084 cases

Hussain

Chiu

Pittam

et al. 2022

Eye

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Introduction: Proton beam therapy has been utilised for the treatment of uveal melanoma in UK for over 30 years, undertaken under a single centre. In the UK, all ocular tumours are treated at one of four centres. We aimed to understand the variation in referral patterns to the UK proton service, capturing all uveal melanoma patients treated with this modality. Methods: Retrospective analysis of data regarding all patients treated at the Clatterbridge Proton service between January 2004 to December 2014. Results: A total of 1084 patients with uveal melanoma were treated. The mean age was 57 years (range 9-90 years), basal diameter of 11.5mm (range 2.0-23.4mm) and tumour thickness of 3.9mm (range 0.1-15.4mm). The majority were TNM stage I (39%) or II (36%). The distance to the optic nerve varied from 0-24.5mm with 148 (14%) of patients having ciliary body involvement. There were variations in the phenotypic characteristic of the tumours treated with protons from different centres, with London referring predominantly small tumours at the posterior pole, Glasgow referring large tumours often at the ciliary body, and Liverpool sending a mix of these groups. Discussion: In the UK, common indications for the use of proton treatment in uveal melanoma include small tumours in the posterior pole poorly accessible for plaque treatment (adjacent to the disc), tumours at the posterior pole affecting the fovea and large anterior tumours traditionally too large for brachytherapy. This is the first UK wide audit enabling capture of all patients treated at the single proton centre.

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Section: Introductionmentioning

confidence: 99%

Proton beam radiotherapy for choroidal and ciliary body melanoma in the UK—national audit of referral patterns of 1084 cases

Hussain

Chiu

Pittam

et al. 2022

Eye

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“…In recent years, there has been a surge in PT treatment facilities ( 6 ), and several smaller cohort studies indicate beneficial effects of PT such as improved overall survival ( 7 ) or prevention of brain-volume loss ( 8 ). However, data from randomized multi-center clinical trials is still lacking ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Late Side Effects in Normal Mouse Brain Tissue After Proton Irradiation

et al. 2021

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Radiation-induced late side effects such as cognitive decline and normal tissue complications can severely affect quality of life and outcome in long-term survivors of brain tumors. Proton therapy offers a favorable depth-dose deposition with the potential to spare tumor-surrounding normal tissue, thus potentially reducing such side effects. In this study, we describe a preclinical model to reveal underlying biological mechanisms caused by precise high-dose proton irradiation of a brain subvolume. We studied the dose- and time-dependent radiation response of mouse brain tissue, using a high-precision image-guided proton irradiation setup for small animals established at the University Proton Therapy Dresden (UPTD). The right hippocampal area of ten C57BL/6 and ten C3H/He mice was irradiated. Both strains contained four groups (nirradiated = 3, ncontrol = 1) treated with increasing doses (0 Gy, 45 Gy, 65 Gy or 85 Gy and 0 Gy, 40 Gy, 60 Gy or 80 Gy, respectively). Follow-up examinations were performed for up to six months, including longitudinal monitoring of general health status and regular contrast-enhanced magnetic resonance imaging (MRI) of mouse brains. These findings were related to comprehensive histological analysis. In all mice of the highest dose group, first symptoms of blood-brain barrier (BBB) damage appeared one week after irradiation, while a dose-dependent delay in onset was observed for lower doses. MRI contrast agent leakage occurred in the irradiated brain areas and was progressive in the higher dose groups. Mouse health status and survival corresponded to the extent of contrast agent leakage. Histological analysis revealed tissue changes such as vessel abnormalities, gliosis, and granule cell dispersion, which also partly affected the non-irradiated contralateral hippocampus in the higher dose groups. All observed effects depended strongly on the prescribed radiation dose and the outcome, i.e. survival, image changes, and tissue alterations, were very consistent within an experimental dose cohort. The derived dose–response model will determine endpoint-specific dose levels for future experiments and may support generating clinical hypotheses on brain toxicity after proton therapy.

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“…Recent clinical studies have proven that HT became treatment of choice for a number of specific types of cancers (9) (10). For several cancer types, such as skull base chordomas, the 5 or 10-year survival rate with HT is 2-3 times higher than the best results obtained with conventional (x-ray) RT (11).…”

Section: Introductionmentioning

confidence: 99%

“…Recent clinical studies have proven that HT became treatment of choice for a number of specific types of cancers. 9 , 10 For several cancer types, such as skull base chordomas, the 5 or 10-year survival rate with HT is 2 to 3 times higher than the best results obtained with conventional (x-ray) RT. 11 HT is the best choice of treatment for a number of pediatric cancers, 12 locally advanced esophageal cancer, 13 as well as a range of other cancers.…”

Section: Introductionmentioning

confidence: 99%