Proton radiation for treatment of cancer of the oropharynx: Early experience at Loma Linda University Medical Center using a concomitant boost technique

Slater, Jerry D.; Yonemoto, Les T.; Mantik, David W.; Bush, David A.; Preston, William; Grove, Roger; Miller, Daniel W.; Slater, James M.

doi:10.1016/j.ijrobp.2004.09.064

Cited by 91 publications

(31 citation statements)

References 19 publications

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“…Previous studies (7)(8)(9)(10) suggested that patients with head and neck cancer may benefit from PBT. PBT may decrease the recurrence risk by increasing the dose to the tumor and, due to the small dose to the mandible, salivary glands and maxilla, it may reduce the risk of xerostomia, dental extractions, dental caries and osteoradionecrosis.…”

Section: Pbt For Different Cancersmentioning

confidence: 99%

The evolution of proton beam therapy: Current and future status (Review)

et al. 2017

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Abstract. Proton beam therapy (PBT) has been increasingly used in a variety of cancers due to its excellent physical properties and superior dosimetric parameters. PBT may improve patient survival by improving the local tumor treatment rate while reducing injury to normal organs, which may result in fewer radiation-induced adverse effects. However, the significant cost of establishing and maintaining proton facilities cannot be overlooked. In addition, there has been significant controversy regarding routine application of this treatment in certain types of cancer. The challenges of PBT in the future mainly include the lack of basic clinical trials, unclear biological effects, immature imaging technology and miniaturization of imaging guidance. Overcoming these limitations may promote the rapid development of PBT. We herein provide an overview of the existing literature on the efficacy and toxicity of common oncological applications of proton beam therapy.

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Section: Pbt For Different Cancersmentioning

confidence: 99%

The evolution of proton beam therapy: Current and future status (Review)

et al. 2017

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“…The value of protons for the most complex head and neck sites (nasopharynx and paranasal sinuses) resides in the ability to limit the dose to optic structures and brainstem and secondarily the mandible and salivary glands and PBT has been used on a clinical trial basis for the treatment of salivary tumors, nasopharyngeal carcinoma, oropharynx,sinonasal, and paranasal sinus malignancies [79][80][81][82][83] . In these tumors PBT can offer the opportunity of dose escalation for cancers where loco-regional control is currently limited by an inability to adequately deliver therapeutic doses without excessive risk of toxicity or minimizing exposure of normal tissues in order to reduce toxicity for patients with possible long-term control with currently-prescribed doses, but at the cost of potential significant toxicity [81] .…”

Section: Head and Neck Cancersmentioning

confidence: 99%

The actual Interest in Radiotherapy for the Utilization of Proton Beam, Highlighting Physics Basis, Technology and Common Clinical Indications

Amichetti

2016

Journal of Tumor

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. Since that years, commercial entities began to build cyclotrons and synchrotrons for clinical purposes. Over the last 10 years, PBT has gathered more interest in the scientific community and more media and patient attention and is now flourishing in the US and abroad. As of December, 2015, 57 proton therapy centers are in operation worldwide, others are under construction and many more in a planning phase [3] . Most patients who have been treated with heavy-particle therapy were treated with protons: PTCOG (Particle Therapy Co-Operative Group) reports that between 1954 and 2014, 137 000 patients globally received part or all of their radiation therapy with particles, and in particular 86% of them with protons [4] . The generation of these particles and the building of dedicated centers, however, requires large investments and operational costs and big infrastructure. Only relatively few studies have demonstrated the effectiveness of proton therapy and the effects are surrounded with uncertainty [5] being the cost-effectiveness still the core of the controversy around the use of PBT. ABSTRACTManaging expensive technology is a debated issue in modern radiation oncology. Proton beam therapy (PBT) represents, considering its cost and its foreseen benefits, a typical case of discussion waiting for more robust results demonstrating the presumable clinical gains against the available radiation therapy (XRT) treatment alternatives based on the use of photons. The treatment with particles utilizes many different beams (neutrons, protons, pions, or helium, neon, argon, and carbon ions) that represent a distinct entity respect conventional XRT which uses photons. PBT is the most common form of heavy-particle radiation therapy used so far; it is not a new invention, being its clinical use proposed in a seminal article by R. Wilson in 1946 [1] and the first patients treated in 1954 at the Lawrence Berkeley National Laboratory in California [2] . Since cyclotron or synchrotron, used to accelerate protons to therapeutic energies, were used primarily for research in particle or nuclear physics, the initial clinical activity in proton therapy was carried out in research facilities and the use of protons in clinical practice has grown slowly for several years in non-clinical setting. More than fifty years later, after a long period of seminal work in a limited number of Institutions, PBT has gained public attention in recent years because of the rapidly increasing number of centers around the world, regardless of their high cost. Hospital-based proton beam facilities have been in operation since 1990 after the opening of the first dedicated clinical center at Loma Linda Medical

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“…An interesting point is that most of them investigated rare diseases (olfactory neuroblastoma, malignant melanoma, local recurrence of nasopharyngeal cancer) ( Table 3), even though excellent outcomes have been reported for these rare diseases [17][18][19][20]. Three retrospective analyses investigated the use of PBT as the sole treatment or a boost technique delivered in combination with photons to treat patients with locally advanced head and neck cancer [21][22][23]. The role of PBT in relation to modern photon IMRT in the treatment of locally advanced head and neck tumors is still undefined.…”

Section: Head and Neck Cancermentioning

confidence: 99%

Clinical evidence of particle beam therapy (proton)

Ogino

2012

Int J Clin Oncol

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Proton beam therapy (PBT) makes it possible to deliver a high concentration of radiation to a tumor using its Bragg peak, and it is simple to utilize as its radiobiological characteristics are identical to those of photon beams. PBT has now been used for half a century, and more than 60,000 patients worldwide are reported to have been treated with proton beams. The most significant change to PBT occurred in the 1990s, when the Loma Linda University Medical Center became the first hospital in the world to operate a medically dedicated proton therapy facility. Following its success, similar medically dedicated facilities have been constructed. Internationally, results have demonstrated the therapeutic superiority of PBT over alternative treatment options for several disease sites. Further advances in PBT are expected from both clinical and technological perspectives.

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Proton radiation for treatment of cancer of the oropharynx: Early experience at Loma Linda University Medical Center using a concomitant boost technique

Cited by 91 publications

References 19 publications

The evolution of proton beam therapy: Current and future status (Review)

The evolution of proton beam therapy: Current and future status (Review)

The actual Interest in Radiotherapy for the Utilization of Proton Beam, Highlighting Physics Basis, Technology and Common Clinical Indications

Clinical evidence of particle beam therapy (proton)

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