Proton Therapy for Breast Cancer: A Consensus Statement From the Particle Therapy Cooperative Group Breast Cancer Subcommittee

Mutter, Robert W.; Choi, J. Isabelle; Jimenez, Rachel; Kirova, Youlia; Fagundes, Marcio; Haffty, Bruce G.; Amos, Richard A.; Bradley, Julie A.; Chen, Peter Y.; Ding, Xuanfeng; Carr, Antoinette M; Taylor, Leslie M.; Pankuch, Mark; Vega, Raymond B. Mailhot; Ho, Alice Y.; Nyström, Petra Witt; McGee, L.A.; Urbanic, James J.; Cahlon, Oren; Maduro, John H.; MacDonald, Shannon M.

doi:10.1016/j.ijrobp.2021.05.110

Cited by 57 publications

(58 citation statements)

References 175 publications

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“…Even in complex cases with CTV volumes extending to the contralateral chest wall, excellent clinical target coverage with low dose exposure to OARs was achieved. IMPT for breast cancer has been of particular interest because of reduced doses to OARs and, in turn, possible reduced risk of longterm AEs [18,38]. Several proton therapy series for breast cancer have demonstrated excellent locoregional control and low risk of AEs [19,[22][23][24].…”

Section: Discussionmentioning

confidence: 99%

Proton therapy for the treatment of inflammatory breast cancer

Fattahi

Mullikin²,

Aziz³

et al. 2022

Radiotherapy and Oncology

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Section: Discussionmentioning

confidence: 99%

Proton therapy for the treatment of inflammatory breast cancer

Fattahi

Mullikin²,

Aziz³

et al. 2022

Radiotherapy and Oncology

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“…These developments may have additional implications for local control. Moreover, with the aim of deescalating local therapies, about 51% of our cohort would today be deemed as "suitable candidates" for PBI only [53,54], either with IOERT, external photons, multicatheter brachytherapy [55], or protons [56][57][58], respectively.…”

Section: Trial Limitationsmentioning

confidence: 99%

Hypofractionated Whole Breast Irradiation and Boost-IOERT in Early Stage Breast Cancer (HIOB): First Clinical Results of a Prospective Multicenter Trial (NCT01343459)

Fastner

Reitsamer

Gaisberger

et al. 2022

Cancers

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Background and purpose: To investigate intraoperative electron radiation therapy (IOERT) as a tumor bed boost during breast conserving surgery (BCS) followed by hypofractionated whole breast irradiation (HWBI) on age-correlated in-breast recurrence (IBR) rates in patients with low- to high-risk invasive breast cancer. Material and methods: BCS and IOERT (11.1 Gy) preceded a HWBI (40.5 Gy) in 15 fractions. Five-year IBR-rates were compared by a sequential ratio test (SQRT) with best evidences in three age groups (35–40 y and 41–50 y: 3.6%, >50 y: 2%) in a prospective single arm design. Null hypothesis (H0) was defined to undershoot these benchmarks for proof of superiority. Results: Of 1445 enrolled patients, 326 met exclusion criteria, leaving 1119 as eligible for analysis. After a median follow-up of 50 months (range 0.7–104), we detected two local recurrences, both in the age group >50 y. With no observed IBR, superiority was demonstrated for the patient groups 41–50 and >50 y, respectively. For the youngest group (35–40 y), no appropriate statistical evaluation was yet possible due to insufficient recruitment. Conclusions: In terms of five-year IBR-rates, Boost-IOERT followed by HWBI has been demonstrated to be superior in patients older than 50 and in the age group 41–50 when compared to best published evidence until 2010.

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“…A reduction in the maximum and mean dose received by the ADA or by the whole heart was obtained in several studies evaluating the DIBH technique, but this did not apply to all patients, emphasizing the importance of individual anatomical chest features [ 140 , 143 , 144 , 145 , 146 ]. Nowadays, proton therapy—the most precise form of radiation treatment available—is gaining more and more ground in front of photon therapy [ 147 ].…”

Section: Radiotherapymentioning

confidence: 99%

“…Although the most important prophylaxis of IRCAD is to reduce the dose of radiation to the heart and coronary arteries—current RT protocols strive to achieve this—some exposure remains inevitable. Therefore, pharmacologic cardio-protective interventions have been considered as well, mainly focusing on limiting oxidative stress, inflammation, fibrosis, and thrombosis [ 147 ].…”

Section: Radiotherapymentioning

confidence: 99%

Myocardial Ischemia Related to Common Cancer Therapy—Prevention Insights

Bădescu

Bădulescu

Scripcariu

et al. 2022

Life

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Modern antineoplastic therapy improves survival and quality of life in cancer patients, but its indisputable benefits are accompanied by multiple and major side effects, such as cardiovascular ones. Endothelial dysfunction, arterial spasm, intravascular thrombosis, and accelerated atherosclerosis affect the coronary arteries, leading to acute and chronic coronary syndromes that negatively interfere with the oncologic treatment. The cardiac toxicity of antineoplastic agents may be mitigated by using adequate prophylactic measures. In the absence of dedicated guidelines, our work provides the most comprehensive, systematized, structured, and up-to-date analyses of the available literature focusing on measures aiming to protect the coronary arteries from the toxicity of cancer therapy. Our work facilitates the implementation of these measures in daily practice. The ultimate goal is to offer clinicians the necessary data for a personalized therapeutic approach for cancer patients receiving evidence-based oncology treatments with potential cardiovascular toxicity.

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Proton Therapy for Breast Cancer: A Consensus Statement From the Particle Therapy Cooperative Group Breast Cancer Subcommittee

Cited by 57 publications

References 175 publications

Proton therapy for the treatment of inflammatory breast cancer

Proton therapy for the treatment of inflammatory breast cancer

Hypofractionated Whole Breast Irradiation and Boost-IOERT in Early Stage Breast Cancer (HIOB): First Clinical Results of a Prospective Multicenter Trial (NCT01343459)

Myocardial Ischemia Related to Common Cancer Therapy—Prevention Insights

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