Proton therapy for the treatment of inflammatory breast cancer

Fattahi, Sayeh; Mullikin, T.C.; Aziz, Khaled; Afzal, Arslan; Smith, Na L.; Francis, Leah N.; Harmsen, William S.; Routman, David M.; Remmes, Nicholas B.; Ahmed, Safia K.; Shumway, Dean A.; Park, Sean S.; Mutter, Robert W.; Corbin, Kimberly S.

doi:10.1016/j.radonc.2022.04.008

Cited by 4 publications

(3 citation statements)

References 48 publications

(70 reference statements)

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“…No patients developed grade 3 or 4 radiation pneumonitis [ 21 ]. Other reports of proton therapy for breast cancer support this finding [ 27 , 28 ].…”

Section: Rationale For Proton Therapysupporting

confidence: 59%

“…The clinical impact of this discrepancy was highlighted in a prospective study of patients treated with proton radiotherapy which reported a rib fracture rate of nearly 7%, which far exceeds rates seen in traditional photon radiation. This rate was even higher, 21%, among patients who received proton therapy for inflammatory carcinoma [ 27 ]. Subsequent evaluation of patients treated on the prospective trial was suggestive of an increased RBE at the distal edge of the proton beams accounting for the fracture rate [ 35 ].…”

Section: Areas Of Uncertainty In Proton Radiation Implementationmentioning

confidence: 99%

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The Potential of Proton Therapy for Locally Advanced Breast Cancer: Clinical and Technical Considerations

2023

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Proton therapy is a promising therapeutic modality with unique physical properties that allow for abrupt dose fall-off distal to the target of interest, thereby sparing nearby organs at risk. A number of studies have identified the utility of proton radiation in mitigating treatment related sequelae for patients with locally advanced breast cancers. Thus, in the following review, we highlight clinical and technical considerations for proton radiotherapy delivery in patients with locally advanced breast cancer.

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“…No patients developed grade 3 or 4 radiation pneumonitis [ 21 ]. Other reports of proton therapy for breast cancer support this finding [ 27 , 28 ].…”

Section: Rationale For Proton Therapysupporting

confidence: 59%

Section: Areas Of Uncertainty In Proton Radiation Implementationmentioning

confidence: 99%

The Potential of Proton Therapy for Locally Advanced Breast Cancer: Clinical and Technical Considerations

2023

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“…The in silico study by Tommasino et al [54] showed a comparable dose-to-skin value between photon and proton therapies, but the work of DeCesaris et al [55] highlighted higher acute grade ≥ 2 radiation dermatitis compared to photons. Fattahi et al [56] evaluated a short-term followup of nineteen patients and concluded that protons could possibly increase the rate of rib fractures. This higher rate of rib fractures could be linked to the increase in LET and RBE at the distal end of the beam [57].…”

Section: Discussionmentioning

confidence: 99%

Exploring Helium Ions’ Potential for Post-Mastectomy Left-Sided Breast Cancer Radiotherapy

Bonaccorsi,

Tessonnier,

Hoeltgen

et al. 2024

Cancers

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Proton therapy presents a promising modality for treating left-sided breast cancer due to its unique dose distribution. Helium ions provide increased conformality thanks to a reduced lateral scattering. Consequently, the potential clinical benefit of both techniques was explored. An explorative treatment planning study involving ten patients, previously treated with VMAT (Volumetric Modulated Arc Therapy) for 50 Gy in 25 fractions for locally advanced, node-positive breast cancer, was carried out using proton pencil beam therapy with a fixed relative biological effectiveness (RBE) of 1.1 and helium therapy with a variable RBE described by the mMKM (modified microdosimetric kinetic model). Results indicated that target coverage was improved with particle therapy for both the clinical target volume and especially the internal mammary lymph nodes compared to VMAT. Median dose value analysis revealed that proton and helium plans provided lower dose on the left anterior descending artery (LAD), heart, lungs and right breast than VMAT. Notably, helium therapy exhibited improved ipsilateral lung sparing over protons. Employing NTCP models as available in the literature, helium therapy showed a lower probability of grade ≤ 2 radiation pneumonitis (22% for photons, 5% for protons and 2% for helium ions), while both proton and helium ions reduce the probability of major coronary events with respect to VMAT.

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Advances in Radiotherapy for Breast Cancer

Upadhyay¹,

Bazan²

2023

Surgical Oncology Clinics of North America

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Proton therapy for the treatment of inflammatory breast cancer

Cited by 4 publications

References 48 publications

The Potential of Proton Therapy for Locally Advanced Breast Cancer: Clinical and Technical Considerations

The Potential of Proton Therapy for Locally Advanced Breast Cancer: Clinical and Technical Considerations

Exploring Helium Ions’ Potential for Post-Mastectomy Left-Sided Breast Cancer Radiotherapy

Advances in Radiotherapy for Breast Cancer

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