Proton Beam Therapy in the Oligometastatic/Oligorecurrent Setting: Is There a Role? A Literature Review

被引：11

作者：

Gaito, Simona ^{[1
,2
]}

Marvaso, Giulia ^{[3
,4
]}

Ortiz, Ramon ^{[5
]}

Crellin, Adrian ^{[6
]}

Aznar, Marianne C. ^{[2
]}

Indelicato, Daniel J. ^{[7
]}

Pan, Shermaine ^{[8
]}

Whitfield, Gillian ^{[2
,8
]}

Alongi, Filippo ^{[9
,10
]}

Jereczek-Fossa, Barbara Alicja ^{[3
,4
]}

Burnet, Neil ^{[8
]}

Li, Michelle P. ^{[8
,11
,12
]}

Rothwell, Bethany ^{[13
,14
]}

Smith, Ed ^{[1
,2
,8
]}

Colaco, Rovel J. ^{[8
]}

机构：

[1] Christie NHS Proton Beam Therapy Ctr, Proton Clin Outcomes Unit, Manchester M20 4BX, England

[2] Univ Manchester, Sch Med Sci, Div Clin Canc Sci, Manchester M13 9PL, England

[3] Univ Milan, Dept Oncol & Hemato Oncol, I-20122 Milan, Italy

[4] IEO European Inst Oncol IRCCS, Dept Radiat Oncol, I-20126 Milan, Italy

[5] Univ Calif San Francisco, Dept Radiat Oncol, San Francisco, CA 94720 USA

[6] Natl Lead Proton Beam Therapy NHSe, Manchester M20 4BX, England

[7] Univ Florida, Dept Radiat Oncol, Jacksonville, FL 32206 USA

[8] Christie Proton Beam Therapy Ctr, Dept Proton Beam Therapy, Manchester M20 3DA, England

[9] IRCCS Osped Sacro Cuore don Calabria, Adv Radiat Oncol Dept, I-37024 Verona, Italy

[10] Univ Brescia, Div Radiol & Radiotherapy, I-25121 Brescia, Italy

[11] Peter MacCallum Canc Ctr, Dept Radiat Oncol, Melbourne, Vic 3000, Australia

[12] Univ Melbourne, Sir Peter MacCallum Dept Oncol, Melbourne, Vic 3010, Australia

[13] Massachusetts Gen Hosp, Dept Radiat Oncol, Div Phys, Boston, MA 02114 USA

[14] Harvard Med Sch, Boston, MA 02114 USA

来源：

CANCERS | 2023年 / 15卷 / 09期

基金：

英国工程与自然科学研究理事会;

关键词：

oligometastases; oligorecurrences; proton beam therapy; STEREOTACTIC ABLATIVE RADIOTHERAPY; BODY RADIATION-THERAPY; BRAIN METASTASES; PHOTON RADIOTHERAPY; PROSTATE-CANCER; RADIOSURGERY; OLIGOMETASTASES; REIRRADIATION; UNCERTAINTY; TOXICITY;

D O I：

10.3390/cancers15092489

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Stereotactic ablative radiotherapy (SABR) and stereotactic radiosurgery (SRS) with conventional photon radiotherapy (XRT) are well-established treatment options for oligorecurrent/oligometastatic disease. Here, we review the available evidence surrounding the current use of proton beam therapy (PBT) in this setting. We describe how the particular physical properties of PBT could be used for the treatment of oligometastases/oligorecurences. Moreover, we further outline how current research has the potential to expand the therapeutic window of PBT whilst minimising the intrinsic uncertainties of this technique. This would potentially lead to an expansion of the commissioning of PBT to include these indications. Background: Stereotactic ablative radiotherapy (SABR) and stereotactic radiosurgery (SRS) with conventional photon radiotherapy (XRT) are well-established treatment options for selected patients with oligometastatic/oligorecurrent disease. The use of PBT for SABR-SRS is attractive given the property of a lack of exit dose. The aim of this review is to evaluate the role and current utilisation of PBT in the oligometastatic/oligorecurrent setting. Methods: Using Medline and Embase, a comprehensive literature review was conducted following the PICO (Patients, Intervention, Comparison, and Outcomes) criteria, which returned 83 records. After screening, 16 records were deemed to be relevant and included in the review. Results: Six of the sixteen records analysed originated in Japan, six in the USA, and four in Europe. The focus was oligometastatic disease in 12, oligorecurrence in 3, and both in 1. Most of the studies analysed (12/16) were retrospective cohorts or case reports, two were phase II clinical trials, one was a literature review, and one study discussed the pros and cons of PBT in these settings. The studies presented in this review included a total of 925 patients. The metastatic sites analysed in these articles were the liver (4/16), lungs (3/16), thoracic lymph nodes (2/16), bone (2/16), brain (1/16), pelvis (1/16), and various sites in 2/16. Conclusions: PBT could represent an option for the treatment of oligometastatic/oligorecurrent disease in patients with a low metastatic burden. Nevertheless, due to its limited availability, PBT has traditionally been funded for selected tumour indications that are defined as curable. The availability of new systemic therapies has widened this definition. This, together with the exponential growth of PBT capacity worldwide, will potentially redefine its commissioning to include selected patients with oligometastatic/oligorecurrent disease. To date, PBT has been used with encouraging results for the treatment of liver metastases. However, PBT could be an option in those cases in which the reduced radiation exposure to normal tissues leads to a clinically significant reduction in treatment-related toxicities.

引用

页数：14

共 78 条

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