Proton Therapy for Breast Cancer After Mastectomy: Early Outcomes of a Prospective Clinical Trial

被引：115

作者：

MacDonald, Shannon M. ^{[1
]}

Patel, Sagar A. ^{[1
]}

Hickey, Shea ^{[1
]}

Specht, Michelle ^{[2
]}

Isakoff, Steven J. ^{[3
]}

Gadd, Michele ^{[2
]}

Smith, Barbara L. ^{[2
]}

Yeap, Beow Y. ^{[4
]}

Adams, Judith ^{[1
]}

DeLaney, Thomas F. ^{[1
]}

Kooy, Hanne ^{[1
]}

Lu, Hsiao-Ming ^{[1
]}

Taghian, Alphonse G. ^{[1
]}

机构：

[1] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Radiat Oncol, Boston, MA USA

[2] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Surg Oncol, Boston, MA USA

[3] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Div Hematol & Oncol, Boston, MA USA

[4] Harvard Univ, Massachusetts Gen Hosp, Sch Med, Dept Med, Boston, MA USA

来源：

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2013年 / 86卷 / 03期

关键词：

RADIATION-THERAPY; RADIOTHERAPY; MORTALITY; RISK; CHEMOTHERAPY; PNEUMONITIS;

D O I：

10.1016/j.ijrobp.2013.01.038

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: Dosimetric planning studies have described potential benefits for the use of proton radiation therapy (RT) for locally advanced breast cancer. We report acute toxicities and feasibility of proton delivery for 12 women treated with postmastectomy proton radiation with or without reconstruction. Methods and Materials: Twelve patients were enrolled in an institutional review board-approved prospective clinical trial. The patients were assessed for skin toxicity, fatigue, and radiation pneumonitis during treatment and at 4 and 8 weeks after thecompletion of therapy. All patients consented to have photographs taken for documentation of skin toxicity. Results: Eleven of 12 patients had left-sided breast cancer. One patient was treated for right-sided breast cancer with bilateral implants. Five women had permanent implants at the time of RT, and 7 did not have immediate reconstruction. All patients completed proton RT to a dose of 50.4 Gy (relative biological effectiveness [RBE]) to the chest wall and 45 to 50.4 Gy (RBE) to the regional lymphatics. No photon or electron component was used. The maximum skin toxicity during radiation was grade 2, according to the Common Terminology Criteria for Adverse Events (CTCAE). The maximum CTCAE fatigue was grade 3. There have been no cases of RT pneumonitis to date. Conclusions: Proton RT for postmastectomy RT is feasible and well tolerated. This treatment may be warranted for selected patients with unfavorable cardiac anatomy, immediate reconstruction, or both that otherwise limits optimal RT delivery using standard methods. (C) 2013 Elsevier Inc.

引用

页码：484 / 490

页数：7