Early Toxicity in Patients Treated With Postoperative Proton Therapy for Locally Advanced Breast Cancer

被引:72
作者
Cuaron, John J. [1 ]
Chon, Brian [2 ]
Tsai, Henry [2 ]
Goenka, Anuj [2 ]
DeBlois, David [2 ]
Ho, Alice [1 ]
Powell, Simon [1 ]
Hug, Eugen [2 ]
Cahlon, Oren [1 ,2 ]
机构
[1] Mem Sloan Kettering Canc Ctr, New York, NY 10065 USA
[2] Procure Proton Therapy Ctr, Somerset, NJ USA
来源
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS | 2015年 / 92卷 / 02期
关键词
RADIATION-THERAPY; POSTMASTECTOMY RADIATION; CHEST-WALL; RADIOTHERAPY; RISK; PNEUMONITIS; IRRADIATION; CHEMOTHERAPY; WOMEN; DOSIMETRY;
D O I
10.1016/j.ijrobp.2015.01.005
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Purpose: To report dosimetry and early toxicity data in breast cancer patients treated with postoperative proton radiation therapy. Methods and Materials: From March 2013 to April 2014, 30 patients with nonmetastatic breast cancer and no history of prior radiation were treated with proton therapy at a single proton center. Patient characteristics and dosimetry were obtained through chart review. Patients were seen weekly while on treatment, at 1 month after radiation therapy completion, and at 3-to 6-month intervals thereafter. Toxicity was scored using Common Terminology Criteria for Adverse Events version 4.0. Frequencies of toxicities were tabulated. Results: Median dose delivered was 50.4 Gy (relative biological equivalent [RBE]) in 5 weeks. Target volumes included the breast/chest wall and regional lymph nodes including the internal mammary lymph nodes (in 93%). No patients required a treatment break. Among patients with > 3 months of follow-up (nZ28), grade 2 dermatitis occurred in 20 patients (71.4%), with 8 (28.6%) experiencing moist desquamation. Grade 2 esophagitis occurred in 8 patients (28.6%). Grade 3 reconstructive complications occurred in 1 patient. The median planning target volume V95 was 96.43% (range, 79.39%-99.60%). The median mean heart dose was 0.88 Gy (RBE) [range, 0.01-3.20 Gy (RBE)] for all patients, and 1.00 Gy (RBE) among patients with left-sided tumors. The median V20 of the ipsilateral lung was 16.50% (range, 6.1%-30.3%). The median contralateral lung V5 was 0.34% (range, 0%-5.30%). The median maximal point dose to the esophagus was 45.65 Gy (RBE) [range, 0-65.4 Gy (RBE)]. The median contralateral breast mean dose was 0.29 Gy (RBE) [range, 0.03-3.50 Gy (RBE)]. Conclusions: Postoperative proton therapy is well tolerated, with acceptable rates of skin toxicity. Proton therapy favorably spares normal tissue without compromising target coverage. Further follow-up is necessary to assess for clinical outcomes and cardiopulmonary toxicities. (C) 2015 Elsevier Inc. All rights reserved.
引用
收藏
页码:284 / 291
页数:8
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