Proton radiotherapy – dosimetric advantages for patients with breast cancer
Authors:
A. Pásztorová; A. Haas; S. Al-Hamami; J. Abrahámová; J. Kubeš; B. Ondrová; M. Andrlík; D. Šimánková
Authors place of work:
Proton Therapy Center Czech, s. r. o., Praha Primář: doc. MUDr. Jiří Kubeš, PhD.
Published in the journal:
Prakt. Lék. 2024; 104(2): 84-92
Category:
Of different specialties
Summary
Adjuvant radiotherapy is a frequently used treatment option for non-metastatic breast cancer. Although highly effective, it can be burdened with several negative side-effects that may increase the risk of cardiovascular and pulmonary diseases, secondary malignancies, and according to recent data, may lead to unwanted suppression of the immune system.
Proton radiotherapy has unique dosimetric advantages that offer the possibility of reducing the integral dose and unwanted dose to the surrounding organs at risk, while simultaneously allowing for optimal coverage of the treatment volume. This benefit becomes more evident in larger or more complex target volumes.
Treatment plans with increased complexity, such as those for bilateral breast cancer, complicated or arched chest shapes (e.g., pectus excavatum), or those involving irradiation of the internal mammary nodes, stand to benefit significantly from proton therapy.
In this article, we highlight situations in which proton radiotherapy offers pronounced dosimetric advantages for breast cancer patients.
Keywords:
breast cancer – proton radiotherapy – dosimetric advantages
Zdroje
- www.svod.cz
- Arnold M, Morgan E, Rumgay H, et al. Current and future burden of breast cancer: Global statistics for 2020 and 2040. Breast 2022; 66: 15–23.
- Darby S, McGale P, Correa C, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: Meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet 2011; 378(9804): 1707–1716.
- Whelan TJ, Olivotto IA, Parulekar WE, et al. Regional nodal irradiation in early stage breast cancer. N Engl J Med. 2015; 373(4): 307–316.
- Fontanilla HP, Woodward WA, Lindberg ME, et al. Current clinical coverage of Radiation Therapy Oncology Group-defined target volumes for postmastectomy radiation therapy. Pract Radiat Oncol. 2012; 2(3): 201–209.
- Estourgie SH, Nieweg OE, Olmos RA, et al. Lymphatic drainage patterns from the breast. Ann Surg. 2004; 239: 232–237.
- Poortmans PM, Weltens C, Fortpied C, et al. European Organisation for Research and Treatment of Cancer Radiation Oncology and Breast Cancer Groups. Internal mammary and medial supraclavicular lymph node chain irradiation in stage I-III breast cancer (EORTC 22922/10925): 15-year results of a randomised, phase 3 trial. Lancet Oncol. 2020; 21(12): 1602–1610.
- Wöckel A, Festl J, Stuber T, et al. Interdisciplinary screening, diagnosis, therapy and follow-up of breast cancer. Guideline of the DGGG and the DKG (S3-Level, AWMF Registry Number 032/045OL, December 2017) – Part 2 with recommendations for the therapy of primary, recurrent and advanced breast cancer. Geburtshilfe Frauenheilkd. 2018; 78(11): 1056–1088.
- Wang H, Wei J, Zheng Q, et al. Radiation-induced heart disease: a review of classification, mechanism and prevention. Int J Biol Sci. 2019; 15(10): 2128–2138.
- Darby SC, Ewertz M, Mcgale P, et al. Risk of ischemic heart disease in women after radiotherapy for breast cancer. N Engl J Med. 2013; 368(11): 987–998.
- Jacobse JN, Duane FK, Boekel NB, et al. Radiation dose-response for risk of myocardial infarction in breast cancer survivors. Int J Radiat Oncol Biol Phys. 2019; 103(3): 595–604.
- Virmani R, Farb A, Carter AJ, et al. Pathology of radiation-induced coronary artery disease in human and pig. Cardiovasc Radiat Med. 1999; 1(1): 98–101.
- Grantzau T, Thomsen MS, Vaeth M, et al. Risk of second primary lung cancer in women after radiotherapy for breast cancer. Radiother Oncol. 2014; 111(3): 366–373.
- Gokula K, Earnest A, Wong LC. Meta-analysis of incidence of early lung toxicity in 3-dimensional conformal irradiation of breast carcinomas. Radiat. Oncol. 2013; 8: 268.
- Stovall M, Smith SA, Langholz BM, et al. Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study. Int J Radiat Oncol Biol Phys. 2008; 72(4): 1021–1030.
- Ares C, Khan S, Macartain AM, et al. Postoperative proton radiotherapy for localized and locoregional breast cancer: potential for clinically relevant improvements?. Int J Radiat Oncol Biol Phys. 2010; 76(3): 685–697.
- Paganetti H, DePauw N, Johnson A, et al. The risk for developing a secondary cancer after breast radiation therapy: Comparison of photon and proton techniques. Radiother. Oncol. 2020; 149: 212–218.
- Chen F, Yu H, Zhang H, et al. Risk factors for radiation induced lymphopenia in patients with breast cancer receiving adjuvant radiotherapy. Ann Transl Med. 2021; 9(16): 1288.
- Sun GY, Wang SL, Song YW, et al. Radiation-induced lymphopenia predicts poorer prognosis in patients with breast cancer: a post hoc analysis of a randomized controlled trial of postmastectomy hypofractionated radiation therapy. Int J Radiat Oncol Biol Phys. 2020; 108(1): 277–285.
- Garda AE, Hunzeker AE, Michel AK, et al. Intensity modulated proton therapy for bilateral breast or chest wall and comprehensive nodal irradiation for synchronous bilateral breast cancer: initial clinical experience and dosimetric comparison. Adv Radiat Oncol. 2022; 7(3): 100901.
- Kote-Jarai Z, Salmon A, Mengitsu T, et al. Increased level of chromosomal damage after irradiation of lymphocytes from BRCA1 mutations carriers. Br J Cancer. 2006; 94(2): 308–310.
adresa pro korespondenci:
MUDr. Andrea Pásztorová
Proton Therapy Center Czech, s. r. o.
Budínova 2437/1a, 180 00 Praha 8
email: andrea.pasztorova@ptc.cz
Štítky
General practitioner for children and adolescents General practitioner for adultsČlánok vyšiel v časopise
General Practitioner
2024 Číslo 2
- Memantine Eases Daily Life for Patients and Caregivers
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Advances in the Treatment of Myasthenia Gravis on the Horizon
- What Effect Can Be Expected from Limosilactobacillus reuteri in Mucositis and Peri-Implantitis?
Najčítanejšie v tomto čísle
- The topical steroid withdrawal and the dependence syndrome
- Fractures of proximal femur
- Mushrooms – a component of healthy nutrition of the future
- The irreplaceable role of carbohydrates in the diet – glucose is not just a source of energy in metabolism