Proton Therapy for Breast Cancer After Mastectomy: Early Outcomes of a Prospective Clinical Trial
Proton Therapy for Breast Cancer After Mastectomy: Early Outcomes of a Prospective Clinical Trial
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DOI：
10.1016/j.ijrobp.2013.01.038
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发表时间：
2013-07-01
影响因子：
7
通讯作者：
Taghian, Alphonse G.
中科院分区：
文献类型：
--
作者：
MacDonald, Shannon M.;Patel, Sagar A.;Taghian, Alphonse G.
目的：剂量学计划研究已经描述了质子放射治疗(RT)用于局部晚期乳腺癌的潜在益处。我们报告了12名接受质子放射治疗的乳腺癌术后患者的急性毒性和质子输送的可行性。方法和材料：12名患者参加了一项机构回顾委员会批准的前瞻性临床试验。在治疗期间以及治疗结束后4周和8周，对患者进行皮肤毒性、疲劳感和放射性肺炎的评估。所有患者都同意拍摄照片以记录皮肤毒性。结果：12名患者中有11名患者为左侧乳腺癌。一名患者接受了双侧植入治疗右侧乳腺癌。5名女性在接受RT时接受了永久性种植，7名女性没有立即进行重建。所有患者均接受质子放射治疗，胸壁剂量为50.4GY(相对生物学效应[RBE])，区域淋巴管剂量为45~50.4GY(RBE)。没有使用任何光子或电子元件。根据不良事件通用术语标准(CTCAE)，辐射期间的最大皮肤毒性为2级。术后最大CTCAE疲劳度为3级。目前尚无RT肺炎病例。结论：质子RT用于乳腺癌术后RT是可行的，且耐受性良好。对于心脏解剖不佳、立即重建或两者兼而有之的患者，这种治疗可能是有保证的，否则会限制使用标准方法的最佳RT交付。(C)2013年爱思唯尔公司。
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.