Early Toxicities After High Dose Rate Proton Therapy in Cancer Treatments.
cancer
early
high dose rate
proton therapy
subacute
toxicity
Journal
Frontiers in oncology
ISSN: 2234-943X
Titre abrégé: Front Oncol
Pays: Switzerland
ID NLM: 101568867
Informations de publication
Date de publication:
2020
2020
Historique:
received:
01
10
2020
accepted:
23
11
2020
entrez:
1
2
2021
pubmed:
2
2
2021
medline:
2
2
2021
Statut:
epublish
Résumé
The conventional dose rate of radiation therapy is 0.01-0.05 Gy per second. According to preclinical studies, an increased dose rate may offer similar anti-tumoral effect while dramatically improving normal tissue protection. This study aims at evaluating the early toxicities for patients irradiated with high dose rate pulsed proton therapy (PT). A single institution retrospective chart review was performed for patients treated with high dose rate (10 Gy per second) pulsed proton therapy, from September 2016 to April 2020. This included both benign and malignant tumors with ≥3 months follow-up, evaluated for acute (≤2 months) and subacute (>2 months) toxicity after the completion of PT. There were 127 patients identified, with a median follow up of 14.8 months (3-42.9 months). The median age was 55 years (1.6-89). The cohort most commonly consisted of benign disease (55.1%), cranial targets (95.1%), and were treated with surgery prior to PT (56.7%). There was a median total PT dose of 56 Gy (30-74 Gy), dose per fraction of 2 Gy (1-3 Gy), and CTV size of 47.6 ml (5.6-2,106.1 ml). Maximum acute grade ≥2 toxicity were observed in 49 (38.6%) patients, of which 8 (6.3%) experienced grade 3 toxicity. No acute grade 4 or 5 toxicity was observed. Maximum subacute grade 2, 3, and 4 toxicity were discovered in 25 (19.7%), 12 (9.4%), and 1 (0.8%) patient(s), respectively. In this cohort, utilizing high dose rate proton therapy (10 Gy per second) did not result in a major decrease in acute and subacute toxicity. Longer follow-up and comparative studies with conventional dose rate are required to evaluate whether this approach offers a toxicity benefit.
Sections du résumé
BACKGROUND
BACKGROUND
The conventional dose rate of radiation therapy is 0.01-0.05 Gy per second. According to preclinical studies, an increased dose rate may offer similar anti-tumoral effect while dramatically improving normal tissue protection. This study aims at evaluating the early toxicities for patients irradiated with high dose rate pulsed proton therapy (PT).
MATERIALS AND METHODS
METHODS
A single institution retrospective chart review was performed for patients treated with high dose rate (10 Gy per second) pulsed proton therapy, from September 2016 to April 2020. This included both benign and malignant tumors with ≥3 months follow-up, evaluated for acute (≤2 months) and subacute (>2 months) toxicity after the completion of PT.
RESULTS
RESULTS
There were 127 patients identified, with a median follow up of 14.8 months (3-42.9 months). The median age was 55 years (1.6-89). The cohort most commonly consisted of benign disease (55.1%), cranial targets (95.1%), and were treated with surgery prior to PT (56.7%). There was a median total PT dose of 56 Gy (30-74 Gy), dose per fraction of 2 Gy (1-3 Gy), and CTV size of 47.6 ml (5.6-2,106.1 ml). Maximum acute grade ≥2 toxicity were observed in 49 (38.6%) patients, of which 8 (6.3%) experienced grade 3 toxicity. No acute grade 4 or 5 toxicity was observed. Maximum subacute grade 2, 3, and 4 toxicity were discovered in 25 (19.7%), 12 (9.4%), and 1 (0.8%) patient(s), respectively.
CONCLUSION
CONCLUSIONS
In this cohort, utilizing high dose rate proton therapy (10 Gy per second) did not result in a major decrease in acute and subacute toxicity. Longer follow-up and comparative studies with conventional dose rate are required to evaluate whether this approach offers a toxicity benefit.
Identifiants
pubmed: 33520724
doi: 10.3389/fonc.2020.613089
pmc: PMC7842185
doi:
Types de publication
Journal Article
Langues
eng
Pagination
613089Informations de copyright
Copyright © 2021 Doyen, Sunyach, Almairac, Bourg, Naghavi, Duhil de Bénazé, Claren, Padovani, Benezery, Noël, Hannoun-Lévi, Guedea, Giralt, Vidal, Baudin, Opitz, Claude and Bondiau.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Clin Neurol Neurosurg. 2007 Sep;109(7):634-8
pubmed: 17601658
Eur J Cancer. 2009 Jan;45(2):228-47
pubmed: 19097774
Radiat Oncol. 2018 Apr 19;13(1):72
pubmed: 29673384
Radiother Oncol. 2018 Dec;129(3):582-588
pubmed: 30177374
J Clin Oncol. 2020 Feb 10;38(5):454-461
pubmed: 31774710
Radiother Oncol. 2019 Oct;139:18-22
pubmed: 31303340
J Clin Oncol. 2020 May 10;38(14):1569-1579
pubmed: 32160096
Lancet Oncol. 2014 Aug;15(9):1027-38
pubmed: 24980873
Radiother Oncol. 2017 Sep;124(3):365-369
pubmed: 28545957
Int J Radiat Oncol Biol Phys. 2020 Feb 1;106(2):440-448
pubmed: 31928642
Radiother Oncol. 2019 Oct;139:46-50
pubmed: 31266652
Cancer Treat Rev. 2016 Feb;43:104-12
pubmed: 26827698
Sci Transl Med. 2014 Jul 16;6(245):245ra93
pubmed: 25031268
Int J Radiat Oncol Biol Phys. 2013 Jun 1;86(2):277-84
pubmed: 23433794
Strahlenther Onkol. 2013 Dec;189(12):1020-5
pubmed: 24052010
Int J Radiat Oncol Biol Phys. 2016 May 1;95(1):312-321
pubmed: 26883563
Radiother Oncol. 2018 Aug;128(2):260-265
pubmed: 29960684
Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S10-9
pubmed: 20171502
Radiother Oncol. 2019 Oct;139:51-55
pubmed: 30850209
JAMA Oncol. 2020 Feb 1;6(2):237-246
pubmed: 31876914
Phys Med Biol. 2017 Jul 7;62(13):5365-5382
pubmed: 28504642
Radiother Oncol. 2016 Feb;118(2):286-92
pubmed: 26867969
Clin Cancer Res. 2019 Jan 1;25(1):35-42
pubmed: 29875213