Abstract
Hadron therapy with protons and carbon ions is widely attracting interest as a potential competitor of conventional photon radiotherapy. Exquisite dose distribution of charged particles allows for a higher local control of the tumor and lower probability of damage to nearby healthy tissues. Heavy ions have presumed biological advantages rising from their high-linear energy transfer (LET) characteristics, including greater cell-killing effectiveness and reduced heterogeneity dependence of radiation response. Although these advantages are clear and supported by data, only 18.0% of proton and carbon ion radiotherapy (CIRT) facilities in Europe are treating breast cancers. This review summarizes the physical and radiobiological properties of charged particles, clinical use of particle beam for breast cancer, and suggested approaches to overcome technical and financial challenges.
Highlights
Breast cancer, ranking first in incidence and mortality, threatens women’s health globally
Combined protocol efficiently kills triple-negative breast cancer (TNBC) stem cells in vitro, likely due to suppressed colony formation, inhibited cell cycles, irreparable DNA lesions, and enhanced apoptosis compared to X-ray combined with cisplatin or carbon ion beam alone
The ballistic and radiobiological properties of particle beam make it a potential treatment option for radioresistant breast cancer subtypes. it could be more cost efficient than photons in patients who are at risk of cardiovascular disease
Summary
Breast cancer, ranking first in incidence and mortality, threatens women’s health globally. Comparative study has been conducted to estimate the gain obtained with PT in term of recurrence and cardiotoxicity risk using clinical data of EORTC 22922/10925, and NCIC-CTG MA.20, including 41 patients of locally advanced breast cancer with nodal involvement. The proton beam significantly lowers mean doses to lung and heart compared to even the most optimized photon beam plan, data are summarized at Table 1, and enables patients to undergo a limited risk of cardiac toxicity [16].
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