Results Of Proton Beam Therapy Research Articles

Rationale for and Preliminary Results of Proton Beam Therapy for Mediastinal Lymphoma

To evaluate the potential of three-dimensional proton beam therapy (3D-PBT) for reducing doses to normal structures in patients with mediastinal lymphomas compared with conventional photon radiation therapy (RT). We treated 10 consecutive patients with mediastinal masses from lymphomas with 3D-PBT between July 2007 and February 2009 to 30.6-50.4 cobalt-Gray equivalents (CGE). Of those patients, 7 had primary refractory or recurrent disease, and 8 had Hodgkin lymphoma. Dosimetric endpoints were compared with those from conventional RT plans. PBT delivered lower mean doses to the lung (6.2 vs. 9.5 Gy), esophagus (9.5 vs. 22.3 Gy), and heart (8.8 vs. 17.7 Gy) but not the breasts (5.9 vs. 6.1 Gy) than did conventional RT. Percentages of lung, esophagus, heart, and coronary artery (particularly the left anterior descending artery) volumes receiving radiation were consistently lower in the 3D-PBT plans over a wide range of radiation doses. Of the 7 patients who had residual disease on positron emission tomography before PBT, 6 (86%) showed a complete metabolic response. In patients with mediastinal lymphomas, 3D-PBT produced significantly lower doses to the lung, esophagus, heart, and coronary arteries than did the current conventional RT. These lower doses would be expected to reduce the risk of late toxicities in these major organs.

Long-Term Results of Proton Beam Therapy for Surgically Inaccessible or Residual Meningiomas

Long-Term Results of Proton Beam Therapy for Surgically Inaccessible or Residual Meningiomas

2120: Preliminary Results of Proton Beam Therapy for Hepatocellular Carcinoma Located Adjacent to the Alimentary Tract

We have shown that proton beam therapy is effective and safe for patients having hepatocellular carcinoma (HCC) when the tumor is located apart from the porta hepatis and the alimentary tract. We retrospectively evaluated the safety and effectiveness of proton beam therapy for HCC located adjacent to the alimentary tract in this study.

Dose distribution to the mediastinum and heart

CorrespondenceDose distribution to the mediastinum and heartB Jones and Y AkineB Jones1University Hospital Birmingham, Birmingham, B15 2TH, UK;2Proton Medical Research Centre, University of Tzukuba, JapanSearch for more papers by this author and Y Akine1University Hospital Birmingham, Birmingham, B15 2TH, UK;2Proton Medical Research Centre, University of Tzukuba, JapanSearch for more papers by this authorPublished Online:28 Jan 2014https://doi.org/10.1259/bjr/88462532SectionsPDF/EPUBFull Text ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail About"Dose distribution to the mediastinum and heart." The British Journal of Radiology, 79(941), p. 448 References 1 Cominos M, Mosleh-Shirazi MA, Tait D, Henrys A, Cornes P. Quantification and reduction of cardiac dose in radical radiotherapy for oesophageal cancer. Br J Radiol 2005;78:1069–74. Link ISI, Google Scholar2 Satoshi I, Keiji N. Atushi O, Narikasu B. Long term toxicity after definitive chemoradiation of oesophageal and gastro-oesophageal junction cancers. J Clin Oncol 2003;21:115–20. Google Scholar3 Sugahara S, Tokuuye K, Okumura T, Nakahara A, Saida Y, Kagei K, et al. Clinical results of proton beam therapy for cancer of the oesophagus. Int J Radiat Oncol Biol Phys 2005;61:76–84. Crossref Medline ISI, Google Scholar Previous article Next article FiguresReferencesRelatedDetailsCited byCharged particle therapy for cancer: The inheritance of the Cavendish scientists?Applied Radiation and Isotopes, Vol. 67, No. 3Impact of Intrafractional Bowel Gas Movement on Carbon Ion Beam Dose Distribution in Pancreatic RadiotherapyInternational Journal of Radiation Oncology*Biology*Physics, Vol. 73, No. 4Effects of Interfractional Anatomical Changes on Water-Equivalent Pathlength in Charged-Particle Radiotherapy of Lung CancerJournal of Radiation Research, Vol. 50, No. 6The Potential Clinical Advantages of Charged Particle Radiotherapy using Protons or Light IonsClinical Oncology, Vol. 20, No. 7Effects of Intrafractional Motion on Water Equivalent Pathlength in Respiratory-Gated Heavy Charged Particle Beam RadiotherapyInternational Journal of Radiation Oncology*Biology*Physics, Vol. 69, No. 1 Volume 79, Issue 941May 2006Pages: 365-451 © The British Institute of Radiology History RevisedJanuary 18,2006ReceivedJanuary 03,2006AcceptedJanuary 18,2006Published onlineJanuary 28,2014 Metrics Download PDF

Proton beam therapy for iris melanoma: a review of 15 cases

To report results of proton beam therapy for iris melanoma. A retrospective case series of 15 patients with nonresectable iris melanomas treated with proton beam therapy between August 1998 and August 2004. The main outcome measures were (1) local tumour control, (2) complications, and (3) eye retention. Of the 15 cases, 11 patients showed documented growth (including two cases of local recurrence following iridocyclectomy) while a further three cases were biopsy-proven melanoma. One patient presented with a newly acquired vascular nodule of the iris associated with angle seeding and glaucoma. Tumour control at mean follow-up of 34 months was 93% (14 of 15 eyes). Common complications included glaucoma in 53% (five patients had glaucoma prior to irradiation), dry eye (27%) and cataract in three patients (20%). Eye retention was possible in 80% (12 cases). Proton beam therapy is an effective treatment for cases of nonresectable iris melanoma. The major complications are cataract and glaucoma.

784 PUBLICATION Preliminary results of proton beam therapy for hepatocellular carcinoma with portal vein tumor thrombus

Sorafenib, a multi-kinase inhibitor with anti-angiogenic activity, was recently approved for the treatment of advanced hepatocellular carcinoma (HCC). Metronomic chemotherapy using tegafur/uracil (4:1 molar ratio), an oral fluoropyrimidine, has been shown to enhance the anti-tumor effect of anti-angiogenic agents in preclinical models. This phase II study evaluated the efficacy and safety of combining metronomic tegafur/uracil with sorafenib in patients with advanced HCC.Patients with histologically- or cytologically-proven HCC and Child-Pugh class A liver function were treated with sorafenib (400 mg twice daily) and tegafur/uracil (125 mg/m2 based on tegafur twice daily) continuously as first-line therapy for metastatic or locally advanced disease that could not be treated by loco-regional therapies. The primary endpoint was progression-free survival (PFS).The study enrolled 53 patients. Thirty-eight patients (72%) were hepatitis B surface antigen-positive. The median PFS was 3.7 months (95% C.I., 1.9–5.5) and the median overall survival was 7.4 months (95% C.I., 3.4–11.4). According to RECIST criteria, 4 patients (8%) had a partial response and 26 patients (49%) had a stable disease. Major grade 3/4 toxicities included fatigue (15%), abnormal liver function (13%), elevated serum lipase (10%) hand-foot skin reaction (HFSR) (9%), and bleeding (8%). HFSR was the major adverse event resulting in dose reduction (19%) or treatment delay (21%).Metronomic chemotherapy with tegafur/uracil can be safely combined with sorafenib and shows preliminary activity to improve the efficacy of sorafenib in advanced HCC patients.

Clinical Results of Proton Beam Therapy for Esophageal Cancer at the University of Tsukuba

Purpose/Objective: Proton beam therapy can deliver higher doses to target tissue with a considerably smaller dose to the adjacent normal tissues compared to that using conventional radiotherapy. The aim of this study is to evaluate the clinical outcomes of proton beam therapy for locally confined esophageal cancer.

Clinical results of proton beam therapy for cancer of the esophagus

To present the results of proton beam therapy for patients with esophageal cancer. This study reviewed 46 patients with esophageal cancer who were treated between 1985 and 1998 using proton beams with or without X-rays. All patients had locoregionally confined disease; all but one had squamous cell carcinoma. Of the 46 patients, 40 received combinations of X-rays (median, 48 Gy) and protons (median, 31.7 Gy) as a boost. The median total dose of combined X-ray and proton radiation for the 40 patients was 76.0 Gy (range, 69.1-87.4 Gy). The remaining 6 patients received only proton beam therapy (median, 82.0 Gy; range, 75-89.5 Gy). The 5-year actuarial survival rate for the 46 patients, patients with T1 (n = 23), and those with T2-T4 (n = 23) was 34%, 55%, and 13%, respectively. The 5-year disease-specific survival rate for the 46 patients, those with T1, and those with T2-T4 was 67%, 95%, and 33%, respectively. The 5-year local control rate for patients with T1 and T2-T4 lesions was 83% and 29%, respectively. The site of the first relapse was locoregional for 16 patients and distant organs for 2 patients. The results suggest that proton beam therapy is an effective treatment for patients with locally confined esophageal cancer. Additional studies are required to determine the optimal total dose, fractionation schedule, and best combinations of protons and conventional X-rays with or without chemotherapy.

Clinical results of proton beam therapy for skull base chordoma

To evaluate clinical results of proton beam therapy for patients with skull base chordoma. Thirteen patients with skull base chordoma who were treated with proton beams with or without X-rays at the University of Tsukuba between 1989 and 2000 were retrospectively reviewed. A median total tumor dose of 72.0 Gy (range, 63.0-95.0 Gy) was delivered. The patients were followed for a median period of 69.3 months (range, 14.6-123.4 months). The 5-year local control rate was 46.0%. Cause-specific, overall, and disease-free survival rates at 5 years were 72.2%, 66.7%, and 42.2%, respectively. The local control rate was higher, without statistical significance, for those with preoperative tumors <30 mL. Partial or subtotal tumor removal did not yield better local control rates than for patients who underwent biopsy only as the latest surgery. Proton beam therapy is effective for patients with skull base chordoma, especially for those with small tumors. For a patient with a tumor of <30 mL with no prior treatment, biopsy without tumor removal seems to be appropriate before proton beam therapy.

587 poster Clinical results of proton beam therapy for skull base chordoma

587 poster Clinical results of proton beam therapy for skull base chordoma

Long-term results of proton beam therapy for carcinoma of the uterine cervix

Purpose To determine the role of proton therapy in patients with carcinoma of the uterine cervix. Methods and materials Between 1983 and 1991, 25 patients with squamous cell carcinoma of the uterine cervix (stages IIB–IVA) were treated with a curative intent by external photon irradiation to the pelvis, followed by proton irradiation to the primary tumor, delivering a median total tumor dose of 86 Gy (range 71 Gy/26 Fr–101 Gy/46 Fr), and were followed for a median period of 139 months (range 11–184 months). Results Ten-year overall survival rates for stages IIB and IIIB/IVA patients were 89% and 40%, respectively. Five-year local control rates for stages IIB and IIIB/IVA patients were 100% and 61%, respectively. Four percent of patients experienced severe (Grade 4 or more) late complications in the intestine or urinary bladder at 5 years. Conclusions External photon and proton therapy is effective for those who are not eligible for intracavitary irradiation, and who otherwise have a poor prognosis. The results show that tumor control, survival, and morbidity are similar to those after conventional therapy.

145 Preliminary results of proton beam therapy of uveal melanoma

Since September 1991, 580 patients have been treated in the centre of proton beam therapy at Orsay for choroidal melanoma. For the 243 first patients, there were 42% men and 58% female. The mean age was 56 years. The mean tumour diameter was 13.1 mm. The mean tumour thickness was 6.3 mm. All patients were treated with 60 Gy with 4 fractions in 4 days after precise localisation of the tumour by surgical procedure and clips. Preliminary results, for the 146 patients that have at least one year followup, are as follows. We have observed complete tumour response in 10%, partial response in 70% and stabilisation in 20%. Precise information about visual results and factors influencing visual results will be given.

Clinical and radiological evaluation of long-term results of stereotactic proton beam radiosurgery in patients with cerebral arteriovenous malformations

Within a period of nearly 10 years, from October, 1980, to May, 1990, a total of 68 patients with a cerebral arteriovenous malformation (AVM) were referred to a radiosurgical center in the United States for stereotactic Bragg peak proton beam therapy. Radiosurgery was chosen as an alternative treatment, either because the AVM was considered to be of high surgical risk due to its size and/or location, or because the patient refused surgery. In 63 patients (92.6%), complete clinical and radiological follow-up examinations were available. Clinical and radiological long-term results were correlated to size and to the Spetzler-Martin scale of the AVM. With increasing size or higher grade on the Spetzler-Martin scale, the clinical results of proton beam therapy became progressively worse. Of 37 patients with an AVM between 3 and 6 cm in diameter, only one-third showed amelioration of their clinical symptoms, and two-thirds remained the same or even deteriorated after radiation treatment. The same results apply to patients with very large AVM's, of whom only one-third profited from proton beam therapy. Although 85.7% of the patients in Spetzler-Martin Grades I and II showed postirradiation amelioration of their clinical symptoms, this compares to only 54.2% of the patients in Grade III, and only 24% in Grade IV. In regard to the radiological results of proton beam therapy, complete obliteration during long-term observation was only detectable in 10 patients or 15.9%, which is less than one-sixth of the whole group of 63 patients. All of these obliterated AVM's were smaller than 3 cm. Almost 85% of the patients treated using stereotactic proton beam therapy did not show any angiographic change in the radiological appearance of their AVM. The results reported here indicate that radiosurgery using stereotactic proton beam therapy is ineffective for the treatment of medium- or large-sized AVM's and should not be recommended for patients harboring an AVM larger than 3 cm. If proton beam treatment is contemplated, it should be restricted to AVM's that are less than 3 cm in size and whose location makes them easily accessible only for proton beam therapy.