Early outcomes of breast cancer patients treated with post-mastectomy uniform scanning proton therapy Journal Article
| Authors: | Luo, L.; Cuaron, J.; Braunstein, L.; Gillespie, E.; Kahn, A.; McCormick, B.; Mah, D.; Chon, B.; Tsai, H.; Powell, S.; Cahlon, O. |
| Article Title: | Early outcomes of breast cancer patients treated with post-mastectomy uniform scanning proton therapy |
| Abstract: | Background: Postmastectomy proton radiotherapy improves normal tissue sparing in comparison to photon-based approaches. Several studies have reported dosimetry comparison and tolerable acute toxicity profile with limited follow-up. We report our institutional experience of postmastectomy proton radiation including clinical efficacy and toxicities. Methods: From December 2013 to February 2015, 42 consecutive patients who received mastectomy for non-metastatic breast cancer were treated with adjuvant chest wall and regional nodal proton therapy at a single proton center. 3D conformal uniform scanning with en face matching fields was used. Results: The median follow-up among patients was 35 months (range 1–55 months). There was one local failure, zero regional nodal failure, and six distant failures. The 3-year rate of locoregional disease-free survival was 96.3%, metastasis-free survival was 84.1%, and overall survival was 97.2%. The only local failure event occurred on the chest wall within the radiation field, approximately 2.5 years after the completion of radiation. Skin dermatitis, fatigue, and esophagitis were the most common acute toxicity. All patients developed grade 1 or 2 acute skin toxicity and there was no grade 3 or 4 acute skin toxicity. Proton radiation is able to achieve excellent target coverage with median PTV V95 over 95% and heart sparing with median mean heart dose less than 1 Gy (RBE). Conclusion: With close to three years of median follow-up, post-mastectomy proton radiation has shown excellent locoregional control rates and favorable toxicity profile. Long-term adverse effect of heart-sparing radiation will require longer follow-up time and randomized clinical trials. © 2018 Elsevier B.V. |
| Keywords: | adult; clinical article; aged; overall survival; fatigue; postoperative period; skin toxicity; cancer patient; disease free survival; outcome assessment; follow up; antineoplastic agent; lymph node dissection; breast cancer; mastectomy; esophagitis; oxygen therapy; cohort analysis; steroid; dyspnea; pneumonia; lymphedema; axillary lymph node; liver metastasis; three dimensional imaging; patient safety; brain metastasis; hyperpigmentation; telangiectasia; dermatitis; clinical effectiveness; neoadjuvant chemotherapy; toxicity; acute toxicity; adjuvant radiotherapy; radiation dose distribution; lung fibrosis; thorax wall; heart; breast augmentation; spine metastasis; clinical outcome; postmastectomy radiation; skin pain; proton therapy; prosthesis infection; local recurrence free survival; planning target volume; implant capsular contracture; metastasis free survival; human; female; priority journal; article; breast implant infection; postmastectomy proton therapy |
| Journal Title: | Radiotherapy and Oncology |
| Volume: | 132 |
| ISSN: | 0167-8140 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2019-03-01 |
| Start Page: | 250 |
| End Page: | 256 |
| Language: | English |
| DOI: | 10.1016/j.radonc.2018.10.002 |
| PUBMED: | 30414757 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Atif Khan's last name is misspelled on the publication -- Source: Scopus |
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