Proton Therapy for Partial Breast Irradiation: Rationale and Considerations
Abstract
:1. Introduction
2. Review Methodology
3. Invasive Partial Breast Irradiation Techniques
4. External Beam Photon Partial Breast Irradiation
5. Proton Partial Breast Irradiation
6. Cost Effectiveness
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | PT Type | N | Dose (Gy (RBE)) | PT Details | MD-Reported Cosmesis | Patient-Reported Cosmesis | PT Toxicity | Disease Control |
---|---|---|---|---|---|---|---|---|
MGH [26,27] | Passive Scattering | 19 | 32 Gy in 8 fx BID | 1–3 fields (1 field treated per fx) | 7 yr Good-excellent: 62% | 7 yr Good-excellent 92% | 69% Telangiectasias 54% Pigmentation changes 62% Other late skin tox | 7 yr LF: 11% PP |
NCC, Korea [29] | Passive Scattering | 30 | 30 Gy in 5 fx QD | 1–2 fields | 3 yr Good-excellent: 69% (89% with 2-field plan) | -- | Increased toxicity with single field plan | 3 yr LF 0% 3 yr DF 0% |
LLU [30,31] | Passive Scattering | 90 | 40 Gy in 4 Gy × 10 fx QD | 2–4 fields | 5 yr Good-excellent: 90% | 5 yr Good-excellent 90% | Acute: 62% Gr1–2RT dermatitis Late: 7% Gr 1 telangiectasia1% Fat necrosis | 5 yr IBTR-FS 97% 5 yr OS 95% |
PCG BRE007 [32,33] | Uniform Scanning Passive Scattering | 37 1 | 40 Gy in 10 fx QD | ≥3 fields (≥2 treated daily) | 3 yr Good-excellent: 100% | BCTOS 4: 13.2% (nipple appearance, breast shape, scar tissue) | Gr 2–7 events ≥Gr 3–none | 3 yr LF and DF: 0% |
MDACC [34] | Passive Scattering | 100 | 34 Gy in 10 fx BID | ≥ 2 fields | 2 yr Good-excellent: 84% | 2 yr Good-excellent 96% | Acute Gr 2: 1% Breast pain 2% Hyperpigmentation 1% Pruritus 12% Dermatitis Late Gr 2: 5% Fatigue 1% Hyperpigmentation 2% Dermatitis | 2 yr LF 0% 2 yr OS 100% |
Mayo [35] | Pencil Beam Scanning | 76 | 21.9 Gy in 3 fx QD | 2 fields | NR | 1 yr Good-excellent 98% | ≥ Gr 2 acute or late tox-none | NR |
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Choi, J.I.; Fox, J.; Bakst, R.; Hasan, S.; Press, R.H.; Chhabra, A.M.; Yeh, B.; Simone, C.B., II; Cahlon, O. Proton Therapy for Partial Breast Irradiation: Rationale and Considerations. J. Pers. Med. 2021, 11, 289. https://doi.org/10.3390/jpm11040289
Choi JI, Fox J, Bakst R, Hasan S, Press RH, Chhabra AM, Yeh B, Simone CB II, Cahlon O. Proton Therapy for Partial Breast Irradiation: Rationale and Considerations. Journal of Personalized Medicine. 2021; 11(4):289. https://doi.org/10.3390/jpm11040289
Chicago/Turabian StyleChoi, J. Isabelle, Jana Fox, Richard Bakst, Shaakir Hasan, Robert H. Press, Arpit M. Chhabra, Brian Yeh, Charles B. Simone, II, and Oren Cahlon. 2021. "Proton Therapy for Partial Breast Irradiation: Rationale and Considerations" Journal of Personalized Medicine 11, no. 4: 289. https://doi.org/10.3390/jpm11040289