scholarly journals Proton Cancer Therapy: Synchrotron-Based Clinical Experiences 2020 Update

2020 ◽  
Author(s):  
Felipe Angel Calvo Manuel ◽  
Elena Panizo ◽  
Santiago M. Martin ◽  
Javier Serrano ◽  
Mauricio Cambeiro ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Beam ◽  
Proton Therapy ◽  
Clinical Results ◽  
Clinical Experiences ◽  
Histological Subtypes ◽  
Data Registration ◽  
Prospective Trials ◽  
Animal Investigation ◽  
Precision Radiotherapy

Proton therapy is an efficient high-precision radiotherapy technique. The number of installed proton units and the available medical evidence has grown exponentially over the last 10 years. As a technology driven cancer treatment modality, specific sub-analysis based on proton beam characteristics and proton beam generators is feasible and of academic interest. International synchrotron technology-based institutions have been particularly active in evidence generating actions including the design of prospective trials, data registration projects and retrospective analysis of early clinical results. Reported evidence after 2010 of proton therapy from synchrotron based clinical results are reviewed. Physics, molecular, cellular, animal investigation and other non-clinical topics were excluded from the present analysis. The actual literature search (up to January 2020) found 192 publications, including description of results in over 29.000 patients (10 cancer sites and histological subtypes), together with some editorials, reviews or expert updated recommendations. Institutions with synchrotron-based proton therapy technology have shown consistent and reproducible results along the past decade. Bibliometrics of reported clinical experiences from 2008 to early 2020 includes 58% of publications in first quartile (1q) scientific journals classification and 13% in 2q (7% 3q, 5% 4q and 17% not specified). The distribution of reports by cancer sites and histological subtypes shown as dominant areas of clinical research and publication: lung cancer (23%), pediatric (18%), head and neck (17%), central nervous system (7%), gastrointestinal (9%), prostate (8%) and a miscellanea of neplasms including hepatocarcinoma, sarcomas and breast cancer. Over 50% of lung, pediatric, head and neck and gastrointestinal publications were 1q.

A pilot study of proton beam theary for mucosal melanoma of the head and neck

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17042-e17042
Author(s):  
S. Zenda ◽  
M. Kawashima ◽  
R. Kohno ◽  
S. Arahira ◽  
T. Nishio ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Beam ◽  
Proton Therapy ◽  
Progression Free Survival ◽  
Late Toxicity ◽  
Distant Metastases ◽  
Proton Beam Therapy ◽  
Mucosal Melanoma ◽  
Cervical Lymph Nodes ◽  
Number Of Patients

e17042 Background: The aim of this study is to clarify the clinical profile of proton beam therapy for mucosal melanoma of the head and neck. Methods: Patients with mucosal melanoma of the head and neck fulfilling the following criteria were enrolled: histologically confirmed malignant melanoma; N0 and M0 disease. Proton therapy was delivered three times a week with planned total dose of 60 GyE in 15 fractions. Results: From January 2004 through January 2007, thirteen patients were enrolled in this study. Patients’ characteristics were as follows: median age, 75 years (range, 56 to 79); male/female, 7/6; T1/2/3/4/rec, 3/2/0/7/1. All could receive the full dose of proton therapy. The most common acute toxicities were mucositis (grade 3: 15%) and dermatitis (grade 2: 15%). One patient had unilateral impairment of visual acuity possibly related with treatment. Initial local control rate was 77.0% (10/13, 95%CI: 46.2–95.0%). With median follow up period of 33.7 months, median progression free survival was 18.9 months and median survival time was not reached. 2-year overall survival rate was 69.7% (95%CI: 31.6–86.1%). Most frequent site of first failure was cervical lymph nodes outside of PTV. Four patients died of disease; cachexia caused by distant metastases in three and carotid blowout because of nodal disease in one. Conclusions: Proton beam therapy for mucosal melanoma of the head and neck achieved favorable results in this limited number of patients, although further investigation about late toxicity is needed. Now, the phase II study of this treatment is ongoing. No significant financial relationships to disclose.

scholarly journals Tongue Displacement Device in Decreasing the Radiation Dose to Tongue and Preventing Proton Beam Overshoot in Proton Therapy for Unilateral Head and Neck Cancer

2021 ◽  
Vol 9 ◽  
Author(s):  
Chae-Seon Hong ◽  
Dongryul Oh ◽  
Sang Gyu Ju ◽  
Yong Chan Ahn ◽  
Yeong-bi Kim ◽  
...  
Keyword(s):  
Radiation Dose ◽  
Head And Neck ◽  
Proton Beam ◽  
Proton Therapy ◽  
Organs At Risk ◽  
Target Volume ◽  
Neck Irradiation ◽  
Tongue Displacement ◽  
Head And Neck Irradiation ◽  
Beam Stopper

The aim of this study was to evaluate the dosimetric characteristics of a semi-customized tongue displacement device (SCTDD) fabricated using a 3D printer for patients receiving unilateral head and neck irradiation with intensity-modulated proton therapy (IMPT) and assess its feasibility as a proton beam stopper compared to a standard mouthpiece (SMP). Seven consecutive patients, three with tonsil cancer, and four with oral cavity cancer were included in this retrospective study. Planning computed tomography (CT) images of each patient were acquired for each device. Both the SCTDD and SMP plans were generated using a single-field optimized IMPT. The clinically relevant dose-volume parameters for the organs at risk (OARs), especially the tongue, were compared between the SCTDD and SMP plans. Additionally, to assess the feasibility of SCTDD as a proton beam stopper, the dose to the contralateral oral mucosa (COM) was compared with that from sMP use. The use of scTDD resulted in a statistically significant decrease in the radiation dose to the tongue and COM compared to sMP. The median mean dose to the tongue was significantly reduced with SCTDD (18.3 Gy(RBE)) compared to the SMP (22.9 Gy(RBE)) (p = 0.016). The percentages of tongue volume receiving doses between 15 and 60 Gy(RBE) were significantly lower with SCTDD. In the COM, SCTDD resulted in a significantly lower median mean (2.9 Gy(RBE) vs. 7.9 Gy(RBE), p = 0.018) and maximum dose (39.1 Gy(RBE) vs. 41.6 Gy(RBE), p = 0.018) doses compared to SMP. The SCTDD effectively decreased the radiation dose to the tongue compared to SMP in patients undergoing unilateral head and neck irradiation with IMPT and acted as a proton beam stopper to protect normal tissues located behind the target volume, such as the COM.

scholarly journals Critical Appraisal of Experimental Radiation Modalities for Malignant Astrocytomas

1990 ◽  
Vol 17 (2) ◽  
pp. 199-208 ◽  
Author(s):  
N.J. Laperriere
Keyword(s):  
Critical Appraisal ◽  
Clinical Results ◽  
Particle Therapy ◽  
Postoperative Radiation ◽  
Postoperative Radiation Therapy ◽  
Initial Management ◽  
Altered Fractionation ◽  
Malignant Astrocytomas ◽  
Prospective Trials ◽  
Radiation Sensitizers

ABSTRACT:The management of patients with supratentorial malignant astrocytomas has remained a major problem. Patients continue to die from a lack of local control in 90% of cases despite an improvement of median survival seen with the use of postoperative radiation therapy. Because of this, there has been considerable interest in exploring novel ways of possibly improving results. This paper reviews the rationale and clinical results with the use of altered fractionation schemes, brachytherapy, radiation sensitizers, hyperthermia, particle therapy, and radiosurgery in the treatment of these patients. Currently, there is no demonstrated advantage with the use of these experimental modalities in the initial management of patients. There would appear to be some benefit for selected patients who are treated with brachytherapy at recurrence, but its efficacy as part of initial management remains to be determined in ongoing randomized prospective trials.

scholarly journals Preselection Tool for the Model-Based Selection of Head and Neck Cancer Patients for Proton Therapy

2019 ◽  
Vol 105 (1) ◽  
pp. E384
Author(s):  
M. Tambas ◽  
H.P. van der Laan ◽  
A.V.D. Hoek ◽  
H.P. Bijl ◽  
M. Dieters ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Proton Therapy ◽  
Model Based ◽  
Selection Of

PO-0930 ROBUSTNESS OF IMPT (INTENSITY MODULATED PROTON THERAPY) COMPARED WITH IMRT FOR HEAD AND NECK CANCERS

2012 ◽  
Vol 103 ◽  
pp. S366-S367
Author(s):  
R. Harding ◽  
J. Lilley ◽  
V.P. Cosgrove ◽  
S.J. Weston ◽  
C.M. Thompson ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Therapy ◽  
Head And Neck Cancers ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated

Reirradiation of Recurrent and Second Primary Head and Neck Cancer With Proton Therapy

2016 ◽  
Vol 96 (4) ◽  
pp. 808-819 ◽  
Author(s):  
Mark W. McDonald ◽  
Omid Zolali-Meybodi ◽  
Stephen J. Lehnert ◽  
Neil C. Estabrook ◽  
Yuan Liu ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Proton Therapy ◽  
Second Primary

scholarly journals Proton Therapy for Head and Neck Adenoid Cystic Carcinoma

2016 ◽  
Vol 96 (2) ◽  
pp. E369-E370
Author(s):  
R.L. Deraniyagala ◽  
C.M. Bryant ◽  
C.G. Morris ◽  
W.M. Mendenhall ◽  
D.J. Indelicato ◽  
...  
Keyword(s):  
Adenoid Cystic Carcinoma ◽  
Head And Neck ◽  
Proton Therapy ◽  
Adenoid Cystic

PO-0850: Proton Beam Reirradiation In Head And Neck Patients at CNAO: preliminary results.

2020 ◽  
Vol 152 ◽  
pp. S458
Author(s):  
S. Ronchi ◽  
B. Vischioni ◽  
M. Bonora ◽  
V. Vitolo ◽  
M.R. Fiore ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Beam ◽  
Preliminary Results

scholarly journals Use of free microvascular flaps in the management of the head and neck defects

2006 ◽  
Vol 63 (8) ◽  
pp. 713-720 ◽  
Author(s):  
Zivorad Nikolic ◽  
Jelena Jeremic ◽  
Radoje Milosavljevic
Keyword(s):  
Head And Neck ◽  
Gold Standard ◽  
Clinical Observation ◽  
Clinical Results ◽  
Test Results ◽  
Flap Necrosis ◽  
Free Flap Reconstruction ◽  
Microsurgical Reconstruction ◽  
Flap Viability ◽  
Patient Series

Background/aim: In the field of contemporary head and neck reconstructive surgery, free vascularized tissue transfer is becoming a gold standard. The aim of this study was to review our clinical results and experience, with use of free microvascular flaps and compare them with the recently published patient series. Methods. During the period from 2001 to 2005, 37 patients underwent microsurgical reconstruction after the tumor ablation in the region of head and neck. Flap viability was monitored intraoperatively with the Ackland test and postoperatively by the clinical observation and mini-Doppler test. Results. The overall success rate was 83.8%. The complications that appeared were: one complete flap necrosis due to venous thrombosis, and five late flap ischemic necroses, in the period from the 10th to 14th postoperative day. Conclusion. Free flap reconstruction of the head and neck is a surgical technique that provides the reconstruction of complex and extensive defects, that could not be performed by using local or regional flaps.

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