Proton therapy for breast cancer
Newswise – New Brunswick, NJ, September 21, 2021 – Bruce Haffty, MD, MS, president of radiation oncology and associate vice chancellor for cancer programs at the Rutgers Cancer Institute in New Jersey and director of radiation oncology system at RWJBarnabas Health, treated a breast cancer patient on proton therapy which is a unique type of radiation therapy that can precisely target and deliver high doses of radiation to a tumor to kill cancer cells. The patient, who was in her late 30s and in the first months of her first pregnancy as she faced a second diagnosis of breast cancer, received radiation therapy during her previous diagnosis. Thus, proton therapy was the best option to treat the affected area while the surrounding tissues previously irradiated were spared from additional radiation.
The Rutgers Cancer Institute and the Laurie Proton Therapy Center at Robert Wood Johnson University Hospital in New Brunswick, a RWJBarnabas health facility, are one of only two programs in the state to offer this select form of treatment. Proton therapy has grown rapidly in recent years and may benefit some breast cancer patients by minimizing damage to nearby tissues and critical organs. A recent consensus statement from the professional nonprofit Particle Therapy Cooperative Group Breast Cancer Subcommittee, assessed the data available for the proton therapy radiation oncology community for breast cancer, and provides consensus recommendations experts on indications and technique, and highlights ongoing clinical trials cost-effectiveness analyzes and key areas for future research. Dr Haffty shares an overview of the work published in the May 2021 edition of International Journal of Radiation Oncology Physical Biology (DO I: 10.1016 / j.ijrobp.2021.05.110).
What are some of the benefits of proton therapy for treating breast cancer?
Proton therapy is not offered for the majority of breast cancer patients. However, there are circumstances where there may be an advantage. Patients who have received radiation therapy in the past and need additional radiation therapy to the same area may potentially benefit, depending on the location of the new problem and the details of the previous radiation therapy. There is an ongoing clinical trial at the Rutgers Cancer Institute in New Jersey in which researchers will assess whether there is a benefit in selected patients when the breast and regional lymph nodes require treatment. There are also occasional cases where the dose of radiation to the heart or lungs with conventional treatment may be greater than ideal and proton therapy may have an advantage. It is important to understand, however, that the majority of breast cancer patients can be safely treated with conventional radiation therapy.
What are the main recommendations suggested by the authors in the review article?
The guideline attempts to highlight specific situations where proton therapy may or may not have a role in the management of breast cancer. The directive also provides important information regarding the technical aspects of delivering proton beams that users should be aware of. The guideline also highlights the many unanswered questions regarding the use of proton therapy in breast cancer and encourages the development and recruitment of patients into clinical trials to address many of these issues.
What’s next for proton therapy research?
With the increase in proton beam installations around the world, numerous clinical trials are underway to attempt to identify clinical situations where the proton beam has an advantage over conventional photon radiotherapy. Clinical trials in breast cancer, brain tumors, lung tumors, tumors of the esophagus and other gastrointestinal tumors, malignant tumors of the prostate, gynecologic and others are all in active clinical trials. using proton beam therapy.
Proton beam technology is also constantly advancing to facilitate the rapid, safe and efficient delivery of proton beam therapy to patients. Another area of research using the proton beam is called FLASH therapy, where the rate of radiation delivery is dramatically increased so that the dose is delivered in a fraction of a second, compared to a few minutes. This rapid delivery has been associated with reduced toxicity to normal tissues in the radiation field and is currently under investigation for potential clinical applications.
Author’s disclosures and additional information can be found here.