Radiation-Induced Toxicity Risks in Photon Versus Proton Therapy for Synchronous Bilateral Breast Cancer
Research output: Contribution to journal › Journal article › Research › peer-review
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- 10.14338_ijpt-21-00023.1
Final published version, 1.45 MB, PDF document
Purpose: This study compares photon and proton therapy plans for patients with synchronous bilateral early breast cancer and estimates risks of early and late radiationinduced toxicities.
Materials and Methods: Twenty-four patients with synchronous bilateral early breast cancer receiving adjuvant radiation therapy using photons, 3-dimensional conformal radiation therapy or volumetric modulated arc therapy, were included and competing pencil beam scanning proton therapy plans were created. Risks of dermatitis, pneumonitis, acute esophageal toxicity, lung and breast fibrosis, hypothyroidism, secondary lung and esophageal cancer and coronary artery events were estimated using published dose-response relationships and normal tissue complication probability (NTCP) models.
Results: The primary clinical target volume V95% and/or nodal clinical target volume V90% were less than 95% in 17 photon therapy plans and none of the proton plans. Median NTCP of radiation dermatitis > grade 2 was 18.3% (range, 5.4-41.7) with photon therapy and 58.4% (range, 31.4-69.7) with proton therapy. Median excess absolute risk (EAR) of secondary lung cancer at age 80 for current and former smokers was 4.8% (range, 0.0-17.0) using photons and 2.7% (range, 0.0-13.6) using protons. Median EAR of coronary event at age 80, assuming all patients have preexisting cardiac risk factors, was 1.0% (range, 0.0-5.6) with photons and 0.2% (range, 0.0-1.3) with protons.
Conclusion: Proton therapy plans improved target coverage and reduced risk of coronary artery event and secondary lung cancer while increasing the risk of radiation dermatitis.
Original language | English |
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Journal | International Journal of Particle Therapy |
Volume | 8 |
Issue number | 4 |
Pages (from-to) | 1-13 |
Number of pages | 13 |
DOIs | |
Publication status | Published - 13 Mar 2022 |
- proton therapy, bilateral breast cancer, treatment planning, bioeffect modeling, normal tissue complication probability, INTERNAL MAMMARY, LUNG-CANCER, RADIOTHERAPY, IRRADIATION, WOMEN, HEART, COMPLICATIONS, DELINEATION, RECURRENCE, CARCINOMA
Research areas
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