Proton therapy for cancer lowers risk of side effects

27 May 2019 News

Proton therapy results in fewer side effects than traditional X-ray radiation therapy for many cancer patients, according to a new study led by Washington University School of Medicine in St. Louis and the Perelman School of Medicine at University of Pennsylvania. Even with reduced side effects, proton therapy resulted in cure rates similar to those of X-ray radiation therapy.

The findings will be presented June 1 by the study’s first author, Brian C. Baumann, MD, a radiation oncologist at Washington University School of Medicine, at the American Society of Clinical Oncology’s annual meeting, in Chicago.

The study is the first major side-by-side comparison of side effects related to proton therapy and X-ray radiation therapy. It included almost 1,500 patients receiving combined chemotherapy and radiation therapy for lung, brain, head and neck, gastrointestinal and gynecologic cancers that had not yet spread to other parts of the body. Such patients receive both radiation and chemotherapy, a treatment regimen that often cures nonmetastatic cancer. But it also causes severe side effects—such as difficulty swallowing, nausea and diarrhea—that reduce quality of life and can, in some cases, require hospitalization.

After controlling for differences between the groups, such as age and additional medical problems, the researchers found that patients receiving proton therapy experienced a two-thirds reduction in the relative risk of severe side effects within 90 days of treatment, compared with patients receiving X-ray radiation therapy. Forty-five of 391 patients receiving proton therapy experienced a severe side effect in the 90-day time frame (11.5 percent). In the X-ray radiation therapy group, 301 of 1,092 patients experienced a severe side effect in the same period (27.6 percent). Patient data on side effects were gathered as the trial was ongoing, rather than after the fact.

“Proton therapy was associated with a substantial reduction in the rates of severe acute side effects—those that cause unplanned hospitalizations or trips to the emergency room—compared with conventional photon, or X-ray, radiation for patients treated with concurrent radiation and chemotherapy,” said Baumann, an assistant professor of radiation oncology at Washington University and an adjunct assistant professor of radiation oncology at Penn. “The opportunity to reduce the risk of severe side effects for patients and thereby improve their quality of life is very exciting to me. While there have been other studies suggesting that proton therapy may have fewer side effects, we were somewhat surprised by the large magnitude of the benefit.”

The researchers focused their study on what are called grade 3 adverse events, which are severe enough to require hospitalization. These can include pain, difficulty swallowing that might result in weight loss, difficulty breathing, and nausea and diarrhea severe enough to cause dehydration.

Sourcemedicalxpress.com

Proton Therapy and Barbecue: My Recipe for Beating Cancer and Being Myself

15 Apr 2019 News

Going through a cancer diagnosis and treatment is so difficult. Thanks to my care team suggesting proton therapy, I never felt like my life became consumed by my lung cancer diagnosis.

The word “barbecue” might make you think of ribs or pulled pork, Kansas City or Memphis-style. But when I hear the word, what I think of is passion and community.

For 10 years, I’ve participated in barbecue competitions throughout Washington state. In fact, I’m a registered member of the Pacific Northwest Barbecue Association (PNWBA), which organizes competitions from Canada to California. I started off as a competitor with my husband, but we quickly grew curious about what makes winning barbecue. It didn’t take long for us to discover how much fun it was to judge!

But when I was diagnosed with a recurrence of lung cancer in 2016, I was afraid that I’d have to give it all up. I can still recall the anxiety and fear I experienced when I learned my cancer had returned. During my first battle with lung cancer, my physicians were able to remove the tumor through surgery. A series of tests showed that surgery wasn’t an option this time around. My thoracic surgeon recommended a treatment I had never heard of: proton radiation therapy. This precise form of radiation targets the cancerous tumor and spares healthy tissues that surround it. For me, that meant protecting my heart, lungs, esophagus, and spinal cord from excess radiation exposure.

Thankfully, life never skipped a beat during treatment. Minimal side effects meant everyday life and my passion for brisket and the community I had become a part of would not need to take a backseat to cancer treatment. When I tell my story to others, many people have never heard of proton therapy and didn’t know that it can be a better alternative to traditional radiation.

Proton therapy isn’t right for every cancer patient but for certain types of cancer, it is an option worth considering. I’m certainly motivated by my positive experience to try to encourage cancer patients to learn about proton therapy and ask their doctors about it.

I felt little more than fatigue throughout my proton therapy treatment. Sessions lasted mere minutes– it took longer to change my clothes! I was at the Seattle Cancer Care Alliance Proton Therapy Center every day for six weeks, so I got to know the doctors, nurses and staff pretty well. They understood what was most important to me and helped me in ways I couldn’t have expected.

One Saturday, I had a proton treatment scheduled in the morning. When I realized that there was a barbecue competition happening nearby that same day, I signed up to judge. Balancing the two was no problem– my team made sure of that! I can proudly say that to date, I’ve judged 45 barbecue competitions, and judging has led to opportunities I could never have imagined.

One of my biggest feats was being named the 2017 PNWBA Judge of the Year along with my husband. It was an accomplishment that I’ll never forget and one that I was proud to celebrate nearly a year after beating cancer. And my husband and I have become master judges!

I doubt anyone would say that cancer treatment is a positive experience. Going through a cancer diagnosis and treatment is so difficult. I just feel grateful to my care team for suggesting proton therapy and then helping me live my best life even during treatment. I never felt like my life became consumed by my lung cancer diagnosis. Thankfully, I was able to remain Melba Fujiura: wife, friend, barbecue enthusiast– and now, cancer survivor.

Source: curetoday.com

Outcomes After Proton Therapy for Treatment of Pediatric High-Risk Neuroblastoma

15 Apr 2019 News

Purpose

Patients with high-risk neuroblastoma (HR-NBL) require radiation to the primary tumor site and sites of persistent metastatic disease. Proton radiation therapy (PRT) may promote organ sparing, but long-term outcomes have not been studied.

Methods and Materials

Sequential patients with HR-NBL received PRT: 2160 cGy (relative biological effectiveness) to primary tumor bed and persistent metastatic sites, with 3600 cGy (relative biological effectiveness) to gross residual disease.

Results

From September 2010 through September 2015, 45 patients with HR-NBL received PRT after systemic therapy, primary tumor resection, and high-dose chemotherapy with stem cell rescue. Median age was 46 months at the time of PRT (range, 10 months to 12 years); 23 patients (51%) were male. Primary tumors were adrenal in 40 (89%); 11 (24%) received boost. Ten metastatic sites in 8 patients were radiated. Double scattered proton beams were used for 19 (42%) patients, in combination with x-rays for 2 (5%). The remaining 26 (58%) received pencil beam scanning, available since January 2013. We observed 97% freedom from primary site recurrence at 3, 4, and 5 years. Overall survival rates were 89%, 80%, and 80% and disease-free survival rates were 77%, 70%, and 70%, at 3, 4, and 5 years, respectively. With median follow-up of 48.7 months from diagnosis (range, 11-90 months) for all patients (57.4 months for those alive), 37 (82%) patients are alive, and 32 (71%) are without evidence of disease. One patient experienced locoregional recurrence; the remaining 12 (27%) experienced relapse at distant, nonradiated sites. Acute toxicities during treatment were mainly grade 1. No patient has experienced World Health Organization grade 3 or 4 long-term renal or hepatic toxicity. Pencil beam scanning plans required less planning time and resources than double scattered plans.

Conclusions

We observe excellent outcomes in patients treated with PRT for HR-NBL from 2010 through 2015, with 82% of patients alive and 97% free of primary site recurrence. No patient has experienced long-term renal or liver toxicity. This treatment maximizes normal tissue preservation and is appropriate for this patient population.

Source: Sciencedirect.com

Spain joins global race to adopt proton therapy against cancer

26 Mar 2019 News

Two private hospitals are due to open centers in Madrid, where children and patients with rare tumors will especially benefit from a treatment with fewer side effects than X-rays

Spain is joining a global race to adopt proton beam therapy, a form of cancer treatment hailed as a less-aggressive alternative to conventional X-ray radiation.

Two private hospitals are building facilities in Madrid; the first one is due to open in the last quarter of this year, and the second one in March 2020. Meanwhile, a scientific society has just issued guidelines to “fill a void” in the use of proton therapy in Spain, and a small group of independent doctors has created a second-opinion network to raise awareness about an option that they say patients are rarely told about because of hospitals’ own business interests.

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Proton Radiation Therapy, a New Weapon Against Cancer

26 Feb 2019 News

The oncologists demand that Spain equip itself with specialized rooms to offer this treatment

In August 2014, the case of four-year-old British boy Ashya King made headlines. The little boy had been diagnosed with medulloblastoma, a type of malignant cranial tumor. He had received surgery and was waiting to be treated with chemotherapy and radiotherapy when his parents decided to remove him irregularly from the hospital in the United Kingdom where he was admitted and travel to Prague for proton treatment.

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4 benefits of proton therapy

26 Feb 2019 News

1) PRECISION OF ADMINISTRATION

Proton therapy offers the ability to guide treatment beams within millimeters of a target. Providers can be more selective about areas affected by treatment and give higher doses of radiation. This is particularly beneficial for cases in which conventional radiotherapy dose limits on surrounding organs, such as the brain or spinal cord, must be established.[1] With greater accuracy in targeting, patients require fewer treatment sessions and experience fewer side effects.[2]

2) MINIMAL DAMAGE TO SURROUNDING HEALTHY TISSUE AND VITAL ORGANS

As a highly-conformal treatment option, proton therapy can help patients avoid the effects of traditional photon therapy such as hearing and vision loss, heart disease, and radiation burns.[3] In children, whose organs and bones are still developing, leaving surrounding tissue unexposed to radiation can stave off future growth problems. When tumors are located near vital organs, precise radiation beams give providers a more efficient and direct way to treat unhealthy cells.[4]

3) FEWER SIDE EFFECTS THAN PHOTON THERAPY

Proton therapy is non-invasive and painless. It reduces the incidence and severity of side effects associated with traditional photon therapy.[5] Many patients report maintaining the quality of life they had pre-diagnosis – continuing at their jobs, going to the gym, and enjoying time with family.[6] With lower treatment exposure to healthy tissue, the likelihood decreases that secondary malignancies will develop as a result of unnecessary radiation exposure.[7]

4) COST SAVINGS DUE TO SHORTER THERAPY DURATION AND ADVERSE EFFECTS AVOIDANCE

The fact that proton therapy can be used to deliver higher doses of radiation and has the ability to leave surrounding tissue undisturbed, are key factors in cost savings for both short- and long-term care costs.[8] Often times patients require fewer treatments with proton therapy than with traditional X-ray therapy, and many patients can receive proton therapy treatment in an outpatient setting. The ability to couple proton therapy with other treatments, such as chemotherapy, also increases the likelihood that cancers can be eradicated with greater efficiency.

With proton therapy technology continuing to evolve, smaller, more compact systems are emerging – allowing a greater number of facilities to offer the treatment. This treatment expansion is likely to result in better patient outcomes – particularly for pediatric patients and those with tumors near vital organs.

Fuente: protominternational.com

 

Outcomes after Proton Therapy for Treatment of Pediatric High-Risk Neuroblastoma

26 Feb 2019 News

Background

Patients with high-risk neuroblastoma (HR-NBL) require radiation to the primary tumor site and sites of persistent metastatic disease. Proton radiotherapy (PRT) may promote organ sparing, but long-term outcomes have not been studied.

Methods

Sequential patients with HR-NBL received PRT: 2160 cGy(RBE) to primary tumor bed and persistent metastatic sites, with 3600 cGy(RBE) to gross residual disease.

Results

From 9/2010-9/2015, 45 patients with HR-NBL received PRT following systemic therapy, primary tumor resection, and high-dose chemotherapy with stem cell rescue. Median age was 46 months at the time of PRT (range 10m – 12y); 23 (51%) were boys. Primary tumors were adrenal in 40 (89%); 11 (24%) received boost. Ten metastatic sites in 8 patients were radiated. Double scattered (DS) proton beams were used for 19 (42%) patients, in combination with x-rays for 2 (5%). The remaining 26 (58%) received pencil beam scanning (PBS), available since 1/2013. We observed 97% freedom from primary site recurrence at 3, 4 and 5 years. Overall survival rates were 89%, 80%, 80% and disease-free survival rates were 77%, 70%, and 70%, at 3, 4, and 5 years, respectively. With median follow-up of 48.7 months from diagnosis (range 11 – 90 months) for all patients (57.4 months for those alive), 37 (82%) patients are alive, and 32 (71%) are without evidence of disease. One patient experienced locoregional recurrence; the remaining 12 (27%) experienced relapse at distant, non-radiated sites. Acute toxicities during treatment were mainly grade 1. No patient has experienced WHO G3/4 long-term renal or hepatic toxicity. PBS plans required less planning time and resources than DS plans.

Conclusions

We observe excellent outcomes in patients treated with PRT for HR-NBL from 2010-2015, with 82% of patients alive and 97% free of primary site recurrence. No patient has experienced long-term renal or liver toxicity. This treatment maximizes normal tissue preservation and is appropriate for this patient population.

Source: redjournal.org

Cancer diagnosis leads to career

19 Feb 2019 News

Andrew Porter becomes a Cincinnati Children’s/UC Health Proton Therapy radiation therapist after his own experience with pediatric cancer and lifesaving proton therapy

At the age of 15, Andrew Porter didn’t think that 10 years later he’d be living and working in Cincinnati, helping pediatric and adult patients overcome cancer at the Cincinnati Children’s/UC Health Proton Therapy Center.

The Lizton, Indiana native was in the middle of his own battle with cancer.

“I was diagnosed with non-metastatic pineal germinoma, a cell tumor found near the pineal gland in the brain,” he says. A high school athlete, Porter says he’d been noticing problems on the baseball field with coordination as well as migraines and fatigue. “I have a family history of migraines, so that’s what my doctors were treating, but when things got worse, they sent me for a scan, and the cancer was discovered,” he adds.

Porter’s physician at Riley Children’s Health in Indianapolis put together a treatment plan for him that involved chemotherapy and proton radiation at the Indiana University (IU) Health Proton Therapy Center, formerly known as the Midwest Proton Radiotherapy Institute.

Proton therapy is a form of radiation treatment used for certain types of cancers and lymphomas. A major advantage over traditional forms of radiotherapy is its ability to deliver radiation to a tumor area with remarkable precision, sparing healthy tissues. There are only 27 proton therapy centers in the U.S.

“It was amazing to be so close to this cutting-edge facility and treatment,” he says. “I remember making the hour and a half drive daily and dreading the treatment, but as we turned into the parking lot for the facility, I would find myself excited to see the radiation therapists. I loved going for treatment there because of them and the way they made me feel. I always felt safe—like a home away from home.”

This was when Porter had a realization about his future that set him on the path for where he is today.

“I said to my parents, ‘I think I want to be a radiation therapist,’” he remembers, adding that he “did his homework” during treatments by asking all about the profession. “Throughout this experience, I was searching for meaning and a purpose. I felt like I was being called into this field for a reason, and I felt like I needed to give back to someone going through this just like my team had given to me—they gave me hope and helped me stay positive. It really felt like it was all meant to be.”

Porter was found to be cancer free in July 2009, but he experienced other issues as a result of his treatment, including avascular necrosis—death of bone tissue due to a lack of blood supply—in his hip. It required an unconventional hip replacement at 18 years old, but allowed him to boat and waterski again—two of his favorite pastimes. He also had corrective surgery on his eye, as the tumor put pressure on his right eye muscle leading to double vision and a “lazy eye.”

However, throughout it all, he kept his goal of becoming a radiation therapist in mind, and after graduating high school in 2011, he worked toward his associate’s degree in radiation therapy at Ivy Tech Community College, Bloomington. He also earned an advanced proton therapy specialist certificate.

“While I was earning my degree, the IU Health Proton Therapy Center shut down, and I was a bit discouraged, because it was my dream job, but little did I know that the UC Health Proton Therapy Center would be opening in 2016,” he says. “It was all part of a plan.”

And when Porter graduated in 2016, the proton center in Cincinnati was looking for new and eager radiation therapists.

He’s been working at the facility since it opened, and sees purpose in every day and in every patient with whom he interacts.

“I love what I do,” he says. “Because of my own battles, I’m able to connect with people in a unique way and build relationships. In my job, I try to take cancer and treatment off of the patient’s mind and make them smile and laugh for a bit. I share my story when I feel it is appropriate, but everyone has their own journey and story. I’m just there to give support in any way that I can and to share time with him or her. I can’t express how much I appreciate my supervisors and team of therapists allowing me to share my experience and even encourage it.

“I’m actually thankful for my diagnosis because it helped jumpstart my life, and it gave me a goal and a purpose. It helped me get through one of the toughest events of my life, and I’m so grateful for the support I had and my good outcome, which is helping me give back today.”

Source: uc.edu

Proton Therapy for Esophageal Cancer

19 Feb 2019 News

Treating esophageal cancer with an adequate dose of radiation can be difficult because of the close proximity of the esophagus to critical structures, such as the heart, lungs and spinal cord. Because protons deposit their highest dose of radiation at the tumor or area of concern, proton therapy can be an excellent choice for treating patients with esophageal cancer.

Proton therapy offers patients and their doctors a unique option for effectively treating esophageal cancer while reducing damage to other critical organs and tissues. The MD Anderson Proton Therapy Center is one of the few centers of its kind treating esophageal cancer with proton technology.

With proton therapy for esophageal cancer, treatments typically take about 15 to 30 minutes each day and are delivered five days a week for approximately four to seven weeks. The course of treatment and length of time per treatment each day varies based on each patient’s individual case. Most patients tolerate the treatments extremely well and are able to continue to work and exercise during their treatment course and immediately after treatment is complete.

Source: mdanderson.org

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