Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Aug;5(4):52.
doi: 10.21037/cco.2016.06.04.

Novel applications of proton therapy in breast carcinoma

John J Cuaron  1 , Shannon M MacDonald  2 , Oren Cahlon  3
Affiliations
Review

Novel applications of proton therapy in breast carcinoma

John J Cuaron et al. Chin Clin Oncol. 2016 Aug.

Abstract

This review will focus on the indications, clinical experience, and technical considerations of proton beam radiation therapy in the treatment of patients with breast cancer. For patients with early stage disease, proton therapy delivers less dose to non-target breast tissue for patients receiving partial breast irradiation (PBI) therapy, which may result in improved cosmesis but requires further investigation. For patients with locally advanced breast cancer requiring treatment to the regional lymph nodes, proton therapy allows for an improved dosimetric profile compared with conventional photon and electron techniques. Early clinical results demonstrate acceptable toxicity. The possible reduction in cardiopulmonary events as a result of reduced dose to organs at risk will be tested in a randomized control trial of protons vs. photons.

Keywords: Protons; breast cancer; indications; technique.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Skin reactions of patients undergoing proton therapy to the chest wall and regional nodes after mastectomy without reconstruction (top row) and after lumpectomy (bottom row). (A and D) Baseline; (B and E) end of RT; (C and F) 1 month follow up after RT.
Figure 2
Figure 2
Mean surface dose among 14 patients treated with photon ± bolus or passive scattering proton therapy.
Figure 3
Figure 3
Digital reconstructions of proton beam arrangements for a patient with breast cancer. (A) A typical beam arrangement used to treat the unreconstructed chest wall and regional lymph nodes; (B) feathered junction with the match line shift superiorly by 1 cm for the same patient as (A).
Figure 4
Figure 4
DVH envelopes corresponding with worst-case-scenario robustness planning analysis using uncertainty shifts of ±3 mm, ±2% for a patient undergoing post mastectomy proton therapy.
Figure 5
Figure 5
DVH envelopes corresponding with worst-case-scenario robustness planning analysis using respiratory motion as measured on 4DCT scan.
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65:5–29. - PubMed
    1. Fisher B, Anderson S, Bryant J, et al. Twenty-year followup of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41. - PubMed
    1. Clarke M, Collins R, Darby S, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–106. - PubMed
    1. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) Darby S, McGale P, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707–16. - PMC - PubMed
    1. Liljegren G, Holmberg L, Bergh J, et al. 10-Year results after sector resection with or without postoperative radiotherapy for stage I breast cancer: a randomized trial. J Clin Oncol. 1999;17:2326–33. - PubMed