Proton Therapy for breast cancer patients : Focused Treatment, Fewer Side Effects

The Hampton University Proton Therapy Institute offers radiation therapy for breast cancer patients that often spares healthy tissue. 

Registered Nurse Donna Sternberg talked about why folks whose Oncologists have prescribed radiation should consider treatment at Hampton’s state-of-the-art center.

Proton Therapy is the most advanced method of radiation therapy used to destroy cancer cells. The team at Hampton Proton Therapy Institute (HUPTI) has made significant stride in using proton treatment for breast cancer. Breast cancer is a complicated and diverse disease. Some patients will receive first chemotherapy and/or surgery, and then external beam radiation therapy. Compared to other conventional external beam radiation technics, the proton beam can be programmed to reach a specified depth, and therefore not expose healthy tissues to unnecessary radiation. Treatment itself is a daily treatment. On an average there are 4 to 6 weeks of daily treatment, from Monday to Friday. We book patients every 15 minutes. The actual duration of the daily session is quite short. For breast cancer specifically, there are few side effects, if any. There is some skin irritation, as there will be with any radiation therapy. But in general our patients are able to continue their normal activities, with no interruption and no side effect.

How Proton Therapy Improves Breast Cancer Treatment

Proton Therapy has become a viable option for breast cancer patients because it limits radiation exposure. Traditional radiation therapy cannot be narrowly targeted and as a result, it carries the risk of damaging the lungs and heart, and causing secondary malignancies. It also commonly causes cosmetic damage, rib fractures and skin deterioration. Proton Therapy helps to avoid those risks by delivering powerful doses of radiation to an extremely precise treatment site. It is a powerful weapon in the battle against breast cancer, that is gentler for the patient and improves quality of life during treatment.

Breast Cancers Treated with Proton Therapy :

  • Early Stage Breast Cancer
  • Locally Advanced Breast Cancer (stage II and III)
  • Ductal carcinoma in-situ
  • Triple-negative Breast Cancer
  • Lobular Carcinoma

Read the latest scientific publications about Proton Therapy for Breast Cancer

Proton pencil beam scanning reduces secondary cancer risk in breast cancer patients with internal mammary chain involvement compared to photon radiotherapy

Cartechini et al.
👉 “Our work indicates a benefit from the use of Protontherapy (PT) in Breast Cancer (BC) patients with nodal involvement. When coupled with the lower normal tissue complication probability (NTCP) expected for distal Organs at Risk (i.e. heart, lung), this represents valuable information for the establishment of cost-effective patient selection criteria for BC treatment. Specifically, we show that the gain offered by PT is maximized when the target volume includes internal-mammary-nodes (IMN). In this setting and especially for younger patients, PT might be an alternative to VMAT irradiation.”

Feasibility study: spot-scanning proton arc therapy (SPArc) for left-sided whole breast radiotherapy

Sheng Chang et al.

👉 “Conventional protontherapy (IMPT or Passive-scattering) could reduce the dose of the heart and LAD in left-side breast cancer patients compared to the photon radiotherapy technique in the high cardiac doses sparing. This study found that the new proton treatment technique, SPArc, could further reduce the D1 of heart and LAD which might mitigate the probability of heart acute and late toxicities (…)
Our feasibility study finds that the technology of SPArc can substantially improve not only the heart and LAD sparing but also the lung sparing in comparison with vIMPT. Previous studies have confirmed that proton therapy can significantly reduce the V500(cGy) and V2000(cGy) of the ipsilateral lung by nearly 50% compared to traditional 3DCRT and IMRT. This study found that SPArc plans further reduced all dose-volume parameters while providing a reduced or similarly high-dose radiation volume with IMPT in left-sided WBRT”

Breast Cancer Survival Is Significantly Decreased Among Premenopausal Women Previously Treated With Radiation for Childhood or AYA Cancer

Jo Cavallo

👉 “Breast cancer–specific survival is significantly decreased among all survivors of childhood and AYA cancer treated with radiotherapy that develop a secondary breast cancer, including women with good prognostic features. Therefore, we may need to consider alternative and even more aggressive treatment in what were considered low-risk populations previously”

Second Cancer Risk After Primary Cancer Treatment With Three-Dimensional Conformal, Intensity-Modulated, or Proton Beam Radiation Therapy

Xiang M, Chng DT, Pollom EL

👉 “The risk of a second cancer diagnosis after primary cancer treatment was similar after intensity-modulated radiotherapy (IMRT) versus 3-dimensional conformal radiotherapy (3DCRT), while proton beam radiotherapy (PBRT) was correlated with a lower risk of second cancer diagnosis”

Proton Therapy in 2020: Where We Are and How We Got Here

Minesh Mehta

👉 “The precision and accuracy of protontherapy treatments have vastly improved by incorporating these technologies into the daily workflow. With normal tissue spared from unnecessary exposure to radiation doses, patients experience fewer short- and long-term side effects and can enjoy a better quality of life.”

The risk for developing a secondary cancer after breast radiation therapy: Comparison of photon and proton techniques

Paganetti et al.

👉 “Conventional (3DCRT) techniques led to the lowest estimated risks of, thyroid and esophageal secondary cancers while Protontherapy PBS demonstrated a benefit for secondary lung and contralateral breast cancer risks, with the highest risks overall associated with VMAT techniques.”

Proton Reirradiation: Expert Recommendations for Reducing Toxicities and Offering New Chances of Cure in Patients With Challenging Recurrence Malignancies

Simone et al.

👉 “The high conformality and lack of exit dose with protontherapy offer significant advantages for reirradiation. By decreasing dose to adjacent normal tissues, proton therapy can more safely deliver definitive instead of palliative doses of reirradiation, more safely dose escalate reirradiation treatment, and more safely allow for concurrent systemic therapy in the reirradiation setting. “

Cardiotoxicity and Radiation Therapy: A Review of Clinical Impact in Breast and Thoracic Malignancies

Elizabeth M. Nichols et al.

👉 “All radiation oncologists should be aware of Radiation-Induced Cardiotoxicity (RIC), with a call to action to support advanced delivery techniques”

👉 “Based on available data, a clear relationship exists between whole-heart dose and risk of cardiac events following RT for breast cancer with a significant increase in risk for left-sided breast cancer patients (…) Patients, with a particular focus on those with left-sided disease, should be evaluated for cardiac-sparing techniques, including but not limited to deep-inspiration breath hold (DIBH), gating, prone positioning, and/or proton therapy, to achieve the lowest dose possible.”

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