Dosimetry and Acute Toxicity Profile of Patients With Esophageal Cancer Treated With Proton Beam Radiation Therapy: Outcomes From the Proton Collaborative Group REG001-09 Trial

Michael Chuong

Dosimetry and Acute Toxicity Profile of Patients With Esophageal Cancer Treated With Proton Beam Radiation Therapy: Outcomes From the Proton Collaborative Group REG001-09 Trial

Miami Cancer Institute

Research output: Contribution to journal › Article › peer-review

Abstract

<p> <h3 id="x-x-cesectitle0002"> Purpose </h3> <p id="x-x-spara008"> Concurrent <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/chemoradiotherapy" title="Learn more about chemoradiation from ScienceDirect's AI-generated Topic Pages"> chemoradiation </a> plays an integral role in the treatment of esophageal cancer. Proton beam radiation therapy has the potential to spare adjacent critical organs, improving toxicity profiles and potentially improving clinical outcomes. <h3 id="x-x-cesectitle0003"> Methods and Materials </h3> <p id="x-x-spara009"> We evaluated the REG001-09 registry for patients undergoing <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/proton-therapy" title="Learn more about proton radiation therapy from ScienceDirect's AI-generated Topic Pages"> proton radiation therapy </a> for esophageal cancer. Demographic, clinicopathologic, toxicity, and <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/dosimetry" title="Learn more about dosimetry from ScienceDirect's AI-generated Topic Pages"> dosimetry </a> information were compiled. <h3 id="x-x-cesectitle0004"> Results </h3> <p id="x-x-spara010"> We identified 155 patients treated <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/dihydrotachysterol" title="Learn more about at 10 from ScienceDirect's AI-generated Topic Pages"> at 10 </a> institutions between 2010 and 2019. One hundred twenty (77%) had adenocarcinoma and 34 (22%) had squamous cell carcinoma. One hundred thirty-seven (88%) received concurrent chemotherapy. The median delivered dose was 50.51 Gy-equivalent (GyE; range, 41.4-70.1). Grade ≥3 toxicities occurred in 22 (14%) of patients and were most commonly <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/plummer-vinson-syndrome" title="Learn more about dysphagia from ScienceDirect's AI-generated Topic Pages"> dysphagia </a> (6%), <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/esophagitis" title="Learn more about esophagitis from ScienceDirect's AI-generated Topic Pages"> esophagitis </a> (4%), anorexia (4%), and nausea (2%). There were no episodes of grade ≥4 <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/lymphocytopenia" title="Learn more about lymphopenia from ScienceDirect's AI-generated Topic Pages"> lymphopenia </a> and no grade 5 toxicities. The average mean heart, lung, and liver doses and average maximum spinal cord dose were 10.0 GyE, 4.8 GyE, 3.8 GyE, and 34.2 GyE, respectively. For <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/gastroesophageal-junction" title="Learn more about gastroesophageal junction from ScienceDirect's AI-generated Topic Pages"> gastroesophageal junction </a> tumors, 8% of patients developed acute grade ≥3 toxicity and the mean heart, liver, right kidney, and left kidney doses were 10.5 GyE, 3.9 GyE, 0.4 GyE, and 4.9 GyE, respectively. Gastroesophageal junction location was protective against development of grade ≥3 toxicity on univariate ( <em> P </em> = .0009) and multivariate ( <em> P </em> = .004) analysis. <h3 id="x-x-cesectitle0005"> Conclusions </h3> <p id="x-x-spara011"> Proton beam radiation therapy affords excellent dosimetric parameters and low toxicity in patients with esophageal cancer treated with curative intent. Prospective trials are underway investigating the comparative benefit of proton-based therapy. </p> </p> </p> </p></p>

Original language	American English
Journal	Advances in Radiation Oncology
Volume	6
State	Published - Jul 15 2021

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@article{4d81783e9b754a4f86d6d17d2880cecb,

title = "Dosimetry and Acute Toxicity Profile of Patients With Esophageal Cancer Treated With Proton Beam Radiation Therapy: Outcomes From the Proton Collaborative Group REG001-09 Trial",

abstract = " Purpose Concurrent chemoradiation plays an integral role in the treatment of esophageal cancer. Proton beam radiation therapy has the potential to spare adjacent critical organs, improving toxicity profiles and potentially improving clinical outcomes. Methods and Materials We evaluated the REG001-09 registry for patients undergoing proton radiation therapy for esophageal cancer. Demographic, clinicopathologic, toxicity, and dosimetry information were compiled. Results We identified 155 patients treated at 10 institutions between 2010 and 2019. One hundred twenty (77\%) had adenocarcinoma and 34 (22\%) had squamous cell carcinoma. One hundred thirty-seven (88\%) received concurrent chemotherapy. The median delivered dose was 50.51 Gy-equivalent (GyE; range, 41.4-70.1). Grade \≥3 toxicities occurred in 22 (14\%) of patients and were most commonly dysphagia (6\%), esophagitis (4\%), anorexia (4\%), and nausea (2\%). There were no episodes of grade \≥4 lymphopenia and no grade 5 toxicities. The average mean heart, lung, and liver doses and average maximum spinal cord dose were 10.0 GyE, 4.8 GyE, 3.8 GyE, and 34.2 GyE, respectively. For gastroesophageal junction tumors, 8\% of patients developed acute grade \≥3 toxicity and the mean heart, liver, right kidney, and left kidney doses were 10.5 GyE, 3.9 GyE, 0.4 GyE, and 4.9 GyE, respectively. Gastroesophageal junction location was protective against development of grade \≥3 toxicity on univariate ( P = .0009) and multivariate ( P = .004) analysis. Conclusions Proton beam radiation therapy affords excellent dosimetric parameters and low toxicity in patients with esophageal cancer treated with curative intent. Prospective trials are underway investigating the comparative benefit of proton-based therapy. ",

author = "Michael Chuong",

note = "Advances in Radiation Oncology (2021) 6(5)",

year = "2021",

month = jul,

day = "15",

language = "American English",

volume = "6",

journal = "Advances in Radiation Oncology",

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T1 - Dosimetry and Acute Toxicity Profile of Patients With Esophageal Cancer Treated With Proton Beam Radiation Therapy: Outcomes From the Proton Collaborative Group REG001-09 Trial

AU - Chuong, Michael

N1 - Advances in Radiation Oncology (2021) 6(5)

PY - 2021/7/15

Y1 - 2021/7/15

N2 - Purpose Concurrent chemoradiation plays an integral role in the treatment of esophageal cancer. Proton beam radiation therapy has the potential to spare adjacent critical organs, improving toxicity profiles and potentially improving clinical outcomes. Methods and Materials We evaluated the REG001-09 registry for patients undergoing proton radiation therapy for esophageal cancer. Demographic, clinicopathologic, toxicity, and dosimetry information were compiled. Results We identified 155 patients treated at 10 institutions between 2010 and 2019. One hundred twenty (77%) had adenocarcinoma and 34 (22%) had squamous cell carcinoma. One hundred thirty-seven (88%) received concurrent chemotherapy. The median delivered dose was 50.51 Gy-equivalent (GyE; range, 41.4-70.1). Grade ≥3 toxicities occurred in 22 (14%) of patients and were most commonly dysphagia (6%), esophagitis (4%), anorexia (4%), and nausea (2%). There were no episodes of grade ≥4 lymphopenia and no grade 5 toxicities. The average mean heart, lung, and liver doses and average maximum spinal cord dose were 10.0 GyE, 4.8 GyE, 3.8 GyE, and 34.2 GyE, respectively. For gastroesophageal junction tumors, 8% of patients developed acute grade ≥3 toxicity and the mean heart, liver, right kidney, and left kidney doses were 10.5 GyE, 3.9 GyE, 0.4 GyE, and 4.9 GyE, respectively. Gastroesophageal junction location was protective against development of grade ≥3 toxicity on univariate ( P = .0009) and multivariate ( P = .004) analysis. Conclusions Proton beam radiation therapy affords excellent dosimetric parameters and low toxicity in patients with esophageal cancer treated with curative intent. Prospective trials are underway investigating the comparative benefit of proton-based therapy.

AB - Purpose Concurrent chemoradiation plays an integral role in the treatment of esophageal cancer. Proton beam radiation therapy has the potential to spare adjacent critical organs, improving toxicity profiles and potentially improving clinical outcomes. Methods and Materials We evaluated the REG001-09 registry for patients undergoing proton radiation therapy for esophageal cancer. Demographic, clinicopathologic, toxicity, and dosimetry information were compiled. Results We identified 155 patients treated at 10 institutions between 2010 and 2019. One hundred twenty (77%) had adenocarcinoma and 34 (22%) had squamous cell carcinoma. One hundred thirty-seven (88%) received concurrent chemotherapy. The median delivered dose was 50.51 Gy-equivalent (GyE; range, 41.4-70.1). Grade ≥3 toxicities occurred in 22 (14%) of patients and were most commonly dysphagia (6%), esophagitis (4%), anorexia (4%), and nausea (2%). There were no episodes of grade ≥4 lymphopenia and no grade 5 toxicities. The average mean heart, lung, and liver doses and average maximum spinal cord dose were 10.0 GyE, 4.8 GyE, 3.8 GyE, and 34.2 GyE, respectively. For gastroesophageal junction tumors, 8% of patients developed acute grade ≥3 toxicity and the mean heart, liver, right kidney, and left kidney doses were 10.5 GyE, 3.9 GyE, 0.4 GyE, and 4.9 GyE, respectively. Gastroesophageal junction location was protective against development of grade ≥3 toxicity on univariate ( P = .0009) and multivariate ( P = .004) analysis. Conclusions Proton beam radiation therapy affords excellent dosimetric parameters and low toxicity in patients with esophageal cancer treated with curative intent. Prospective trials are underway investigating the comparative benefit of proton-based therapy.

UR - https://scholarlycommons.baptisthealth.net/se-all-publications/4086

M3 - Article

VL - 6

JO - Advances in Radiation Oncology

JF - Advances in Radiation Oncology

ER -

Dosimetry and Acute Toxicity Profile of Patients With Esophageal Cancer Treated With Proton Beam Radiation Therapy: Outcomes From the Proton Collaborative Group REG001-09 Trial

Abstract

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