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

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

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-...

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Main Authors: Jacob S. Parzen, MD, Michael D. Chuong, MD, John Chang, MD, Lane Rosen, MD, James Urbanic, MD, William Hartsell, MD, Henry Tsai, MD, Christopher Sinesi, MD, Jing Zeng, MD, Mark Mishra, MD, Carlos Vargas, MD, Craig Stevens, MD, PhD, Peyman Kabolizadeh, MD, PhD
Format: Article
Language:English
Published: Elsevier 2021-09-01
Series:Advances in Radiation Oncology
Online Access:http://www.sciencedirect.com/science/article/pii/S2452109421001093
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spelling doaj-b81d6a59444649d8a93c4f32881d5a392021-10-01T05:07:14ZengElsevierAdvances in Radiation Oncology2452-10942021-09-0165100751Dosimetry and Acute Toxicity Profile of Patients With Esophageal Cancer Treated With Proton Beam Radiation Therapy: Outcomes From the Proton Collaborative Group REG001-09 TrialJacob S. Parzen, MD0Michael D. Chuong, MD1John Chang, MD2Lane Rosen, MD3James Urbanic, MD4William Hartsell, MD5Henry Tsai, MD6Christopher Sinesi, MD7Jing Zeng, MD8Mark Mishra, MD9Carlos Vargas, MD10Craig Stevens, MD, PhD11Peyman Kabolizadeh, MD, PhD12Beaumont Proton Therapy Center, Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, MichiganMiami Cancer Institute, Department of Radiation Oncology, Miami, FloridaNorthwestern Medicine Chicago Proton Center, Department of Radiation Oncology, Warrenville, IllinoisWillis-Knighton Cancer Center, Department of Radiation Oncology, Shreveport, LouisianaCalifornia Protons Therapy Center, Department of Radiation Oncology, San Diego, CaliforniaNorthwestern Medicine Chicago Proton Center, Department of Radiation Oncology, Warrenville, IllinoisPrinceton ProCure Proton Therapy Center, Department of Radiation Oncology, Kendall Park, New JerseyHampton University Proton Therapy Institute, Department of Radiation Oncology, Hampton, VirginiaSeattle Cancer Care Alliance Proton Therapy Center, Department of Radiation Oncology, Seattle, WashingtonMaryland Proton Treatment Center, Department of Radiation Oncology, Baltimore, MarylandMayo Clinic Proton Center, Department of Radiation Oncology, Phoenix, ArizonaBeaumont Proton Therapy Center, Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, MichiganBeaumont Proton Therapy Center, Department of Radiation Oncology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan; Corresponding author: Peyman Kabolizadeh, MD, PhDPurpose: 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.http://www.sciencedirect.com/science/article/pii/S2452109421001093
collection DOAJ
language English
format Article
sources DOAJ
author Jacob S. Parzen, MD
Michael D. Chuong, MD
John Chang, MD
Lane Rosen, MD
James Urbanic, MD
William Hartsell, MD
Henry Tsai, MD
Christopher Sinesi, MD
Jing Zeng, MD
Mark Mishra, MD
Carlos Vargas, MD
Craig Stevens, MD, PhD
Peyman Kabolizadeh, MD, PhD
spellingShingle Jacob S. Parzen, MD
Michael D. Chuong, MD
John Chang, MD
Lane Rosen, MD
James Urbanic, MD
William Hartsell, MD
Henry Tsai, MD
Christopher Sinesi, MD
Jing Zeng, MD
Mark Mishra, MD
Carlos Vargas, MD
Craig Stevens, MD, PhD
Peyman Kabolizadeh, MD, PhD
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
Advances in Radiation Oncology
author_facet Jacob S. Parzen, MD
Michael D. Chuong, MD
John Chang, MD
Lane Rosen, MD
James Urbanic, MD
William Hartsell, MD
Henry Tsai, MD
Christopher Sinesi, MD
Jing Zeng, MD
Mark Mishra, MD
Carlos Vargas, MD
Craig Stevens, MD, PhD
Peyman Kabolizadeh, MD, PhD
author_sort Jacob S. Parzen, MD
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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
publisher Elsevier
series Advances in Radiation Oncology
issn 2452-1094
publishDate 2021-09-01
description 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.
url http://www.sciencedirect.com/science/article/pii/S2452109421001093
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