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Proton therapy for thymic malignancies: multi-institutional patterns-of-care and early clinical outcomes from the proton collaborative group and the university of Florida prospective registries.
- Source :
- Acta Oncologica; Jul2019, Vol. 58 Issue 7, p1036-1040, 5p, 1 Chart
- Publication Year :
- 2019
-
Abstract
- Objective: Thymic malignancies (TM) are rare tumors with long-term survivorship, causing concerns for radiotherapy-related late side effects. Proton therapy (PT) reduces the radiation dose to organs at risk, potentially decreasing long-term toxicities while preserving disease control. We report patterns-of-care and early clinical outcomes after PT for thymoma and thymic carcinoma. Methods: Between January 2008 and March 2017, 30 patients with TMs enrolled on one of two IRB-approved prospective protocols and received postoperative or definitive PT. Clinical outcomes, pathology, treatment dose, toxicities, and follow-up information were analyzed. Results: Twenty-two thymoma patients with a median age of 52.1 years (range, 23–72) received a median RT dose of 54 Gy (RBE) (range, 45–70) either postoperatively (91%) or definitively (9%); 23% received adjuvant chemotherapy. Among eight thymic carcinoma patients, the median age was 65.5 years (range, 38-88) and median RT dose was 60 Gy (RBE) (range, 42–70) delivered postoperatively (75%) or definitively (25%); 50% received chemotherapy. Median follow-up for all patients was 13 months (range, 2–59 months). Five patients relapsed, one locally (3%). Three patients died of disease progression, including two thymomas and one thymic carcinoma patient; a fourth died of intercurrent disease. One patient with thymic carcinoma and 1 with thymoma are alive with disease. No patients treated with PT for their initial disease (de novo) experienced grade ≥3 toxicities. The most common grade 2 toxicities were dermatitis (37%), cough (13%), and esophagitis (10%). Conclusion: Adjuvant and definitive PT are being used in the treatment of TMs. Early results of the largest such cohort reported to date demonstrates an acceptable rate of recurrence with a favorable toxicity profile. Longer follow-up and a larger patient cohort are needed to confirm these findings. [ABSTRACT FROM AUTHOR]
- Subjects :
- SKIN inflammation
COUGH -- Risk factors
ACADEMIC medical centers
ADJUVANT treatment of cancer
CANCER relapse
ESOPHAGUS diseases
INTERPROFESSIONAL relations
LONGITUDINAL method
MEDICAL cooperation
MEDICAL protocols
POSTOPERATIVE period
RADIATION doses
RESEARCH
INSTITUTIONAL review boards
TREATMENT effectiveness
DISEASE progression
THYMOMA
PROTON therapy
CHEMORADIOTHERAPY
DISEASE risk factors
Subjects
Details
- Language :
- English
- ISSN :
- 0284186X
- Volume :
- 58
- Issue :
- 7
- Database :
- Complementary Index
- Journal :
- Acta Oncologica
- Publication Type :
- Academic Journal
- Accession number :
- 137343359
- Full Text :
- https://doi.org/10.1080/0284186X.2019.1575981