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Spot Scanning Proton Therapy for Malignancies of the Base of Skull: Treatment Planning, Acute Toxicities, and Preliminary Clinical Outcomes.

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Title: Spot Scanning Proton Therapy for Malignancies of the Base of Skull: Treatment Planning, Acute Toxicities, and Preliminary Clinical Outcomes.
Authors: Grosshans, David R.1 dgrossha@mdanderson.org, Zhu, X. Ronald2, Melancon, Adam2, Allen, Pamela K.1, Poenisch, Falk2, Palmer, Matthew2, McAleer, Mary Frances1, McGovern, Susan L.1, Gillin, Michael2, DeMonte, Franco3, Chang, Eric L.4, Brown, Paul D.1, Mahajan, Anita1
Source: International Journal of Radiation Oncology, Biology, Physics. Nov2014, Vol. 90 Issue 3, p540-546. 7p.
Subjects: Brain cancer patients, Treatment of brain cancer, Chondrosarcoma, Proton therapy, Radiotherapy treatment planning, Acute toxicity testing, Health outcome assessment, Therapeutics
Abstract: Purpose To describe treatment planning techniques and early clinical outcomes in patients treated with spot scanning proton therapy for chordoma or chondrosarcoma of the skull base. Methods and Materials From June 2010 through August 2011, 15 patients were treated with spot scanning proton therapy for chordoma (n=10) or chondrosarcoma (n=5) at a single institution. Toxicity was prospectively evaluated and scored weekly and at all follow-up visits according to Common Terminology Criteria for Adverse Events, version 3.0. Treatment planning techniques and dosimetric data were recorded and compared with those of passive scattering plans created with clinically applicable dose constraints. Results Ten patients were treated with single-field-optimized scanning beam plans and 5 with multifield-optimized intensity modulated proton therapy. All but 2 patients received a simultaneous integrated boost as well. The mean prescribed radiation doses were 69.8 Gy (relative biological effectiveness [RBE]; range, 68-70 Gy [RBE]) for chordoma and 68.4 Gy (RBE) (range, 66-70) for chondrosarcoma. In comparison with passive scattering plans, spot scanning plans demonstrated improved high-dose conformality and sparing of temporal lobes and brainstem. Clinically, the most common acute toxicities included fatigue (grade 2 for 2 patients, grade 1 for 8 patients) and nausea (grade 2 for 2 patients, grade 1 for 6 patients). No toxicities of grades 3 to 5 were recorded. At a median follow-up time of 27 months (range, 13-42 months), 1 patient had experienced local recurrence and a second developed distant metastatic disease. Two patients had magnetic resonance imaging-documented temporal lobe changes, and a third patient developed facial numbness. No other subacute or late effects were recorded. Conclusions In comparison to passive scattering, treatment plans for spot scanning proton therapy displayed improved high-dose conformality. Clinically, the treatment was well tolerated, and with short-term follow-up, disease control rates and toxicity profiles were favorable. [ABSTRACT FROM AUTHOR]
Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Spot Scanning Proton Therapy for Malignancies of the Base of Skull: Treatment Planning, Acute Toxicities, and Preliminary Clinical Outcomes.
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  Data: <searchLink fieldCode="AR" term="%22Grosshans%2C+David+R%2E%22">Grosshans, David R.</searchLink><relatesTo>1</relatesTo><i> dgrossha@mdanderson.org</i><br /><searchLink fieldCode="AR" term="%22Zhu%2C+X%2E+Ronald%22">Zhu, X. Ronald</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Melancon%2C+Adam%22">Melancon, Adam</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Allen%2C+Pamela+K%2E%22">Allen, Pamela K.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Poenisch%2C+Falk%22">Poenisch, Falk</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Palmer%2C+Matthew%22">Palmer, Matthew</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22McAleer%2C+Mary+Frances%22">McAleer, Mary Frances</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22McGovern%2C+Susan+L%2E%22">McGovern, Susan L.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Gillin%2C+Michael%22">Gillin, Michael</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22DeMonte%2C+Franco%22">DeMonte, Franco</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Chang%2C+Eric+L%2E%22">Chang, Eric L.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Brown%2C+Paul+D%2E%22">Brown, Paul D.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Mahajan%2C+Anita%22">Mahajan, Anita</searchLink><relatesTo>1</relatesTo>
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  Data: <searchLink fieldCode="JN" term="%22International+Journal+of+Radiation+Oncology%2C+Biology%2C+Physics%22">International Journal of Radiation Oncology, Biology, Physics</searchLink>. Nov2014, Vol. 90 Issue 3, p540-546. 7p.
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  Data: <searchLink fieldCode="DE" term="%22Brain+cancer+patients%22">Brain cancer patients</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+of+brain+cancer%22">Treatment of brain cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Chondrosarcoma%22">Chondrosarcoma</searchLink><br /><searchLink fieldCode="DE" term="%22Proton+therapy%22">Proton therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Radiotherapy+treatment+planning%22">Radiotherapy treatment planning</searchLink><br /><searchLink fieldCode="DE" term="%22Acute+toxicity+testing%22">Acute toxicity testing</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Therapeutics%22">Therapeutics</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Purpose To describe treatment planning techniques and early clinical outcomes in patients treated with spot scanning proton therapy for chordoma or chondrosarcoma of the skull base. Methods and Materials From June 2010 through August 2011, 15 patients were treated with spot scanning proton therapy for chordoma (n=10) or chondrosarcoma (n=5) at a single institution. Toxicity was prospectively evaluated and scored weekly and at all follow-up visits according to Common Terminology Criteria for Adverse Events, version 3.0. Treatment planning techniques and dosimetric data were recorded and compared with those of passive scattering plans created with clinically applicable dose constraints. Results Ten patients were treated with single-field-optimized scanning beam plans and 5 with multifield-optimized intensity modulated proton therapy. All but 2 patients received a simultaneous integrated boost as well. The mean prescribed radiation doses were 69.8 Gy (relative biological effectiveness [RBE]; range, 68-70 Gy [RBE]) for chordoma and 68.4 Gy (RBE) (range, 66-70) for chondrosarcoma. In comparison with passive scattering plans, spot scanning plans demonstrated improved high-dose conformality and sparing of temporal lobes and brainstem. Clinically, the most common acute toxicities included fatigue (grade 2 for 2 patients, grade 1 for 8 patients) and nausea (grade 2 for 2 patients, grade 1 for 6 patients). No toxicities of grades 3 to 5 were recorded. At a median follow-up time of 27 months (range, 13-42 months), 1 patient had experienced local recurrence and a second developed distant metastatic disease. Two patients had magnetic resonance imaging-documented temporal lobe changes, and a third patient developed facial numbness. No other subacute or late effects were recorded. Conclusions In comparison to passive scattering, treatment plans for spot scanning proton therapy displayed improved high-dose conformality. Clinically, the treatment was well tolerated, and with short-term follow-up, disease control rates and toxicity profiles were favorable. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=egs&AN=98574489
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      – SubjectFull: Treatment of brain cancer
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      – SubjectFull: Chondrosarcoma
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