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Proton Therapy for Breast Cancer
First publications report good tolerance. No increased skin / cosmetic
toxicities reported (
MacDonald, MGH, IJROBP 86:484, 2013
) – long-term
cosmesis data not yet available.
Challenge:
most important clinical endpoints are long term reduction in
cardiac morbidity/mortality and reduction of second malignancy induction
without good clinically predictive surrogates (Reliability of biomarkers,
Ultrasound, perfusion MR images still uncertain)
Indication:
➢
Young women with
➢
left-sided breast cancer, in whom most advanced photon-technique
can not reduce mean heart dose to -for example- < 5 Gy.
➢
Pre-existing coronary artery disease / cardiac morbidity
➢
Combined modality therapy using cardiotoxic systemic agents
(anthracyclines, Herbitux)
“