دورية أكاديمية
أعرض في EDS

Phase 1 trial of preoperative image guided intensity modulated proton radiation therapy with simultaneously integrated boost to the high risk margin for retroperitoneal sarcomas.

التفاصيل البيبلوغرافية
العنوان: Phase 1 trial of preoperative image guided intensity modulated proton radiation therapy with simultaneously integrated boost to the high risk margin for retroperitoneal sarcomas.
المؤلفون: DeLaney TF; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Chen YL; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Baldini EH; Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, Massachusetts., Wang D; Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois., Adams J; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Hickey SB; Cancer Center Protocol Office, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Yeap BY; Biostatistics/Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Hahn SM; Department of Radiation Oncology, M.D. Anderson Cancer Center, Houston, Texas., De Amorim Bernstein K; Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Nielsen GP; Department of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Choy E; Medical Oncology Section, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Mullen JT; Surgical Oncology Section, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts., Yoon SS; Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
المصدر: Advances in radiation oncology [Adv Radiat Oncol] 2017 Jan 04; Vol. 2 (1), pp. 85-93. Date of Electronic Publication: 2017 Jan 04 (Print Publication: 2017).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101677247 Publication Model: eCollection Cited Medium: Print ISSN: 2452-1094 (Print) Linking ISSN: 24521094 NLM ISO Abbreviation: Adv Radiat Oncol Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Philadelphia, PA] : Elsevier Inc., [2016]-
مستخلص: Purpose: To conduct phase 1 and 2 trials with photon intensity modulated radiation therapy and intensity modulated proton therapy (IMPT) arms to selectively escalate the retroperitoneal sarcoma preoperative radiation dose to tumor volume (clinical target volume [CTV] 2) that is judged to be at a high risk for positive margins and aim to reduce local recurrence. We report on the IMPT study arm in phase 1.
Methods and Materials: Patients aged ≥18 years with primary or locally recurrent retroperitoneal sarcoma were treated with preoperative IMPT, 50.4 GyRBE in 28 fractions, to CTV1 (gross tumor volume and adjacent tissues at risk of subclinical disease) with a simultaneous integrated boost to CTV2 to doses of 60.2, 61.6, and 63.0 GyRBE in 28 fractions of 2.15, 2.20, and 2.25 GyRBE, respectively. The primary objective of the phase 1 study was to determine the maximum tolerated dose to CTV2, which will be further tested in the phase 2 study.
Results: Eleven patients showed increasing IMPT dose levels without acute dose limiting toxicities that prevented dose escalation to maximum tolerated dose. Acute toxicity was generally mild with no radiation interruptions. No unexpected perioperative morbidity was noted. Eight months postoperatively, one patient developed hydronephrosis that was treated by stent with ureter dissected off tumor and received 57.5 GyRBE. Retained ureter(s) was (were) subsequently constrained to 50.4 GyRBE without further problem. With an 18-month median follow-up, there were no local recurrences.
Conclusions: IMPT dose escalation to CTV2 to 63 GyRBE was achieved without acute dose limiting toxicities. The phase 2 study of IMPT will accrue patients to that dose. Parallel intensity modulated radiation therapy phase 1 arm is currently accruing at the initial dose level. Ureters that undergo a high dose radiation and/or surgery are at risk for late hydro-ureter. Future studies will constrain retained ureters to 50.4 GyRBE to avoid ureteral stricture.
التعليقات: Comment in: Int J Radiat Oncol Biol Phys. 2017 Oct 1;99(2):292-295. (PMID: 28871972)
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معلومات مُعتمدة: C06 CA059267 United States CA NCI NIH HHS; U19 CA021239 United States CA NCI NIH HHS
تواريخ الأحداث: Date Created: 20170726 Latest Revision: 20240326
رمز التحديث: 20240326
مُعرف محوري في PubMed: PMC5514168
DOI: 10.1016/j.adro.2016.12.003
PMID: 28740917
قاعدة البيانات: MEDLINE
الوصف
تدمد:2452-1094
DOI:10.1016/j.adro.2016.12.003