Beyond Mean Heart Dose: Cardiac Metrics for the Modern Era
- International Journal of Radiation Oncology, Biology, Physics
Although radiation therapy is a key treatment for patients with breast cancer, the proximity of the heart to the treatment area – especially in patients with left-sided breast cancer – increases the risk of radiation-induced cardiac disease (RIC). Reducing this risk is an important area of continued study for researchers. While mean heart dose remains a key metric used to indicate the risk of a cardiac event following RT, the authors of this article point to several studies to advocate for further research aimed at better understanding which substructures in the heart may be more specifically correlated to RIC (like the left anterior descending artery) and then further studying the threshold for RT on those substructures. Empirical evidence linking the heart’s substructures to RT thresholds and RIC risk – paired with proton therapy technology like pencil-beam scanning – could pave the way for delivering even more precise RT, while reducing the potential risk of RIC in breast cancer patients.
Preoperative Radiosurgery in Brain Tumors
- The Radiosurgery Society
There is growing interest among the medical community in using irradiation – or radiosurgery – as a pre-operative treatment for brain tumors. A webinar held by The Radiosurgery Society covers the latest research, clinical evidence, and rationale for using pre- operative radiosurgery to treat brain tumors. Dr. Victor Mangona of Texas Center for Proton Therapy noted that it is not uncommon for patients with brain tumors to have a dominant mass, as well as smaller lesions, and pre-operative radiosurgery has the potential to simultaneously treat presenting symptoms like these, while gathering a pathology report of the patient’s tumor. Additionally, patients may also benefit from faster time to treatment because they would not have to wait on post-operative recovery, before undergoing irradiation treatment.
A Better Way To Irradiate Lethal CNS Metastases? Randomized Trial Makes Case for Proton Craniospinal Irradiation for Leptomeningeal Spread
- American Society of Clinical Oncology
Interim analysis of a Phase II study of patients with metastatic lung and breast cancers indicates that proton craniospinal irradiation therapy can mitigate disease progression in the central nervous system and improve overall survival when used to treat patients whose disease has metastasized into the leptomeningeal space surrounding the brain and spinal cord. Survival for patients with this disease is four to six months with standard irradiation treatments, such as whole-brain radiotherapy (WBRT) or focal spine radiotherapy. While these therapies relieve symptoms, they do not stop progression in the leptomeningeal space or prolong survival. Whereas analysis of the study indicated proton craniospinal irradiation therapy increased survival from six months to 9.9 months. Additionally, results showed that 92 percent of patients receiving standard photon involved-field radiotherapy (IFRT) saw disease progression in the central nervous system at six months – compared to only 22 percent of patients who received proton craniospinal irradiation.