Proton therapy may reduce serious side effect of lung cancer treatment
EUREKALERT

Contact: Beth Bukata
bethb@astro.org
703-839-7332
American Society for Therapeutic Radiology and Oncology

Patients with locally advanced lung cancer who receive chemotherapy and proton therapy, a specialized form a radiation therapy only available in a few centers in the United States, have fewer instances of a serious side effect called bone marrow toxicity than patients who receive chemotherapy and another type of radiation therapy called intensity modulated radiation therapy (IMRT), according to a study presented at the 2008 Chicago Multidisciplinary Symposium in Thoracic Oncology, sponsored by ASTRO, ASCO, IASLC and the University of Chicago.

The standard of care for patients with locally advanced non-small-cell lung cancer is chemotherapy and radiation therapy. Unfortunately, these aggressive treatments can put patients at risk of a serious side effect called bone marrow toxicity that can lead to delayed or missed treatments, hospitalizations and growth problems.

To try to alleviate this side effect, doctors at M.D. Anderson Cancer Center examined 142 patients with locally advanced non-small cell lung cancer. Of those, 75 patients received chemotherapy plus a type of targeted photon (X-ray) radiation therapy called intensity modulated radiation therapy (IMRT). The remaining 67 patients received chemotherapy and proton beam therapy. Proton beam therapy is a type of external beam therapy that uses protons rather than photons to kill fast growing cancer cells.

"Because proton therapy allows us to control the radiation differently than other types of external beam radiation therapy, we were hopeful that we could keep radiation away from critical structures, like the bones to avoid bone marrow toxicity," said Ritsuko Komaki, M.D., FASTRO, a radiation oncologist at M.D. Anderson Cancer Center in Houston.

After a follow-up time of 17 months, researchers found patients who received proton therapy with chemotherapy had a significant reduction in bone marrow toxicity compared to patients who received IMRT and chemotherapy. These findings suggest that using proton therapy over other types of radiation may allow doctors to give a higher dose of radiation without compromising the chemotherapy schedule to the lung tumor while avoiding some debilitating side effects, like bone marrow toxicity.

"These results are very promising for people with locally advanced lung cancer," said Dr. Komaki. "However, we need to now confirm these findings with a randomized trial."


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The abstract, "Significant Reduction of Bone Marrow Toxicity (BMT) for Patients with Locally Advanced (LA) NSCLC Treated with Concurrent Chemotherapy (CT) and Proton Beam Therapy (PBT) Compared to Intensity Modulated Radiation Therapy (IMRT)," will be presented on Friday, November 14. To speak with Ritsuko Komaki, M.D., please call Beth Bukata or Nicole Napoli on November 13-14, 2008, in the Press Room at the Chicago Marriott Downtown at 312-595-3177. You may also e-mail them at bethb@astro.org or nicolen@astro.org.

_________________
April/03 My Wife Deborah, age 46, diagnosed adenocarcinoma NSCLC
1/20/2006 Admitted to hospital Respiratory distress
1/23/2006 Ran to the light and is waiting for us to be rejoined in the Kingdom Of Heaven Her journey is Over but mine lingers on for Now!!!
4/23/07 DEb is joined in Peace by her Puppy Dawg Daisy from Cancer
8/30/07 Got new Pup named Mocha!!

"No matter hnow much it hurts, No matter how alone you feel, Your friends will help you get through anything!!"
Scrubs!!!!Yes the comedy show!!!

The Reason I advocate
If you would like to see our family photos Click on this link!
http://deborah-wallin.memory-of.com/

My memory-of Link is good to go now if you want to see it!!

Thank you for the information. I'm new to cancer care-giving and I am not a doctor. I live in an Indianapolis suburb and I am here to learn more on proton therapy. My patient is looking into the option and I really want to contribute to the research aspect. I understand that with this therapy there may be fewer side effects. I've also learned that proton therapy may be used with other cancer treatments. My question is how long does it normally take to become effective? Thanks for the help! I know that IU Health which is really close to where my patient lives has a Proton Therapy center. I found some information at the IU Health Proton Therapy website but any additional information would really help us. Thank you again and I look forward to hearing back!

Welcome to LCSC. I don't know anything about Proton Therapy except that I would suspect it is promoted primarily by institutions that have bought the technology and need to pay for it. But maybe it has enough additional value to be worth checking out. I looked at the Grace site to find some posts for you - not much there but here are a couple of links.:

http://cancergrace.org/forums/index.php ... 788.0;wap2
http://cancergrace.org/forums/index.php?topic=6800.0

Hope this helps! And thanks for helping out your friend/family member/acquaintance. Caregivers are a huge part of the wellness equation.

_________________
(photo: me in '61)
Female never smoked, 52 at diagnosis, otherwise healthy
09/08: false cardiac event = finding of 3 cm tumor upper right lobe plus two .5 cm nodes elsewhere on chest x-ray at ER
09/08: CTScan with IV contrast confirms.
10/08: Pulmonary referral for EBUS - bronchoscopy - confirms NSCLC - adenocarcinoma, with bronchoalveolar features
10/08: PetScan - further confirmation, classified T1N0MX (false negative) VATS scheduled.
11/08: full open surgery - revised to T4N2MX with positive spread to 2 lymph nodes, removed upper lobe with 3 cm tumor and partial mid lobe with (1) .5 cm tumor, 3 lymph nodes on trachea - 1 lymph node and margins negative.
5 night hospital stay.
12/08: Port-a-cath implanted
12/08: Brain MRI and hearing test - good other than minor high end loss in left ear
12/08: start (4) 21 day cycles of chemo - day 1 cisplatin and gemcitabine, day 8 gemcitabine alone, day 15 off - tolerated it pretty well - a little hair thinning and follicle inflammation, some ringing in ears and vertigo, much fatigue, and nausea. Kept my taste-buds almost intact.
02/27/09: completed 4 cycles of chemo!
03/03/09: removed port-a-cath
03/27/09: tattooed for radiation
03/30/09: start radiation (IMRT) 5x/wk for 6 weeks - fatigue, moderate esophagitis
5/08/09: completed treatment
6/22/09: NED
9/18/09: Recurrance in the liver and scattered in lungs. No symptoms. Rx Tarceva.
9/25/09: start Tarceva
11/20/09: clear lungs, shrinkage in liver.
2/24/10: still good on Tarceva
6/3/10: graduated to 6 month scan
12/9/10: new 6 cm tumor in liver
12/28/10: stop Tarceva
1/10/11: carbo/alimta/avastin
3/11/11: scan after 3 cycles 72%ish met reduction, stay the course
5/26/11: scan after 6 cycles, stable.
5/31/11: begin Avastin maintenance.
8/17/11: met growth, stop Avastin. Start Alimta.
10/25/11: met growth, stop Alimta. Wondering what to do next?
1/24/11: start hospice

Thank you for this Randy. I've been hearing lots about this therapy, but didn't understand how it works. Now I do! Thanks! I'll keep this in mind as I deal with the folks I work with at Gilda's.

MI Judy

_________________
6/07 DX NSCLC, Left Upper Lobe wedge resection: Stage 2.3/4, (2B?) Adenocarcinoma, measures 2.5x1.5x1.1cm. Involving visceral pleura but not through it. 5 rounds chemo, carboplatin and Taxol. Subsequent scans NED.

1/11 3.5 mm node found. 10/11 CT node now 8 mm, and new 6 mm node. 11/11 CT Pet shows slight uptake. 1/4/12 Biopsy - Pneumothorax complication. 1/14/12 Lobectomy of upper rt. lobe. NSCLC Adenocarcinoma in situ, nonmucinous (bronchioloalveolar carcinoma) 1.4cm involves pulmonary parenchyma.
3/14/12 Begin 4 cycles of Cisplatin/Navelbein, with Neulasta shot
4/6/12 Chemo changed to Carboplatin/Navelbine without Neulasta shot. Reduced chemo by 50% due to intolerance.
7/5/12 CT scan is clean, NED for lung cancer! There are issues with liver and stomach that will be investigated but not believed to be because of cancer. Wait and see!

*Avatar was taken 7/3/12 on our way out to see the Fireworks on a friends boat on their lake!

Mom dx SCLC 1/96, passed 10/19/96, age 62
Dad dx Brain cancer 4/87, passed 6/87, age 57
Sister dx Brain cancer 4/83, passed 12/83, age 25

I've looked at Proton Therapy. My understanding is that it can be used on many types of tumors. It is especially useful in not harming adjacent tissue. It's energy is released at the center of the tumor and in the shape of the tumor. There is no through radiation or "exit wound rash" It has been effective for prostate radiation causing no unwanted side effects such as ED.,urinary problems etc. The number of sessions are less than IMRT which is what I had done. Two years ago, I also had Cyberknife treatments. At that time, IMRT and Cyberknife were state of the art and still are. Proton Therapy is another step in the evolvement of cancer treatment. We need to always welcome any new method as we would a new less invasive chemo drug.

Randy, thanks for bringing this subject to these forums in the way you did. People will look at it and understand that maybe it will be useful for themselves or someone they love. Surgery wasn't an option for me and this treatment is one that in cases like mine and many more can be a life saver. I commend any institution willing to put out the dollars to build these facilities. Obviously, cancer treatment is big business. I hear people say that this hospital or that hospital are" only in it for the money."
That subject can only be guaged by the quality of care and the results they provide.