ESTRO PT 2018

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) ➢ 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) Indication:

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