title: Radiation therapy planning with photons and protons for early and advanced breast cancer: an overview.
abstract: Postoperative radiation therapy substantially decreases local relapse and moderately reduces breast cancer mortality, but can be associated with increased late mortality due to cardiovascular morbidity and secondary malignancies. Sophistication of breast irradiation techniques, including conformal radiotherapy and intensity modulated radiation therapy, has been shown to markedly reduce cardiac and lung irradiation. The delivery of more conformal treatment can also be achieved with particle beam therapy using protons. Protons have superior dose distributional qualities compared to photons, as dose deposition occurs in a modulated narrow zone, called the Bragg peak. As a result, further dose optimization in breast cancer treatment can be reasonably expected with protons. In this review, we outline the potential indications and benefits of breast cancer radiotherapy with protons. Comparative planning studies and preliminary clinical data are detailed and future developments are considered.
authors.affiliation: Department of Radiation Medicine, Paul Scherrer Institute, Villigen-PSI, Switzerland. damien.weber@hcuge.ch
authors.forename: Damien C
authors.initials: DC
authors.lastname: Weber
authors.forename: Carmen
authors.initials: C
authors.lastname: Ares
authors.forename: Antony J
authors.initials: AJ
authors.lastname: Lomax
authors.forename: John M
authors.initials: JM
authors.lastname: Kurtz
mesh_terms: D001943:Breast Neoplasms / Q000191:economics / Q000532:radiotherapy* / Q000601:surgery; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D017048:Health Care Costs; D006801:Humans; D017785:Photons / Q000627:therapeutic use*; D061766:Proton Therapy; D011878:Radiotherapy / Q000191:economics* / Q000379:methods*; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D011522:Protons
chemical_list: D011522:Protons