Choi J Isabelle, Hardy-Abeloos Camille, Lozano Alicia, Hanlon Alexandra, Vargas Carlos, Maduro John H, Bradley Julie, Offersen Birgitte, Haffty Bruce, Pankuch Mark, Amos Richard, Kim Nalee, MacDonald Shannon M, Kirova Youlia, Mutter Robert W
Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
New York Proton Center, New York, NY, USA.
Clin Transl Radiat Oncol. 2024 Aug 27;48:100847. doi: 10.1016/j.ctro.2024.100847. eCollection 2024 Sep.
PURPOSE/OBJECTIVES: The indications, techniques, and extent to which proton beam therapy (PBT) is employed for breast cancer are unknown. We seek to determine PBT utilization for breast cancer.
MATERIALS/METHODS: The Particle Therapy Co-Operative Group (PTCOG) Breast Subcommittee developed an IRB-approved 29-question survey and sent it to breast cancer radiation oncologists at all active PBT centers worldwide in June 2023. Descriptive statistics were used to summarize responses, and comparisons by continent were performed using Fisher's exact tests.
Of 79 surveys distributed, 28 recipients submitted responses (35 % response rate) representing fifteen U.S., 8 European, and 5 Asian centers (continent response rate 50 %, 38 %, and 18 %, respectively). Overall, 93 % reported treating breast cancer patients with PBT; 13 (50 %) have treated ≥100 breast cancer patients at their center since opening. Most (89 %) have pencil beam scanning technology. Nearly half (46 %) use moderate hypofractionation (15-20 fractions) for regional nodal irradiation and 42 % conventional fractionation (25-30 fractions). More European centers prefer hypofractionation (88 %) vs. Asian (50 %) and U.S. (21 %) centers (p = 0.003). Common patient selection methods were practitioner determination/patient preference (n = 16) and comparative plan evaluation (n = 15). U.S. centers reported the most experience with breast PBT, with 71 % having treated ≥100 breast cancer patients vs. 38 % in Europe and none in Asia (p = 0.001). Of respondent centers, 39 % enrolled ≥75 % of breast PBT patients on a research study.
Utilization, patient selection methods, and dose-fractionation approaches for breast cancer PBT vary worldwide. These survey data serve as a benchmark from which successor surveys can provide insight on practice pattern evolution.
目的/目标：质子束治疗（PBT）用于乳腺癌的适应症、技术及应用程度尚不清楚。我们试图确定PBT在乳腺癌治疗中的应用情况。
材料/方法：粒子治疗合作组（PTCOG）乳腺小组委员会制定了一项经机构审查委员会批准的包含29个问题的调查问卷，并于2023年6月将其发送给全球所有活跃的PBT中心的乳腺癌放射肿瘤学家。使用描述性统计来总结回复，并使用Fisher精确检验进行各大洲之间的比较。
在分发的79份调查问卷中，28位受访者提交了回复（回复率35%），代表了15个美国中心、8个欧洲中心和5个亚洲中心（各大洲的回复率分别为50%、38%和18%）。总体而言，93%的受访者报告使用PBT治疗乳腺癌患者；自中心开业以来，13个中心（50%）已治疗了≥100例乳腺癌患者。大多数（89%）拥有笔形束扫描技术。近一半（46%）在区域淋巴结照射时采用中等程度的超分割放疗（15 - 20次分割），42%采用常规分割放疗（25 - 30次分割）。与亚洲（50%）和美国（21%）中心相比，更多欧洲中心倾向于超分割放疗（88%）（p = 0.003）。常见的患者选择方法是医生决定/患者偏好（n = 16）和比较计划评估（n = 15）。美国中心报告在乳腺PBT方面经验最丰富，71%的中心已治疗≥100例乳腺癌患者，而欧洲为38%，亚洲则无（p = 0.001）。在回复的中心中，39%的中心将≥75%的乳腺PBT患者纳入了研究。
全球范围内，乳腺癌PBT的应用、患者选择方法和剂量分割方法各不相同。这些调查数据可作为一个基准，后续调查可据此洞察实践模式演变情况。
