Proton Beam Therapy in Older Patients With Esophageal Cancer

10/31/17

Researchers compared the effects of proton beam therapy plus chemotherapy vs traditional radiation therapy plus chemotherapy in older patients undergoing surgery for esophageal cancer.

The study was presented by Scott Lester, MD, radiation oncologist at Mayo Clinic (Rochester, MN), at the 4th Annual Particle Therapy Cooperative Group North America Conference (October 23-25, 2017; Chicago, IL).

Older patients with esophageal cancer not only experience more post-treatment heart and lung problems than younger patients, but are also at a higher risk for death after receiving a combination of preoperative radiation therapy and chemotherapy. However, proton beam therapy in place of traditional radiation therapy in the preoperative setting has yet to be fully understood.

Dr Lester and colleagues conducted a study to assess the effects of proton beam therapy plus chemotherapy in patients with esophageal cancer. A total of 571 patients were sampled from the Mayo Clinic Cancer Center, MD Anderson Cancer Center, and the University of Maryland Cancer Center from 2007 to 2013, 35% of whom were aged 65 years or older at. Among this patient subset, 43% received 3-D conformal radiation, 36% received intensity-modulated radiation, and 21% received proton beam therapy. Researchers assessed outcomes by each type of radiation treatment.

Results of the study showed that older patients treated with proton beam therapy benefited from improved outcomes and lower toxicities; these patients demonstrated lower rates of heart and lung problems, and they had a lower postoperative mortality rate than the patients treated with either of the other radiation methods.

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Researchers noted that no patients treated with proton beam therapy experienced a postoperative death. They attribute this to proton beam therapy’s ability to reduce the dosage to important areas surrounding the esophagus, including the heart and lungs.

“Age itself should not be a disqualifying factor for aggressive cancer treatment, but efforts to minimize the side effects of treatment are especially important in the elderly,” said Dr Lester in his presentation. "This study showed that advanced radiation techniques, especially proton beam therapy, can help improve outcomes in this population and may allow for more patients [aged] 65 years and older to undergo aggressive treatment for their esophagus cancer."—Zachary Bessette