ArticleRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology2020
The risk for developing a secondary cancer after breast radiation therapy: Comparison of photon and proton techniques.
Article in Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 53 citations in OpenAlex.
- Comparison of in-field secondary cancer risk based on therapeutic proton dose between proton arc therapy and intensity-modulated proton therapy in lung cancer patients.Journal of applied clinical medical physics · 2026Article
- Proton therapy in young breast cancer patients with germline TP53 and ATM mutations: a case series.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Toxicity profiles of proton and photon radiotherapy in postoperative breast cancer: a 10-year real-world cohort study.Breast cancer research : BCR · 2026Article
- Breast cancer radiotherapy and the risk of lung injury: Advances and perspectives.Advances in radiotherapy & nuclear medicine · 2026Article
- Advances in proton therapy technology and global clinical applications.Frontiers in oncology · 2026Review
- Article
- Radiation-induced malignancies from simultaneous integrated boost-VMAT for oropharyngeal cancer delivered with four different fractionation schemes.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2026Article
- Dosimetric and On-treatment Clinical Results of a Volumetric-based Skin-sparing Planning Technique for Patients Treated to the Breast and Chest Wall With Pencil-Beam Scanning Proton Therapy.Advances in radiation oncology · 2025Article
- Proton therapy for breast cancer: Reducing toxicity.Thoracic cancer · 2024Review
- A framework for in-field and out-of-field patient specific secondary cancer risk estimates from treatment plans using the TOPAS Monte Carlo system.Physics in medicine and biology · 2024Article
- Dosimetric analysis of six whole-breast irradiation techniques in supine and prone positions.Scientific reports · 2024Article
- Incidence of Nonkeratinocyte Skin Cancer After Breast Cancer Radiation Therapy.JAMA network open · 2024Article
- Evaluation of conventional IMRT and VMAT strategies for postmastectomy radiation therapy after immediate implant-based reconstruction using the new ESTRO-ACROP contouring guidelines.Radiation and environmental biophysics · 2024Article
- Radiation Therapy for Stage IIA/B Seminoma: Modeling Secondary Cancer Risk for Protons and VMAT versus 3D Photons.Cancers · 2024Article
- Postmastectomy radiotherapy in breast reconstruction: Current controversies and trends.Cancer innovation · 2024Review
- Exploring Helium Ions' Potential for Post-Mastectomy Left-Sided Breast Cancer Radiotherapy.Cancers · 2024Article
- Trends in Radiation Dose to the Contralateral Breast During Breast Cancer Radiation Therapy.Radiation research · 2023Article
- Review
- A dose planning study for cardiac and lung dose sparing techniques in left breast cancer radiotherapy: Can free breathing helical tomotherapy be considered as an alternative for deep inspiration breath hold?Technical innovations & patient support in radiation oncology · 2023Article
- The Potential of Proton Therapy for Locally Advanced Breast Cancer: Clinical and Technical Considerations.Current oncology (Toronto, Ont.) · 2023Review
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
background and purposeTo compare secondary malignancy risks of modern proton and photon therapy techniques for locally advanced breast cancer. METHODS AND MATERIALS: We utilized dosimetric data from 34 [10 photon-VMAT, 10 photon-3DCRT, 14 pencil beam scanning proton (PBS)] breast cancer patients who received comprehensive nodal irradiation. Employing a model based on organ equivalent dose to account for both inhomogeneous organ dose distributions and non-linear functional dose relationships, we estimated excess absolute risk, excess relative risk, and lifetime attributable risk (LAR) for secondary malignancies. The model uses dose distribution, number of fractions, age at exposure, attained age, the linear-quadratic dose response relationship for cell survival, repopulation factor, as well as gender specific age dependencies, and initial slopes of dose response curves.
resultsThe LAR for carcinoma at age 70 was estimated to be up to 3.64% for esophagus with an advantage of 3DCRT over PBS and VMAT. For the ipsilateral lung, risks were lowest for PBS (up to 5.56%), followed by 3DCRT (up to 6.54%) and VMAT (up to 7.7%). For the contralateral lung, there is a clear advantage of 3DCRT and PBS techniques (risk <0.86%) over VMAT (up to 4.4%). The risk for the contralateral breast is negligible for 3DCRT and PBS but was estimated as up to 1.2% for VMAT. Risks for the thyroid are overall negligible. Independently performed comparative treatment plans on 10 patients revealed that the risk for the contralateral lung and breast using VMAT can be more than an order of magnitude higher compared to PBS. Sarcoma risks were estimated as well showing similar trends but were overall lower compared to carcinoma.
conclusionConventional (3DCRT) techniques led to the lowest estimated risks of, thyroid and esophageal secondary cancers while PBS demonstrated a benefit for secondary lung and contralateral breast cancer risks, with the highest risks overall associated with VMAT techniques.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.