Executive Summary of Clinical and Technical Guidelines for Esophageal Cancer Proton Beam Therapy From the Particle Therapy Co-Operative Group Thoracic and Gastrointestinal Subcommittees
Michael D. Chuong, Christopher L. Hallemeier, Heng Li, Xiaorong Zhu, Xiaodong Zhang, E. Tryggestad, Jen Yu, Ming Yang, J. Isabelle Choi, Minglei Kang, Wei Liu, Antje Knopf, Artūrs Meijers, Jason K. Molitoris, Smith Apisarnthanarax, Huan Giap, Bradford S. Hoppe, Percy Lee, Joe Y. Chang, Charles B. Simone, Steven H. Lin
Abstract
Radiation therapy (RT) is an integral component of potentially curative management of esophageal cancer (EC). However, RT can cause significant acute and late morbidity due to excess radiation exposure to nearby critical organs, especially the heart and lungs. Sparing these organs from both low and high radiation dose has been demonstrated to achieve clinically meaningful reductions in toxicity and may improve long-term survival. Accruing dosimetry and clinical evidence support the consideration of proton beam therapy (PBT) for the management of EC. There are critical treatment planning and delivery uncertainties that should be considered when treating EC with PBT, especially as there may be substantial motion-related interplay effects. The Particle Therapy Co-operative Group Thoracic and Gastrointestinal Subcommittees jointly developed guidelines regarding patient selection, treatment planning, clinical trials, and future directions of PBT for EC.