An attempt to test whether precise proton beam therapy can benefit breast cancer patients

British scientists have launched a trial of proton beam therapy to assess whether precise treatment could help breast cancer patients.

The researchers want to investigate whether some patients will benefit from the treatment compared to traditional radiation therapy.

A small number of breast cancer patients are at higher risk of long-term heart problems after traditional radiotherapy.

It is hoped that offering these patients proton beam therapy – which can target the radiation beams more precisely – will provide sufficient radiation therapy to the breast tissue while minimizing ‘off-target’ radiation to the heart.

Each year around 30,000 breast cancer patients in the UK are offered radiotherapy after surgery.

Standard radiation therapy uses high-energy X-rays to destroy cancer cells and reduce the chance of the disease returning.

Treatment is successful in the vast majority of patients, but in less than 1% of those treated, traditional radiotherapy can lead to heart problems later in life.

This is usually because the breast tissue and lymph nodes that need radiation therapy are close to the heart, or you already have an increased risk of heart problems.

As a result, the researchers want to assess whether these patients will benefit from proton beam therapy using charged particles instead of X-rays to target tumors more precisely.

The hope is that using this treatment will minimize the amount of radiation delivered to the heart during traditional treatment while still targeting cancer cells.

Nearly 200 patients will take part in the trial, which is being led by scientists from the University of Cambridge, The Institute of Cancer Research in London and The Royal Marsden NHS Foundation Trust.

Those offered proton beam therapy will be treated at The Christie NHS Foundation Trust in Manchester or University College London Hospitals NHS Foundation Trust, and those traveling far from home will be provided with accommodation.

The study will measure the radiation dose delivered to the heart as an early predictor of possible heart problems, avoiding the need for years of follow-up.

“While only a very small group of people are at higher risk of heart problems later in life, it can still be a serious problem,” said lead researcher Professor Charlotte Coles of the University of Cambridge.

“Most patients treated with radiation have decades of healthy life ahead of them and we must do everything we can to avoid possible future heart problems related to treatment.

“Standard radiotherapy to the breast is really effective for most people and has very few side effects, but there is a small group of patients for whom proton beam therapy may be a better option.”

Professor Judith Bliss from The Institute of Cancer Research in London added: “We are delighted to launch the PARABLE study to test proton beam therapy and determine whether it has advantages over standard radiation therapy in a group of people who may need more targeted treatment.

“The PARABLE trial will measure the average dose of radiation therapy delivered to the heart to predict long-term damage to the heart. Leveraging this early predictor will allow us to uncover the potential benefits of proton beam therapy for long-term heart health over a period of years, not decades.”

Dr Anna Kirby, Clinical Oncology Consultant at the Royal Marsden NHS Foundation Trust, added: “We hope that the PARABLE trial will help us further personalize radiotherapy and give people access to the best radiotherapy treatment for them, wherever they live.”

Dr Kotryna Temcinaite, Senior Research Communications Manager at Breast Cancer Now, added: “If the PARABLE study shows that proton beam therapy works better than standard radiotherapy for these people, it could pave the way for this treatment to be made available through the NHS for these people.” . who needs it.”

The PARABLE study was funded by the National Institute for Health and Care Research and the Medical Research Council.

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