Dataset Information

Proton Therapy in the Management of Luminal Gastrointestinal Cancers: Esophagus, Stomach, and Anorectum.

ABSTRACT: While the role of proton therapy in gastric cancer is marginal, its role in esophageal and anorectal cancers is expanding. In esophageal cancer, protons are superior in sparing the organs at risk, as shown by multiple dosimetric studies. Literature is conflicting regarding clinical significance, but the preponderance of evidence suggests that protons yield similar or improved oncologic outcomes to photons at a decreased toxicity cost. Similarly, protons have improved sparing of the organs at risk in anorectal cancers, but clinical data is much more limited to date, and toxicity benefits have not yet been shown clinically. Large, randomized trials are currently underway for both disease sites.

SUBMITTER: Kobeissi JM

PROVIDER: S-EPMC9221464 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Proton Therapy in the Management of Luminal Gastrointestinal Cancers: Esophagus, Stomach, and Anorectum.

Kobeissi Jana M JM Simone Charles B CB Hilal Lara L Wu Abraham J AJ Lin Haibo H Crane Christopher H CH Hajj Carla C

Cancers 20220610 12

While the role of proton therapy in gastric cancer is marginal, its role in esophageal and anorectal cancers is expanding. In esophageal cancer, protons are superior in sparing the organs at risk, as shown by multiple dosimetric studies. Literature is conflicting regarding clinical significance, but the preponderance of evidence suggests that protons yield similar or improved oncologic outcomes to photons at a decreased toxicity cost. Similarly, protons have improved sparing of the organs at ris ...[more]

PMID: 35740544

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Project description:BackgroundThe COVID-19 pandemic dramatically impacted endoscopy practice. Recommendations were to postpone elective cases, including procedures for removal of luminal neoplasia. This provided a natural experiment to evaluate outcomes related to these decisions and the impact of time to procedure on change in histology.AimsThe primary aim is to examine time to endoscopy for therapy of colorectal polyps and Barrett's esophagus with dysplasia and oncologic outcomes during the COVID-19 pandemic.MethodsThis was a retrospective cohort study of individuals referred for endoscopic therapy of advanced colorectal polyps and dysplastic Barrett's esophagus (BE) between July 2019 and January 2022. Multivariable logistic regression was used to evaluate whether time to therapeutic exam was associated with a change in histology. Time from index to therapeutic exam before versus after the start of the pandemic (March 20, 2020) was compared using a Cox regression.ResultsThere were 310 patients (56% male, mean age 65) who were referred for colon polyps (n = 256) and BE-related neoplasia (n = 54). The median time to therapeutic exam was 78 days (range 4-718). Time to therapy was shorter for colon polyp cases completed after versus before the pandemic (HR: 1.49, 95% CI 1.14-1.96). The pandemic was not associated with a difference in time to exam for BE. Change in histology from index to therapeutic exam was noted in 51 cases (16.5%) and was mostly upstaging (70.6%). There was no association between time to therapeutic exam, sex, or timing related to the pandemic on the probability of being upstaged for colon polyps or BE.ConclusionsFewer than 1 in 5 cases had a change in histology from index to therapeutic exam, and there was no delay related to the COVID-19 pandemic. These findings suggest that procedures for removal of advanced colon polyps or dysplastic BE can potentially be postponed with minimal impact, helping guide triaging decisions going forward.

Dataset Information

Proton Therapy in the Management of Luminal Gastrointestinal Cancers: Esophagus, Stomach, and Anorectum.

Publications

Proton Therapy in the Management of Luminal Gastrointestinal Cancers: Esophagus, Stomach, and Anorectum.

Similar Datasets

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