Proton therapy for Vtach ablation at Mayo

[IonsAreOurFuture]

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Using proton beam therapy to treat heart rhythm disorder

Radiation therapy is a common treatment for cancer, but could it also help treat dangerous heart rhythms? Mayo Clinic recently completed the first clinical trial in humans using proton beam therapy, a type of radiation, to treat patients with potentially life-threatening arrhythmias. They say...

medicalxpress.com

The mean heart dose with linac based SRS 25 Gy x1 ends up being about 8 Gy, so I can see some potential sparing there. Waiting for full paper and presentation.

 

[NotMattSpraker]

Using proton beam therapy to treat heart rhythm disorder

Radiation therapy is a common treatment for cancer, but could it also help treat dangerous heart rhythms? Mayo Clinic recently completed the first clinical trial in humans using proton beam therapy, a type of radiation, to treat patients with potentially life-threatening arrhythmias. They say...

medicalxpress.com

The mean heart dose with linac based SRS 25 Gy x1 ends up being about 8 Gy, so I can see some potential sparing there. Waiting for full paper and presentation.

Pretty sick patient population, long term survival is not common. Also proton SRS is just SRS. Not sure there is a big clinical motivation.

I think there are some pre-clinical papers that protons may have a different biological effect though, so maybe we will learn some cool stuff!

 

[evilbooyaa]

Would watch for pericarditis/high dose heart toxicities with proton SRS. Maybe less of an issue with a multi-field arc style plan in terms of the variable RBE at end of bragg peak jacking up what the patient actually receives.

But hey, if we can prove that RT for V-Tach should become a prominent part of an EP's mindset, I'm all for it, regardless of whether it's proton or photons. Of course, we'll have no evidence that protons provides any clinical benefit to a patient (compared to photon SBRT) but I suppose that's par for the course.

Given SBRT is paid the same, I don't see much clamoring for it from proton facilities either.... maybe when RO-APM gets

 

[Gfunk6]

I've been waiting and waiting for CK based cardiac ablation to be covered by Medicare. It still hasn't happened.

Given SBRT is paid the same, I don't see much clamoring for it from proton facilities either.... maybe when RO-APM gets

If (and that's a big if) RO-APM ever happens, protons will be your "get of jail free" card.

 

[yesmaster]

For V-tach, it's probably a good thing if there's more research being done

Protons, I do suspect that more and more RCT trials will be done with protons as THE radiation modality, even if you could deliver the plan with a LINAC. Then, academic centers will say protons were used on the clinical trial, and a community LINAC could be used but they can't vouch for it. Very sneaky.

 

[Lamount]

As someone who does a lot of CRA and a fair amount of protons in the chest... I find this very interesting -interesting like I am happy not to be the one who is actually doing it first (or second).

 

[OTN]

In this case the increased scarring from protons might be of benefit

 

[Upgrayedd]

For V-tach, it's probably a good thing if there's more research being done

Protons, I do suspect that more and more RCT trials will be done with protons as THE radiation modality, even if you could deliver the plan with a LINAC. Then, academic centers will say protons were used on the clinical trial, and a community LINAC could be used but they can't vouch for it. Very sneaky.

I’m ok with this. Got pressured into doing one with my partner on a traditional linac. It is a TON to learn. Went well; but I do think much more heart could be spared; even if LET uncertainties exist. I kind of think that, like peds, I’m ok with the big dogs monopolizing this.