New Study in Red Journal Reveals Growth in Use of Proton Therapy for Treating Wider Variety of Conditions
The National Association for Proton Therapy (NAPT), the nation’s leading organization dedicated to increasing patient access to one of the most advanced cancer treatments, announced the publication of a study in the International Journal of Radiation Oncology-Biology-Physics (Red Journal) that examines the use of proton therapy to treat a growing number of conditions and tumor sites.
Proton therapy is the preferred treatment for pediatric patients needing curative radiotherapy. Proton radiotherapy decreases the risks for cancers caused by radiotherapy, decreases brain injury and improves neurocognitive function after treatment, and significantly reduces overall acute and acute and chronic life-long side effects.
- Kahalley LS, Peterson R, Ris MD, et al. Superior Intellectual Outcomes After Proton Radiotherapy Compared With Photon Radiotherapy for Pediatric Medulloblastoma. J Clin Oncol. 2020;38(5):454-461. doi:10.1200/JCO.19.01706
Proton beam therapy is effective for treating prostate cancer, with excellent long-term outcomes and fewer long-term, costly side effects such as bowel toxicities.
- Grewal AS, Schoenewolf C, Jeong Min E, et al. Four-Year Outcomes from a Prospective Phase II Clinical Trial of Moderately Hypofractionated Proton Therapy for Localized Prostate Cancer. Int J Radiat Oncol Biol Phys. 2019;105: 713-722
Head and Neck Cancer
Proton therapy improves overall survival and reduces high grade complications for head and neck cancers compared with photon therapy. Side effects of radiation for head and neck cancer can cause malnutrition, need for feeding tubes, dehydration, and other costly side effects that can require hospitalizations. Proton therapy delivers less radiation to healthy tissue and thus reduces the incidence of these costly side effects. Impact of organ movements are not significant in head and neck cancers, which allows proton beam therapy to deliver higher doses to the tumor volumes with significantly reduced radiation to normal tissues than do photon beam irradiation.
- Wang L, Fossati P, Paganetti H, et al. The Biological Basis for Enhanced Effects of Proton Radiation Therapy Relative to Photon Radiation Therapy for Head and Neck Squamous Cell Carcinoma. Int J Part Ther. 2021;8(1):3-13.
- Hanania AN, Zhang X, Gunn B, et al. Proton Therapy for Major Salivary Gland Cancer: Clinical Outcomes. Int J Part Ther. 2021;8(1):264-272.
- Xingzhe L, Sarin K, Anna L, et al. Toxicity Profiles and Survival Outcomes Among Patients With Nonmetastatic Nasopharyngeal Carcinoma Treated With Intensity-Modulated Proton Therapy vs Intensity-Modulated Radiation Therapy. JAMA Netw Open. 2021;4(6):e2113205.
Skull Cancer and Chordomas
Proton therapy is the treatment of choice for base of skull cancers and chordomas, where sensitive brain and ocular structures prevent safe treatment with conventional radiation. Proton therapy has been shown to improve tumor control and overall survival for these cancers compared with photon therapy.
- Holtzman A, Rotondo, R Rutenberg, M et al. Clinical Outcomes Following Dose-Escalated Proton Therapy for Skull-Base Chordoma. Int J Part Ther. 2021;8(1):179–188.
Proton therapy can improve outcomes when used to treat brain tumors, offering reduced side effects and treatment options where no safe options exist in the treatment of recurrent brain tumors. Proton therapy can also decrease injury to normal brain tissues in primary brain tumor treatment.
- Brown PD, Chung C, Liu DD, et al. A prospective phase II randomized trial of proton radiotherapy vs. intensity modulated radiotherapy for patients with newly diagnosed glioblastoma. Neuro-Oncology. 2021;
Proton therapy reduces radiation dose to the heart and lungs, preventing long term cardiac toxicity for patients with breast cancer.
- Mutter R, Choi I, Jimenez R, et al. Proton Therapy for Breast Cancer: A Consensus Statement From the Particle Therapy Cooperative Group Breast Cancer Subcommittee. Int J Radiat Oncol Biol Phys. 2021 Oct;11(2):337-359. doi: 10.1016/j.ijrobp.2021.05.110
Locally Advanced Stage Non-Small Cell Lung Cancer
Proton therapy is the most common ion beam used in lung cancer treatment. Compared with standard–dose photon therapy, proton treatment significantly reduced the dose to normal tissues including the lung, esophagus, spinal cord, and heart, even with dose escalation. As proton therapy can reduce the dose to adjacent normal tissues, patients with stage III lung cancer may benefit from this new technique.
- Yu N, DeWees T, Voss M, et al. Cardiopulmonary Toxicity Following Intensity-Modulated Proton Therapy (IMPT) Versus Intensity-Modulated Radiation Therapy (IMRT) for Stage III Non-Small Cell Lung Cancer. Science Direct. 2022;23(8):e526-e535.
Proton therapy improves survival for hepatocellular carcinoma compared with photon therapy and stereotactic body radiation therapy. Since 85% of hepatocellular carcinoma develops in patients with cirrhosis of the liver and its associated liver insufficiency, it is essential the HCC therapy spares uninvolved liver to minimize the risk of further compromise of hepatic function.
- Cheng JY, Liu CM, Wang YM, et al. Proton versus photon radiotherapy for primary hepatocellular carcinoma: a propensity-matched analysis. Radiat Oncol. 2020;15(1):159.
Proton therapy leads to fewer secondary radiation-induced cancer across all cancer than photon therapy.
- Xiang M, Chang DT, Pollom EL. Second cancer risk after primary cancer treatment with three-dimensional conformal, intensity-modulated, or proton beam radiation therapy. Cancer. 2020;126(15):3560-3568.
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