Date Printed: May 21, 2018: 08:14 PM

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Proton Beam Therapy Research Summary

Proton beam therapy (PBT) has been used for the treatment of cancer for several years with published clinical data supporting its use as a treatment for pediatric central nervous system tumors, uveal melanomas, and skull-based tumors.

With regard to prostate cancer, there is limited published clinical data supporting PBT comparative superiority over alternative forms of radiation therapy (e.g., intensity modulated radiation therapy (IMRT), brachytherapy) and other treatment modalities (e.g., radical prostatectomy, cryosurgery, and hormonal therapy).

According to the American Society of Radiation Oncology (ASTRO, 2014) “In the treatment of prostate cancer, the use of PBT is evolving as comparative efficacy evidence is still being developed. In order for an informed consensus on the role of PBT for prostate cancer to be reached, it is essential to collect further data, especially to understand how the effectiveness of proton therapy compares to other radiation therapy modalities such as IMRT and brachytherapy. There is a need for more well-designed registries and studies with sizable comparator cohorts for data collection.”

The National Comprehensive Cancer Network (NCCN, Version 2.2016) notes that “The American Society of Radiation Oncology (ASTRO) has evaluated proton therapy and created a model policy to support the society’s positon on payment coverage for proton therapy. ASTRO”s current policy states that “Proton beam therapy for primary treatment of prostate cancer should only be performed within the context of a prospective clinical trial or registry. An ongoing prospective randomized trial is accruing patients to compare prostate proton therapy and prostate IMRT. The NCCN panel believes no clear evidence supports a benefit or decrement to proton therapy over IMRT for either treatment efficacy or long-term toxicity.”

The National Cancer Institute (2015) “There is interest in the use of proton beam therapy for the treatment of prostate cancer. Although the dose distribution of this form of charged-particle radiation could theoretically improve the therapeutic ratio of prostate radiation, allowing for an increase in dose to the tumor without a substantial increase in side effects, no randomized controlled trials have been reported that compare its efficacy and toxicity with those of other forms of radiation therapy.”

Both the ASTRO and the NCCN Clinical Practice Guidelines in Oncology® for prostate cancer (Version 2.2016) does not support the routine use of PBT for prostate cancer.

Date Printed: May 21, 2018: 08:14 PM