But that advantage is theoretical. Issue: August 25, Perspective from Joel E. Tepper, MD. Read next. August 21, Receive an email when new articles are posted on. Please provide your email address to receive an email when new articles are posted on. You've successfully added to your alerts. You will receive an email when new content is published. Click Here to Manage Email Alerts. We were unable to process your request. Please try again later.
If you continue to have this issue please contact customerservice slackinc. Back to Healio. Adam P. References: Epstein K. Institute for Clinical and Economic Review. Brachytherapy and proton beam therapy for treatment of clinically-localized, low-risk prostate cancer. Available at: www. Accessed on July 24, Kuhlthau KA. J Clin Oncol. Particle Therapy Co-Operative Group.
Hadron therapy patient statistics. Sheets NC. Disclosures: Drs. Is proton beam therapy superior to IMRT in the treatment of prostate cancer? Proton beam therapy shows promise in prostate cancer treatment. References: Berrington de Gonzalez A. Lancet Oncol. Shipley WU. Talcott JA. Zietman AL. Perspective Back to Top Joel E. Tepper, MD The only potential advantage to protons is one of physical dose distribution.
Joel E. Disclosures: Dr. Tepper reports no relevant financial disclosures. And yet, people—and their health insurance companies—are willing to pay for much costlier chemotherapy treatments to prolong life, if only for a few weeks or months.
He cites an example of a drug for metastatic prostate cancer, shown to extend life on average by four months. Search Press enter to begin your search. Our website uses cookies to analyze website traffic, improve user experience and provide personalized content and ads. By using this site without changing your settings, you agree to our privacy policy. Close Privacy Overview This website uses cookies to improve your experience while you navigate through the website.
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These cookies will be stored in your browser only with your consent. Several NCI-funded randomized clinical trials comparing proton and traditional radiation therapy are currently ongoing. See the box below. Many people with locally advanced cancers are treated with a combination of chemotherapy and either traditional or proton radiation. For patients getting chemotherapy and radiation at the same time, finding ways to limit side effects without making the treatment less effective is a high priority, Dr.
Baumann said. He and his colleagues analyzed data from nearly 1, adults with 11 different types of cancer. All participants had received simultaneous chemotherapy plus radiation at the University of Pennsylvania Health System between and and had been followed to track side effects and cancer outcomes, including survival.
Almost had received proton therapy and the rest received traditional radiation. Those who received proton therapy experienced far fewer serious side effects than those who received traditional radiation, the researchers found.
Over the course of treatment, performance status scores were half as likely to decline for patients treated with proton therapy as for those who received traditional radiation. And proton therapy appeared to work as well as traditional radiation therapy to treat cancer and preserve life. In addition, all of the study participants were treated at a single institution, which can make it difficult to generalize the findings to a larger population.
Buchsbaum emphasized. Although single-institution studies have inherent limitations, Dr. Also, because patients were not randomly assigned to treatment groups, there were differences between patients who got proton and traditional radiation, and that may have skewed the results.
For instance, patients who received proton therapy were, on average, older likely because Medicare typically covers the cost of proton therapy and had more health issues. Park and Yu noted. Socioeconomic status and social support can affect treatment outcomes, they wrote. In addition, fewer people with head and neck cancer—who are more likely to suffer from radiation-associated side effects—were included in the proton therapy group, the editorialists added. In their analysis, the investigators used complex statistical techniques to try to account for these differences as much as possible.
Buchsbaum said, although there are barriers to large studies of proton therapy. Baumann noted. Buchsbaum agreed that proton therapy may be especially helpful for older and sicker patients, but he noted that ongoing phase 3 trials were not designed to analyze this group of patients. And because proton therapy may cause fewer side effects, future trials could also explore whether combining proton therapy with chemotherapy might be more tolerable for patients, the authors wrote.
For example, both chemotherapy and traditional radiation for lung cancer can irritate the esophagus, making it painful and difficult for patients to eat. But proton therapy might limit damage to the esophagus, making it easier for a patient to tolerate the combination, Dr. Baumann explained. Future studies could also explore whether combining proton therapy with higher doses of chemotherapy might increase cures without causing more side effects, he added. Buchsbaum agreed, saying that it would be worthwhile to explore this possibility.
Baumann and his colleagues are currently studying the cost effectiveness of proton therapy, considering aspects like the costs of treating side effects and the value of preserved quality of life. September 30, , by NCI Staff. September 28, , by NCI Staff. September 9, , by NCI Staff.
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Mehta says when evaluating the cost of proton therapy, the consideration has to include not only the cost of delivering whatever number of treatments is deemed optimal, but also the potential benefit of reducing long-term effects, especially with brain tumors.
Mehta says one patient, a young child with a medulloblastoma, was successfully treated with conventional radiation therapy only to have a soft tissue sarcoma develop three years later at the site where the radiation exited his body. Evolving Technology Sameer R. Keole, MD, is director of the PBT program at the Mayo Clinic in Arizona, which, when it opens in , will feature pencil beam scanning, an advance over current radiation and proton therapy methods because its beam conforms more closely to the tumor, better sparing surrounding healthy tissue from harm.
The Mayo Clinic will have eight proton beam treatment rooms open in at its sites in Arizona and Minnesota. Keole says many disease sites prostate, breast, lung, etc have excellent clinical prospective trials suggesting proton therapy is at least equivalent to IMRT.
PBT is not experimental "and should be moving forward," Keole says. He agrees that there is a need for prospective studies. However, he says, "We're not going to be able to conduct these studies if we don't have buy-in from payers. We can't execute clinical trials in this country for radiation therapy without the cooperation of the insurance carriers.
No venture capital or taxpayer dollars have gone into building its centers. Keole doesn't know whether that offer will convince more insurance carriers to allow their patients to enroll in the clinical trials, but he is hoping the answer is yes.
The researchers expect that the cost of proton therapy will come down over time. Like any new technology, it will take time to be adopted and become more mainstream.
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