Piotr Wysocki: There is still no proof that proton beam therapy is superior to IMRT in terms of quality of life in patients with localized prostate cancer

Piotr Wysocki, Professor of Medicine and Head of the Department of Oncology at Jagiellonian University Hospital in Poland, shared on LinkedIn:

“There is still no proof that proton beam therapy is superior to IMRT in terms of quality of life in patients with localized prostate cancer.

A recently published analysis of the SEER-Medicare database evaluated 10,807 patients with localized prostate cancer, of whom 7.3% received photon beam therapy (PBT) and 92.7% – IMRT (intensity-modulated radiotherapy). The study compared only the safety of both curative treatment modalities with respect to genitourinary (GU) and gastrointestinal (GI) toxicities. The study revealed that the frequency of GU and GI toxicities was similar between both treatment strategies at 6, 12, and 24 months following the completion of the irradiation.

The frequency of GI toxicity for IMRT versus PBT was 3.5% versus 2.5% at 6 months (P = .18), 9.5% versus 10.2% at 12 months (P = .18), and 20.5% versus 23.4% at 24 months (P = .11). The frequency of GU toxicity for IMRT versus PBT was 6.8% versus 5.7% (P = .30), 14.3% versus 12.2% (P = .13), and 28.2% versus 25.8% (P = .21) at 6, 12, and 24 months, respectively.

Despite its retrospective nature, Yu JB et al.’s analysis provides important data confirming that contemporary classical (photon beam) radiotherapy is not inferior to proton beam radiotherapy in terms of toxicity. For a long time, it was the superior safety profile of photon beam therapy that was claimed as the advantage of this relatively novel and very expensive treatment modality over photon beam irradiation. Since the PARTIQoL and COMPPARE studies comparing PBT and IMRT with regard to the patient-reported quality of life are still ongoing, the results provided by Yu JB et al. should be used to reassure our patients that the “older but widely available” radiotherapy technology can be considered as the active and safe alternative to the “novel and very expensive” proton beam therapy.”

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Source: Piotr Wysocki/LinkedIn