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Proton therapy for early stage prostate cancer: is there a case?

Authors Chan T, Tan PW, Tang JI

Received 15 March 2016

Accepted for publication 7 August 2016

Published 9 September 2016 Volume 2016:9 Pages 5577—5586

DOI https://doi.org/10.2147/OTT.S108559

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Professor Min Li


Tabitha Y Chan, Poh Wee Tan, Johann I Tang

Department of Radiation Oncology, National University Cancer Institute, Singapore

Abstract:
Proton-beam therapy (PBT) for prostate cancer has been in used for several decades, with its technique evolving significantly over this period. A growing number of centers now routinely utilize pencil-beam scanning as an advanced technique of PBT. Interest and controversy concerning its use have recently come under scrutiny. While the past decade has produced an assemblage of evidence suggesting that PBT is safe and effective for early stage prostate cancer, it is still unknown whether the theoretical dosimetric advantages of PBT translate into meaningful clinical improvements over routine intensity-modulated radiation therapy, which is commonly used for these patients. Outcomes from early trials using whole courses of PBT have shown mixed results when compared with routine intensity-modulated radiation therapy. Therefore, randomized trials comparing these two techniques should be undertaken, as this would help in defining the role of PBT for this patient group. This article aims to describe the basics of PBT, review the reasons for the growing interest in PBT, review the evidence for PBT, review the controversy surrounding PBT, and inquire about PBT’s future in the treatment of prostate cancer, with attention to its physical properties, comparative clinical and cost-effectiveness, and advances in its delivery.

Keywords: proton beam, radiation, prostate cancer, clinical outcomes, controversies, future direction

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