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Comparative Outcomes After Definitive Chemoradiotherapy Using Proton Beam Therapy Versus Intensity Modulated
Mian Xi1, Cai Xu2, Zhongxing Liao3
1Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Radiation Oncology, Cancer Center, Sun Yat-sen University, State Key Laboratory of Oncology in South China, Collaborative Innovation Centre for Cancer Medicine, Guangzhou, Guangdong, China.
International Journal of Radiation Oncology, Biology, Physics
|December 28, 2017
Summary
Proton beam therapy (PBT) shows improved survival outcomes compared to intensity modulated radiation therapy (IMRT) for esophageal cancer (EC) patients receiving chemoradiotherapy (CRT). PBT may offer better progression-free survival and locoregional control, particularly for advanced stages.
Area of Science:
- Radiation Oncology
- Medical Physics
- Clinical Oncology
Background:
- Esophageal cancer (EC) treatment often involves definitive chemoradiotherapy (CRT).
- Comparing different radiation modalities like proton beam therapy (PBT) and intensity modulated radiation therapy (IMRT) is crucial for optimizing patient outcomes.
Purpose of the Study:
- To compare clinical outcomes between PBT and IMRT in patients with EC treated with definitive CRT.
- To evaluate differences in survival, recurrence, and treatment toxicity between PBT and IMRT for EC.
Main Methods:
- Retrospective analysis of 343 EC patients treated with definitive CRT between 2007-2014.
- Comparison of clinical outcomes between patients receiving PBT (n=132) and IMRT (n=211).
- Cox proportional hazards regression model used to assess the association between patient/treatment variables and survival.
Main Results:
- PBT group demonstrated significantly better overall survival (OS), progression-free survival (PFS), and distant metastasis-free survival (DMFS) compared to IMRT.
- Multivariate analysis indicated PBT was associated with improved OS, PFS, and locoregional failure-free survival (LRFFS) compared to IMRT.
- Subgroup analysis revealed significantly higher 5-year OS and PFS rates for PBT in stage III EC patients, with no significant differences in stage I/II disease.
Conclusions:
- PBT may be associated with improved survival outcomes (OS, PFS, LRFFS) compared to IMRT in esophageal cancer patients undergoing definitive CRT.
- The potential benefits of PBT appear more pronounced in patients with locally advanced (stage III) disease.
- Prospective studies are needed to confirm these findings and further elucidate the role of PBT in EC treatment.
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