Particle therapy toxicity outcomes: A systematic review.

Area of Science:

• Oncology
• Radiation Oncology
• Medical Physics

Background:

• Particle therapy (PT), encompassing proton beam therapy (PBT) and carbon ion therapy (CIT), offers physical advantages over traditional photon therapy.
• Reduced integral and exit doses in PT are hypothesized to decrease treatment toxicity and enhance patient quality of life.

Purpose of the Study:

• To systematically review and synthesize evidence on toxicity outcomes associated with particle therapy (PT).
• To complement previous reviews focusing on tumor control, this study specifically examines the impact of PT on treatment-related morbidities and quality of life.

Main Methods:

• A systematic literature search was conducted across three major databases by two independent researchers.
• Evidence quality was assessed using the National Health and Medical Research Council (NHMRC) hierarchy.
• 179 studies were included in the review.

Main Results:

• The majority of included studies reported acceptable and favorable toxicity profiles for PT.
• Comparative data indicated reduced morbidities and improved quality of life for patients treated with PT across various cancer types (head and neck, pediatrics, sarcomas, CNS, GI, ocular, prostate) versus photon radiotherapy.
• The overall quality of evidence supporting these findings was generally low.

Conclusions:

• Particle therapy demonstrates potential for reduced toxicity and improved quality of life compared to photon radiotherapy.
• The current evidence base is limited by the low quality of studies, necessitating more rigorous comparative clinical trials.
• Future research should incorporate advancements in PT technology, delivery techniques, and imaging guidance.