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Proton Radiotherapy Found To Have Tiny Edge

December 17, 2012
Written by: , Filed in: Abdominal Imaging
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Expensive proton radiotherapy for prostate cancer, which is supposed to minimize such side effects as incontinence and erectile dysfunction, mostly doesn’t, according to a new study.

Proton beam therapy centers, costing tens of millions of dollars, have been springing up, offering radiation therapy for cancer. Proton beams can be targeted more precisely than conventional radiotherapy, theoretically reducing damage to healthy tissue and thus creating fewer side effects.

Researchers from the Yale School of Medicine tested that theory. They compared outcomes from proton radiotherapy to those from intensity modulated radiotherapy (IMRT), the current standard in radiotherapy treatment. They reported their results in an article published online last week in Annals of Oncology.

After six months, prostate-cancer patients receiving proton therapy had fewer urinary problems. The difference was slight but statistically significant. But after 12 months, there was no difference in side effects—urinary, erectile, gastrointestinal, or musculoskeletal—between the two treatments.

“We were surprised by these findings,” said Cary P. Gross, MD, senior author of the study. “Cancer centers are paying up to $100 million to build their own proton centers, and patients are traveling long distances to undergo proton therapy because the conventional wisdom has been that proton radiotherapy is better than IMRT.”

He continued:

Our results suggest that this enthusiasm for proton therapy may be premature. It remains to be seen how proton radiotherapy will compare to IMRT at 10 or 15 years post-treatment.

Dr. Gross is co-director of the Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center. He was quoted in a Yale news release.

James Yu, MD, lead author of the study and an assistant professor of therapeutic radiology at Yale, provided some important perspective in an interview with the Wall Street Journal. “It’s not that proton radiation causes a lot of side effects,” he said. “The takeaway point is that IMRT already had a low side-effect profile.”

Medicare paid more than $32,000 for a course of proton radiotherapy compared to less than $19,000 for IMRT. Unless further research finds improved outcomes for proton therapy, Medicare could very well decide to stop reimbursing for it. If that happens, proton-beam centers would likely have to find other revenue streams to survive.

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One Response to “Proton Radiotherapy Found To Have Tiny Edge”

  1. Radiology Daily»AlertArchive » TN Legislature Derails University Proton Deal on April 22nd, 2013 at 2:16 pm

    […] Proton therapy centers are all the rage. They promise radiation therapy that’s more focused than conventional X-ray therapy, reducing damage to healthy tissue. We’ve reported on them most recently in December. […]