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The first randomised comparison of protons with modern photon radiotherapy for lung cancer. Protons spared the heart but not the lung overall, and neither severe lung inflammation nor local failure was reduced: 10.5 per cent against 6.5 per cent for lung inflammation, 10.5 against 10.9 per cent for local failure.
Liao and colleagues randomised patients with stage IIB to IIIB non-small-cell lung cancer having chemoradiotherapy to passive scattering proton therapy or intensity-modulated photon radiotherapy. Each patient had both plans made, and was eligible for randomisation only if both met the same organ dose constraints at the same tumour dose. Compared with photons (92 patients), protons (57) exposed less lung to 5 to 10 Gy(RBE), more lung to 20 Gy(RBE) or more, and less heart at all dose levels. Grade 3 or worse radiation pneumonitis occurred in 6.5 per cent with photons and 10.5 per cent with protons; local failure in 10.9 and 10.5 per cent. The posterior probability of photons being better was 0.54. Both endpoints improved over the course of the trial in both arms.
The physical advantage of protons did not, in this trial, translate into less lung damage or better control. It used an older proton technique without pencil-beam scanning, so it does not settle the question for current proton treatment.
Shares Proton range uncertainty and the range margin, Pencil-beam scanning and intensity-modulated proton therapy, Proton therapy and the tags precision, radiation.
Shares Journal of Clinical Oncology, IMRT / IGRT (modern external beam) and the tags precision, radiation.
Shares IMRT / IGRT (modern external beam) and the tags precision, radiation.
Shares IMRT / IGRT (modern external beam) and the tags precision, radiation.
Shares IMRT / IGRT (modern external beam) and the tags precision, radiation.
Shares IMRT / IGRT (modern external beam) and the tags precision, radiation.
Shares the tags precision, radiation.
Shares the tags precision, radiation.
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