Draft Key Questions
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Archived: This report is greater than 3 years old. Findings may be used for research purposes, but should not be considered current.
Radiotherapy with charged particles can potentially deliver maximal doses while minimizing irradiation of surrounding tissues. It may be more effective or less harmful than other forms of radiotherapy for some cancers. Currently, seven centers in the United States have facilities for particle (proton) irradiation, and at least four are under construction, each costing between $100 and $225 million. The aim of this Technical Brief was to survey the evidence on particle beam radiotherapy.
In brief, there are many publications on particle (mainly proton) beam therapy for the treatment of cancer. However, they typically do not use a concurrent control, focus on heterogeneous populations, and employ different definitions for outcomes and harms. Comparative studies in general, and randomized trials in particular, are likely needed to document the theorized incremental advantages of particle beam therapy over other radiotherapies (e.g., IMRT, conventional radiotherapy or stereotactic photon radiosurgery) in many cancers. In addition, incremental benefits should be considered and interpreted with respect to corresponding incremental costs (and risks). This is especially important in the light of the anticipated diffusion of this technology to treating common cancers in which extreme precision in radiation delivery is not a sine-qua-non. We anticipate that systematic reviews of the current literature will not be able to provide definitive answers on the effectiveness and safety of particle beam therapy compared to other interventions for most if not all cancer categories.
NOTICE OF ERRATUM
November 4, 2009
The following corrections were made to the report:
Table B in the executive summary: the study attributed to HMI (Germany) was corrected to GSI (Germany). For this same study, “proton boost” was corrected to “carbon (ion) boost”. “HMI=Hahn Meitner Institute” in the footnote was corrected to “GSI=Gesellschaft fuer Schwerionenforschung“
The same changes were made in Table 7 on page 29 of the full report.
These corrections do not change the conclusions of the report.