Database Analysis Finds IMRT More Effective Than CRT and Proton Beam in Prostate Cancer

Bonnie Gillis
Published: Thursday, Mar 29, 2012
IMRT More Effective Than CRT and Proton Beam in Prostate Cancer

IMRT vs Proton Beam Therapy

Events per 100 person-years of follow-up*
 
  IMRT Proton
Morbidity
Bowel 12.2 17.8
Urinary non-incontinence 7.5 6.3
Urinary incontinence 3.1 3.3
Erectile dysfunction 6.6 7.4
Hip fracture 0.8 0.7
Cancer control
Additional cancer treatments 2.2 1.9

*Propensity score adjustment was used to balance demographic, disease and institutional characteristics

Adapted from Sheets N, Goldin G, Meyer AM, et al. Comparative effectiveness of intensity modulated radiation therapy (IMRT), proton therapy and conformal radiation therapy in the treatment of localized prostate cancer. Presented at: 2012 Genitourinary Cancers Symposium presscast. January 31, 2012; San Francisco, CA.
Intensity-modulated radiation therapy (IMRT) was superior to conformal radiation therapy (CRT) in reducing recurrence and significant side effects in men with localized prostate cancer, according to a comparative effectiveness study based on the Surveillance, Epidemiology, and End Results (SEER)-Medicare database. The study also found that proton beam therapy, the most expensive radiation modality available, did not improve outcomes as compared with IMRT.

Since 2000, use of IMRT has supplanted use of CRT. By 2008, almost 0% of prostate cancer patients who required radiation were treated with CRT, while nearly 100% received IMRT.

Senior author of the study, Ronald C. Chen, MD, MPH, University of North Carolina in Chapel Hill, said that there are few studies to directly compare radiation therapy options. “This study validated the change in practice, showing that IMRT better controls prostate cancer and results in fewer side effects,” he stated.

Chen spoke at a presscast about this study during the 2012 Genitourinary Cancers Symposium sponsored by the American Society of Clinical Oncology (ASCO), February 2-4, in San Francisco, California. Nathan Christopher Sheets, MD, presented the study at the ASCO GU Cancers Symposium.

IMRT vs CRT in Prostate Cancer

Events per 100 person-years of follow-up*
 
  CRT IMRT Rate
Ratio
Morbidity
Bowel 14.7 13.4 .91
Urinary non-incontinence 8.8 8.8  
Urinary incontinence 3.7 3.5  
Erectile dysfunction 5.3 5.9 1.12
Hip fracture 1.0 0.8 0.78
Cancer control
Additional cancer treatments 3.1 2.5 0.81

*Propensity score adjustment was used to balance demographic, disease, and institutional characteristics

IMRT indicates intensity-modulated radiation therapy; CRT, conformal radiation therapy

FISH indicates fluorescence in situ hybridization; CEP17, chromosome 17; IHC, immunohistochemistry.

Adapted from Sheets N, Goldin G, Meyer AM, et al. Comparative effectiveness of intensity modulated radiation therapy (IMRT), proton therapy and conformal radiation therapy in the treatment of localized prostate cancer. Presented at: 2012 Genitourinary Cancers Symposium presscast. January 31, 2012; San Francisco, CA.
The database included more than 12,000 patients with localized prostate cancer treated with CRT, IMRT, or proton beam therapy from 2002-2007.


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