ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2018
Comparative Toxicities and Cost of Intensity-Modulated Radiotherapy, Proton Radiation, and Stereotactic Body Radiotherapy Among Younger Men With Prostate Cancer.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
61 citing papers in PubMed, 2 syntheses or guidelines pooled it, 97 citations in OpenAlex.
- Evidence-based indications for proton therapy in adults determined using the GRADE approach.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Pooled it
- Clinical Efficacy and Safety of Proton and Carbon Ion Radiotherapy for Prostate Cancer: A Systematic Review and Meta-Analysis.Frontiers in oncology · 2021Pooled it
- Trial
- Patterns of Health Care Spending in Prostate Cancer.JAMA network open · 2026Article
- Dosimetric Predictors of Problematic Receptive Anal Intercourse After Prostate Radiation Therapy.Advances in radiation oncology · 2026Article
- Particle Therapy Co-Operative Group Consensus Statement on Reirradiation With Proton Therapy for Prostate Cancer.International journal of particle therapy · 2026Article
- Factors Associated With Rectal Spacer Use in Prostate Cancer Patients Receiving Radiation Therapy.Cancer medicine · 2026Article
- Insurance Network Status and 1-Year Health Care Utilization and Outpatient Costs Among Commercially Insured Patients With Newly Diagnosed and Non-Definitively Treated Prostate Cancer, 2010-2021.Cancer medicine · 2026Article
- Postoperative proton therapy in uterine and cervical cancer: promising evidence but remaining questions.Translational cancer research · 2026Article
- Combining Statins with Radiotherapy for Prostate Cancer: From Photon Experience to Proton Potential.Journal of clinical medicine · 2026Review
- Association Between Rectal Spacer Use and Erectile Dysfunction Diagnosis Among Men Receiving Prostate Radiotherapy: US County-Level Analysis.Cancer medicine · 2025Article
- Navigating Cancer Treatment: A Journey from 2D to 3D Cancer Models and Nanoscale Therapies.ACS pharmacology & translational science · 2025Review
- Rectal spacer use and bowel, urinary, and sexual dysfunction diagnosis and related procedures among men receiving prostate radiotherapy: US county-level analysis.World journal of urology · 2025Article
- Article
- Bowel Disorder Incidence and Rectal Spacer Use in Patients With Prostate Cancer Undergoing Radiotherapy.JAMA network open · 2025Article
- Rectal spacer use and overall long-term healthcare costs: payer perspective.Frontiers in oncology · 2025Article
- Health Disparities and Inequities in the Utilization of Proton Therapy for Prostate Cancer.Cancers · 2024Review
- Impact of Rectal Spacer on Toxicity Reduction in Men Treated With Proton Versus Photon Therapy.International journal of particle therapy · 2024Article
- A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure.Radiation research · 2024Review
- Transcriptional Inflammatory Signature in Healthy Donors and Different Radiotherapy Cancer Patients.International journal of molecular sciences · 2024Article
1 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
10 authors at 3 institutions in 3 countries.
Funding
Abstract
Purpose To compare the toxicities and cost of proton radiation and stereotactic body radiotherapy (SBRT) with intensity-modulated radiotherapy (IMRT) for prostate cancer among men younger than 65 years of age with private insurance. Methods Using the MarketScan Commercial Claims and Encounters database, we identified men who received radiation for prostate cancer between 2008 and 2015. Patients undergoing proton therapy and SBRT were propensity score-matched to IMRT patients on the basis of clinical and sociodemographic factors. Proportional hazards models compared the cumulative incidence of urinary, bowel, and erectile dysfunction toxicities by treatment. Cost from a payer's perspective was calculated from claims and adjusted to 2015 dollars. Results A total of 693 proton therapy patients were matched to 3,465 IMRT patients. Proton therapy patients had a lower risk of composite urinary toxicity (33% v 42% at 2 years; P < .001) and erectile dysfunction (21% v 28% at 2 years; P < .001), but a higher risk of bowel toxicity (20% v 15% at 2 years; P = .02). Mean radiation cost was $115,501 for proton therapy patients and $59,012 for IMRT patients ( P < .001). A total of 310 SBRT patients were matched to 3,100 IMRT patients. There were no significant differences in composite urinary, bowel, or erectile dysfunction toxicities between SBRT and IMRT patients ( P > .05), although a higher risk of urinary fistula was noted with SBRT (1% v 0.1% at 2 years; P = .009). Mean radiation cost for SBRT was $49,504 and $57,244 for IMRT ( P < .001). Conclusion Among younger men with prostate cancer, proton radiation was associated with significant reductions in urinary toxicity but increased bowel toxicity at nearly twice the cost of IMRT. SBRT and IMRT were associated with similar toxicity profiles; SBRT was modestly less expensive than IMRT.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.