ArticleCancer2019
Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting.
Article in Cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 25 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
- Review
- Combining Statins with Radiotherapy for Prostate Cancer: From Photon Experience to Proton Potential.Journal of clinical medicine · 2026Review
- Modern proton therapy in prostate cancer: precision in practice.Frontiers in oncology · 2026Review
- Association of Circulating Inflammatory Biomarker Levels and Toxicity in Patients Undergoing Pelvic Radiation for Cancer: A Critical Review.Advances in radiation oncology · 2025Review
- ACR-ARS Practice Parameter for the Performance of Proton Beam Therapy.International journal of particle therapy · 2024Article
- Article
- Does renal failure worsen radiation cystitis following radical prostatectomy?International urology and nephrology · 2023Article
- Effects of Dibutylphthalate and Steroid Hormone Mixture on Human Prostate Cells.International journal of molecular sciences · 2023Article
- Article
- Postoperative Effect Observation and Clinical Study of Dahuang Zhechong Pills fromComputational intelligence and neuroscience · 2022Article
- Dose-volume histogram parameters and patient-reported EPIC-Bowel domain in prostate cancer proton therapy.Radiation oncology journal · 2021Article
- Postoperative or Salvage Proton Radiotherapy for Prostate Cancer After Radical Prostatectomy.International journal of particle therapy · 2021Article
- Consensus Statement on Proton Therapy for Prostate Cancer.International journal of particle therapy · 2021Article
- Radiotherapeutic Management of Synchronous Prostate and Rectal Cancers Using Proton Beam Therapy.International journal of particle therapy · 2021Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundDespite increasing utilization of proton-beam therapy (PBT) in the postprostatectomy setting, no data exist regarding toxicity outcomes relative to intensity-modulated radiotherapy (IMRT). The authors compared acute and late genitourinary (GU) and gastrointestinal (GI) toxicity outcomes in patients with prostate cancer (PC) who received treatment with postprostatectomy IMRT versus PBT.
methodsWith institutional review board approval, patients with PC who received adjuvant or salvage IMRT or PBT (70.2 gray with an endorectal balloon) after prostatectomy from 2009 through 2017 were reviewed. Factors including combined IMRT and PBT and/or concurrent malignancies prompted exclusion. A case-matched cohort analysis was performed using nearest-neighbor 3-to-1 matching by age and GU/GI disorder history. Logistic and Cox regressions were used to identify univariate and multivariate associations between toxicities and cohort/dosimetric characteristics. Toxicity-free survival (TFS) was assessed using the Kaplan-Meier method.
resultsThree hundred seven men (mean ± SD age, 59.7 ± 6.3 years; IMRT, n = 237; PBT, n = 70) were identified, generating 70 matched pairs. The median follow-up was 48.6 and 46.1 months for the IMRT and PBT groups, respectively. Although PBT was superior at reducing low-range (volumes receiving 10% to 40% of the dose, respectively) bladder and rectal doses (all P ≤ .01), treatment modality was not associated with differences in clinician-reported acute or late GU/GI toxicities (all P ≥ .05). Five-year grade ≥2 GU and grade ≥1 GI TFS was 61.1% and 73.7% for IMRT, respectively, and 70.7% and 75.3% for PBT, respectively; and 5-year grade ≥3 GU and GI TFS was >95% for both groups (all P ≥ .05).
conclusionsPostprostatectomy PBT minimized low-range bladder and rectal doses relative to IMRT; however, treatment modality was not associated with clinician-reported GU/GI toxicities. Future prospective investigation and ongoing follow-up will determine whether dosimetric differences between IMRT and PBT confer clinically meaningful differences in long-term outcomes.
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Registered trials
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