Evidence map›Paper›PMID 33198942›Full record

Trial reportJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2021

Toxicity and Survival After Intensity-Modulated Proton Therapy Versus Passive Scattering Proton Therapy for NSCLC.

Olsi Gjyshi, Ting Xu, Adnan Elhammali, David Boyce-Fappiano, Stephen G Chun, Saumil Gandhi, Percy Lee, Aileen B Chen, Steven H Lin, Joe Y Chang and 9 more

2 registry-linked trialsOpen access · bronzeAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 27 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 4 pooled it
3.0field-weighted citation impact, top 6% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT00915005 phase2completednot on this map

A Bayesian Randomized Trial of Image-Guided Adaptive Conformal Photon vs Proton Therapy, With Concurrent Chemotherapy, for Locally Advanced Non-Small Cell Lung Carcinoma: Treatment Related Pneumonitis and Locoregional Recurrence

TypeinterventionalSponsorM.D. Anderson Cancer CenterRan2009 to 2020Enrolled275ConditionsNon-Small-Cell Lung CarcinomaArmsPhoton Therapy, Proton Therapy, Paclitaxel, Carboplatin
NCT00991094 recruitingnot on this map

Data Collection to Assess Acute and Late Normal Tissue Sequelae in Proton Therapy for Adults

TypeobservationalSponsorM.D. Anderson Cancer CenterRan2005 to 2027Enrolled5,000ConditionsBreast Carcinoma, Esophageal Carcinoma, Genitourinary System Carcinoma, Head and Neck CarcinomaArmsQuality-of-Life Assessment, Questionnaire Administration
3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 4 syntheses or guidelines pooled it, 41 citations in OpenAlex.

  1. Technical Considerations on Proton Therapy in NRG's Multi-Institutional Clinical Trials.International journal of radiation oncology, biology, physics · 2026
    Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Trial
  6. Review
  7. Review
  8. Article
  9. Review
  10. Article
  11. Review
  12. ACR-ARS Practice Parameter for the Performance of Proton Beam Therapy.International journal of particle therapy · 2024
    Article
  13. Exploring treatment options in cancer: Tumor treatment strategies.Signal transduction and targeted therapy · 2024
    Review
  14. Article
  15. Article
  16. Review
  17. Recent trends in radiotherapy use for major cancers in Korea.Japanese journal of clinical oncology · 2023
    Article
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 1 institution in 1 country.

Olsi GjyshiDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ting XuDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Adnan ElhammaliDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
David Boyce-FappianoDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Stephen G ChunDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Saumil GandhiDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Percy LeeDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Aileen B ChenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Steven H LinDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Joe Y ChangDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Anne TsaoDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Carl M GayDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
X Ronald ZhuDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Xiaodong ZhangDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
John V HeymachDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Frank V FossellaDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Charles LuDepartment of Thoracic-Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Quynh-Nhu NguyenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Zhongxing LiaoDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: zliao@mdanderson.org.
The University of Texas MD Anderson Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
Proton Therapy to Reduce Heart Damage for Lung Cancer PatientsR21CA222749 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI LIAO, ZHONGXING · 2019 to 2020
$388k
NCI NIH HHS P30 CA016672NCI NIH HHS R21 CA222749
6 · The paper itself

Abstract

objectiveAlthough intensity-modulated radiation therapy (IMPT) is dosimetrically superior to passive scattering proton therapy (PSPT) for locally advanced NSCLC (LA-NSCLC), direct comparisons of clinical outcomes are lacking. Here, we compare toxicity profiles and clinical outcomes after IMPT versus PSPT for LA-NSCLC.

methodsThis is a nonrandomized, comparative study of two independent cohorts with LA-NSCLC (stage II-IIIB, stage IV with solitary brain metastasis) treated with concurrent chemotherapy and proton beam therapy. Toxicity (Common Terminology Criteria for Adverse Events version 4.0) and outcomes were prospectively collected as part of a clinical trial (ClinicalTrials.gov identifier NCT00915005) or prospective registry (ClinicalTrials.gov identifier NCT00991094).

resultsOf 139 patients, 86 (62%) received PSPT and 53 (38%) IMPT; median follow-up times were 23.9 and 29.0 months, respectively. IMPT delivered lower mean radiation doses to the lungs (PSPT 16.0 Gy versus IMPT 13.0 Gy, p < 0.001), heart (10.7 Gy versus 6.6 Gy, p = 0.004), and esophagus (27.4 Gy versus 21.8 Gy, p = 0.005). Consequently, the IMPT cohort had lower rates of grade 3 or higher pulmonary (17% versus 2%, p = 0.005) and cardiac (11% versus 0%, p = 0.01) toxicities. Six patients (7%) with PSPT and zero patients (0%) with IMPT experienced grade 4 or 5 toxicity. Lower rates of pulmonary (28% versus 3%, p = 0.006) and cardiac (14% versus 0%, p = 0.05) toxicities were observed in the IMPT cohort even after propensity score matching for baseline imbalances. There was also a trend toward longer median overall survival in the IMPT group (23.9 mo versus 36.2 mo, p = 0.09). No difference was found in the 3-year rates of local (25% versus 20%, p = 0.44), local-regional (29% versus 36%, p = 0.56) and distant (52% versus 51%, p = 0.71) recurrences.

conclusionsIMPT is associated with lower radiation doses to the lung, heart, and esophagus, and lower rates of grade 3 or higher cardiopulmonary toxicity; additional clinical studies will be needed to assess the potential differences in survival between the two techniques.

Indexed as

Carcinoma, Non-Small-Cell LungLung NeoplasmsProton TherapyRadiotherapy, Intensity-ModulatedHumansNeoplasm Recurrence, LocalRadiotherapy DosageRadiotherapy Planning, Computer-AssistedCardiac toxicityEsophageal toxicityIMPTLung cancerProton beam therapyPulmonary toxicity

Identifiers

PMID33198942
PMCPMC7855203
OpenAlexW3094213671

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.