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In the first multicentre randomised comparison of protons and IMRT for localised prostate cancer, bowel, urinary and sexual quality of life and five-year cancer control were the same with either technique.
Late-breaking abstract LBA01 at the 2024 ASTRO Annual Meeting, published in the meeting supplement of the International Journal of Radiation Oncology, Biology, Physics. PARTIQoL (NCT01617161) randomised 450 men with low- or intermediate-risk localised prostate cancer at 29 centres between June 2012 and November 2021 to proton beam therapy or intensity-modulated radiotherapy, without hormone therapy, stratified by institution, age, rectal spacer use and fractionation. The primary endpoint was the change in EPIC bowel quality of life at 24 months.
With a median follow-up of 60.3 months, bowel scores declined only slightly in both arms: from 93.7 to 91.8 with protons and from 93.5 to 91.9 with IMRT at 24 months (p=0.836), a difference that was neither statistically significant nor clinically meaningful. Urinary incontinence, urinary irritation and sexual function did not differ at any time point, and there were no sustained differences in subgroups by risk group, age, rectal spacer or fractionation. Five-year progression-free survival was 93.4% with protons and 93.7% with IMRT (p=0.706). This record carries the abstract's figures only.
For men with low- or intermediate-risk prostate cancer, protons and modern IMRT give the same excellent quality of life and cancer control, so the choice can rest on access, cost and convenience rather than on an expected sparing of bowel or bladder. The result removes prostate cancer from the list of adult indications where a proton advantage was assumed but untested.
Shares Bragg peak, Relative biological effectiveness (RBE), Linear energy transfer (LET), Pooled coverage-with-evidence for proton therapy across all centres and the tag radiation-wave5.
Shares Bragg peak, PARTIQoL, Relative biological effectiveness (RBE), Linear energy transfer (LET) and the tag radiation-wave5.
Shares Bragg peak, PARTIQoL, Relative biological effectiveness (RBE), Linear energy transfer (LET) and the tag radiation-wave5.
Shares Bragg peak, Relative biological effectiveness (RBE), Linear energy transfer (LET), Proton therapy and the tag radiation-wave5.
Shares PARTIQoL, Relative biological effectiveness (RBE), Linear energy transfer (LET), Pooled coverage-with-evidence for proton therapy across all centres.
Shares Relative biological effectiveness (RBE), Linear energy transfer (LET).
Shares Bragg peak, Relative biological effectiveness (RBE), Linear energy transfer (LET), Proton therapy.
Shares Relative biological effectiveness (RBE), Linear energy transfer (LET).