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The first multicentre randomised trial of protons versus IMRT for localised prostate cancer found no difference in bowel, urinary or sexual quality of life and the same cancer control at five years.
PARTIQoL (NCT01617161) randomised 450 men with low- or intermediate-risk localised prostate cancer at 29 centres between 2012 and 2021 to proton beam therapy or intensity-modulated photon radiotherapy, without hormone therapy, with the change in EPIC bowel quality of life at 24 months as the primary endpoint. It is one of the few adult proton-versus-photon trials able to test whether a distal LET and RBE difference near rectum and bladder is clinically real, and accrual was slow in a field where patients can obtain protons off-trial.
Reported as a late-breaking abstract at ASTRO 2024 with a median follow-up of 60.3 months: bowel scores fell only slightly in both arms (91.8 with protons and 91.9 with IMRT at 24 months, from 93.7 and 93.5 at baseline; p=0.836), with no differences in urinary incontinence, urinary irritation or sexual function at any time point and five-year progression-free survival of 93.4% with protons and 93.7% with IMRT (p=0.706). Neither technique beat the other, so the adult proton case in prostate cancer rests on other arguments than a wider therapeutic window.
Numbers are from the trial as recorded here; see the source links in the table below. This is orientation, not medical advice: ask your team how closely the trial population matches you.
Shares Bragg peak, Caution: proton therapy vs IMRT, Relative biological effectiveness (RBE), Linear energy transfer (LET) and the tag radiation-wave5.
Shares Bragg peak, Alpha/beta ratio, Relative biological effectiveness (RBE), Linear energy transfer (LET) and the tag radiation-wave5.
Shares Alpha/beta ratio, Caution: proton therapy vs IMRT, Relative biological effectiveness (RBE), Linear energy transfer (LET).
Shares Bragg peak, Caution: proton therapy vs IMRT, Relative biological effectiveness (RBE), Linear energy transfer (LET).
Shares PARTIQoL: phase 3 randomised trial of proton therapy versus IMRT for localised prostate cancer (ASTRO 2024 late-breaking abstract), Massachusetts General Hospital Cancer Center, Proton therapy, IMRT / IGRT (modern external beam).
Shares How many radiotherapy visits: the prostate fractionation trials, CHHiP, PACE-B, IMRT / IGRT (modern external beam).
Shares How many radiotherapy visits: the prostate fractionation trials, CHHiP, PACE-B, Prostate cancer.
Shares Bragg peak, Alpha/beta ratio, Relative biological effectiveness (RBE), Linear energy transfer (LET).