The latest retrospective study on proton therapy for esophageal cancer uses actual data to give the answer to recommending proton therapy for esophageal cancer!

In August 2021, the University Hospital of Tsukuba, Japan, published a review in the Journal of Personalized Medicine, which comprehensively discussed the role of Japanese particle therapy in multidisciplinary treatment from the basic and clinical applications of particle therapy such as protons and carbon ions in Japan, and reviewed the effect of protons in the treatment of esophageal cancer

Why is proton therapy recommended for patients with esophageal cancer?

The article pointed out that the current gold standard for the treatment of localized esophageal cancer is still surgery, but when some patients are diagnosed, they cannot operate because the tumor has progressed to an advanced stage, the physical condition is not good, and the reluctance to undergo surgery is not available, and simultaneous radiotherapy and chemotherapy have become the main choice

However, studies have confirmed that the use of photon radiotherapy is associated with cardiorespirotoxicity and advanced adverse effects in patients with esophageal cancer, and that cardiopulmonary toxicity in patients with esophageal cancer affects the management

Simply put, a higher dose of photon radiotherapy will lead to serious complications in organs or tissues around the esophagus, such as the heart, lungs, etc.

Therefore, proton therapy, with a special "Bragg peak effect", provides convenience

▲Proton treatment of esophageal cancer,

Efficacy and safety of protons in the treatment of esophageal cancer

01

A 2015 study evaluated the effects

The results showed that the 2-year disease-specific survival rate with proton therapy combined with chemotherapy was 77%, the 2-year local control rate was 66%, and there was no cardiopulmonary toxicity

02

A 2019 Japanese multicenter retrospective study evaluated the efficacy

The results of the study showed that the 5-year overall survival rate (OS) of patients with stage I.

The study confirmed that protons are not inferior to esophageal cancer compared with photon radiotherapy, and the incidence of toxicity is low, which can be used as an alternative therapy

▲ 5-year survival rate of proton treatment for esophageal cancer,

03

A 2020 randomized study compared the total toxic burden (TTB) and survival of intensity-modulated radiotherapy (IMRT) and proton therapy

Note: The total toxicity burden (TTB) is defined as ≥ grade 2 pneumonia, cardiac or esophageal toxicity

The results of the study show that proton therapy for esophageal cancer can reduce the total toxic burden, that is, cardiorespirotoxicity and less

▲Comparison of the survival of IMRT with proton therapy for esophageal cancer

Comparison of IMRT and proton the total toxic burden of esophageal cancer,

In addition to the above three studies, there are many studies that confirm the remarkable effect of protons in the treatment of esophageal cancer:

▲Comparative study on the safety of photon radiotherapy and proton in the treatment of esophageal cancer

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