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dc.contributor.authorMishra, M.V.
dc.contributor.authorKhairnar, R.
dc.contributor.authorBentzen, S.M.
dc.date.accessioned2019-10-08T13:01:10Z
dc.date.available2019-10-08T13:01:10Z
dc.date.issued2019
dc.identifier.urihttps://www.scopus.com/inward/record.uri?eid=2-s2.0-85072730630&doi=10.1016%2fj.ctro.2019.08.006&partnerID=40&md5=09537119d2de04db6a733abd5c60b15f
dc.identifier.urihttp://hdl.handle.net/10713/11053
dc.description.abstractBackground and purpose: Patient-level benefits of proton beam therapy (PBT) relative to photon therapy for prostate cancer (PC) continue to be the focus of debate. Although trials comparing the two modalities are underway, most are being conducted using “conventional” PBT (passive scattering/uniform scanning [PS/US]) rather than pencil beam scanning (PBS). The dosimetric benefits of PBS are well-known, but comparative data are limited. This analysis compares PBS toxicity rates with those of PS/US in a prospective multicenter registry. Methods: We evaluated acute/late gastrointestinal (GI) and genitourinary (GU) toxicity rates for men with low-to-intermediate risk PC enrolled in PCG 001-09. Acute toxicities with the two techniques were compared using χ2 tests, and the cumulative incidence methods for late toxicity. Multivariable analyses (MVAs) for acute toxicity were performed using logistic regression, and cox proportional hazards models for late toxicity. Results: Patients were treated using PS/US (n = 1105) or PBS (n = 238). Acute grade ≥2 GI toxicity in PBS did not significantly differ from that with PS/US (2.9% and 2.1%, respectively; P = 0.47). Acute grade ≥2 GU toxicity was significantly higher with PBS (21.9% and 15.1%; P < 0.01). In MVA, PBS was significantly associated with increased acute grade ≥2 GU toxicity (RR = 1.57, p < 0.001). Late grade ≥2 GI and GU toxicities did not differ significantly between groups. Conclusions: This is the first multi-institutional comparative effectiveness evaluation of PBT techniques in PC. Differences in acute GU toxicity warrant further evaluation, and highlight the urgent need for prospective data using PBT. © 2019 The Authorsen_US
dc.description.sponsorshipThis research was funded through an American Society of Radiation Oncology Comparative Effectiveness Grant and was presented at the 2018 American Society of Radiation Oncology Annual Meeting. Appendix Aen_US
dc.description.urihttps://doi.org/10.1016/j.ctro.2019.08.006en_US
dc.language.isoen-USen_US
dc.publisherElsevier Ireland Ltden_US
dc.relation.ispartofClinical and Translational Radiation Oncology
dc.subjectComparative effectiveness, Toxicityen_US
dc.subjectPassive scattering, uniform scanningen_US
dc.subjectPencil beam scanningen_US
dc.subjectProstate canceren_US
dc.subjectProton therapyen_US
dc.titleProton beam therapy delivered using pencil beam scanning vs. passive scattering/uniform scanning for localized prostate cancer: Comparative toxicity analysis of PCG 001-09en_US
dc.typeArticleen_US
dc.identifier.doi10.1016/j.ctro.2019.08.006


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