Particle therapy for prostate cancer: The past, present and future

Abstract

Although prostate cancer control using radiotherapy is dose‐dependent, dose–volume effects on late toxicities in organs at risk, such as the rectum and bladder, have been observed. Both protons and carbon ions offer advantageous physical properties for radiotherapy, and create favorable dose distributions using fewer portals compared with photon‐based radiotherapy. Thus, particle beam therapy using protons and carbon ions theoretically seems suitable for dose escalation and reduced risk of toxicity. However, it is difficult to evaluate the superiority of particle beam radiotherapy over photon beam radiotherapy for prostate cancer, as no clinical trials have directly compared the outcomes between the two types of therapy due to the limited number of facilities using particle beam therapy. The Japanese Society for Radiation Oncology organized a joint effort among research groups to establish standardized treatment policies and indications for particle beam therapy according to disease, and multicenter prospective studies have been planned for several common cancers. Clinical trials of proton beam therapy for intermediate‐risk prostate cancer and carbon‐ion therapy for high‐risk prostate cancer have already begun. As particle beam therapy for prostate cancer is covered by the Japanese national health insurance system as of April 2018, and the number of facilities practicing particle beam therapy has increased recently, the number of prostate cancer patients treated with particle beam therapy in Japan is expected to increase drastically. Here, we review the results from studies of particle beam therapy for prostate cancer and discuss future developments in this field.

Optimal Androgen Deprivation Therapy Combined with Proton Beam Therapy for Prostate Cancer: Results from a Multi-Institutional Study of the Japanese Radiation Oncology Study Group

“…Several randomized trials and meta-analyses performed in the 1990s and 2000s showed a significant benefit of androgen deprivation therapy (ADT) combined with RT in terms of biochemical control and overall survival (OS) among patients with intermediate-risk and high-risk PC [4][5][6][7]. Because the relatively low irradiation doses (65-70 Gy) were used in those trials, the optimal duration of ADT to use in combination with high-dose RT remains unknown [8]. Since ADT has negative impacts on bone, lipid, and glucose metabolism and increases the risks of bone fractures, metabolic syndrome, and diabetes mellitus [9][10][11], it is desirable to perform the minimum ADT necessary to control PC.…”

Quantitative estimation of track segment yields of water radiolysis species under heavy ions around Bragg peak energies using Geant4-DNA

“…Cancer patients can nowadays select several modalities in radiotherapy such as conventional X-ray therapy and particle therapies (e.g., proton therapy, heavy ion therapy and boron neutron capture therapy). The number of patients receiving particle therapy for cancer (mainly proton or C-ion beams) is increasing annually 1 . There are two major advantages to particle therapy.…”

Chronoradiation Therapy for Prostate Cancer: Morning Proton Beam Therapy Ameliorates Worsening Lower Urinary Tract Symptoms

“…Proton beam therapy (PBT) is a promising curative therapy for localized prostate cancer as well as surgical resection and other radiation therapies (RTs) such as intensity-modulated radiation therapy and heavy particle therapy [ 1 ]. In Japan, national health insurance has covered PBT since April 2018 and the number of treatment facilities has increased.…”

“…In Japan, national health insurance has covered PBT since April 2018 and the number of treatment facilities has increased. PBT for prostate cancer reduces the incidence of late toxicity because of smaller radiation doses and volumes directed at the organs at risk surrounding the prostate [ 1 ]. However, one of the relatively frequent adverse events following PBT treatment is lower urinary tract symptoms (LUTS).…”