Patient-Reported Quality of Life in Prostate Cancer Patients Treated With 3D Conformal, Intensity-Modulated or Proton Beam Radiotherapy Phillip J. Gray, Jonathan J. Paly, Beow Y. Yeap, Martin G. Sanda, James A. Talcott, Howard M. Sandler, Jeff M. Michalski, Daniel A. Hamstra, Justin E. Bekelman and Jason A. Efstathiou
Utilization of IMRT: SEER Data 100% Percent of Radiotherapy for Prostate Cancer 90% IMRT 80% 70% 60% 50% 40% 30% 20% 3-D CRT 10% 0% 2000 2001 2002 2003 2004 2005 2006 2007 2008 Bekelman, Mitra, Efstathiou, et al., IJROBP 2011; Sheets, Goldin, Meyer, et al., JAMA 2012
US Proton Therapy Centers Proton center in operation Proton center under construction Proton center in development
Patient Reported Bowel Toxicity 3-D CRT Bowel/Rectal Domain 100 * * Absolute Instrument Score * 90 80 70 60 0 0 3 12 24 Follow-up (months) *: Clinically meaningful change Proton Beam IMRT Bowel/Rectal Domain Bowel/Rectal Domain 100 100 * * * * Absolute Instrument Score Absolute Instrument Score * 90 90 * 80 80 70 70 60 60 0 0 0 3 12 24 0 2 6 12 24 Follow-up (months) Follow-up (months)
Patient Reported Urinary Toxicity 3-D CRT Urinary Irritation/Obstruction Domain 100 Absolute Instrument Score 90 80 70 60 0 0 3 12 24 Follow-up (months) *: Clinically meaningful change Proton Beam IMRT Urinary Irritation/Obstruction Domain Urinary Irritation/Obstruction Domain 100 100 Absolute Instrument Score Absolute Instrument Score 90 90 80 80 * * 70 70 60 60 0 0 0 3 12 24 0 2 6 12 24 Follow-up (months) Follow-up (months)
79.2 Gy R IMRT A N Patient-Reported D Low- Quality of Life Intermediate O ENDPOINTS N=350 Risk Prostate Cost-Effectiveness M Cancer Physics/Biology I Z Proton Beam E 79.2 Gy (RBE) clinicaltrials.gov identifier: NCT01617161
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