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Proton beam radiation and prostate cancer management

Posted Sep 28 2008 7:03pm

For many years, the facility at Loma Linda in California was the only commercially functional proton beam radiation facility in the USA. Now there are five such facilities (at Loma Linda, CA; Bloomington, IN; Boston, MA; Houston, TX; and Jacksonville, FL), with three more under construction and 10 more in the planning stage. About 8,000 men have undergone proton beam radiotherapy for prostate cancer since the Loma Linda facility first opened in 1990.

There seems no doubt that proton beam radiotherapy (PBRT) is a valuable and effective method for the treatment of prostate cancer and certain other forms of cancer, but prostate cancer is the “clinical business model” on which proton beam radiotherapy has been primarily dependent. The problem is that there has never been a randomized clinical trial of PBRT as compared to standard forms of external beam radiotherapy, and building new PBRT facilities is expensive. Why would we be doing this unless there was a clear and proven clinical benefit for patients?

For a detailed discussion of this topic, see the recent article in Oncology News International. You can also cast a vote on whether you believe there should be randomized clinical trials of PBRT in prostate cancer on the CancerNetwork.com home page. The “New” Prostate Cancer InfoLink would note that without such clinical trials, no new form of hormone therapy or chemotherapy would even get approved for the treatment of prostate cancer! If PBRT really is better than standard external beam radiotherapy, then let’s find out for sure and stop wasting money on the older technology. If it isn’t, then we probably don’t need PBRT facilities all over the country!

Filed under: Management, Treatment

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