Adverse Events Decreased With Proton Chemoradiotherapy

Proton chemoradiotherapy is associated with a significantly lower risk for 90-day adverse events and a decrease in performance status during treatment compared with photon therapy, according to a study published online December in JAMA Oncology.

Brian C. Baumann, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective, nonrandomized comparative effectiveness study involving 1,483 adults with nonmetastatic, locally advanced cancer treated with concurrent chemoradiotherapy. Overall, 391 received proton therapy and 1,092 received photon therapy.

Patients receiving proton therapy were significantly older (median, 66 versus 61 years) and had less favorable Charlson-Deyo comorbidity scores (median, 3.0 versus 2.0). The cohorts had similar baseline grade ≥2 toxicity and Eastern Cooperative Oncology Group performance status. The researchers found that proton chemoradiotherapy was associated with a significantly lower relative risk for 90-day adverse events of at least grade 3, 90-day adverse events of at least grade 2, and a decline in performance status during treatment (relative risks, 0.31, 0.78, and 0.51, respectively) in propensity score-weighted analysis. No difference was seen in disease-free or overall survival.

"Reduced adverse events associated with proton therapy could offer an opportunity to intensify chemoradiotherapy treatments and/or broaden inclusion criteria on clinical trials to include older, sicker patients, which may improve oncologic outcomes," the authors write.

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