title: Clinical controversies: proton therapy for prostate cancer.
abstract: Proton therapy has been used in the treatment of prostate cancer for several decades, and interest surrounding its use continues to grow. Proton-based treatment techniques have evolved significantly over this period, and several centers now routinely use technologies such as pencil-beam scanning. However, whether the theoretical dosimetric advantages of the proton beam translate into clinically meaningful improvements for prostate cancer patients is unknown, and outcomes from single-arm experiences using whole courses of proton beam therapy in the treatment of early-stage prostate cancer have shown mixed results when compared with contemporary intensity-modulated radiotherapy. A randomized trial comparing proton beam therapy with intensity-modulated radiotherapy in early-stage disease has been launched and will be important in defining the role for proton therapy in this setting. We review the available evidence and present the current state of proton beam therapy for prostate cancer.
authors.affiliation: Harvard Radiation Oncology Program, Boston, MA, USA. kmouw@lroc.harvard.edu
authors.forename: Kent W
authors.initials: KW
authors.lastname: Mouw
authors.forename: Alexei
authors.initials: A
authors.lastname: Trofimov
authors.forename: Anthony L
authors.initials: AL
authors.lastname: Zietman
authors.forename: Jason A
authors.initials: JA
authors.lastname: Efstathiou
mesh_terms: D004307:Dose-Response Relationship, Radiation; D019317:Evidence-Based Medicine; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000532:radiotherapy*; D058958:Organs at Risk / Q000528:radiation effects; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D061766:Proton Therapy / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D018787:Radiation Oncology / Q000379:methods*; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated; D016032:Randomized Controlled Trials as Topic