Is PBT for Prostate Cancer Associated With Less GU or GI Toxicity vs IMRT?

Background: Protons are expensive and inefficient. The 5-vault proton center has 1 beam that 5 vaults need to share. As proton facilities in the United States have multiplied, their financial backers have urged that they be filled. There is evidence that breast cancer patients have inferior cosmetic outcomes when compared to photon treatment. The most common male cancer is prostate cancer, and if you own a proton center, what possible benefit is there to randomizing prostate cancer patients? Objective: To compare the toxicities of protons versus photons for definitive treatment of localized prostate cancer. Design: Comparative review. Participants: Patients diagnosed between 2010 and 2017 who had localized prostate cancer and had only proton beam therapy (PBT) or intensity-modulated photon radiation, with prostate cancer being their first and only cancer; patients receiving <20 fractions were ineligible. Methods: The data came from a SEER–Medicare-linked database that links Medica more...