More Evidence Needed on Charged-Particle Therapy

-- Eric Metcalf

Wednesday, September 16, 2009

WEDNESDAY, Sept. 16 (HealthDay News) -- Research comparing the safety and effectiveness of charged-particle radiation therapy with other treatments for cancer is scant, pointing to a need for comparative studies, preferably randomized trials, according to research published online Sept. 15 in the Annals of Internal Medicine.

Teruhiko Terasawa, M.D., of Tufts Medical Center in Boston, and colleagues conducted a systematic review of 243 articles in which charged-particle radiation therapy -- defined as irradiation with protons, helium ions, or heavier ions -- was used alone or with other interventions to treat cancer. Eight were randomized trials, all with relatively small sample sizes and most dealing with relatively uncommon cancers.

The researchers found that none of the studies demonstrated a significant difference in overall or cancer-specific survival. Four trials did show a significant difference in other outcomes, such as better local control with helium ions than brachytherapy for uveal melanoma. In nine nonrandomized comparative studies, none found charged-particle radiation therapy significantly better than alternatives for relevant clinical outcomes.

"In summary, several studies of charged-particle radiation therapy for the treatment of cancer have been published. However, these studies do not document the circumstances in contemporary treatment strategies under which radiation therapy with charged particles is superior to other modalities. Comparative studies in general, and randomized trials in particular (when feasible), are needed to document the theoretical advantages of charged-particle radiation therapy in specific clinical situations," the authors conclude.

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