Evaluating the Effectiveness of Proton Beam Therapy Compared to Conventional Radiotherapy in Non-Metastatic Rectal Cancer: A Systematic Review of Clinical Outcomes
Author(s)
Le, K; Marchant, JN; Le, KDR;
Details
Publication Year 2024-08-31,Volume 60,Issue #9,Page 1426
Journal Title
Medicina
Publication Type
Research article
Abstract
Background and Objectives: Conventional radiotherapies used in the current management of rectal cancer commonly cause iatrogenic radiotoxicity. Proton beam therapy has emerged as an alternative to conventional radiotherapy with the aim of improving tumour control and reducing off-set radiation exposure to surrounding tissue. However, the real-world treatment and oncological outcomes associated with the use of proton beam therapy in rectal cancer remain poorly characterised. This systematic review seeks to evaluate the radiation dosages and safety of proton beam therapy compared to conventional radiotherapy in patients with non-metastatic rectal cancer. Materials and Methods: A computer-assisted search was performed on the Medline, Embase and Cochrane Central databases. Studies that evaluated the adverse effects and oncological outcomes of proton beam therapy and conventional radiotherapy in adult patients with non-metastatic rectal cancer were included. Results: Eight studies were included in this review. There was insufficient evidence to determine the adverse treatment outcomes of proton beam therapy versus conventional radiotherapy. No current studies assessed radiotoxicities nor oncological outcomes. Pooled dosimetric comparisons between proton beam therapy and various conventional radiotherapies were associated with reduced radiation exposure to the pelvis, bowel and bladder. Conclusions: This systematic review demonstrates a significant paucity of evidence in the current literature surrounding adverse effects and oncological outcomes related to proton beam therapy compared to conventional radiotherapy for non-metastatic rectal cancer. Pooled analyses of dosimetric studies highlight greater predicted radiation-sparing effects with proton beam therapy in this setting. This evidence, however, is based on evidence at a moderate risk of bias and clinical heterogeneity. Overall, more robust, prospective clinical trials are required.
Publisher
MDPI
Keywords
Humans; *Proton Therapy/methods; Radiotherapy Dosage; *Rectal Neoplasms/radiotherapy; Treatment Outcome; conventional radiotherapy; intensity-modulated radiotherapy; proton beam therapy; rectal cancer; recurrence; survival; three-dimensional conformational radiation therapy; toxicity; volumetric modulated arc therapy
Department(s)
Surgical Oncology
Open Access at Publisher's Site
https://doi.org/10.3390/medicina60091426
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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