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Merits of Proton Radiation Therapy for Cancer Debated

Randomized controlled trials should be performed, authors argue

MONDAY, May 5 (HealthDay News) -- Because proton beam radiation therapy has not been definitively proven to be superior to conventional photon x-ray therapy in the treatment of cancer, randomized controlled trials comparing the two modalities are warranted, according to an article and accompanying correspondence published in the May 20 issue of the Journal of Clinical Oncology.

In their article, Eli Glatstein, M.D., of the University of Pennsylvania School of Medicine in Philadelphia, and colleagues respond to a previously published editorial that argued that it would be unethical to perform randomized trials due to the claimed superiority of proton therapy.

Glatstein and colleagues counter that while proton therapy clearly achieves better dose distribution than x-rays, there is no evidence that this results in improved clinical outcomes. Randomized controlled trials would provide the answer and are thus justified, they write. In addition, due to the high cost of establishing proton centers, the clinical benefit of proton therapy should be confirmed before such expenditures are undertaken, they suggest.

"It is likely that well-designed clinical trials that randomly assign proton beam therapy to patients would be supported by the National Cancer Institute and possibly even third-party payers themselves. To accrue the required numbers for such studies would probably require a concerted effort from virtually all the major centers where proton beam therapy is available. We believe this would be a good thing," Glatstein and colleagues write.

Abstract -- Glatstein
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Letter to the Editor -- Macbeth
Letter to the Editor -- Brada

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