WEB REVIEW – Proton Therapy for lung cancer: decreased risk of secondary malignancies

In the treatment of cancer, it is challenging to deliver an adequate dose of radiation to the tumor while sparing nearby normal tissues. Proton therapy’s advantage for many lung cancer patients is based on this feature.

By minimizing the exposure of normal tissues, proton therapy allows to spare critical nearby structures such as the esophagus, heart and spinal cord, and shows tremendous advantages when compared with tradition radiation therapy : lower short and long-term side effects and better quality of life for the patient.

A study was conducted to compare non small cell lung cancer treatment (NSCLC) with IMRT (intensity modulated radiation therapy, an advanced form of traditional radiotherapy) and proton therapy to assess the radiation dose deposited on adjacent organs at risk (OARs).

NB: NSCLC includes adenocarcinoma, squamous-cell lung carcinoma, large-cell lung carcinoma, and represents most common types of lung cancer. No data was presented in this study for small cell lung cancer due to concerns that rapid tumor volume changes during proton therapy could lead to loss of plan validity and overdosing of OARs.

It was shown that proton therapy for NSCLC maintained an optimal tumor coverage while significantly reducing the radiation dose to adjacent organs at risk (heart, brachial plexus, oesophagus, etc), resulting in lower side effects and patient morbidity. The study underlined the advantages of PT over traditional radiation therapy, and recommended to investigate proton therapy for small cell lung cancer as well.