Meta-analysis of efficacy and safety of proton therapy versus photon therapy for esophageal cancer

Radiotherapy plays an important rol in the treatment of esophageal cancer. Proton therapy has unique physical properties and higher relative biological effectiveness compared with photon therapy. Meta-analysis of 45 studies comparing proton therapy versus photon therapy for esophageal cancer, found that proton therapy was associated with significantly reduced irradiation doses to organs at risk and incidence of grade 2 or higher radiation pneumonitis and pericardial effusion, and grade 4 or higher lymphocytopenia. Photon therapy was associated with poor OS and PFS compared with proton therapy. The authors conclude that these findings suggest that proton therapy may be more effective and safer than photon therapy for patients with esophageal cancer.