Executive Director Message

StuartKlein.pngThe 2019 meeting of the American Society of Clinical Oncologists included at least two research presentations about proton therapy that deserve a closer look.

First, a study1 from the University of Pennsylvania and Washington University in St. Louis that suggests a significant reduction in side effects for patients treated with proton therapy versus photon therapy, also known as X-ray therapy. Researchers analyzed the data from 1,483 adult non-metastatic cancer patients with various types of cancer who received a combination of chemotherapy and radiation therapy. Of the patients who received proton therapy, 11.5% had a side effect that required hospitalization within 90 days of treatment, while 27.6% of photon patients were hospitalized. Disease-free survival and overall survival rates were similar for both groups. This is more evidence that proton therapy is a highly effective cancer treatment that provides patients an excellent quality of life compared to conventional radiation.

Second, a study2 from the University of Western Ontario, London, Canada, that assessed online advertising and marketing claims made by proton centers. The researchers questioned whether centers’ claims were consistent with international consensus guidelines for usage of proton therapy to treat cancer. They found that 58% of proton center websites did not cite references for claims being made. The UF Health Proton Therapy Institute is at the forefront of clinical research and discovery as part of an academic health center. Sharing credible, accurate, reliable information with patients and those recently diagnosed with cancer is of utmost importance. It is why we include medical journal article references on our website. We are committed to treating patients who can most benefit from proton therapy. Through high-quality clinical trials we rigorously document patient outcomes, including for cancers that may not be included currently in international guidelines for proton therapy. This is how medicine moves forward. We must ask the questions, design the studies, perform the research, document and report outcomes to understand the full potential of proton therapy in cancer care.

  1. “Comparative effectiveness of proton therapy versus photon therapy as part of concurrent chemoradiotherapy for locally advanced cancer.” https://abstracts.asco.org/239/AbstView_239_267523.html
  2. “Online advertising and marketing claims by providers of proton beam therapy: Are they guideline based?” https://abstracts.asco.org/239/AbstView_239_252491.html


Stuart L. Klein

Executive Director

COMPPARE Study Is Activated

The national clinical trial to compare prostate cancer patient outcomes following proton therapy or photon (X-ray) therapy is underway. According to COMPPARE and Proton project manager Adrienne Greenewalt, the first five sites participating in the study are activated and accruing patients.

The clinical trial is known as COMPPARE which stands for “A Prospective COMparative Study of Outcomes with Proton and Photon RAdiation in PRostate CancEr (COMPPARE).” This study is funded by the Patient-Centered Outcomes Research Institute (PCORI) and led by Nancy P. Mendenhall, MD, at the University of Florida. COMPPARE will ask 3,000 prostate cancer patients (ages 30-80) across the United States who have chosen to be treated with proton therapy or photon therapy to answer brief surveys regarding treatment choice, quality of life, and side effects for at least three years.

In addition, proton therapy patients can choose to participate in a randomized trial in which half will be randomly assigned to the standard course of therapy and the other half will receive a shorter “hypofractionated” course in which the total dose of radiation will be divided into larger doses with fewer treatments. This additional study will evaluate whether quality of life, side effects, and cure rates differ between patients receiving standard therapy versus shorter therapy.

The goal of the study is to answer the following patient-centered questions:

  1. How likely are men to experience different quality of life issues with protons versus photons?
  2. How likely are men to experience different side effects with either treatment?
  3. Which treatment will result in a better cure rate?
  4. Is a shorter, higher dose treatment regimen as safe and effective as a longer, lower dose treatment regimen?

Because men of African descent are 1.6 times more likely to be diagnosed with prostate cancer and more than twice as likely to die from it, the study team is actively working to recruit Black men to this study and assess whether quality of life, side effects and cancer recurrence outcomes differ for these patients.

Participants in the study over the first three years will receive up to $250 for completing surveys before radiation begins, during treatment, and at follow-up visits. For more information about the study, visit www.comppare.org. Research reported in this study website was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (PCS-2017C1-0422). The views, statements, and opinions presented in this study website are solely the responsibility of the author(s) and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.

Favorable Outcomes For Prostate Cancer Patients

By Adam Holtzman, MD

Many men are interested in sexual health following treatment for prostate cancer. In the largest known published analysis of patient-reported sexual health outcomes of potent men at baseline treated with external beam radiotherapy, we reviewed outcomes of men treated at the UF Health Proton Therapy Institute.1 All patients underwent high-dose, image-guided proton radiotherapy for the treatment of prostate cancer. Sexual function of potent men was almost 70% at 2 years and 61% at 5 years following treatment. This compares very favorably to other reported outcomes and treatment modalities even when factoring for baseline age and comorbidities.  We also identified a highly favorable cohort: 80% men treated with high-dose image-guided proton radiotherapy who report “very good” function at baseline retained potency at 5 years.

  1. Adam L. Holtzman, Curtis B. Bryant, Nancy P. Mendenhall, William M. Mendenhall, R. Charles Nichols, Randal H. Henderson, Nicholas Figura, Christopher G. Morris, Christopher R. Williams, Zuofeng Li, Bradford S. Hoppe. “Patient-Reported Sexual Survivorship Following High-Dose Image-Guided Proton Therapy for Prostate Cancer.” Radiotherapy and Oncology 134 (2019): 204-210. DOI: https://doi.org/10.1016/j.radonc.2019.01.029

Golf Tournament Save the Date

The 15th Annual Play Golf. Fight Cancer.® Classic to benefit the proton research program at the UF Health Proton Therapy Institute will take place October 21, 2019 at the World Golf Village, St. Augustine, Florida.

Sponsorships are available with various levels that include foursomes, recognition on promotional materials and signage, and sponsor’s logo displayed on the website, social media and player gift. Call 904-588-1423 to speak to the sponsorship director or email playgolffightcancer@floridaproton.org . Foursomes and individual players can register online at www.playgolffightcancer.org.

According to Nancy P. Mendenhall, MD, professor and associate chair of UF Health Radiation Oncology and medical director of the UF Health Proton Therapy Institute, the generosity of past participants has made it possible to perform research that is changing the way cancer treatment is handled in the United States and around the world.

“Please, join us for a fun event as we Play Golf. Fight Cancer.® Together, we can help current and future cancer patients from Florida and around the world get the care – and the confidence – they need to live a happier, healthier and longer life,” said Mendenhall.

About This Newsletter

The Precision Newsletter is an electronic-only publication that is distributed by email. Each issue is sent monthly to patients, alumni patients and friends of the University of Florida Health Proton Therapy Institute. As the official newsletter of the Institute, the content is compiled and prepared by our communications representative and approved by the editor Stuart Klein, executive director of UF Health Proton Therapy Institute. Special bulletin newsletters may occasionally be prepared when timely topics and new developments in proton therapy occur. If you would like to send a Letter to the Editor, please click here.


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