Proton beam therapy in adults : a systematic review

37 p.ill.,LIST OF TABLES 3 -- LIST OF ABBREVIATIONS 4 -- SCIENTIFIC REPORT 6 -- 1 INTRODUCTION 6 -- 1.1 BACKGROUND 6 -- 1.2 BELGIAN CONTEXT 6 -- 1.3 PROJECT SCOPE 7 -- 1.4 INCIDENCE AND PROGNOSIS .9 -- 1.5 AIM OF THE STUDY 9 -- 2 METHODOLOGY 10 -- 2.1 CLINICAL RESEARCH QUESTION 10 -- 2.2 LITERATURE SEARCH AND SELECTION .10 -- 2.3 QUALITY APPRAISAL AND DATA EXTRACTION 11 -- 2.3.1 Quality appraisal 11 -- 2.3.2 Data extraction 11 -- 2.4 STATISTICAL ANALYSIS 11 -- 2.5 GRADE .12 -- 3 RESULTS .12 -- 3.1 OVERVIEW OF SELECTED STUDIES .12 -- 3.2 SYSTEMATIC REVIEWS AND HTA REPORTS 18 -- 3.3 EFFECTIVENESS BY INDICATION 19 -- 3.3.1 Low-grade glioma .19 -- 3.3.2 Primary sinonasal tumours and recurrences of head & neck tumours .19 -- 3.3.3 Breast cancer 19 -- 3.3.4 Pancreatic cancer 19 -- 3.3.5 Hepatocellular cancer .20 -- 3.3.6 Locally recurrent rectal cancer 20 -- 3.3.7 Key points 20 -- 3.4 SAFETY 21 -- 3.4.1 Low-grade glioma .21 -- 3.4.2 Primary sinonasal tumours and recurrences of head & neck tumours .22 -- 3.4.3 Breast cancer 23 -- 3.4.4 Pancreatic cancer 24 -- 3.4.5 Hepatocellular cancer .25 -- 3.4.6 Locally recurrent rectal cancer 28 -- 3.4.7 Key points 28 -- 3.5 SECONDARY TUMOURS .29 -- 3.6 ONGOING TRIALS 29 -- 4 DISCUSSION .31 -- 4.1 SCARCE AND FLAWED EVIDENCE ON THE EFFECTIVENESS OF PROTON TREATMENT .31 -- 4.2 UNCERTAINTY ABOUT THE SAFETY OF PROTON TREATMENT .32 -- 4.3 FEW DATA ON SECONDARY TUMOURS .32 -- 4.4 SOME RCTS UNDERWAY, BUTNOT IN THE VERYNEAR FUTURE 33 -- 4.5 LIMITATIONS OF THIS REPORT 33 -- REFERENCES .3