Treatment Comparisons for Various Diagnoses

The table below reports long-term side effects of photon radiation and ongoing treatments needed to manage each long-term treatment-related side effect. The table also shows some long-term advantages of proton therapy.

Treatment Comparisons

IndicationLong-term treatment-related side effects of photon therapy Advantages of proton therapyOngoing treatments needed to manage each long-term treatment-related side effect
- Low Grade Gloma
- Meningioma
- Pituitary Adenomas
- Chordoma
- Chondrosarcoma
- Cognitive dysfunction
- Endocrinopathies
- Inner ear and hearing damage
- Visual/optic pathway damage
- Decreased dose to parts of the brain and therefore less risk of cognitive dysfunction
- Decreased risk of endocrinopathies
- Decreased dose to inner ear
- Decreased dose to optic pathways
- Endocrinology referral and supportive treatments
- Hearing aid support
- Visual aids/glasses/referrals
- Hodgkin's Lymphoma (mediastinal forms)
- Non-Hodgkin's Lymphoma (mediastinal forms)
- Cardiac toxicity
- Breast tissue damage/radiation exposure
- Increased risk of secondary cancers
- Decreased cardiac dose
- Decreased dose to the breast
- Decreased risk of secondary cancers
- Cardiac support/referrals/
monitoring/medications as required
- Monitoring/diagnostics
- Secondary cancer prevention/early detection
- Paranasal sinus
- Salivary Glands
- Nasopharyngeal
- Tonsil tumours
- Visual disturbances, partial blindness
- Inability to deliver an effective radiation dose safely
- Long-term dysphagea
- Need for long-term supportive nutrition/PEG
- Hearing loss
- Cognitive dysfunction
- Decreased dose to optical pathways
- Allows for safe dose escalation
- Decreased brain tissue exposure with subsequent decreased risk of cognitive dysfunction
- Decreased dose to inner ear
- Decreased dose to oesophagus and therefore decreased risk of swallowing difficulties and the need for supportive nutrition
- Supportive nutrition
- PEG insertion/PEG management
- Specialised dietician care
- Specialist referrals/nursing care
- Non-small cell bronchogenic- Bronchial toxicity
- Higher risk of spinal lesions
- Risk of partial paralysis & hypoesthesia
- Higher risk of pneumonitis
- Decreased bronchial toxicity
- Reduced risk of pneumonitis
- Reduced dose to spinal cord with reduced risk of spinal lesions/partial paralysis/hypoesthesia
- Specialist referrals
- Paralysis management
- Physiotherapy
- Pancreatic- Inability to achieve a therapeutic dose with photons
- Very poor prognosis
- Potential to achieve local control with dose escalation using protons- Pain management
- Anal- Post-radiation cystitis
- Bleeding
- Fibrosis
- Pain
- Increased risk of bowel movement difficulties
- Decreased dose to bowel
- Decreased dose to abdominal cavity
- Decreased dose to bladder
- Decreased risk of bleeding
- Decreased risk of fibrosis and post-radiation cystitis
- Bowel management
- Pain management
- Retroperitoneal & Abdominal Sarcomas- Inability to achieve a therapeutic dose with photons
- Very poor prognosis
- Potential to achieve local control with dose escalation using protons- Pain management
- Paediatric tumours requiring craniospinal irradiation- Spinal growth retardation
- Endocrine insufficiencies from pituitary gland, hypothalamus
- Thyroid injury
- Hearing loss
- Secondary malignant neoplasms (SMN)
- Decreased dose to spine
- Decreased dose to parts of brain and therefore less risk of cognitive dysfunction
- Decreased risk of endocrinopathies
- Decreased dose to inner ear
- Decreased dose to optic pathways
- Endocrinology referral and supportive treatments
- Hearing aid support
- Visual aids/glasses/referrals
- Spinal treatments
- Monitoring of secondary malignancies
- Paediatric tumours requiring brain-only irradiation- Cognitive dysfunction
- Endocrinopathies
- Inner ear and hearing damage
- Visual/optic pathway damage
- Secondary cancers
- Decreased dose to parts of brain and therefore less risk of cognitive dysfunction
- Decreased risk of endocrinopathies
- Decreased dose to inner ear
- Decreased dose to optic pathways
- Endocrinology referral and supportive treatments
- Hearing aid support
- Visual aids/glasses/referrals
- Monitoring of secondary malignancies
- Breast- Cardiac toxicity
- Breast tissue damage/radiation exposure
- Increased risk of secondary cancers
- Decreased cardiac dose
- Decreased dose to the breast
- Decreased risk of secondary cancers
- Cardiac support/referrals/ monitoring/medications as required
- Monitoring/diagnostics
- Secondary cancer prevention/early detection
Lana Phillips 3:05 pm