Image-guided moderately hypofractionated proton beam therapy for localized prostate cancer: 5-year outcomes of a phase II trial

Background and purpose (extract from abstract): The purpose of the study is to confirm the efficacy and feasibility of moderately hypofractionated proton beam therapy (PBT) at a total dose of 63 Gy relative biological effectiveness (RBE) in 21 fractions for prostate cancer.

Materials and methods (extract): For each patient, two fiducial markers (Gold Anchor; Naslund Medical AB, Huddinge, Sweden, or VISICOIL; RadioMed, Bartlett, TN, USA) were implanted in the prostate before CT simulation for the use of image-guided PBT.

Daily treatment was performed using a passive scattering method with daily matching of the intraprostatic fiducial markers using kilovoltage orthogonal X-ray images...

Discussion (extract): …the lower toxicity observed in the current cohort is hypothesized to result from the use of image-guided RT (IGRT) with fiducial markers using a shrunken field technique, which significantly contributed to this more favorable toxicity rate.

Conclusion (extract): We demonstrated low incidence of late adverse GU and GI events alongside excellent disease control, validating the safety of this fractionation schedule.

Article from the Journal of Radiation Research, 2026