Ronald C. Chen, MD, MPH, will use the PCORI grant to conduct national comparative study of intensity-modulated radiation therapy and proton beam for prostate cancer.

UNC Lineberger’s Ronald C. Chen, MD, MPH, will use the five-year, $11.9 million grant to fund a comparative study of two radiation treatments for prostate cancer.

The Patient-Centered Outcomes Research Institute (PCORI) has awarded UNC Lineberger Comprehensive Cancer Center’s Ronald C. Chen, MD, MPH, a five-year, nearly $12 million grant to fund a comparative study of two radiation treatments for prostate cancer.

It is estimated that one-in-three men being treated for prostate cancer receive radiation therapy. The most common form of radiation treatment is intensity-modulated radiation therapy, or IMRT. Studies have shown that IMRT, which uses x-rays, is effective for many patients, but some patients may experience short- and long-term side effects related to urination and bowel movements. There is growing interest in using proton therapy to treat prostate cancer – which is a more expensive type of radiation treatment – but it is unknown whether proton therapy has fewer side effects compared to IMRT.

“Radiation therapy is an effective treatment for prostate cancer, but we do not have perfect knowledge about what form of radiation therapy is most effective or the impact the various forms of radiation therapy may have on a patient’s quality of life,” said Chen, who is an associate professor of radiation oncology at the UNC School of Medicine. “It is exciting to partner with Dr. Nancy Mendenhall and researchers across the country to conduct the largest prospective study to date comparing IMRT to proton radiation for prostate cancer, examining side effects, quality of life, cure rates and survival.”

Chen and Mendenhall, who is the medical director of the University of Florida Health Proton Therapy Institute in Jacksonville, are dual principal investigators for this study.

More than 161,000 men in the United States will be diagnosed with prostate cancer this year, and the disease will cause 28,000 deaths, according to American Cancer Society estimations. The incidence of prostate cancer is projected to increase with the recent decision by the US Preventive Services Task Force to recommend that clinicians inform men ages 55 to 69 years about the potential benefits and harms of prostate-specific antigen (PSA) screening. It previously had not recommended PSA screening.

This study will involve a prospective comparison of IMRT and proton therapy, with a focus on patient quality of life, toxicity and the effectiveness of controlling disease. The researchers will enroll 1,500 patients treated with proton therapy and 1,500 patients treated with IMRT from 42 treatment centers in the United States.

Chen said findings from the study will influence health policy. Many insurers currently do not cover proton therapy for prostate cancer due to its higher cost and the lack of scientific data measuring its effectiveness compared to IMRT.

“This study provides an opportunity to address some important questions regarding the comparative effectiveness of proton therapy versus IMRT, and we expect the findings will help patients, clinicians, insurers and policy makers decide the role of proton therapy in treating prostate cancer,” said Chen, who is a member of UNC Lineberger’s Cancer Outcomes Research Program and its Cancer Prevention and Control Program.

PCORI is an independent, nonprofit organization authorized by Congress in 2010. Its mission is to fund research that will provide patients, their caregivers, and clinicians with the evidence-based information needed to make better-informed healthcare decisions. For more information about PCORI’s funding, visit