Published in the Red Journal, this retrospective analysis by MD Anderson group reviewed 212 patients treated with IMRT and PT, most (152 [72%]) had no failure; of the 60 patients with failure, 27 (45%) had Local Failure (within the ITV); 23 (38%) had Marginal Failure (between the ITV and PTV+10mm); and 10 (17%) had Regional Failure (>10 mm outside the PTV). MF rates were no different for IMRT or PSPT patients.

The study concluded that no differences in LF, MF, or RF patterns were found for IMRT vs. PSPT. Proton therapy more often required adaptive planning, and the techniques used for adaptive planning did not compromise tumor control.