Executive summary

This review article provides a comprehensive analysis of the literature focusing on assessment of comparative photon-proton dosimetry, oncological outcome and toxicity of proton therapy for rhabdomyosarcoma (RMS) across various anatomical sites. Based on the 21 studies selected for this review including comparative dosimetric (7 studies), outcome (13 studies), and toxicity (14 studies), PT has demonstrated a significant advantage in reducing radiation to OARs, a notable decrease in integral dose, and comparable disease control to well-established photon series, with lower rates of acute and late toxicities in specific RMS sites. The authors concluded that clear evidence of the therapeutic superiority of PBT compared to modern photon techniques has not yet been demonstrated; however, PBT can be considered an excellent treatment option, in particular for young children and patients with specific primary sites, such as the head and neck area (and especially the parameningeal regions), genito-urinary, pelvic, and paravertebral regions.

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