Fewer Complications, Side-Effects for Esophageal Cancer Patients
Because most esophageal cancers are in close proximity to many critical organs, the need to reduce exposure to surrounding, healthy tissue is a major treatment consideration. A number of clinical and modeling studies have demonstrated that proton therapy may be safer than, and equally effective as, more conventional radiation in certain scenarios:
Locally advanced, unresectable esophageal cancer
- Can be applied in higher doses with less cardiac and pulmonary toxicities 
- Demonstrates favorable cancer control rates using dose escalated proton therapy [2-5]
Resectable esophageal cancer with neoadjuvant therapy
- Reduces radiation exposure to the heart, lung, and liver 
- Results in lower rates of post-operative, cardiac, gastrointestinal, and wound complications as compared to conventional radiation
- Produces fewer side-effects including less nausea and adverse hematologic reactions 
Recurrent esophageal cancer
- Can re-irradiate with acceptable cancer control rates and safety 
1. Wang, S.L., et al., Investigation of clinical and dosimetric factors associated with postoperative pulmonary complications in esophageal cancer patients treated with concurrent chemoradiotherapy followed by surgery. Int J Radiat Oncol Biol Phys, 2006. 64(3): p. 692-9.
2. Koyama, S., et al., Proton beam therapy for patients with esophageal carcinoma. Jpn J Clin Oncol, 1994. 24(3): p. 144-53.
3. Sugahara, S., et al., Clinical results of proton beam therapy for cancer of the esophagus. Int J Radiat Oncol Biol Phys, 2005. 61(1): p. 76-84.
4. Yu, J., et al., Motion-robust intensity-modulated proton therapy for distal esophageal cancer. Med Phys, 2016. 43(3): p. 1111-8.
5. Chuong, M.D., et al., Improving Outcomes for Esophageal Cancer using Proton Beam Therapy. Int J Radiat Oncol Biol Phys, 2016. 95(1): p. 488-97.
6. Fernandes, A., et al., A Prospective Study of Proton Beam Reirradiation for Esophageal Cancer. Int J Radiat Oncol Biol Phys, 2016. 95(1): p. 483-7.