ORIGINAL RESEARCH article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1644829
This article is part of the Research TopicNational Cancer Research Month 2025: Advances in Detection, Treatment and Therapies in OncologyView all 15 articles
Proton beam radiation therapy vs. photon radiation therapy and the overall survival of adult and pediatric patients diagnosed with sarcoma
Provisionally accepted
- 1University of Nebraska Medical Center, Omaha, United States
- 2Mayo Hospital, Lahore, Pakistan
- 3Nebraska Medicine, Omaha, United States
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Background: The use of proton beam radiation therapy (PBT) has increased in patients diagnosed with sarcoma. However, there is a lack of information about its survival benefit in these patients. Objective: We want to investigate the association of PBT with the overall survival (OS) of sarcoma patients. Methods: We used the National Cancer Database and assessed the OS using multivariable Cox regression analysis adjusted for age, sex, race, education, income, insurance status, histology, comorbidity score, radiation therapy dose, chemotherapy, surgery, and year of diagnosis. Results: Among the 117,694 patients, 3,573 (3%) received PBT. Patients receiving PBT had longer OS than those receiving photon radiation therapy (PRT) (HR: 0.73, CI: 0.68 -0.79). PBT was also associated with improved OS compared to PRT in chordoma (HR: 0.57, CI: 0.44-0.74), rhabdomyosarcoma (HR: 0.58, 95% CI: 0.47-0.72), or chondrosarcoma (HR: 0.35, CI: 0.24-0.51) patients. Among patients who received surgery, PBT was associated with improved OS compared to PRT in chordoma (HR: 0.37, CI: 0.22-0.60), chondrosarcoma (HR: 0.52, CI: 0.28-0.97), or osteosarcoma (HR: 0.32, CI: 0.12-0.89) patients. Among patients with no surgery, PBT was associated with improved OS compared to PRT in chordoma (HR: 0.57, CI: 0.44-0.74), rhabdomyosarcoma (HR:0.56, CI: 0.44-0.70), chondrosarcoma (HR:0.24, CI: 0.15-0.37), osteosarcoma (HR: 0.51, CI: 0.30-0.87), or other histology type (HR:0.76, CI: 0.66-0.86) patients. Conclusion: The use of PBT was associated with improved OS compared to photon RT in sarcoma patients. PBT was associated with improved OS in patients diagnosed with chordoma, rhabdomyosarcoma, or chondrosarcoma.
Keywords: Proton beam radiation therapy, Sarcoma, Chordoma, Rhabdomyosarcoma, Chondrosarcoma, Ewing sarcoma, Osteosarcoma, National Cancer Database
Received: 10 Jun 2025; Accepted: 26 Aug 2025.
Copyright: © 2025 AMIN, Mateen, Amin and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chi Lin, University of Nebraska Medical Center, Omaha, United States
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