This is the first study that compares the outcomes of patients treated with photon based radiotherapy vs. proton based radiotherapy for patients with gliomas. Based on the National Cancer Data Base (NCDB), patients with a diagnosis of World Health Organization (WHO) Grade I-IV glioma between the years of 2004-13 included 49,405 patients treated with XRT and 170 patients treated with PBT were compared on the overall survival rate.

With multivariable analysis and propensity score, all patients treated with PBT were found to have superior median and 5 year survival than patients treated with XRT: 45.9 vs. 29.7 months (p = 0.009) and 46.1 vs. 35.5% (p = 0.0160). This study concluded that PBT is associated with improved OS compared to XRT for patients with gliomas. This finding warrants verification in the randomized trial setting in order to account for potential patient imbalances not adequately captured by the NCDB, such as tumor molecular characteristics and patient performance status.