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Radiation using protons, which stop inside the tumour instead of passing through, so tissue behind it gets no dose.
Proton therapy exploits the Bragg peak: protons deposit maximum energy at a depth set by their energy and then stop, so there is no exit dose, and pencil-beam scanning paints the tumour layer by layer. This lowers the integral dose to normal tissue and reduces second cancers in children, which is why it is established for paediatric tumours, skull-base and spine tumours, and re-irradiation. Clinical dose is reported at a constant relative biological effectiveness of 1.1; linear energy transfer, and therefore RBE, rises at the distal edge, so that convention can under- or over-state biological dose to a late-responding organ sitting just beyond the target. Whether that window, plus the tissue's alpha/beta ratio, is large enough to beat modern IMRT in adults is the open question (PARTIQoL, RADCOMP, NRG oesophagus and lung). Range uncertainty and cost remain. Compact single-room systems (Mevion, IBA Proteus One) expand access. The simple version is that protons stop inside the tumour, so tissue behind it is spared.
Bragg peak: protons deposit maximum energy at a depth set by their energy, with no exit dose. Pencil-beam scanning paints the tumour.
Dependencies are what this technology cannot be delivered without: manufacturing steps, instruments, software, upstream methods. See its full chain on the map.
For men with low- or intermediate-risk prostate cancer, protons and modern IMRT give the same excellent quality of life and cancer control, so the choice can rest on access, cost and convenience rather than on an expected sparing of bowel or bladder. The result removes prostate cancer from the list of adult indications where a proton advantage was assumed but untested.
The physical advantage of protons did not, in this trial, translate into less lung damage or better control. It used an older proton technique without pencil-beam scanning, so it does not settle the question for current proton treatment.
The reason cardiac surveillance belongs in Hodgkin lymphoma survivorship care, the reason smoking cessation is a specific intervention for this group rather than general advice, and part of the reason modern protocols try to limit both mediastinal radiation and cumulative anthracycline dose.
The reason every current Hodgkin lymphoma trial is a de-escalation trial, and the reason survivors need lifelong surveillance rather than discharge at five years. It is also a warning about assuming that a gentler protocol is a safer one until a cohort has been followed long enough to say.
A proton plan that looks safe on a 1.1 RBE map can still over-dose a late-responding organ sitting on the distal edge. Comparing protons with IMRT without an LET-weighted view asks the wrong physical question.
The millimetres added for range uncertainty are healthy tissue irradiated to protect the target, and they are a large part of why the theoretical advantage of protons over photons is smaller in practice.
Query for this technology: (TITLE:"proton therapy" OR ABSTRACT:"proton therapy" OR TITLE:"proton beam therapy" OR ABSTRACT:"proton beam therapy"). Results are unfiltered search hits about Proton therapy, not a curated reading list.
Shares Joe Y. Chang, Theodore S. Hong, Hokkaido University Hospital, Apollo Hospitals (Apollo Cancer Centres) and the tag precision.
Shares American Society for Radiation Oncology, European Society for Radiotherapy and Oncology, Siteman Cancer Center, Washington University, Linac, proton system and brachytherapy machine manufacturing and the tag precision.
Shares Chang Gung Memorial Hospital, Apollo Hospitals (Apollo Cancer Centres), Cleveland Clinic Abu Dhabi, Nasal cavity and paranasal sinus cancers (including esthesioneuroblastoma) and the tag precision.
Shares The University of Kansas Cancer Center, National Cancer Center Hospital East, Locoregionally advanced nasopharyngeal carcinoma (stage III to IVA), Recurrent and metastatic nasopharyngeal carcinoma and the tag precision.
Shares National Cancer Center Hospital East, Recurrent and metastatic nasopharyngeal carcinoma, Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes, University College London Hospitals / UCL Cancer Institute and the tag precision.
Shares Chang Gung Memorial Hospital, Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes, Surgery and radiotherapy cure most, get least, Glioma & glioblastoma and the tag precision.
Shares Sylvester Comprehensive Cancer Center, University of Miami, Cancer Center Clínica Universidad de Navarra / CIMA, National Cancer Center Hospital East, Locally advanced cervical cancer and the tag precision.
Shares Sylvester Comprehensive Cancer Center, University of Miami, Cancer Center Clínica Universidad de Navarra / CIMA, National Cancer Center Hospital East, Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes and the tag precision.
Open-source projects that implement or serve this technology, from OnCo's own catalogue: licence and last activity as the repository reported them on the day of the fetch. Listing is not endorsement; check the licence before reuse and the validation before clinical use.
The CERN-led toolkit for simulating the passage of particles through matter, the physics engine under TOPAS, GATE and much radiotherapy research.
DKFZ's open MATLAB toolkit for radiotherapy treatment planning research: photons, protons, carbon ions, dose calculation and optimisation.
The open-source release of TOPAS, the Geant4-based Monte Carlo tool for proton and photon therapy simulation used across radiotherapy physics.
A fast Monte Carlo dose engine for proton therapy from UCLouvain, used inside OpenTPS and other research systems.
An open treatment planning system in Python from UCLouvain, built for proton therapy research with the MCsquare Monte Carlo dose engine.
Every source this page cites, grouped by who published it. Grouping is read from the web address, not assigned by hand.
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