“Proton beam therapy (PBT) is more expensive process than conventional radiotherapy (XRT), but some studies suggest PBT causes less side effects. PBT is not a new invention, the first patients were treated by PBT in 1954. PBT is becoming more widespread, althought this therapy requires large investments, high operation costs and big infrastructure. As of December 2015, 57 proton therapy centers are in operation worldwide and others are under building or planning.
Clinical benefit (improving survival rate or less toxicity) of proton therapy compared to other treatments has yet to be proved. The biggest handicap of the proton therapy is the lack of randomized trials to demonstrate the benefits of this therapy. The main argument of opponents of therapy is the high cost.
The author mentions some thoughts on treatment of various types of cancer by proton therapy (pediatric tumors, adult tumors: prostate tumor, uveal melanoma, chordoma and chondrosarcoma, breast cancer, lung cancer, brain tumors, head and neck cancers, GI malignancies, Hodgkin’s lymphoma, re-irradiation).
The author’s final conclusion: proton therapy at present is costly and accessible to a few patients only. The missions of the future: oncologist community should agree that the PBT is effective and new technical developments should be done that enable this technology to become cheaper and more accessible.” – Maurizio Amichetti
What is proton therapy?
„Proton therapy is an advanced way of treating cancer patients who need radiation therapy. Treatment involves using a beam of protons — subatomic particles carrying a positive charge — that is generated by accelerating hydrogen gas in a particle accelerator called a cyclotron. This proton beam is then directed to the cancerous site in the patient’s body. The beam can be shaped precisely to match the specific size and shape of the tumor. As the beam passes through DNA molecules in cancerous cells, the positive charge of the protons pulls negatively charged electrons in the DNA out of place. This ionization process changes the fundamental characteristics of the individual atoms that make up the DNA molecule, which in turn changes how its base pairs interact and replicate. The DNA becomes so damaged that the cell can no longer function and undergoes apoptosis, or programmed cell death, in which the cell sends out signals to break down its own structures.”
How is proton therapy different from radiation therapy?
„Traditional radiation therapy uses X-rays, which expose the patient to potentially harmful electromagnetic radiation as they enter and exit the body. Protons, on the other hand, stop at a pre-determined depth inside the patient and do not deposit any radiation dose beyond that depth.”
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