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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 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.
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 Poorly differentiated chordoma (SMARCB1-deficient), Pencil-beam scanning and intensity-modulated proton therapy, Growth and final height after treatment in childhood, and growth hormone, SJMB12.
Shares Persistent radiation-induced alopecia, Growth and final height after treatment in childhood, and growth hormone, COG ACNS0331, Breast cancer after chest radiotherapy in childhood, and the screening that follows.
Shares COG ACNS0331, Teeth, jaws and facial growth after treatment in childhood, Children's Hospital of Philadelphia, WNT-activated medulloblastoma.
Shares Growth and final height after treatment in childhood, and growth hormone, COG ACNS0331, Breast cancer after chest radiotherapy in childhood, and the screening that follows, Teeth, jaws and facial growth after treatment in childhood.
Shares Case Comprehensive Cancer Center, O'Neal Comprehensive Cancer Center at UAB, MUSC Hollings Cancer Center, Sylvester Comprehensive Cancer Center, University of Miami.
Shares Apollo Hospitals (Apollo Cancer Centres), Georgetown Lombardi Comprehensive Cancer Center, Samsung Medical Center, Spinal cord tumours (intramedullary and intradural).
Shares Very-high-energy electron therapy, Compact FLASH and proton systems at the price of a conventional linac, A coordinated FLASH radiotherapy evidence programme with shared dose-rate standards, Pencil-beam scanning and intensity-modulated proton therapy.
Shares WNT-activated medulloblastoma, Charité Universitätsmedizin Berlin, Central nervous system germ cell tumours (germinoma and non-germinomatous), Group 3 and group 4 medulloblastoma (non-WNT/non-SHH).
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.