[Current situation and perspectives of proton therapy]

Area of Science:

• Medical Physics
• Radiation Oncology
• Oncology

Background:

• Proton beam therapy (PBT) is established for rare and pediatric tumors due to its precision.
• Increasing use of PBT generates more dosimetric and clinical data for broader applications.
• Photon therapy remains a standard, but PBT's unique physical properties warrant investigation.

Purpose of the Study:

• To review potential indications for proton beam therapy beyond its current uses.
• To assess the comparative advantages of PBT versus photon therapy based on available evidence.
• To highlight ongoing research and future directions for PBT in oncology.

Main Methods:

• Systematic literature review on Medline using keywords: proton beam therapy, cancer, heavy particle, charged particle.
• Analysis of retrospective and dosimetric studies comparing PBT with photon therapy.
• Inclusion of ongoing clinical trial data (Phase 0-IV) and in silico analyses.

Main Results:

• No Phase III trials directly comparing PBT and photon therapy are published.
• Retrospective and dosimetric studies indicate PBT advantages, especially for thoracic and abdominal tumors adjacent to organs at risk.
• Potential for improved safety profile and/or tumor control with PBT.

Conclusions:

• PBT shows promise for expanded indications in oncology, supported by retrospective and dosimetric data.
• Ongoing clinical trials are investigating PBT for common cancers.
• Further research and clinical trials are needed to confirm PBT's benefits and establish its role in broader cancer treatment paradigms.