Abstract

Proton therapy is a rapidly expanding modality for cancer treatments, with many new facilities being built around the world. Indeed, two such facilities will be installed in the next few years in the NHS, providing the capability of advanced proton therapy for a select number of patients.

The main advantage of protons for radiotherapy is the localised deposition of energy (dose) in the so-called Bragg peak. This 'focus' of high dose can be considered a spot of radiation, which can be painted over the tumour, such as to conform the high doses to the tumour more effectively than conventional radiotherapy using photons. Current state-of-the-art proton therapy is based on the Pencil Beam Scanning (PBS) approach (pioneered and developed at the Paul Scherrer Institut in Switzerland), which provides the flexibility and efficiency of modern radiotherapy techniques such as IMRT. However, only now are reports based on meaningful numbers of patients beginning to emerge, with encouraging results.

In this presentation, the basics of PBS proton therapy will be presented and its potential advantages demonstrated. In addition, an overview of the first clinical results from our own, and other clinics, will be discussed. Given its dose sparing advantages, we will show that proton therapy brings significant advantages in the treatment of children and young adults, but also in the treatment of geometrically complex and large tumours over a whole spectrum of indications. The installation of two such facilities in the UK will thus be an important addition to the NHS armoury in the fight against cancer.