Current evidence for and future research in proton therapy

Programme stream(s): Treatment
Programme session type(s): Parallel session

Chair: Maria Hawkins, University of Oxford
Speaker: Daniel Indelicato, University of Florida, USA
Speaker: Cai Grau, Aarhus University, Denmark
Speaker: David Sebag-Montefiore, University of Leeds

11:00 am-12:30 pm

Room: Dochart

Nearly one‐half of patients with newly diagnosed cancer will undergo radiotherapy, a form of treatment that has been available for more than 100 years. Most of these patients receive external‐beam radiotherapy using photons. Over the past 10 years, there has been increased interest in proton‐beam RT and this technology is now available in the NHS in Manchester and London.
Although the international proton therapy clinical trials portfolio is rapidly expanding, most patients had been accrued to observational studies. Most importantly, the continued absence of high‐level evidence that proton‐based treatment results in improved clinically significant results for any specific cancer type, site, or age group highlights the further need to evaluate protons effectiveness with conventional radiotherapy in a randomized fashion.

Participants will learn about the major challenges for the future of proton radiotherapy:

– Advance radiobiological knowledge to address uncertainty in optimal fraction sizes and doses and relative biologic effectiveness for each tumour site (biology);
– Research uncertainties of effective dose and range at the end of the Bragg peak (physics and accuracy);
– Integration of technology to advance key areas from beam acceleration and delivery through treatment planning and image guidance (engineering/physics to create equipoise with x‐ray–based treatment).
– Exchange of technology, funding, and infrastructure between academic centres, health care payers, industry, and funding agencies (operational).
– Definition of the patient population to be studied (clinical) and designing proof‐of‐principle international trials to optimise treatment of the selected cancer is key in supporting proof of clinical effectiveness and cost effectiveness including involving patients and public ab initio. (societal).
– Incorporating translational rich elements (including biomarker metabolic, immune etc) will aid with further refinement of the indications.