Is spending on proton beam therapy for cancer going too far, too fast?

Epstein, Keith

doi:10.1136/bmj.e2488

Cited by 18 publications

(10 citation statements)

References 4 publications

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“…In addition, establishing a European Hadron Therapy Register (or better, an International Register) to make better use of the data being generated by the many existing hadron therapy centers would be greatly beneficial. A further controversial article was published in the Biology and Medicine Journal (entitled "Is spending on proton beam therapy for cancer going too far too fast" [129]. However, in answer to this paper, a group of UK oncologists claimed the report misrepresented the approach being used in the UK [130].…”

Section: Discussionmentioning

confidence: 99%

Towards Laser Driven Hadron Cancer Radiotherapy: A Review of Progress

et al. 2014

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It has been known for about sixty years that proton and heavy ion therapy is a very powerful radiation procedure for treating tumors. It has an innate ability to irradiate tumors with greater doses and spatial selectivity compared with electron and photon therapy and, hence, is a tissue sparing procedure. For more than twenty years, powerful lasers have generated high energy beams of protons and heavy ions and it has, therefore, frequently been speculated that lasers could be used as an alternative to radiofrequency (RF) accelerators to produce the particle beams necessary for cancer therapy. The present paper reviews the progress made towards laser driven hadron cancer therapy and what has still to be accomplished to realize its inherent enormous potential.

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Section: Discussionmentioning

confidence: 99%

Towards Laser Driven Hadron Cancer Radiotherapy: A Review of Progress

et al. 2014

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“…[48][49][50][51][52] With the more popular use of proton treatment, the cost-effectiveness comparisons between proton and X-ray treatment attract a lot of attention, especially on some specific sites such as left side breast cancer, head and neck cancer, pediatric cancer, and prostate cancer. [53] For left breast cancer and head and neck cancer, a series report by Lundkvist et al showed incremental cost-effectiveness ratio (iCER, cost/life years gain) of 34290 and 3811, respectively. [54,55] The assumption of their model included reducing the risks of ischemic heart disease, other cardiovascular diseases, and pneumonitis by proton treatment.…”

Section: Cost-effectiveness Consideration For Proton Therapymentioning

confidence: 99%

What are the potential benefits of using proton therapy in Taiwanese cancer patients?

2015

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“…The cost of proton therapy for prostate cancer is typically about twice as much as conventional radiation, three times that of surgery, and 4-5 times that of brachytherapy 9 . In June 2011, a study of prostate cancer patients receiving conventional radiation showed fewer gastrointestinal problems than a similar group treated with proton beams.…”

Section: Proton Beam Therapymentioning

confidence: 99%

“…PBT is also predicted to be useful for children with brain tumours because of its reduced impact on subsequent neuropsychological and IQ development. However, randomized controlled trials (RCT) are required at various PBT centres to examine and evaluate the longterm effects and benefits, so as to establish a strong clinical efficacy and toxicity of PBT, and answer the questions raised and clarify the doubts expressed by a few critics 9 . For example, in hypoxic tumours such as head and neck cancer, Edinburgh randomized trial studies to compare fast neutrons (with high RBE) and photons showed that local control was similar but late severe radiation morbidity was significantly high in the neutrontreated patients 10 .…”

Section: Proton Beam Therapymentioning

confidence: 99%

Evolution and Progress in the Application of Radiation in Cancer Diagnosis and Therapy

Aggarwal¹

2017

Current Science

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Cancer is a ubiquitous health problem globally caused by poor food quality, environmental pollution, genetic factors, etc. Despite the manifold presumptive theories put forth for its causation, there is an extreme paucity of knowledge as regards the actual etiology of cancer, as well as any preventive or prophylactic therapy. The treatment options available include surgery, chemotherapy and radiation therapy (both internal and external). There have been technical and technological advancements in the fields of 'cancer surgery' and 'cancer chemotherapy', and radiotherapy in oncology is not too far behind. X-rays (from linear accelerators LINACs) and gamma rays (e.g. in Bhabhatron) are commonly used for radiation treatment of various types of cancers. New developments include proton beam therapy (PBT) and heavy ion beam therapy (IBT) (e.g. C +6 ion). These new developments of PBT and IBT offer significant advantages to treat paediatric patients, and to radiate deep-seated and radioresistant tumours. This article gives an overview of the various radiation therapies used worldwide, cost comparison of setting up these facilities, operational and treatment costs and advantages, limitations as well as the present status of different charged particle therapy facilities available worldwide.Keywords: Accelerators, cancer, diagnosis, oncology, radiation therapy. CANCER (a generic term for more than 100 different diseases characterized by uncontrolled, abnormal growth of cells) is one of the major killer diseases in humans whose origins are not yet well established despite extensive research in different international laboratories and hospitals all over the world. There are various kinds of cancers, e.g. breast cancer which accounts for 23% of all cancer cases in females, brain cancer, lung cancer, gastrointestinal (GI) cancer, cervical cancer, prostate cancer, etc. The treatment and prognosis are dependent upon the stage at which the cancer is detected, which in turn is governed by the accurate and sensitive cancer diagnostic methodology. Imaging techniques based on different radiations like X-rays and -rays are highly valuable, and are internationally recognized 'gold standards' for cancer diagnosis. X-rays, -rays, -particles, protons and heavy ions are useful for radiation therapy before or after the surgery of a cancerous organ. Radiation therapy can be given by internal radiation (brachytherapy) or external radiation for the treatment of cancer. About 4% of people in developed countries are diagnosed with cancer each year, and more than 50% of these patients are subjected to radiation therapy, along with surgery, as a part of their treatment protocols. Radiation therapy may be used with curative intent, or as a palliative treatment, where cure is not possible. It can be used alone or in combination with other approaches (surgery and chemotherapy) to treat localized solid tumours (e.g. cancers of the skin, brain, breast, or cervix), and also to treat cancers such as leukaemia and lymphoma. Radiation therapy works by ...

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Is spending on proton beam therapy for cancer going too far, too fast?

Abstract: Both the US and UK are pouring money into proton accelerators, which have been described as the world’s “most costly medical devices.” Keith Epstein asks if the investment is premature

Cited by 18 publications

References 4 publications

Towards Laser Driven Hadron Cancer Radiotherapy: A Review of Progress

Towards Laser Driven Hadron Cancer Radiotherapy: A Review of Progress

What are the potential benefits of using proton therapy in Taiwanese cancer patients?

Evolution and Progress in the Application of Radiation in Cancer Diagnosis and Therapy

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