Protons Radiation Oncology Radiotherapy Physics

Protons: A New Era?

Craniopharyngioma Treatment Plan from Ajithkumar et al Clinical Oncology 2018

For our third Journal Club on 2018 we will be discussing protons. We will be discussing some of the medical, economic and political aspects of this modality that have been extensively covered in a theme issue from the team at Clinical Oncology. The issue contains contributions from @thomas_mee , @ranmackay   @MontefioreD and @proton_therapy 


Modern radiotherapy is at a significant point in its’ history with multiple factors converging within the same time frame. These factors include new platforms for treatment, greater understanding of radiobiology and exponential leaps in processing power. These developments are accompanied by increased demand for high technology treatment but a parallel discussion about value in healthcare.

These issues are perhaps no more acute than in the issue of proton therapy. Although not a new treatment (one of contributors, Raj Jena, points out that the therapy is 64 years old this year) it is about to have a debut in the UK with NHS treatment facilities close to an opening date in both London and Manchester (and a Private unit already open in Wales).

The costs of centres are huge, the RCT evidence base is thin and the legacy of financial problems and distorted referral practice are evident in the USA. There are still many unanswered questions about the best use of the treatment outside of paediatric and brain tumour practice.

By bringing together some of the authors from the issue we hope to tackle some of the big questions around these important new developments.

Dr Raj Jena (@ml4cancer) who is a member of the European Network for Light Ion Therapy (ENLIGHT) and the Editor of the Special Edition will be online for one hour alongside Richard Amos (@proton_physicist ) the research lead for Clinical Protons at UCLH on Sunday 6th May at 8pm (BST) 1pm CST

In the days leading up to the live hour we hope to have contributions from proton physicists, researchers and clinicians

Whilst waiting for the journal club you may want to listen to the special issue podcasts recorded by @saifahmad_uk with three of the issue authors Prof. Stephen Hahn, Prof. Anthony Zietman and Prof. Marco Durante

As ever we are grateful to authors and editors for their time and generosity in making the journal club happen. The team have made the entire content of the journal free until May 6th here

During the live hour we will asking questions in this structure:


T1: What have been the challenges (political and practical) in establishing new proton facilities in the UK?


T2: What does the current evidence base support for proton based therapy?


T3: In what areas are protons likely to deliver greatest benefit for future patients?


T4: How is the research effort in proton therapy best coordinated and what questions are most pressing?


I do hope you will join us for at some point in the week or during the live hour.

If you’re new to to the Journal Clubs you can get up to date on how to participate here

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