The Promises And Perils Of Proton Radiotherapy: Two-Day Symposium In Baltimore

Main Category: Radiology / Nuclear Medicine
Also Included In: Conferences;  Cancer / Oncology;  Pediatrics / Children's Health
Article Date: 06 Apr 2009 - 1:00 PDT

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Proton therapy has been hailed as a revolutionary cancer treatment, with higher cure rates and fewer side effects than traditional X-ray photon radiotherapy. Proton therapy is the modality of choice for treating certain small tumors of the eye, head, head or neck. It is also safer -- especially for young children -- because it exposes less of the tissue surrounding a tumor to the dosage, proton therapy lowers the risk of secondary cancers later in life.

What does the scientific evidence show about proton therapy? With the rapid proliferation of proton facilities in the United States, what will current and future practitioners of proton radiotherapy need to know?

Now a panel of researchers, clinicians, and public health experts will debate the promise and perils of proton radiotherapy -- a 70-year-old idea that bridges medicine and particle physics. Spearheaded by the AAPM Science Council and sponsored by the American Association of Physicists in Medicine (AAPM), "A Symposium on the Promise and Perils of Proton Radiotherapy" takes place from May 8 to 9 at the Radisson Plaza Lord Baltimore in Maryland. For full details, visit http://www.aapm.org/meetings/09PRS/.

At the symposium, international experts will discuss issues such as current clinical practice, machinery, future developments in delivery and planning, and operational startup and ongoing costs. Controversies related to planning and treatment uncertainties, the question of clinical trials, and biological questions such as RBE and secondary neutrons will also be presented.

HIGHLIGHTS OF THE SYMPOSIUM

• Dr. Eric Klein of Washington University in St. Louis will begin the symposium with a session that presents the state-of-the-art in understanding and creating therapeutic beam of protons. In theory, a thin beam of protons can destroy a tumor with less damage to surrounding tissues than the broader cone of X-ray photons. This is because the protons penetrate a specific distance into the body and release most of their energy at the very end of this trek via an effect called the Bragg peak.
  
  
• The largest session, chaired by Dr. Christopher Rose of the Valley Radiotherapy Associates Medical Group in California, will take a look the latest clinical studies that test these theoretical advantages in the treatment of cancers of the lungs, skull, and prostate. The technology has proven particularly promising for treating small, shallow cancers near the eyes and spine, and for tumors in children, whose developing organs could be damaged by collateral damage.
  
  
• Speakers in a sister session will argue for a lack of clinical evidence supporting some uses of proton therapy. Evidence that it is superior to older technologies is murky for prostate cancer, for example, a controversy that nevertheless has failed to deter the large number of people currently being treated for prostate cancer. "On paper, proton therapy undoubtedly has theoretical advantages … but there are many uncertainties involved when we deliver the radiation to the patient," says Dr. Jatinder Palta of University of Florida Health Science Center in Gainesville, who will chair a session considering these difficulties. While better imaging technologies have improved the aiming of proton beams, irregularities in body or the movements of internal organs can still throw off this targeting, causing unintended damage. The consequences of this damage and new schemes to avoid it will be considered.
  
  
• The process of creating proton beams also generates a large number of neutrons -- which may cause secondary cancers. Studies of survivors of the Hiroshima bomb, who received large doses of neutrons, will be presented to assess this risk.
  
  
• Members of the public health community will join in an evidence-based cost-benefit analysis of the treatment, which can costs two to three times more than traditional therapies. Five clinics with cyclotrons in the United States currently offer the treatment, with four more under construction and a tenth in development. When is the cost justified? What are the ethical issues involved? How can the planning of proton treatments be improved? These and other questions will be addressed both for the benefit of those in the field and for members of the press and public.

ABOUT THE SYMPOSIUM

"A Symposium on the Promise and Perils of Proton Radiotherapy" is organized the by Science Council of the American Association of Physicists in Medicine (AAPM) to inform current and future practitioners of proton radiotherapy. The symposium will be begin with breakfast at 7:00 a.m. on Friday, May 8, and continue until 4:00 pm on Saturday, May 9. All sessions will take place in the Calvert Ballroom of the Radisson Plaza Lord Baltimore in Maryland. For a full list of speakers and the scientific program, visit http://www.aapm.org/meetings/09PRS/MeetingProgramInfo.asp.

Notes:

ABOUT AAPM

The AAPM is a scientific, educational, and professional nonprofit organization whose mission is to advance the application physics to the diagnosis and treatment of human disease. The Association encourages innovative research and development, helps disseminate scientific and technical information, fosters the education and professional development of medical physicists, and promotes the highest quality medical services for patients. In 2008, AAPM celebrated its 50th year of serving patients, physicians, and physicists.

Source:
Devin Powell
American Institute of Physics

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