Tuesday, March 21, 2017

Book Review: Proton Beam Therapy

'Proton Beam Therapy' by Harald Paganetti evaluates the basics of proton therapy physics and technology and then outlines some of the current physical, biological, and clinical challenges.
After a brief outline of cancer therapy in general and the approaches of radiation therapy in particular, author homes on to proton therapy, its background and present challenges. Which is followed by a rather heavy discussion on the physics involved in proton therapy, mentioning also that proton therapy is controversial, as the cost involved is higher than conventional therapy.
Then comes a study of the technical challenges being posed by this syatem, which made the proton therapy to wait all these years for its practical introduction to cancer treatment. Though the physics involved in this was known to us for many years, its application had to wait.
The road ahead, is then discussed. The need for more accurate delivery verification and feedback systems to avoid treatment errors, biological challenges like toxicities, comparative effectiveness with reference to other methods of treatment, and possibility of combinations with other approaches, are some of the points covered.
Proton beam therapy is hailed as the most cost-effective treatment, not for all patients or all cancers, but, for those patients that benefit the most from proton therapy. It can be gathered from this book that proton therapy will be used in the future at least for selected patient populations or treatment sites. That is, patients with larger tumour volumes, as well as tumours where photons do not allow dose escalation to levels needed for tumour control.
This book certainly gave me some idea of what to expect in cancer therapy in the years to come.