title: Clinical controversies: proton therapy for thoracic tumors.
abstract: Photon and proton therapy techniques have both improved dramatically over the past decade. As a result, high radiation doses can be delivered while sparing organs at risk. However, in many series, older proton techniques have been compared with contemporary photon techniques, hampering a fair comparison. By virtue of their physical properties and because of modern 4-dimensional and imaging evolution, protons show theoretical superiority compared with photons. Current nonrandomized studies suggest that protons may indeed spare organs at risk much better that the best available photon techniques, leading to fewer side effects and the possibility for safe dose escalation. This is the basis for ongoing randomized trials.
authors.affiliation: Radiation Oncology, University Hospitals Leuven/KU Leuven, Leuven, Belgium. dirk.deruysscher@uzleuven.be
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ruysscher
authors.forename: Joe Y
authors.initials: JY
authors.lastname: Chang
mesh_terms: D002986:Clinical Trials as Topic; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008175:Lung Neoplasms / Q000532:radiotherapy*; D009361:Neoplasm Invasiveness; D058958:Organs at Risk / Q000528:radiation effects; D017785:Photons / Q000627:therapeutic use; D061766:Proton Therapy / Q000009:adverse effects / Q000379:methods*; D011788:Quality of Life; D018787:Radiation Oncology / Q000379:methods*; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage