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
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