Proton beam therapy is an advanced form of external radiotherapy that uses high-energy proton beams instead of photon x-ray beams or electrons. Carefully measured doses of protons are delivered to the precise area needing treatment, using the latest IBA ProteusONE technology. This ensures that the delivery of proton beam therapy is highly accurate and prevents the risk of radiation reaching surrounding healthy tissue.
Radiotherapy is used to kill and destroy cancer cells. It utilises radiation in the form of high-energy x-rays, known as photons, to kill and damage the cancerous cells and prevent their growth and reproduction. It can be used as a non-surgical option to treat cancer, and it can also be used to shrink a tumour or in combination with other treatments.
The Rutherford Cancer Centres and Elekta are bringing the next generation of personalised adaptive radiotherapy technology to oncology centres across the UK, with the new MR-linac Elekta Unity now available at the Rutherford Cancer Centre North West in Liverpool.
External Research Paper
In principle, proton therapy offers a substantial clinical advantage over conventional photon therapy. This is because of the unique depth-dose characteristics of protons, which can be exploited to achieve significant reductions in normal tissue doses proximal and distal to the target volume. These may, in turn, allow escalation of tumor doses and greater sparing of normal tissues, thus potentially improving local control and survival while at the same time reducing toxicity and improving quality of life.
Protons, accelerated to therapeutic energies ranging from 70 to 250 MeV, typically with a cyclotron or a synchrotron, are transported to the treatment room where they enter the treatment head mounted on a rotating gantry. The initial thin beams of protons are spread laterally and longitudinally and shaped appropriately to deliver treatments. Spreading and shaping can be achieved by electro-mechanical means to treat the patients with “passively-scattered proton therapy” (PSPT) or using magnetic scanning of thin “beamlets” of protons of a sequence of initial energies. The latter technique can be used to treat patients with optimized intensity modulated proton therapy (IMPT), the most powerful proton modality.
Despite the high potential of proton therapy, the clinical evidence supporting the broad use of protons is mixed. It is generally acknowledged that proton therapy is safe, effective and recommended for many types of pediatric cancers, ocular melanomas, chordomas and chondrosarcomas. Although promising results have been and continue to be reported for many other types of cancers, they are based on small studies. Considering the high cost of establishing and operating proton therapy centers, questions have been raised about their cost effectiveness. General consensus is that there is a need to conduct randomized trials and/or collect outcomes data in multi-institutional registries to unequivocally demonstrate the advantage of protons.
Treatment planning and plan evaluation of PSPT and IMPT require special considerations compared to the processes used for photon treatment planning. The differences in techniques arise from the unique physical properties of protons but are also necessary because of the greater vulnerability of protons to uncertainties, especially from inter- and intra-fractional variations in anatomy. These factors must be considered in designing as well as evaluating treatment plans. In addition to anatomy variations, other sources of uncertainty in dose delivered to the patient include the approximations and assumptions of models used for computing dose distributions for planning of treatments. Furthermore, the relative biological effectiveness (RBE) of protons is simplistically assumed to have a constant value of 1.1. In reality, the RBE is variable and a complex function of the energy of protons, dose per fraction, tissue and cell type, end point, etc.
These uncertainties, approximations and current technological limitations of proton therapy may limit the achievement of its true potential. Ongoing research is aimed at better understanding the consequences of the various uncertainties on proton therapy and reducing the uncertainties through image-guidance, adaptive radiotherapy, further study of biological properties of protons and the development of novel dose computation and optimization methods. However, residual uncertainties will remain in spite of the best efforts. To increase the resilience of dose distributions in the face of uncertainties and improve our confidence in dose distributions seen on treatment plans, robust optimization techniques are being developed and implemented. We assert that, with such research, proton therapy will be a commonly applied radiotherapy modality for most types of solid cancers in the near future.
Mohan R, Grosshans D. Proton therapy - Present and future. Adv Drug Deliv Rev. 2017 Jan 15;109:26-44. doi: 10.1016/j.addr.2016.11.006. Epub 2016 Dec 3. PMID: 27919760; PMCID: PMC5303653.
*Please refer to the Terms and Conditions of this website when leaving the site and viewing third party content.
Dr Bart Kurec is a consultant clinical oncologist in substantive post in Worcestershire Oncology Centre, specialising in the management of...
Read moreDr Rhian Davies is a Consultant Clinical Oncologist specialising in the management of urological cancers. Her NHS post is in...
Read moreDr Jason Lester is a senior Consultant Clinical Oncologist based in South Wales. He trained and qualified in United Medical...
Read moreDr Sarah Harris qualified from King's College Hospital in 1989. She worked as Consultant Clinical Oncologist at Guys and St...
Read moreDr Gaurav Kumar received primary medical education and core oncology training from India. After working as a consultant in oncology...
Read moreDr Russell Banner is a Consultant Clinical Oncologist based in South Wales. His undergraduate training was at Christ’s College, Cambridge...
Read moreProfessor Roger Taylor is a Consultant Clinical Oncologist specialising in the treatment of patients with brain tumours and lymphoma. Professor...
Read moreDr Ramkumar is a Consultant Clinical Oncologist specialising in non-surgical treatment of Head and Neck cancer, Skull Base Tumours and...
Read moreProfessor Peter Barrett-Lee is a Consultant Clinical Oncologist, Professor of Oncology in the School of Medicine at Cardiff University and...
Read moreDr Cheng Boon is Consultant Clinical Oncologist at the Worcester Oncology Centre at Worcester Royal Hospital. He completed medical training...
Read moreDr Kein Yim is a Consultant Clinical Oncologist. He undertook his medical training in the prestigious institutions of Edinburgh, Cambridge,...
Read moreDr Andrew Gaya is a consultant clinical specialist, who specialises in the multimodality treatment of gastroinstestinal cancers. Using a personalised...
Read moreDr Esme Hill graduated from Birmingham University, also completing an Intercalated BSc in the History of Medicine at University College...
Read moreDr Arif specialises in Gastrointestinal cancers (liver, pancreas, bile duct and bowel cancers). She graduated from India and completed post-graduate...
Read moreDr Sanjay Raj’s special interest is the treatment of breast cancer with chemotherapy, radiotherapy and biological and endocrine treatments. He...
Read moreDr Chris Herbert qualified in medicine at Birmingham University in 2000. He trained in Clinical Oncology in Bristol and completed...
Read moreDr Brinda Sethugavalar studied primary medical education at the University of Dundee Medical School and obtained MBChB in 2004. She completed...
Read moreDr Hans van der Voet is a senior consultant clinical oncologist and radiotherapy lead at the James Cook University Hospital...
Read moreDr Sanana Masinghe has been a consultant clinical oncologist at James Cook University Hospital, South Tees NHS Trust since 2016 and also...
Read moreDr Josef Kovarik is an acting consultant clinical oncologist and a Lead of ENT Oncology at the Northern Centre for Cancer...
Read moreDr Muthiah Sivaramalingam has been a consultant in Clinical Oncology since 2007 and has been Principal Investigator for many clinical...
Read moreThe Rutherford Cancer Centres provide high-quality cancer care by offering access to innovative and advanced treatment techniques using leading technology.
We provide exceptional patient support from diagnosis through to treatment and recovery, with leading consultants available at our centres across the country.
The Rutherford Cancer Centres provide cancer treatments and other healthcare services across the UK with our centres designed to put the patient experience first.
If you'd like to speak to us about any of the treatments we offer please don’t hesitate to get in touch. Call us on 0800 210 0402 or
© Copyright Rutherford Health Plc 2017 - 2022
All rights Reserved