Proton therapy for prostate cancer

Proton beam radiation therapy allows dose escalation to the tumor with less scatter radiation dose to the surrounding tissues because of the physical characteristics of protons compared with x-rays. Although numerous published reports have shown excellent clinical outcomes after proton therapy for prostate cancer, no randomized trial has been reported to date directly comparing protons and x-rays. As such, significant controversy remains regarding the use of proton therapy over x-rays with intensity-modulated radiation therapy (IMRT). This chapter summarizes the physics of proton therapy and recent technical advances in the delivery of the proton beam and reveiws the published clinical data. This chapter also describes the protocol used at MD Anderson for treating prostate cancer with proton therapy.