An evidence based review of proton beam therapy: The report of ASTRO's emerging technology committee

Aaron M. Allen*, Todd Pawlicki, Lei Dong, Eugene Fourkal, Mark Buyyounouski, Keith Cengel, John Plastaras, Mary K. Bucci, Torunn I. Yock, Luisa Bonilla, Robert Price, Eleanor E. Harris, Andre A. Konski

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review


Proton beam therapy (PBT) is a novel method for treating malignant disease with radiotherapy. The purpose of this work was to evaluate the state of the science of PBT and arrive at a recommendation for the use of PBT. The emerging technology committee of the American Society of Radiation Oncology (ASTRO) routinely evaluates new modalities in radiotherapy and assesses the published evidence to determine recommendations for the society as a whole. In 2007, a Proton Task Force was assembled to evaluate the state of the art of PBT. This report reflects evidence collected up to November 2009. Data was reviewed for PBT in central nervous system tumors, gastrointestinal malignancies, lung, head and neck, prostate, and pediatric tumors. Current data do not provide sufficient evidence to recommend PBT in lung cancer, head and neck cancer, GI malignancies, and pediatric non-CNS malignancies. In hepatocellular carcinoma and prostate cancer and there is evidence for the efficacy of PBT but no suggestion that it is superior to photon based approaches. In pediatric CNS malignancies PBT appears superior to photon approaches but more data is needed. In large ocular melanomas and chordomas, we believe that there is evidence for a benefit of PBT over photon approaches. PBT is an important new technology in radiotherapy. Current evidence provides a limited indication for PBT. More robust prospective clinical trials are needed to determine the appropriate clinical setting for PBT.

Original languageEnglish
Pages (from-to)8-11
Number of pages4
JournalRadiotherapy and Oncology
Issue number1
StatePublished - Apr 2012


  • Evidence based guidelines
  • Proton beam therapy
  • Radiation therapy


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