• Chart of the day: Accelerating growth in proton beam accelerators

    Another fine chart from the recent paper by Amitabh Chandra, Jonathan Holmes, and Jonathan Skinner:

    No, this is not an explosion in high energy physics research. This is medicine, very expensive medicine.



    • When I search Pubmed for proton beam therapy with the modifier of phase III clinical trial, I get 22 hits of which 15 are trials of proton pump drugs. There is one randomized trial from 1995 comparing the then standard radiation with standard radiation plus a proton beam boost. No difference in survival or length of freedom from relapse; the proton boost did yield better control of the tumor in the prostate but with more toxicity.
      Proton beam therapy was developed in the late 1980’s to answer the problem of imprecision of the conventional therapy of the day. Since then, the precision of ordinary photon beam therapeutic radiation has improved substantially by the use of techniques like IMRT. Proton beams are still a little more precise, but the difference is about one millimeter or so which I doubt has clinical significance. Proton beam is a hardware solution to a software problem. Is it anything more than a marketing tool?