Proton beam therapy

These heavily charged particles are produced by a cyclotron and deliver their energy and therefore biological effects in a small-defined area at the end of their range (often millimetres)—the so-called 'Bragg peak'. This reduces the dose to underlying normal tissue. Complex multiple beams can be used to deliver a high dose to a small area. So far their use has been limited to superficial tumours such as uveal melanomas. Higher-energy beams now allow deeper-seated tumours to be treated e.g. chordoma of the clivus.

Approximately 2000-3000 patients are treated worldwide each year and most of the treatment centres are still based in physics laboratories. Improvements may be made by better tumour selection and technical advances in treatment delivery.

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