Can proton therapy be considered a standard of care in oncology? Lessons from the United States

Cet article passe en revue les avancées récentes en matière de délimitation du volume tumoral cible, de radiothérapie guidée par l'imagerie et de radiothérapie adaptative, puis recherche la façon de combiner ces différentes avancées pour améliorer les résultats cliniques et réduire la toxicité à long terme des rayonnements ionisants

Résumé en anglais

In April 2018, the New York Times ran an article documenting the exuberant overexpansion of proton beam therapy centres in the USA.1 Twenty-seven centres have opened, and a comparable number are in the planning stages; yet, over a third of these are in deep financial trouble, with mounting losses, debt restructuring, and bankruptcies. How did such a promising and exciting medical technology expand so far and then contract so fast? Was this due to problems in the technology itself, or aspects of healthcare financing unique to the USA? How did a technology expand so far ahead of its supportive evidence? And what are the implications for the UK as it stands on the threshold of its own proton age?