ReviewActa oncologica (Stockholm, Sweden)2017
Radiobiological issues in proton therapy.
Review in Acta oncologica (Stockholm, Sweden), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 37 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
37 citing papers in PubMed.
- Clinical outcomes of image-guided proton therapy for histologically confirmed stage I non-small cell lung cancer.Radiation oncology (London, England) · 2018Trial
- Microdosimetric characterization of proton relative biological effectiveness in pancreatic ductal adenocarcinoma cell lines.Frontiers in oncology · 2026Article
- Experimental design and control methods for dose rate optimization in a synchrotron-based proton therapy beamline.Precision radiation oncology · 2025Article
- Why are not all paediatric cancer patients treated with protons? A population-based report from Sweden, 2016-2023.Acta oncologica (Stockholm, Sweden) · 2025Article
- Clinical advances and challenges in dose constraints for organs at risk in proton therapy: A systematic review of the last decade's literature.Precision radiation oncology · 2025Review
- The proton therapy research beamline at the Christie NHS foundation trust.Biomedical physics & engineering express · 2025Article
- Current state of proton therapy for tumors of the central nervous system in Spain: physical bases, indications, controversies and perspectives.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Review
- Advanced Radiotherapy Technologies in Spine Tumors: What the Surgeon Needs to Know.Global spine journal · 2025Article
- Interpreting the biological effects of protons as a function of physical quantity: linear energy transfer or microdosimetric lineal energy spectrum?Scientific reports · 2024Article
- Possible association of dose rate and the development of late visual toxicity for patients with intracranial tumours treated with pencil beam scanned proton therapy.Radiation oncology (London, England) · 2024Article
- Incorporating variable RBE in IMPT optimization for ependymoma.Journal of applied clinical medical physics · 2024Article
- Heterogeneity in biological response of MDA-MB-231 cells after proton irradiation along different parts of the depth-dose curve: before, within, and behind the Bragg peak.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2024Article
- Intensity modulated proton arc therapy via geometry-based energy selection for ependymoma.Journal of applied clinical medical physics · 2023Article
- Characterisation and Quenching Correction for an AlSensors (Basel, Switzerland) · 2022Article
- Reflections on beam configuration optimization for intensity-modulated proton therapy.Physics in medicine and biology · 2022Review
- Particle Therapy for Breast Cancer.Cancers · 2022Review
- Assessment of the Relative Biological Efficiency of Pencil Beam Scanning of Protons in Mice in Vivo.Doklady. Biochemistry and biophysics · 2021Article
- Proton Therapy for HPV-Associated Oropharyngeal Cancers of the Head and Neck: a De-Intensification Strategy.Current treatment options in oncology · 2021Review
- Future Perspectives of Proton Therapy in Minimizing the Toxicity of Breast Cancer Radiotherapy.Journal of personalized medicine · 2021Review
- Linear energy transfer weighted beam orientation optimization for intensity-modulated proton therapy.Medical physics · 2021Article
Corrections and comments
- Erratum issuedCorrection.2019
Authors and funding
6 authors.
Funding
Abstract
backgroundThe relative biological effectiveness (RBE) for particle therapy is a complex function of particle type, radiation dose, linear energy transfer (LET), cell type, endpoint, etc. In the clinical practice of proton therapy, the RBE is assumed to have a fixed value of 1.1. This assumption, along with the effects of physical uncertainties, may mean that the biologically effective dose distributions received by the patient may be significantly different from what is seen on treatment plans. This may contribute to unforeseen toxicities and/or failure to control the disease. Variability of Proton RBE: It has been shown experimentally that proton RBE varies significantly along the beam path, especially near the end of the particle range. While there is now an increasing acceptance that proton RBE is variable, there is an ongoing debate about whether to change the current clinical practice. Clinical Evidence: A rationale against the change is the uncertainty in the models of variable RBE. Secondly, so far there is no clear clinical evidence of the harm of assuming proton RBE to be 1.1. It is conceivable, however, that the evidence is masked partially by physical uncertainties. It is, therefore, plausible that reduction in uncertainties and their incorporation in the estimation of dose actually delivered may isolate and reveal the variability of RBE in clinical practice. Nevertheless, clinical evidence of RBE variability is slowly emerging as more patients are treated with protons and their response data are analyzed. Modelling and Incorporation of RBE in the Optimization of Proton Therapy: The improvement in the knowledge of RBE could lead to better understanding of outcomes of proton therapy and in the improvement of models to predict RBE. Prospectively, the incorporation of such models in the optimization of intensity-modulated proton therapy could lead to improvements in the therapeutic ratio of proton therapy.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.