Evidence map›Paper›PMID 33227715›Full record

ReviewPhysics in medicine and biology2021

Roadmap: proton therapy physics and biology.

Harald Paganetti, Chris Beltran, Stefan Both, Lei Dong, Jacob Flanz, Keith Furutani, Clemens Grassberger, David R Grosshans, Antje-Christin Knopf, Johannes A Langendijk and 11 more

Abstract readReview
In one paragraph

Review in Physics in medicine and biology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 74 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
74citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

74 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. The current status of FLASH particle therapy: a systematic review.Physical and engineering sciences in medicine · 2023
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
  10. Review
  11. Advancing proton therapy together: insights on practice, technology, and implementation.Technical innovations & patient support in radiation oncology · 2025
    Article
  12. Practical considerations for handling implants in proton therapy.Journal of applied clinical medical physics · 2025
    Article
  13. Article
  14. Article
  15. Article
  16. Differentiation Stage Predicts Radiosensitivity in Mesenchymal-Like Pancreatic Cancer.International journal of radiation oncology, biology, physics · 2025
    Article
  17. Review
  18. Article
  19. Article
  20. Article

14 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Harald PaganettiDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, United States of America.ORCID 0000-0002-6257-2413
Chris BeltranDivision of Medical Physics, Department of Radiation Oncology, Mayo Clinic, Rochester, United States of America.
Stefan BothDepartment of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands.
Lei DongDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, United States of America.
Jacob FlanzDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, United States of America.
Keith FurutaniDivision of Medical Physics, Department of Radiation Oncology, Mayo Clinic, Rochester, United States of America.
Clemens GrassbergerDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, United States of America.
David R GrosshansDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States of America.
Antje-Christin KnopfDepartment of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands.
Johannes A LangendijkDepartment of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands.
Hakan NystromDanish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.
Katia ParodiLudwig-Maximilians-Universität München, Department of Experimental Physics-Medical Physics, Munich, Germany.
Bas W RaaymakersDepartment of Radiotherapy, University Hospital Utrecht, The Netherlands.
Christian RichterOncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
Gabriel O SawakuchiDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, United States of America.ORCID 0000-0001-5560-0650
Marco SchippersPaul Scherrer Institut, Villigen, Switzerland.
Simona F ShaitelmanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States of America.
B K Kevin TeoDepartment of Radiation Oncology, University of Pennsylvania, Philadelphia, United States of America.
Jan UnkelbachRadiation Oncology Department, University Hospital Zürich, Zürich, Switzerland.
Patrick WohlfahrtDepartment of Radiation Oncology, Massachusetts General Hospital, Boston, United States of America.
Tony LomaxPaul Scherrer Institut, Villigen, Switzerland.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DIANE BODURKA · 1985 to 2026
$290.8M
Project 3: Enhanced Sensitivity of Tumors to Proton Beam Therapy: Mechanisms and Biomarkers.P01CA261669 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI TITT, UWE · 2021 to 2025
$14.0M
MDACC Clinical and Research Physics SupportU19CA021239 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI HONG, THEODORE S · 2014 to 2018
$11.2M
NCI NIH HHS P01 CA261669NCI NIH HHS P30 CA016672NCI NIH HHS U19 CA021239
6 · The paper itself

Abstract

The treatment of cancer with proton radiation therapy was first suggested in 1946 followed by the first treatments in the 1950s. As of 2020, almost 200 000 patients have been treated with proton beams worldwide and the number of operating proton therapy (PT) facilities will soon reach one hundred. PT has long moved from research institutions into hospital-based facilities that are increasingly being utilized with workflows similar to conventional radiation therapy. While PT has become mainstream and has established itself as a treatment option for many cancers, it is still an area of active research for various reasons: the advanced dose shaping capabilities of PT cause susceptibility to uncertainties, the high degrees of freedom in dose delivery offer room for further improvements, the limited experience and understanding of optimizing pencil beam scanning, and the biological effect difference compared to photon radiation. In addition to these challenges and opportunities currently being investigated, there is an economic aspect because PT treatments are, on average, still more expensive compared to conventional photon based treatment options. This roadmap highlights the current state and future direction in PT categorized into four different themes, 'improving efficiency', 'improving planning and delivery', 'improving imaging', and 'improving patient selection'.

Indexed as

NeoplasmsProton TherapyBiologyHumansPhotonsPhysicsRadiotherapy DosageRadiotherapy Planning, Computer-Assisteddosimetryimagingproton radiation therapy

Identifiers

PMID33227715
PMCPMC9275016

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

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.