Red Journal shines beam on protons: Part 1


The prestigious International Journal of Radiation Oncology-Biology-Physics, or Red Journal, has devoted an entire issue to the subject of particle therapy—bringing protons into the limelight of medical practice. It is the official journal of the American Society for Radiation Oncology.

Much of the nearly 600-page issue, nearly double the normal size, includes 75 articles ranging from clinical outcomes to commentary on a modality increasingly gaining recognition as a preferred option for treatment of tumors.

Over the past 10 years, proton therapy’s availability has increased from three centers to 22 centers across the country, providing more of an opportunity to study its impact on a broad set of patients. The journal included articles about prostate, lung, breast, head and neck, gastrointestinal and ocular cancer.

“Proton therapy is a very attractive treatment for cancer, based on the legacy of sound theory and on decades of clinical experience. Until recently, however, it has been regarded as exotic, expensive, and irrelevant to the majority of cancer patients and practitioners,” wrote Anthony L. Zietman of the department of radiation oncology at Massachusetts General Hospital in the journal’s opening editorial. “We have now reached a ‘tipping point.’”

Continued strong, demonstrable results and a continued decline in the cost are needed to push proton therapy toward wider adoption and investment in the technology. The Red Journal’s attention to the subject “shows how far this treatment, and our specialty, has come,” Zietman wrote.

Dr. Allen Meek, medical director for Provision Medical Group, said the journal offers concrete proof that proton therapy is coming out of obscurity.

“As a radiation oncologist I’ve long been an advocate for proton therapy, but we have a big hill to climb educating patients and their referring physicians,” Meek said. “The presence of this publication does a lot to help make our case.”

Dr. Marcio Fagundes, Medical Director for Provision Center for Proton Therapy agreed.

“I often give patients who come for consult copies of peer-reviewed articles on proton therapy to share with their physicians,” Fagundes said. “The evidence is definitely stacking up in favor of proton therapy, and the Red Journal helped us take a leap forward in that regard.”

If history repeats itself, this publication could mark a shift in the development of proton therapy from a “novel” approach to cancer treatment to a widely accepted and available one, said Scott Warwick, Provision vice president for strategic initiatives and program development who is currently serving as chairman for the National Association for Proton Therapy.

“If I recall correctly, there was a sentinel journal publication in the history of PET (positron emission tomography) that was instrumental in the breakthrough of that advance imaging technology,” Warwick said. “Let’s hope this significant event will have a similar impact on the field of proton therapy.”

The Red Journal also includes several articles of interest to patients weighing their options for cancer treatment.

For example, a University of Florida study of prostate cancer patients includes 1,300 men and reveals positive outcomes for men treated with proton therapy. More on that and other studies in Part 2 of our Red Journal coverage.