Click here to


Are you sure ?

Yes, do it No, cancel

Point/Counterpoint: Most Pediatric Patients Should Be Treated at Proton Therapy Centers

C Hua1*, S Flampouri2*, P Xia3*, D Mah4*, A Olch5*, (1) St. Jude Childrens Research Hospital, Memphis, TN, (2) Emory University, Atlanta, GA, (3) The Cleveland Clinic Foundation, Cleveland, OH, (4) Procure Treatment Center, Somerset, NJ, (5) Children's Hospital of Los Angeles, Los Angeles, CA


(Wednesday, 7/15/2020) 10:30 AM - 11:30 AM [Eastern Time (GMT-4)]

Room: Track 5

Many physicists consider proton therapy an ethical choice for pediatric and adolescent cancer patients based on the superior physical dose distribution and the long-term survival rate. However, a recent survey showed only 20% of radiation therapy clinics that treat children had access to proton beams. The debatable question then arises whether we are offering a suboptimal treatment to the majority of pediatric cancer patients.

Nonbelievers of proton therapy may argue against it by giving these reasons: unclear biological dose (i.e. RBE), substantial range uncertainty and sensitivity to patient setup and anatomic changes, dose conformity of superficial tumors, prolonged treatment time especially for large tumors, cost, patient and caregiver away from home, no strong clinical evidence of significantly reduced toxicities, and improved photon plan quality and delivery. On the other hand, proton therapy proponents could list many exciting developments, such as reduced spot size for improved dose sculpting, single-room compact proton gantry, biologically relevant dose calculation and optimization, FLASH proton irradiation for normal tissue sparing, fast Monte Carlo dose calculation, in vivo range verification, and direct stopping power calculation for reduced range uncertainty.

The debate session provides points/counterpoints to consider when choosing proton or photon therapy for pediatric population, but technical knowledge gained will be also valuable and practical for medical physicists who are mainly involved in adult radiotherapy. The debate will be open to the audience to participate and express their perspectives.

Learning Objectives:
1. Recognize the challenges of treating pediatric cancers with radiation therapy.
2. Describe the latest breakthrough technologies, treatment uncertainties, and mitigation strategies for proton and photon therapy.
3. Be able to provide technical consultations on planning and delivery considerations as well as pros and cons affecting the choice of proton or photon therapy.



Not Applicable / None Entered.


Not Applicable / None Entered.

Contact Email