Anita Mahajan1
1Mayo Clinic, Radiation Oncology, Rochester, USA
Hypothesis: Proton therapy is the standard of care for pediatric patients, adolescents and young adults who require radiotherapy for many reasons. Methods: Review the unique physical characteristics of particle therapy and interactions in the patient. Consider accomplishments, challenges and hurdles in delivery of treatment for children. Results: Particle therapy has a property of the Bragg peak that describes the rapid fall off of energy deposition in patients. This allows massive reduction in unnecessary dose to the patient which will be associated with fewer immediate and late side effects for vulnerable populations. In comparison to x-ray based radiation plans, proton plans always has a smaller low radiation dose bath that is associated with excess morbidity without compromise of therapeutic dose to the tumor. Proton therapy delivery technology is more complicated that typical x-ray treatment machines; however, with a concerted effort between experienced clinicians and physicists who have had a strong commitment to efficiency, cost reduction, and safety there has been increased availability, confidence and technological advances that have led to excellent outcomes. Conclusion: Proton therapy has a irrefutable advantage over x-ray therapy by virtua of its physical properties and interactions with matter. With the current and future proton therapy technology and increasing availability, it should be the standard of care for these vulnerable populations when considering the optimal therapeutic index.