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Three discipline collaborative radiation therapy (3DCRT) special debate: The United States needs at least one carbon ion facility

Year: 2019

Type: article

Abstract: Radiation oncology is a highly multidisciplinary medical specialty, drawing significantly from three scientific disciplinesmedicine, physics, and biology.As a result, discussion of controversies or changes in practice within radiation oncology involves input from all three disciplines.For this reason, significant effort has been expended recently to foster collaborative multidisciplinary research in radiation oncology, with substantial demonstrated benefit.(1,2 ) In light of these results, we endeavor here to adopt this "team-science" approach to the traditional debates featured in this journal.This article is part of a series of special debates entitled "Three Discipline Collaborative Radiation Therapy (3DCRT)" in which each debate team will include a radiation oncologist, medical physicist, and radiobiologist.We hope that this format will not only be engaging for the readership but will also foster further collaboration in the science and clinical practice of radiation oncology. | INTRODUCTIONHigh linear energy transfer (LET) radiotherapy has long held the promise of improved efficacy against tumors that are refractory to conventional radiotherapy.While such an increase in efficacy is achievable with fast neutron therapy, poor physical dose distribution characteristics have limited its potential.Carbon ions are an elegant solution in that they combine the biological effectiveness of fast neutron therapy with physical dose shaping characteristics even better than proton therapy.However, the cost of technology to deliver this treatment is tremendous and its clinical potential remains largely unproven.Clinical trials are underway in several countries, helping us gather the necessary data to demonstrate its efficacy.However, the United States, a traditional world leader in the development and implementation of advanced healthcare technology, is not among them.Considering the substantial potential benefit of this treatment and also our current efforts to contain the costs of healthcare, is now the time for the United States to step from the sidelines to participate in this research?This is the subject of this month's 3DCRT debate.Arguing for the proposition will be Drs.

Source: Journal of Applied Clinical Medical Physics

DOI: 10.1002/acm2.12727