Paging Dr. Hall.
Where are we in the quest to demonstrate the superiority of protons? For anything..? Here is a review of largely disappointing published and ongoing trials designed to accomplish this feat, with the underlying theme that the designs are the real problem. It hits you with both the detailed intricacies of the radiobiologic differences between photons and protons as well as some harsh common sense that has been missing in many trials to date. Simply(!) put, many comparisons are born out of attempts to capitalize on the unique dosimetry of protons—which, by the way, has just as many downsides as that of photons—while completely ignoring the unique biologic responses induced by protons ripe for therapeutic exploitation. | Prasanna, Int J Radiat Oncol Biol Phys 2021