Proton therapy and cancer: clinical horizon 2030 in Spain

Abstract

Proton therapy is the external beam irradiation technique that, by providing extreme dosimetric accuracy, minimises exposure to unnecessary disperse ionising radiation effects to normal, non-cancerous tissues. This technology requires high-cost investments, but its rate of implementation has been exponential over the last 15 years. In 2023, proton therapy will have a competitive business portfolio in the international healthcare environment: more than 128 active centres (46 in the USA). The progression of clinical activity in proton therapy identifies the following sequence: more than 55,000 patients treated until 2006, more than 75,000 in 2010, more than 100,000 in 2014 and 312,000 in May 2023. In addition, 38 proton therapy centres under construction and 29 in planning (including the next 10 planned in the National Health System, SNS) are registered. The most robust clinical evidence published since 2010 has been reviewed. Among the studies evaluated (>30,000 patients analysed), mature results are observed, reproducible among expert institutions, where the dosimetric benefit allows establishing levels of clinical benefit in the context of the dynamism of multimodal cancer treatment. The 2030 clinical horizon of proton therapy in Spain, will be aligned to the international impulse of the last two decades, but in an exceptional context of availability of the technological resource due to the recent donation to the SNS of 10 proton therapy units by the Amancio Ortega Foundation. This singular (admirable) action of sponsorship does impulse the promotion of health in the Spanish population and will allow extreme technological availability, literally at the patient’s bedside. The Spanish Society of Radiation Oncology has the compromise to impulse research, development, and innovation at the service of the patients and society.