REVIEW OF CURRENT PROTOCOLS FOR PROTONTHERAPY IN USA

The basis for interest in proton beams by clinical radiation oncologis ts lies in reduction in treatment volume. The yields from employing a smaller treatment volume are the increase of tumor control probability and the reduction of normal tissues complication probability. The cli nical use of proton therapy began in 1954 at Uppsala University in Swe den and in 1961 at Harvard Cyclotron Laboratory in Boston, USA, So far , the total number of worldwide patients treated by protons is about 2 0,000. In this paper attention will be given to the treatment of patie nts at the Massachusetts General Hospital-Massachusetts Eye and Ear In firmary-Harvard Cyclotron Laboratory, and at the Loma Linda University Medical Center. In particular, a review of the literature about the t echniques and the results of treatment of skull base and cervical spin e chordoma and low grade chondrosarcoma, skull base meningioma, pituit ary tumors, paranasal sinus carcinoma, glioblastoma multiforme, artero -venous malformations, uveal melanoma, macular degeneration, retinobla stoma, thoracic spine-sacrum tumors, and prostate carcinoma Is present ed. In order to verify and improve the clinical results, the conduct o f prospective trials on an inter-institutional basis is essential. To facilitate the conduct of such studies the US National Cancer Institut e and the American College of Radiology have established the Proton Th erapy Oncology Group (PROG). Several phase III and some phase I-II tri als are active at the Massachusetts General Hospital, Harvard Cyclotro n Laboratory, and at the Loma Linda University Medical Center.