SBRT 2016

How to Prove the Benefit of Protons or Other Technology?

 Randomized Controlled Trials (RCTs) are the golden standard to proof benefit of competitive treatments 1. Technology evolves fast and when the outcomes are published the technique has already been outdated 2. Events are rare or delayed (secondary tumors, cardiac morbidity) 3. Equipoise is missing if the “experimental” technique is only meant to reduce side effects or the induction of secondary tumors (ALARA: less is better)