ABSTRACT
The main purpose of recent advances in surgical technology – for example, laparoscopic, thoracoscopic, robot-assisted surgery – is reduction of surgical collateral damage by reducing the surgical trauma, thus reducing the normal tissue complication probability (NTCP). Minimally invasive and organ-sparing surgery, both crucial developments in contemporary surgery, are typical examples. Particle therapy fits nicely into this line, its main purpose being reduction of radiation toxicity by reducing dose to tissues surrounding malignant tumours. Employing particle therapy, in particular proton therapy, thus encounters comparable issues as surgery when having to demonstrate its added value in terms of superiority regarding toxic effects of radiation, or its non-inferiority or equivalence regarding tumour outcome. integrating particle beam therapy into multidisciplinary treatment decisions should follow generally accepted principles of evidence-based medicine: just like using a new drug or a novel surgical technique does not require different reasoning at multi-disciplinary tumour boards, neither does particle therapy.
