Although proton radiotherapy has been used for patient treatment for decades, very few established indications for proton therapy exist. This is due to the limited availability of proton radiotherapy for clinical studies, and often superior dose distribution and therefore a perceived inherent benefit of protons. Nevertheless, due to dosimetric and biologic uncertainties as well as uncertainties of the clinical benefit, further evidence is needed.

DCPT is now able to treat tumours of the entire body as well as moving tumours. Compared to the size of the Danish population there is capacity to treat established indications as well as a large number of patients in protocols, in order to examine new indications for proton therapy.

Ongoing studies include patients with paediatric cancer, tumours of the brain, liver, recurrent pelvic tumours and recurrent head and neck cancer. There are ongoing national randomised trials offered to patients with cancer of the breast, oesophagus, prostate and head and neck cancer. Upcoming trials include randomised national trial for patients with cancer of the lung and uterine cervix and prospective un-randomized studies for lymphoma and leptomeningeal metastasis.

The clinical studies are initiated by the Danish Multidisciplinary Cancer Groups in cooperation with DCPT. The Danish Centre for Particle Therapy is therefore deeply engaged in national cooperative groups. We are discussing patients for proton treatment in and outside protocols with colleagues from all Danish oncology departments on a daily basis.