@brianjarvis What the PARTIQoL study did was shut down most insurance reimbursement (including Medicare Advantage but not classic Medicare) for proton treatment of prostate cancer. Medicare just started a precertification demo to lower cost on overused / unnecessary procedures. That may cut off Medicare proton funding for prostate cancer within 5 years if that gets expanded. Most proton facilities do a lot of head /neck and pediatric cancers because insurance will pay for them because proton treatment has been shown to be superior in trials vs. photon.

The fact that photon and proton treatments show comparable outcomes does not negate the laws of physics. It just means that the scattered photon doses from the latest machines are not doing enough biological damage to be measurable, at least not with the methods and time frames in these studies.