Integratie van borstreconstructie en bestraling: hoe het proton-fotondebat methodologische lacunes blootlegt

For breast cancer patients undergoing mastectomy and reconstruction, postmastectomy radiation therapy (PMRT) jeopardizes reconstruction outcomes, yet no universal consensus exists for integrating PMRT with breast reconstruction. The recent expansion of proton therapy has intensified a debate over its role in this setting. While protons offer superior dosimetry and cardiac sparing compared to photons, several studies -focusing on implant-based reconstruction- report higher rates of capsular contracture and reconstruction failure with protons, whereas others show comparable protons outcomes to photons.