Combining Statins with Radiotherapy for Prostate Cancer: From Photon Experience to Proton Potential

Statins have shown promise as radiosensitizers in photon-based radiotherapy (RT), with studies demonstrating improved biochemical recurrence-free survival and reduced toxicity in prostate and other solid tumors. However, existing data derived entirely from photon-based RT and the potential synergy with proton therapy remain hypothetical at this stage. The current narrative review extrapolates the therapeutic benefits of statins observed in photon-based RT to proton therapy (PBT) to enhance therapeutic efficacy. The proposed combination of statins and PBT is a theoretical extension grounded in the mechanistic overlap between statin-induced radiosensitization and proton-specific advantages in dose conformity and linear energy transfer (LET). The hypothesis of enhanced synergy between statins and PBT warrants systematic preclinical testing and clinical trials before translation into standard practice.