Makbule Tambas1, Hans Paul van der Laan2, Roel J H M Steenbakkers2, Jerome Doyen3, Beate Timmermann4, Ester Orlandi5, Morten Hoyer6, Karin Haustermans7, Petra Georg8, Neil G Burnet9, Vincent Gregoire10, Valentin Calugaru11, Esther G C Troost12, Frank Hoebers13, Felipe A Calvo14, Joachim Widder15, Fabian Eberle16, Marco van Vulpen17, Philippe Maingon18, Tomasz Skóra19, Damien C Weber20, Kjell Bergfeldt21, Jiri Kubes22, Johannes A Langendijk2. 1. University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, The Netherlands. Electronic address: m.tambas@umcg.nl. 2. University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, The Netherlands. 3. Department of Radiation Oncology, Centre Antoine-Lacassagne, University of Côte d'Azur, Nice, France. 4. Department of Particle Therapy, University Hospital Essen, West German Proton Therapy Centre Essen (WPE), West German Cancer Center (WTZ), Germany; German Cancer Consortium (DKTK), Germany. 5. Radiation Oncology Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Pavia, Italy. 6. Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark. 7. Department of Radiation Oncology, UZ Leuven, Belgium. 8. MedAustron Ion Therapy Center, Austria. 9. Proton Beam Therapy Centre, The Christie NHS Foundation Trust, Manchester, UK. 10. Radiation Oncology Department, Centre Léon Bérard, Lyon, France. 11. Institut Curie, Radiation Oncology Department, Paris & Proton Center, Orsay, France. 12. OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden - Rossendorf, Germany; Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany; National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany; Helmholtz Association / Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Germany; German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany. 13. Department of Radiation Oncology (MAASTRO Clinic), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre+, The Netherlands. 14. Department of Radiation Oncology, University of Navarra, Madrid, Spain. 15. Department of Radiation Oncology, Comprehensive Cancer Center Vienna, Medical University of Vienna, Austria. 16. Department of Radiotherapy and Radiooncology, University Hospital Marburg, Marburg Ion-Beam Therapy Center (MIT), University Center for Tumor Diseases Frankfurt and Marburg (UCT), Germany. 17. HollandPTC, Delft, The Netherlands. 18. Sorbonne University, AP-HP. Sorbonne University, Hôpitaux Universitaires La Pitié Salpêtrière, Paris, France. 19. Maria Skłodowska-Curie National Research Institute of Oncology, Department of Radiotherapy, Kraków, Poland. 20. Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Switzerland. 21. Skandion Clinic, Uppsala, Sweden. 22. Depatment of Oncology, Motol University Hospital and Proton Therapy Center Czech, Prague, Czech Republic.
Abstract
BACKGROUND AND PURPOSE: Major differences exist among proton therapy (PT) centres regarding PT delivery in adult cancer patient. To obtain insight into current practice in Europe, we performed a survey among European PT centres. MATERIALS AND METHODS: We designed electronic questionnaires for eight tumour sites, focusing on four main topics: 1) indications and patient selection methods; 2) reimbursement; 3) on-going or planned studies, 4) annual number of patients treated with PT. RESULTS: Of 22 centres, 19 (86%) responded. In total, 4233 adult patients are currently treated across Europe annually, of which 46% consists of patients with central nervous system tumours (CNS), 15% head and neck cancer (HNC), 15% prostate, 9% breast, 5% lung, 5% gastrointestinal, 4% lymphoma, 0.3% gynaecological cancers. CNS are treated in all participating centres (n = 19) using PT, HNC in 16 centres, lymphoma in 10 centres, gastrointestinal in 10 centres, breast in 7 centres, prostate in 6 centres, lung in 6 centres, and gynaecological cancers in 3 centres. Reimbursement is provided by national health care systems for the majority of commonly treated tumour sites. Approximately 74% of centres enrol patients for prospective data registration programs. Phase II-III trials are less frequent, due to reimbursement and funding problems. Reasons for not treating certain tumour types with PT are lack of evidence (30%), reimbursement issues (29%) and/or technical limitations (20%). CONCLUSION: Across European PT centres, CNS tumours and HNC are the most frequently treated tumour types. Most centres use indication protocols. Lack of evidence for PT and reimbursement issues are the most reported reasons for not treating specific tumour types with PT.
BACKGROUND AND PURPOSE: Major differences exist among proton therapy (PT) centres regarding PT delivery in adult cancer patient. To obtain insight into current practice in Europe, we performed a survey among European PT centres. MATERIALS AND METHODS: We designed electronic questionnaires for eight tumour sites, focusing on four main topics: 1) indications and patient selection methods; 2) reimbursement; 3) on-going or planned studies, 4) annual number of patients treated with PT. RESULTS: Of 22 centres, 19 (86%) responded. In total, 4233 adult patients are currently treated across Europe annually, of which 46% consists of patients with central nervous system tumours (CNS), 15% head and neck cancer (HNC), 15% prostate, 9% breast, 5% lung, 5% gastrointestinal, 4% lymphoma, 0.3% gynaecological cancers. CNS are treated in all participating centres (n = 19) using PT, HNC in 16 centres, lymphoma in 10 centres, gastrointestinal in 10 centres, breast in 7 centres, prostate in 6 centres, lung in 6 centres, and gynaecological cancers in 3 centres. Reimbursement is provided by national health care systems for the majority of commonly treated tumour sites. Approximately 74% of centres enrol patients for prospective data registration programs. Phase II-III trials are less frequent, due to reimbursement and funding problems. Reasons for not treating certain tumour types with PT are lack of evidence (30%), reimbursement issues (29%) and/or technical limitations (20%). CONCLUSION: Across European PT centres, CNS tumours and HNC are the most frequently treated tumour types. Most centres use indication protocols. Lack of evidence for PT and reimbursement issues are the most reported reasons for not treating specific tumour types with PT.
Authors: Yi Hsuan Chen; Dominique Molenaar; Carin A Uyl-de Groot; Marco van Vulpen; Hedwig M Blommestein Journal: Cancers (Basel) Date: 2022-05-16 Impact factor: 6.575
Authors: Makbule Tambas; Hans Paul van der Laan; Arjen van der Schaaf; Roel J H M Steenbakkers; Johannes Albertus Langendijk Journal: Cancers (Basel) Date: 2022-01-28 Impact factor: 6.639