Proton therapy for pediatric malignancies: Fact, figures and costs. A joint consensus statement from the pediatric subcommittee of PTCOG, PROS and EPTN

Damien C Weber; Jean Louis Habrand; Bradford S Hoppe; Christine Hill Kayser; Nadia N Laack; Johanes A Langendijk; Shannon M MacDonald; Susan L McGovern; Luke Pater; John P Perentesis; Juliette Thariat; Beate Timmerman; Torunn I Yock; Anita Mahajan

doi:10.1016/j.radonc.2018.05.020

Proton therapy for pediatric malignancies: Fact, figures and costs. A joint consensus statement from the pediatric subcommittee of PTCOG, PROS and EPTN

Radiother Oncol. 2018 Jul;128(1):44-55. doi: 10.1016/j.radonc.2018.05.020. Epub 2018 Jun 21.

Authors

Affiliations

¹ Center for Proton Therapy, Paul Scherrer Institute, ETH Domain, Villigen PSI, Switzerland. Electronic address: [email protected].
² Centre de lutte contre le cancer François-Baclesse, Caen, France.
³ Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, USA.
⁴ Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA.
⁵ Department of Radiation Oncology, Mayo Clinic, Rochester, USA.
⁶ Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.
⁷ Department of Radiation Oncology, Massachusetts General Hospital, Boston, USA.
⁸ Department of Radiation Oncology, MD Anderson Cancer Center, Houston, USA.
⁹ Department of Radiation Oncology, University of Cincinnati, USA.
¹⁰ Cincinnati Children's Hospital Medical Center, University of Cincinnati, USA.
¹¹ WPE, University Hospital Essen, Germany.

PMID: 29937209
DOI: 10.1016/j.radonc.2018.05.020

Abstract

Radiotherapy plays an important role in the management of childhood cancer, with the primary aim of achieving the highest likelihood of cure with the lowest risk of radiation-induced morbidity. Proton therapy (PT) provides an undisputable advantage by reducing the radiation 'bath' dose delivered to non-target structures/volume while optimally covering the tumor with tumoricidal dose. This treatment modality comes, however, with an additional costs compared to conventional radiotherapy that could put substantial financial pressure to the health care systems with societal implications. In this review we assess the data available to the oncology community of PT delivered to children with cancer, discuss on the urgency to develop high-quality data. Additionally, we look at the advantage of combining systemic agents with protons and look at the cost-effectiveness data published so far.

Keywords: CNS tumors; Children; Lymphoma; Pediatric cancer; Proton therapy; Sarcoma.

Publication types

Review

MeSH terms

Child
Consensus
Cost-Benefit Analysis
Humans
Neoplasms / radiotherapy*
Proton Therapy / economics*
Radiotherapy Dosage