Dr. Steven Frank.

ASTRO 2013: Is proton therapy cost-effective?

September 25, 2013
by Nancy Ryerson, Staff Writer
At ASTRO 2013, the society took a side in the debate over proton therapy's efficacy for prostate cancer, advising that the treatment only be used in clinical trials until more evidence emerges. Meanwhile, other studies presented at the conference called attention to well-researched benefits of the therapy, which sometimes suffers from its reputation for being too costly without enough evidence to back up its benefits.

One study from the MD Anderson Proton Therapy Center demonstrated that the use of proton therapy for head and neck cancer patients decreased the use of feeding tubes by 50 percent.

Head and neck cancer is linked with HPV in approximately 70 percent of cases, and the disease most often impacts men in their forties and fifties. "These are people who would have to live with these side effects for the next 40 years," Dr. Steven Frank, study leader and director of advanced technologies at MD Anderson, told DOTmed News.

The research team's next step is to prove the treatment's financial value.

"The feeding tube is a manifestation of symptoms. Nausea, not getting enough nutrition, inability to swallow," said Frank. "So feeding tube use is a predictor of increased doctor visits and emergency room visits, and those can add a substantial cost."

Taken together, two additional studies presented at ASTRO deal with the duel criticisms of proton therapy: its effectiveness and its cost benefit. One looked at proton therapy's benefits for treating pediatric brain cancer. Because proton therapy limits radiation exposure to healthy tissue compared with traditional radiation therapy, the treatment is often used on pediatric brain tumor cases, but few clinical studies have been done showing those benefits.

The new study looked at outcomes for 70 patients with localized ependymoma, the largest patient sample reported for pediatric brain tumor treatment with proton therapy. At patient follow-up after 46 months, overall survival was at 95 percent.

IQ was also measured after treatment. Researchers found that numbers increased after two years, indicating that the proton therapy treatments successfully preserved brain function.

The second study presented sought to project the cost effectiveness of proton therapy for pediatric brain tumors when compared with standard photon radiation therapy.

It found that because proton therapy decreases the risk of heart failure and secondary malignancy for pediatric brain tumors, the treatment resulted in cost-savings compared with photons in 95 percent of all simulations. The study authors hope their research will encourage more study into the treatment's potential financial benefits.

"In today's health care environment, people are being challenged to show value," said Frank. "Does proton therapy work? Yes. Now we have to prove that it justifies the cost."