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Study shows US proton therapy utilization increasing for complex cancers beyond prostate

by John R. Fischer, Senior Reporter | January 30, 2024
Rad Oncology Proton Therapy
The use of proton therapy as a treatment for cancers beyond prostate has substantially increased over the past ten years.
In the last decade, additional research has proven the effectiveness of proton therapy as a treatment option for different forms of cancer, leading to greater investments and changes in reimbursement practices that have made it more accessible as well as affordable.

Over ten years ago, proton therapy was primarily used to treat prostate cancer patients. But according to “Temporal Evolution and Diagnostic Diversification of Patients Receiving Proton Therapy in the United States: A Ten-Year Trend Analysis (2012-21) from the National Association for Proton Therapy," more studies have led to proportional increases in applications for treating complex cancers beyond prostate, including breast, which rose from 1.7% to 9.2%; head and neck, from 5.9% to 14.5%; and gastrointestinal cancer, from 3.2% to 7%.

Published by the National Association for Proton Therapy, the paper recorded a jump in the number of patients who underwent the treatment between 2012 and 2021, from 5,377 to 15,829. While the number of prostate cancer patients treated with PT remained stable, the proportion relative to the entire number of patients treated fell by almost 20%, from 43.4% to 25%.
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The result has been a more balanced percentage of patients treated for prostate cancer compared to a greater variety of complex tumor cases and the achievement of milestones, such as proton therapy becoming the standard of care for pediatric cancer cases.

"This progress is due in part to more institutions and therapy centers coming online, which allows an increasing number of multicenter and randomized trials. As research has matured, additional payors have also started to provide coverage for proton treatment," NAPT executive director Jennifer Maggiore told HCB News.

The rise in studies around proton therapy is due to greater demands for evidence that can guide health policy decisions rather than basing them on speculations and outdated information, says Maggiore. The dosimetric advantages of being able to more precisely target tumors and avoid surrounding healthy tissues and organs have also driven home how effective it is, compared to photon radiation.

Historically, the limited number of centers in the past and restrictive commercial insurance policies have also been barriers to accessibility by making proton therapy too distant and too expensive for patients. Maggiore says this is also changing, as evidenced by the study, which reported more center openings, preventing patients from having to travel far for care. Additionally, the construction of smaller, more compact one-room centers has lowered construction costs for these facilities and procedure costs.

"Today’s proton centers are supported by a major health center or academic institutions that are more likely to have the infrastructure and resources to support numerous research studies. For many, proton therapy will become a regional resource that is increasingly available to treat a wider variety of tumor sites," said Maggiore.

She adds that the findings here support the need and drive for further trials to better understand the full potential of proton therapy and increase its accessibility and affordability.

The findings were published in the International Journal of Radiation Oncology-Biology-Physics (Red Journal).

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