Authors' recommendations: The American Cancer Society estimates that there are 14.5 million cancer survivors in America, with approximately 1.7 million new diagnoses expected in 2014. Half of all patients diagnosed with cancer will receive some form of radiation therapy as part of their treatment. Proton beam therapy has attracted much clinical interest due to its physical properties, which have the potential to deliver more accurately targeted radiation as well as to reduce the amount of normal tissue exposed to radiation. Currently, there are 14 PBT centers across America, with 11 more planned or under construction. There is only sparse evidence comparing PBT to other forms of radiation as well as alternative treatments. To date, there has been only one randomized controlled trial comparing PBT to an alternative treatment, and few high-quality observational studies are available. Despite these limitations, ICER's review found that PBT was superior to surgical treatment of tumors of the eye, and appears to be a safer alternative to conventional radiation in brain and spinal tumors as well as pediatric cancers, although most of the evidence in the latter two conditions has been based on simulation modeling rather than actual clinical study. There was insufficient evidence to determine whether PBT offers any improvement over alternative treatments for many other conditions, including bone, breast, gastrointestinal, head and neck cancers, lymphomas, and benign arteriovenous malformations. For many other conditions, including prostate, liver and lung cancer, PBT provides comparable outcomes but at greatly increased cost. Payments for PBT are typically 2-3 times higher than for other forms of radiation treatment and may approach $50,000 per course of treatment in some situations. The higher costs and limited evidence of effectiveness have prompted many policymakers to carefully examine the circumstances under which PBT should be offered.

Project Status: Completed

URL for project: http://www.icer-review.org/proton-beam-therapy-2/

Year Published: 2014

URL for published report: http://www.icer-review.org/wp-content/uploads/2014/07/pbt_final_report_040114.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Institute for Clinical and Economic Review

Contact Address: 101 Merrimac St., 10th FL., Boston MA, USA 02114, Tel: (617) 724-4445 , Fax: (617) 726-9414

Contact Name: info@icer-review.org

Contact Email: info@icer-review.org

Copyright: Institute for Clinical and Economic Review (ICER)