by
Lauren Dubinsky, Senior Reporter | July 03, 2024
Following the evidence
As the body of evidence mounts, most insurance companies will cover proton therapy for cancers with a demonstrated reduction in acute side-effects. One such example is certain patients with head and neck cancer.
At this year's American Society of Clinical Oncology (ASCO) annual meeting, Dr. Steven Frank, professor of radiation oncology and executive director of the Particle Therapy Institute at the MD Anderson Cancer Center in Texas, presented a study showing that oropharyngeal cancer patients treated with intensity modulated proton therapy (IMPT) experienced a significant reduction in malnutrition and feeding-tube dependence compared to traditional intensity modulated radiation therapy (IMRT).
There are about 10,000 taste buds in the anterior oral cavity and if a patient receives just two weeks of radiation therapy, according to Frank, it can wipe out those taste buds. He believes that maintaining a patient's ability to taste food during treatment provides motivation to continue eating and maintaining nourishment.
Insurance companies providing coverage for this indication is a fairly new phenomenon. In 2008, MD Anderson was only able to treat about 3% of their head and neck cancer patients with proton therapy, but now roughly 35% of those patients are receiving it.
"Over the last 10 years, we've been able to advance and articulate the value of proton therapy, which has allowed for health policy to be advocated and advanced," said Frank. "This randomized trial is the first large phase-three level-one evidence to be able to demonstrate that clinical value with the reduction of these major toxicities."
Frank and his team have developed model policies within the National Association for Proton Therapy (NAPT) and also helped ASTRO update its policies to include proton therapy indications.
His next goal is to demonstrate its cost-effectiveness through a reduction in healthcare costs associated with emergency room visits, hospitalizations, and imaging procedures. Although proton therapy is more expensive to deliver than radiotherapy, he has found that reducing those downstream costs mitigates the expense of treatment.
Joern Meissner
solution to the cost-challenge
July 05, 2024 10:21
Dear Editor,
thank you for the nice article pointing out the challenges with proton therapy accessibility and its cost. I wish the article would’ve also focused on solutions, on reducing cost.
Upright patient treatment may be part of the answer. There is currently one FDA cleared proton therapy system that can do upright and supine treatment, is much smaller and hence less costly. There is a second upright treatment system that is about to be FDA cleared. both manufacturers claim that their system fits into linac vault. while this claim needs to be validated through a feasibility study for each installation, it is also easy to see how this is a cost advantage.
attendees of ASTRO, ESTRO and PTCOG know who I’m talking about so I don’t have to mention their names here, and risk that my comment does not get published.
Best regards,
Joern Meissner
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