Proton Therapy Congress 2016
Proton therapy for paediatric indications
Prof Roger Taylor - Swansea University Medical School, Swansea, UK
My presence at this conference is because really since 2008 I’ve been involved in the initiative to bring high energy proton therapy to the UK. I was involved in the initial submission to the Department of Health making the case for proton therapy, particularly for children. Although I work in Wales at the moment and I’ve been there for the last ten years, before that I spent eighteen years as a clinical oncologist in Leeds and my main special area of practice was in the treatment of children with cancer. It was round about twenty years ago I realised there was potential for reducing the side effects of radiotherapy in children by the use of proton therapy so that has encouraged me to try and be involved in making the case for proton therapy in the UK and I’ve continued on that basis ever since.
And there will be a beam clinic in Newport in the near future?
That’s right, yes, of course that’s just fifty miles from Swansea. We don’t quite know what patients will be treated yet. There are a number of standard indications for proton therapy, those are patients with tumours near to radiosensitive structures such as the skull base or the spinal cord where proton therapy can enable the delivery of an effective dose of radiotherapy without causing unacceptable damage to those organs nearby. But in children the main aim is to reduce the dose of radiotherapy to the organs and areas of the body that don’t need to be treated with radiotherapy to try to reduce some of the long-term side effects of treating children. So we don’t know quite yet which patients will be treated over and above those that have standard indications so we are discussing with the centre in Newport what the indications might be for the future. One of the benefits of this meeting could be to facilitate and promote discussion over the role of proton therapy for patients with indications that currently aren’t being treated. In other words, to what extent do the indications for proton therapy need to be expanded over and above what groups are treated at the moment.
What about the issue of cost effectiveness?
It’s important to look at cost effectiveness the proper way. Although proton therapy is currently expensive once there are more centres in the UK treating patients then the cost per patient will come down. It may still be more expensive than conventional IMRT photon radiotherapy but it will come down. But the other thing to bring into the equation is the cost of treating long-term complications. For instance, if you can spare a child a lifelong need for treating some complication such as hormone deficiency or an orthopaedic problem or whatever, then in the long term proton therapy can become cost effective. It’s important to bear that in mind so not just looking at the up-front additional costs of proton therapy but looking at the long-term reduction in costs in terms of avoiding the need for treating side effects maybe over many decades.
