Comparative proton versus photon treatment planning for the Medicare Medical Treatment Overseas Program: The Royal Adelaide Hospital experience

Abstract

Introduction: Australia's first proton beam therapy (PBT) service, The Australian Bragg Centre for Proton Therapy and Research, is scheduled to open in the near future providing PBT for patients closer to home. Patients currently access Commonwealth funding for PBT via the Medicare Medical Treatment Overseas Program (MTOP). Proton versus photon treatment planning is a prerequisite for the MTOP application. The Royal Adelaide Hospital (RAH) Department of Radiation Oncology has been providing this since 2016. We aim to provide a descriptive overview of our proton versus photon treatment planning process, presenting a summary of the comparative planning results and the treatment pathways selected for the patients referred. Methods: All patients referred to the RAH for comparative planning between January 2016 and December 2018 were included in the analysis. Comparative plans were generated for each case using Pinnacle or Eclipse treatment planning systems. The planning techniques used and plan quality metrics were reported. Results: Forty three patients were referred for comparative planning. The age range was 1-63 years, with the majority (72%) being paediatric patients (age ≤18 years). Of the 19 cases that have been submitted to MTOP, 16 have been accepted and 3 denied. Two of the accepted cases chose not to travel abroad for PBT. The other 14 cases have received PBT overseas. Conclusions: The RAH has provided an important service to demonstrate the dosimetric difference between PBT and photon therapy for Australian patients, an important step in supporting the funding of patients for treatment overseas.

Estimating Potential Benefits to Neurocognition with Proton Therapy in Adults with Brain Tumors

“…In the evaluations, where clinical indications for PT are uncertain, comparative dosimetry has value to quantify the dosimetric benefits of proton therapy as compared with photon therapy [ 24 , 25 ]. A proton versus photon comparative planning program from Australia has significantly increased the number of referrals for PT overseas since its beginning in 2016 [ 26 ]. A similar Proton Therapy Consultation Service exists for Canadian patients ( http://protonsatuhn.ca/ ).…”

Radiation Oncology Oral

“…In the first 16 monthly VTBs the mean attendance has been 53 (range 20-103) radiotherapy professionals (mostly ROs). On average 14 (11)(12)(13)(14)(15)(16)(17)(18)…”

Travelling overseas for proton beam therapy: A retrospective interview study

“…Over a two-year period, a total of 43 patients were referred to this service, 19 of these referrals resulting in applications to MTOP and following review by MTOP, 16 of these applications received approval and subsequently travelled OS for PBT. 4 Paediatric, AYA patients and their families have a distinct set of challenges they face when given a cancer diagnosis, with research concluding that a supportive care model of practice is required to best support this cohort of patients. [5][6][7] A systematic literature review identified there are no publications investigating the experiences of Australian patients and their families travelling OS for PBT.…”