Proton radiotherapy should be further developed in Poland

Abstract

Proton radiation therapy needs to be further developed in Poland by virtue of both epidemiological considerations and because this type of radiation exhibits very advantageous biological and physical properties. The underlying benefit of such therapy is to make lower integral radiation dose delivered to structures beyond a given target area, including critical organs, resulting in reduced toxicities for patients. Of somewhat less import is the improvement in dose distributions for target areas (vs photons), which can potentially bring about a better local control. As a result, proton radiotherapy is mainly indicated for paediatric cases, where any development of complications is most likely because of the long lifetimes and the heightened radiosensitivity of healthy tissues. The most recent studies also show that certain subpopulations of patients can benefit from proton beam radiotherapy in cases of widespread cancers such as from the lung or breast. A further advantage is found after conducting a cost-effectiveness analysis whereby proton beam radiotherapy was demonstrated as a cost-effective procedure, with both lowered costs for treating complications and indirect costs. By the term 'development' as used herein, it is understood that there is a need to open another proton therapy centre in Poland; this question however being left open in the presented article. Nevertheless, before taking such a high-level decision, the following requires consideration: the working experience garnered by the existing Cyclotron Centre at Bronowice (CCB), outcomes from current prospective clinical trials and, above all, delivering appropriately managed and coordinated oncological care for cancer patients in Poland regarding multi-centre collaboration between specialists. NOWOTWORY J Oncol 2017; 67, 1: 65-70

Trends in cancer mortality among Poland’s oldest old (aged 85 years and older)

“…However, not all institutions were found to be properly equipped. A 2015 study reported that only 28% of hospitals and 2% of specialist ambulatory providers participating were able to provide laboratory tests, CT and MRI scans, and endoscopy examinations; fewer than half of the audited providers could undertake the intraoperative pathology necessary to assess the margins of some tumor excisions [24].…”

“…The national screening programs for breast, cervical, and colorectal cancers, were introduced as part of the National Program for Cancer Disease Control in 2006 and extended through 2015 and was later renewed for 2016-24 [31]. However, a pilot from 2018 reported 16% for breast, 20% for cervical, and 40% for colorectal cancer screening [24]. While the oldest old fall outside the boundaries of breast cancer screening, diagnostic testing of breast cancer should not be delayed.…”

Budget Impact Analysis for Proton Beam Therapy for pediatric population in Poland

“…Despite its high costs many studies show that PBT is cost effective in terms of treatment complications and indirect costs. [2] Currently, PBT is used in a very small number of cancers. Most countries use PBT in the pediatric population, where the incidence of radiation-related complications is relatively higher due to the longer life expectancy and the higher sensitivity of healthy tissues to radiation.…”

“…According to forecasts, by 2025 an increase in the incidence of cancer in Poland is expected from 310,000 up to 350,000. [2] e aim of the study was to evaluate a budget impact of PBT from the public payer perspective in Poland. [5] METHODS e budget impact analysis (BIA) concerns the nancial consequences of extending the use of PBT from the perspective of the Polish public payer (National Health Fund, NHF) in 9 oncological indications in pediatric population (table 1).…”

Budget Impact Analysis for Proton Beam Therapy in adult population in Poland

“…It is expected that by the end of 2025 the number of new cases in Poland will increase to 350,000 annually. [6]…”