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.