Selection of patients for radiotherapy with protons aiming at reduction of side effects: The model-based approach

TLDR

New radiation techniques aim to reduce dose to normal tissues and prevent side effects, and proton therapy offers superior beam properties for better normal‑tissue sparing. The study aims to develop a stepwise methodology for selecting patients for proton therapy to reduce side effects. The methodology consists of a stepwise selection process, with an alternative approach provided when randomized controlled trials are not feasible. The Dutch health authorities have accepted this method for selecting patients for proton therapy.

Abstract

Most new radiation techniques, have been introduced primarily to reduce the dose to normal tissues in order to prevent radiation-induced side effects. Radiotherapy with protons is such a radiation technique that due to its superior beam properties compared to photons enables better sparing of normal tissues. This paper describes a stepwise methodology to select patients for proton therapy when the primary aim is to reduce side effects. This method has been accepted by the Dutch health authorities to select patients for proton therapy. In addition, an alternative method is described in case randomised controlled trials are considered not appropriate.