[Proton therapy centres opened; what next?]

Area of Science:

• Oncology
• Radiation Therapy
• Medical Physics

Background:

• Proton therapy, a targeted radiation treatment, was introduced in the Netherlands in 2018 after extensive societal debate.
• Its implementation is unique, with a cap of 2,200 patients annually, representing 4.4% of all radiotherapy patients.

Purpose of the Study:

• To outline the framework for proton therapy implementation in the Netherlands.
• To establish criteria for patient selection ensuring clinically relevant benefits over conventional photon therapy.
• To foster international cooperation and enhance the Netherlands' reputation in advanced radiotherapy.

Main Methods:

• Patient selection relies on sophisticated prediction models to assess the likelihood of side effects.
• Eligibility for proton therapy is determined by a clinically significant expected difference in side effects compared to photon therapy.
• National indication protocols are being developed to define specific prediction models and acceptable side effect differences.

Main Results:

• Proton therapy centers are operational with a defined annual patient capacity.
• A systematic approach to patient selection is in place, prioritizing those most likely to benefit.
• National guidelines are under development to standardize the application of proton therapy.

Conclusions:

• The Dutch approach to proton therapy integrates advanced selection methods to maximize patient benefit.
• National protocols are crucial for guiding the appropriate use of proton therapy and ensuring equitable access.
• This strategic implementation aims to uphold and advance the Netherlands' international standing in radiotherapy innovation.