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Pan-Canadian consensus recommendations for proton beam therapy access in Canada.

Gunita Mitera1, Derek Tsang2, Boyd McCurdy3

  • 1Canadian Association of Provincial Cancer Agencies, Toronto, Ontario, Canada.

Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology
|October 13, 2022
PubMed
Summary

Canadian cancer patients lack access to Proton Beam Therapy (PBT) due to inconsistent out-of-country treatment processes. This study developed pan-Canadian recommendations to ensure equitable access to PBT for eligible patients.

Keywords:
Adult oncologyCanadaClinical practice guidelinesModel-based approachPediatric oncologyProton therapy

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Area of Science:

  • Oncology
  • Radiation Therapy
  • Health Policy

Background:

  • Proton Beam Therapy (PBT) is an advanced cancer treatment not currently available in Canada.
  • Variability in assessment and referral processes across Canadian jurisdictions creates inequitable access to out-of-country PBT for eligible patients.

Purpose of the Study:

  • To develop a framework document for consistent and equitable access to PBT for appropriate Canadian cancer patients.
  • To create pan-Canadian consensus recommendations for PBT access.

Main Methods:

  • A modified Delphi process involving 22 PBT clinical and administrative experts from across Canada.
  • External peer-review by provincial cancer and system partners.
  • Community consultation via electronic survey and live discussion, with a 70% consensus threshold.

Main Results:

  • A final set of 27 recommendations developed over four consensus rounds.
  • Recommendations cover patient eligibility (anatomic site, characteristics, clinical efficacy), program level (regulatory, equipment, quality assurance), and system level (referral, costing, patient estimates).
  • Recommendations were finalized in June 2021 and distributed to all 43 Canadian cancer programs.

Conclusions:

  • A pan-Canadian consensus-building approach successfully generated evidence-based, peer-reviewed recommendations.
  • These recommendations support the application of consistent clinical criteria for PBT treatment options, facility setup, and high-quality access.