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

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.