Indications for proton therapy


Proton therapy currently gains traction as a modality for radiation therapy. In Poland, according to Regulation of Ministry of Health of 6th of July 2016 (Journal of Laws, item 855), treatment of the following types of tumors are funded by government with this method:

1) Base of the skull and spinal axis tumors in adult: chordoma and chondrosarcoma ICD-10:C41 code (patients after non-radical resections or not amenable to surgery of primary tumor or recurrent), pediatric: soft tissue and bone sarcomas, ICD-10: C41 and C49 code (cases with parameningeal location, base of the skull and parameningeal location).

2) Perinasal sinuses tumors: malignant melanoma, esthesioneroblastoma, adenoid cystic carcinoma, mucoepidermoid carcinoma, undifferentiated carcinoma, codes: ICD-10: C30, C31 (patients after non-radical resections or not amenable to surgery of primary tumor or recurrent).

3) Pediatric tumors requiring cerebroispinal axis irradiations, codes: ICD-10: C-71 (germ cell tumors: medulloblastoma and other PNETs, pineocytoma, Malignant ependymoma with cerebrospinal fluid dissemination, choroid plexus carcinoma).

4) Low grade gliomas (WHO G1 and G2) ICD: C71 (patients who benefit from sparing organs-at-risk in comparison to photon radiotherapy).

 

Currently, in many institutions clinical trials focused on efficacy of proton therapy for all possible tumor location are being conducted.