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Referral of breast cancer patients to proton therapy is now possible
20 February 2019
In January, the nationwide indication protocol for proton therapy for breast cancer was approved. This allows all Dutch radiation-oncologists to refer eligible breast cancer patients for proton therapy treatment, This is very good news for this group of patients, says Hans Langendijk, director of the UMCG proton therapy center. 'A number of patients have already started their proton therapy treatment for breast cancer in Groningen.'
Indication protocol
Until recently, breast cancer patients in the Netherlands could only receive photon radiotherapy. The recently approved indication protocol specifies the criteria for breast cancer patients to be eligible for proton therapy. A too high radiation dose to the heart when applying photon therapy is an important benchmark. This would otherwise increase the lifetime risk of heart complications. Using proton therapy it is almost always possible to reduce the radiation dose to the heart to within acceptable levels, preventing such complications. For many patients though, proton therapy will offer little benefit as the dose to the heart is already very low when applying photon radiotherapy.
Proton therapy is a novel radiation technique that typically reduces the radiation damage to tissues surrounding the tumor, when compared to standard photon radiotherapy. It may take many years before such damage results in complications. Using prediction models it is possible to estimate the probability for such complications to occur.
In June 2018, minister Bruno Bruins officially opened the UMCG proton therapy center. It is the first center of its kind in the Netherlands and more than 130 patients have been treated with proton therapy. Most of these are children and patients with head-and-neck cancer; for this group of patients, an indication protocol had been approved at an earlier stage. More than 50 pediatric cancer patients have been treated, in close collaboration with the Prinses Maxima Center.
The proton therapy centers in Delft and Maastricht have also started patient treatments. In the next few years, the UMCG proton therapy center will increase the number of cancer indications that can be treated with proton therapy as well as the number of patients treated each year. At full capacity, the center will treat 600 patients per year. The total capacity of the three active proton therapy centers in the Netherlands is 1600 patients per year.
