Indications and additional criteria for proton therapy

To be eligible for proton therapy, applications must meet both certain indications and a number of additional criteria.

If you are in doubt whether or not a particular indication qualifies for proton therapy - even if it is not on the list of standard indications - please contact PARTICLE at protontherapy@uzleuven.be.

Type tumor

(Para)spinal, skull base chordoma

Skull base chondrosarcoma

(Para)spinal 'adult soft tissue' sarcoma

Pelvic sarcoma

Rhabdomyosarcoma

Ewing's sarcoma

Retinoblastoma

Low-grade glioma (including optic pathway glioma)

Ependymoma

Craniopharyngeoma

 

Pineal parenchymal tumours (not pineoblastoma)

Esthesioneuroblastoma

 

Medulloblastoma / primitive neuroectodermal tumours (PNET)

 

Central nervous system germ cell tumour

Non-resectable osteosarcoma

 

ATRT (atypical teratoid rhabdoid tumor)

Primary tumours of the central nervous system requiring craniospinal
irradiation, with curative intent.

Mengioma

 

Bijkomende voorwaarden
  • Radiotherapy should be indicated in the report of the Multidisciplinary Oncology Consultation (MOC). Furthermore, proton radiotherapy should be the most appropriate radiotherapy treatment.
  • Curative treatment (not for palliative purposes).
  • It should be a first radiotherapy treatment for the condition for which the patient is being referred.
  • Benign tumours of the central nervous system which - because of their location - can not be treated in another way, may be treated by proton therapy, provided that a multidisciplinary opinion (from professionals including at least a neurosurgeon and a radiotherapist) confirms that proton therapy is the only possible treatment.
Type tumor

 

Ocular melanoma, where brachytherapy is not possible

 

Paraspinal or sacral, skull base chordoma

 

Paraspinal or sacral , skull base chondrosarcoma/sarcoma

Meningioma, for which no other medical treatment (surgery, chemotherapy, photon therapy etc.) is possible

Cerebral arterio-venous malformations (AVM), for which surgery, embolisation and (stereotactic) photon radiotherapy are all impossible or have already been delivered without success.

Medulloblastoma

Primary tumours of the central nervous system requiring craniospinal irradiation, with curative intent.

Bijkomende voorwaarden
  • Radiotherapy should be indicated in the report of the Multidisciplinary Oncology Consultation (MOC). Furthermore, proton radiotherapy should be the most appropriate radiotherapy treatment.
  • For intraocular melanoma, an opinion from a specialised centre (KULeuven, UCL) is also required, confirming that brachytherapy is not possible.
  • Curative treatment (not for palliative purposes).
  • It should be a first radiotherapy treatment for the condition for which the patient is being referred.
  • Benign tumours of the central nervous system which - because of their location - can not be treated in another way, may be treated by proton therapy, provided that a multidisciplinary opinion (from professionals including at least a neurosurgeon and a radiotherapist) confirms that proton therapy is the only possible treatment (AVM, meningioma, etc.).

General selection criteria to be examined with reference to each patient for whom an application dossier for hadron therapy has been submitted:

  • Good general state of health (grade 0 or 1, WHO classification – cf. annex).
  • No comorbidity rendering survival beyond 5 years unlikely.
  • No other factors, such as on-going medical treatments, making it too difficult or impossible for the patient to spend the necessary periods of time abroad.

 

WHO/ECOG PERFORMANCE STATUS* Grade 0: fully active, able to carry on all pre-disease performance without restriction Grade 1: restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work Grade 2: ambulatory and capable of all self-care but unable to carry out any work activities. Up and about more than 50% of waking hours Grade 3: capable of only limited self-care, confined to bed or chair more than 50% of waking hours Grade 4: completely disabled. Cannot carry on any self-care. Totally confined to bed or chair

** as published in: “Oken, M.M., Creech, R.H., Tormey, D.C., Horton, J., Davis, T.E., McFadden, E.T., Carbone, P.P.: Toxicity And Response Criteria Of The Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649-65

Last edit: 23 April 2024