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
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(Para)spinal, skull base chordoma |
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Skull base chondrosarcoma |
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(Para)spinal 'adult soft tissue' sarcoma |
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Pelvic sarcoma |
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Rhabdomyosarcoma |
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Ewing's sarcoma |
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Retinoblastoma |
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Low-grade glioma (including optic pathway glioma) |
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Ependymoma |
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Craniopharyngeoma
|
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Pineal parenchymal tumours (not pineoblastoma) |
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Esthesioneuroblastoma
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Medulloblastoma / primitive neuroectodermal tumours (PNET) |
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Central nervous system germ cell tumour |
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Non-resectable osteosarcoma |
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ATRT (atypical teratoid rhabdoid tumor) |
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Primary tumours of the central nervous system requiring craniospinal |
| 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
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Ocular melanoma, where brachytherapy is not possible |
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Paraspinal or sacral, skull base chordoma |
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Paraspinal or sacral , skull base chondrosarcoma/sarcoma |
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Meningioma, for which no other medical treatment (surgery, chemotherapy, photon therapy etc.) is possible |
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Cerebral arterio-venous malformations (AVM), for which surgery, embolisation and (stereotactic) photon radiotherapy are all impossible or have already been delivered without success. |
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Medulloblastoma |
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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