Government seeks suitable sites for proton beam therapy

BMJ 2009; 339 doi: (Published 20 August 2009) Cite this as: BMJ 2009;339:b3389
  1. Adrian O’Dowd
  1. 1Margate

    A new drive to boost the effectiveness of cancer treatment in the United Kingdom by using an advanced form of radiotherapy has been launched.

    The Department of Health is inviting hospitals to bid to provide proton beam therapy―a type of radiotherapy in which a cyclotron produces a beam of protons.

    Proton beam therapy can treat tumours without damaging vital organs because it targets the malignancy precisely, providing better dose distribution than conventional radiotherapy. It is particularly suitable for children.

    The department has asked the NHS’s national specialised commissioning team to identify possible providers of proton beam services in England, though the services could be accessible to the whole of the UK. Trusts will be invited to submit an expression of interest, with some indication of how they would provide the service.

    The only current facility in the UK is at the Clatterbridge Centre for Oncology NHS Foundation Trust in the Wirral, Merseyside. This treats between 100 and130 patients with certain types of eye tumour every year.

    Patients (mostly children) who need proton beam therapy currently have to go abroad, sometimes at a cost of around £40 000 (€47 000; $66 000) each.

    The NHS national commissioning group for proton therapy began commissioning overseas centres to take UK patients in April 2008. Since then around 40 patients have either been treated or been approved for treatment, mostly in Switzerland and France but also in the United States. Provision has been made for 50 patients to be referred abroad in 2009/10.

    The commissioning group is also working with Scotland, Wales, and Northern Ireland to help commission treatment for patients in those countries, although each country will pay for the treatments themselves.

    The chairman of the national commissioning group, Adrian Crellin, said, “Proton beam therapy is a much safer way of treating specific types of cancer that occur in the retina, skull, and spine without damaging vital organs.”

    Although the therapy can treat only 1% of cancer patients needing radiotherapy, said Dr Crellin, “for these very specific types of tumour there is really very little alternative to using proton therapy to get the high cure rate.”

    The government envisages that two sites in England will provide the therapy within three to five years, treating around 1500 patients every year.

    The health department said that consensus was strong among UK and international experts on the benefits of the treatment for certain rarer cancers.

    Dr Crellin said that the results of treatment at Clatterbridge for patients with eye tumours were “brilliant.” He added: “They have a 90% cure rate there. We know the proton . . . can deliver very high doses of curative treatment with huge accuracy.”

    The type of therapy used at Clatterbridge is low energy, but adapting the technology to deliver higher energy treatments would allow a greater range of cancers to be treated, he said.

    “What is becoming increasingly clear is that in the future a large proportion of the treatment of children with cancer will be with proton therapy as opposed to conventional radiotherapy—perhaps at least 50%,” he added.

    Setting up facilities in the UK made economic sense as well, he said: “I think the cost will be significantly lower [for the NHS] for the patients that we are currently sending abroad.”


    Cite this as: BMJ 2009;339:b3389

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