Photo Credit: Dr. Microbe

The National Association for Proton Therapy’s surveys from 2012 to 2021 show a rise in proton therapy recipients, a decline in prostate cancer cases, and notable increases in pediatric, CNS, and skull base treatments, indicating evolving patient trends and treatment complexity.

The following is a summary of “Temporal Evolution and Diagnostic Diversification of Patients Receiving Proton Therapy in the United States: A Ten-Year Trend Analysis (2012-21) from the National Association for Proton Therapy,” published in the December 2023 issue of Oncology by Hartsell et al.

From 2012 to 2021, the the National Association for Proton Therapy conducted a comprehensive assessment through eight surveys encompassing operational proton centers across the United States. This analysis aimed to evaluate the evolving trends and diversification in patients undergoing proton therapy by scrutinizing treated cases, diagnoses, and treatment complexity.

Beginning in 2015 and subsequently annually, detailed surveys were dispatched to active proton centers in the US, soliciting data from 2012 to 2014 and for the preceding calendar year(s). Collated patient numbers treated at each center were categorized based on tumors in various segments: central nervous system (CNS), intraocular, pituitary, skull base/skeleton, head/neck, lung, retroperitoneal/soft tissue sarcoma, pediatric (solid tumors in children aged ≤18), gastrointestinal tract, urinary tract, female pelvic, prostate, breast, and categorized as “other.” Complexity assessments relied on CPT codes 77520-77525.

Noteworthy survey response rates were observed, ranging from 100% in 2015 to 94.9% in 2021, with supplementary publicly available data yielding nearly comprehensive information on all centers. Comparative trend analysis between 2012 and 2021 revealed a gradual increase in the annual total number of patients receiving proton therapy, escalating from 5,377 to 15,829. Considerable numeric upticks were evident in head/neck (316 to 2,303; 7.3-fold), breast (93 to 1,452; 15.6-fold), and gastrointestinal cases (170 to 1,259; 7.4-fold). Likewise, notable increments were observed for the central nervous system (598 to 1,743; 2.9-fold), pediatric (685 to 1,870; 2.7-fold), and skull base (179 to 514; 2.9-fold) treatments. Conversely, the percentage of proton-treated patients for prostate cancer decreased from 43.4% to 25.0% of the total. Simple compensated treatments decreased from 43% in 2012 to 7% in 2021, while intermediate complexity treatments surged from 45% to 73%.

This analysis delineates a gradual surge in proton therapy recipients, indicating a marked proportional decline among patients receiving proton treatment for prostate cancer. Notably, treatments for pediatric, CNS, and skull base cases, considered typical indications for proton therapy, exhibited a gradual increase. Moreover, substantial proportional escalations were witnessed for breast, lung, head/neck, and gastrointestinal tumors, signifying evolving trends in patient demographics. An upward trajectory in treatment complexity over time was also observed.

Source: sciencedirect.com/science/article/abs/pii/S0360301623083153