A scoping review of patient selection methods for proton therapy

Nicole Zientara, Eileen Giles, Hien Le, Michala Short

Research output: Contribution to journalReview articlepeer-review

10 Citations (Scopus)

Abstract

The aim was to explore various national and international clinical decision-making tools and dose comparison methods used for selecting cancer patients for proton versus X-ray radiation therapy. To address this aim, a literature search using defined scoping review methods was performed in Medline and Embase databases as well as grey literature. Articles published between 1 January 2015 and 4 August 2020 and those that clearly stated methods of proton versus X-ray therapy patient selection and those published in English were eligible for inclusion. In total, 321 studies were identified of which 49 articles met the study’s inclusion criteria representing 13 countries. Six different clinical decision-making tools and 14 dose comparison methods were identified, demonstrating variability within countries and internationally. Proton therapy was indicated for all paediatric patients except those with lymphoma and re-irradiation where individualised model-based selection was required. The most commonly reported patient selection tools included the Normal Tissue Complication Probability model, followed by cost-effectiveness modelling and dosimetry comparison. Model-based selection methods were most commonly applied for head and neck clinical indications in adult cohorts (48% of studies). While no ‘Gold Standard’ currently exists for proton therapy patient selection with variations evidenced globally, some of the patient selection methods identified in this review can be used to inform future practice in Australia. As literature was not identified from all countries where proton therapy centres are available, further research is needed to evaluate patient selection methods in these jurisdictions for a comprehensive overview.

Original languageEnglish
Pages (from-to)108-121
Number of pages14
JournalJournal of Medical Radiation Sciences
Volume69
Issue number1
DOIs
Publication statusPublished or Issued - Mar 2022
Externally publishedYes

Keywords

  • Clinical decision-making
  • decision support techniques
  • patient selection
  • proton therapy
  • radiotherapy

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging

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