Proton Therapy Patient Selection Methods and the Impact of COVID-19: A Cross-Sectional International Survey

Introduction: The COVID-19 outbreak has had far-reaching impacts on cancer services worldwide. It has yet to be described how the pandemic has impacted patient selection methods for proton therapy (PT) specifically. This survey aimed to investigate the current international methods implemented for PT patient selection and to determine whether COVID-19 has impacted PT practice. Methods: A 44-question survey was conducted from 29th January 2024 to 18th March 2024 using the Qualtrics platform. PT centres in 21 countries were invited to respond to the survey regarding patient selection methods used currently and prior to the pandemic, as well as impacts of COVID-19 on patient selection and service provision. The survey was disseminated with assistance from The Particle Therapy Co-operative Group. Results: Nine centres completed the survey: four in Europe, three in the United States of America (USA), and two in Asia. Diagnosis or indications lists, clinical trials group assignment, dose distribution, dose metrics, and expert recommendations were the most reported patient selection approaches within the last five years. Only one centre in the USA reported changes to patient selection approaches during the height of the pandemic, mainly ceasing use of clinical trial group assignment. Six of the nine centres continued to treat patients infected with COVID-19. Five respondents indicated various suspensions or delays for certain treatment groups. Conclusions: The findings show most respondents did not alter their patient selection approaches during the pandemic. These findings, however, cannot be generalised to all PT centres due to the small sample size of respondents.