The American Society for Radiation Oncology (ASTRO) issued a news release in March announcing that at a recent meeting the Board of Directors approved the following statement on the use of proton beam therapy for prostate cancer:
“While proton beam therapy is not a new technology, its use in the treatment of prostate cancer is evolving. ASTRO strongly supports allowing for coverage with evidence development for patients treated on clinical trials or within prospective registries. ASTRO believes that collecting data in these settings is essential to informing consensus on the role of proton therapy for prostate cancer, especially insofar as it is important to understand how the effectiveness of proton therapy compares to other radiation therapy modalities such as IMRT and brachytherapy. The comparative efficacy evidence of proton beam therapy is still being developed,” said Michael L. Steinberg, MD, FASTRO, ASTRO chairman. “We look forward to new and innovative research that will more clearly define the role of proton beam therapy for localized prostate cancer among the currently available treatment options.”
ASTRO media relations manager Michelle Kirkwood said that the statement was approved by ASTRO's Board at its February 23-24 meeting and was issued March 13 to coincide with its message to members.
In addition, Steinberg, Chair of the UCLA Department of Radiation Oncology, explained in a telephone interview that ASTRO's public policy committee had drafted a similar statement several years ago, and that the issue arose a few months ago and was addressed at the February Board meeting. There wasn't a delay, he said, but it was a process and ASTRO has now decided to take policy positions to address important issues in health care: “We've involved in embracing the value proposition in health care dealing with cost and quality and believe that it is an appropriate use of technologies when patients are on clinical trials [to provide additional data].”
Also interviewed by OT was the Chair of the Radiation Therapy Oncology Group's Comparative Effectiveness Subcommittee, Jason A. Efstathiou, MD, PhD, Assistant Professor of Radiation Oncology at Massachusetts General Hospital (MGH) and lead investigator of the first clinical trial comparing proton vs. photon therapy for prostate cancer.
“The data [for proton therapy] is mature, and it's not an investigational treatment; the safety and efficacy data are definitely there,” he said. “But we need better evidence to determine whether quality of life is better, the same, or even worse than with other forms of conventional therapy,” he said, adding that the study will also look at cost effectiveness.
The five-year randomized trial will eventually accrue 400 men to receive either proton beam therapy or intensity-modulated radiation therapy, and is currently being conducted at MGH in partnership with the University of Pennsylvania Abramson Cancer Center.
Additional centers will be added over the course of the trial, said Efstathiou, adding that he has proposed naming it “PARTIQoL,” for Prostate Advanced Radiation Technologies Investigating Quality of Life.