Proton beam therapy

Proton beam therapy (PBT) as the physical properties of protons permit dose delivery at specific tissue depths. Protons deliver a low dose of energy when entering the body and deposit the bulk of their radiation energy at the end of their range of penetration, a phenomenon known as the "Bragg peak." 

Proton beam therapy (PBT) was first selected for review by the HTA program in 2014.
  • In 2018, the HCA director selected PBT for rereview based on newly available published evidence that could change the original coverage determination.
  • A rereview of proton beam therapy was conducted in 2019.

Status: Decision completed

Why is PBT being reviewed?

There are significant uncertainties with the use of PBT. Some of these are technical and some are the cost of treatment with PBT is substantially higher than for other EBRT modalities such as IMRT and 3D-CRT. With the recent availability of PBT in Washington, it is timely to assess the evidence on its clinical benefits, potential harms, and costs in comparison to alternative treatment options for a variety of cancers.

Primary criteria ranking

  • Safety = Medium
  • Efficacy = High
  • Cost = High

Documentation

Assessment timeline

  • Draft key questions published: July 3, 2018
  • Public comment period: July 4 to 18, 2018
  • Final key questions published: July 31, 2018
  • Draft report published: March 1, 2019
  • Public comment period: March 2 to April 1, 2019
  • Final report published: April 17, 2019
  • HTCC public meeting: May 17, 2019