An interim analysis of outcome data from the UK Proton Overseas Programme
Gaito, Simona Burnet, Neil G Aznar, Marianne Camille Foden, Philip Howell, C. Pan, Shermaine Saunders, Daniel Crellin, A Smith, Ed Whitfield, Gillian A
Gaito, Simona
Burnet, Neil G
Aznar, Marianne Camille
Foden, Philip
Howell, C.
Pan, Shermaine
Saunders, Daniel
Crellin, A
Smith, Ed
Whitfield, Gillian A
Citations
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Abstract
Purpose or Objective
The Proton Overseas Program (POP) was launched in 2008
by the National Health Service (NHS) to deliver high energy
Proton Beam Therapy (PBT) abroad to UK patients until
this became available in the UK (in 2018). The NHS used a
systematic evidence based and prioritised approach. More
than 10 years since its inception, we report the long term
outcomes on patient groups who have accessed this
programme; results compare favourably with other studies
(1).
Material and Methods
Between 2008 and 2018, 1352 patients with eligible
indications, from 46 centres across the UK, were referred
for consideration of PBT. A national expert panel, adhering
to approved criteria, established the appropriateness of
PBT in each case. All cases were of sufficient performance
status to travel, were appropriately staged and received
treatment in experienced PBT centres. 1264 patients were
approved (93.5 % of the referrals), 1096 (86.7%) were
treated in North America and 168 (13.3%) were treated in
Europe. Patient, tumour, treatment and follow-up data
were collated in a centralised database. A Proton Clinical
Outcomes Unit (PCOU) has been established to monitor
this patient cohort as well as standardise and improve
prospective outcome data collection for UK PBT patients
going forward. Systematic follow-up data was available for
979 patients (77.1% of those approved for PBT). Mirroring
the National Institute for Health and Care Excellence’s
(NICE) definition of children, and Teenagers and Young
adults (TYA), analysis has been conducted on the
subgroups ≤25 vs >25 years old (y). Patients, disease and
treatment characteristics are listed in Table 1.
Results
After a median follow-up of 34 months (range 6-123), the
Local Control (LC) rate for the whole cohort is 85.3%; by
age (≤25 y vs >25 y) LC rates are 87% for the younger group
vs 78.8% for the older group. For tumours of the central
nervous system (CNS), the LC rate is 84.1% (86.2% ≤ 25 y vs
79.2% > 25 y). For tumours outside the CNS the LC rate is 87.3% (88.1% in ≤ 25 y vs 75% in > 25 y). Further analysis
on the major histological subgroups is listed in Table 1.
The data show that LC is highest for craniopharyngioma
(97.7%) in the CNS subgroup and for Ewing’s sarcoma
(88.2%) in the body subgroup. Figure 1 illustrates the
Kaplan-Meier survival estimates (95% Confidence Intervals)
for the main groups.
Conclusion
The outcome of patients treated through the POP
compares favourably with that reported in the literature
(1). The POP has facilitated equitable access to PBT abroad
for patients with complex needs from across the UK
without disadvantaging patient outcome. The PCOU
continues to collect data from these patients, as well as
from patients who have been treated at the now
established PBT service in UK. This prospective data
registry will, over time, inform us further of the outcomes
of patients treated with PBT to improve patient care.
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Gaito S, Burnet N, Aznar M, Foden P, Howell C, Pan S, et al. OC-0441: An interim analysis of outcome data from the UK Proton Overseas Programme. Radiotherapy and Oncology . 2020 Nov;152:S243.