Brain Tumour UK gives cautious welcome to specialist brain cancer proton unit
Brain Tumour UK has welcomed the Government's announcement that a specialist proton therapy centre is to be built in the UK over the next five years to treat brain and spinal chord tumours [1]. But the charity warned that the centres should be the focus of carefully designed scientific research to ensure that the true benefits of the therapy are measured. Furthermore, the therapy will not be of benefit to the most common brain tumours, including gliomas, meningiomas and secondary brain cancer. It will largely be used to treat rare tumours at the base of the skull, including chordomas and chondrosarcomas.
Proton therapy is a form of radiation therapy that has been in use since the 1970s. Proton particles have a large mass and should not spread so far in tissue with the result, in theory, that healthy, non-tumour tissue receives less harmful radiation. This means that a tumour could be given a larger dose of radiation than with normal radiotherapy, whilst causing less harm to the healthy brain.
But although the therapy is theoretically promising, Brain Tumour UK warns that there is a lack of robust evidence to show that it offers significant clinical advantage over modern radiotherapy. A substantial review of the evidence for proton therapy has concluded:
"The claim by proton therapy supporters that protons are the treatment of choice for chordoma and chondrosarcoma [tumours at the base of the skull] is no longer tenable based on the currently available evidence." [2]
Trevor Lawson, a spokesman for Brain Tumour UK, commented:
"The challenge here is that new technologies do not have to clear the scientific research hurdles that we apply to new drugs. Brain Tumour UK welcomes this announcement, but we need to be very clear that proton therapy is not a miracle cure for brain tumours.
"The lack of robust scientific evidence to show that proton therapy offers significant clinical advantage over modern, radiotherapy is a problem. Brain Tumour UK wants the best for patients and the Government must ensure that this new centre undertakes high quality research trials that demonstrate whether this treatment really is the best and which patients are most likely to benefit."
Many of the most reported studies showing proton therapy benefit compared it with older, less precise forms of radiotherapy. Furthermore, proton therapy is of no benefit to the most common brain tumours including gliomas, meningiomas and secondary brain cancer.
1. The Department for Health is issuing an announcement on the new unit today (18 August 2009).
2. Proton Therapy in Clinical Practice: Current Clinical Evidence, Brada, M., Pijls-Johannesma, M., and De Ruysscher, D., Journal of Clinical Oncology, 25 (8) 10 March 2007