Author: Aman Anand, Jonathan B. Ashman, Martin Bues, Brady S. Laughlin, Lisa McGee, Justin Pettit, Fan Yang, Libing Zhu 👨🔬
Affiliation: Department of Radiation Oncology Mayo Clinic, Mayo Clinic Arizona, Mayo Clinic 🌍
Purpose: Proton therapy (PT) offers significant clinical and economic benefits across various cancers, whereas it also has faced skepticism due to its historically high costs and perceived overuse in American healthcare. Advancements in PT technology and operational strategies have not only improved clinical outcomes but, in specific contexts, demonstrated cost-effectiveness compared to alternative radiotherapy (RT) treatments. This study examines the evolution of PT, its economic implications, and its role in advancing global cancer care.
Methods: A comprehensive analysis of peer-reviewed clinical data, healthcare expenditure reports, and global PT implementation strategies was conducted. We analyzed per-fraction costs, long-term healthcare savings, and patient outcomes across common cancer types treated with PT.
Results: Proton therapy (PT) costs per fraction range from $4,707 to $6,690, but studies show significant long-term savings for specific patient groups. In pediatric medulloblastoma, PT reduced long-term cardiac, pulmonary, and gastrointestinal toxicity compared to X-ray radiotherapy (XRT), with no observed side effects in PT-treated patients. European cost analysis found PT cost-effective, gaining 0.68 quality-adjusted life years (QALY) per child at an ICER of €-34,622. For head and neck cancers, PT achieved a 72% 5-year disease-free survival in paranasal sinus tumors, with lower toxicity, dysphagia, and mucositis, preserving quality of life by minimizing weight loss and gastrostomy tube dependence. In the Netherlands, treatment costs ranged from €12,062 (eye melanoma) to €89,716 (head and neck cancer), with indirect costs high but reducible by up to 65% with higher patient volumes, emphasizing PT’s cost-saving potential with increased utilization.
Conclusion: Proton therapy, once considered an emblem of healthcare excess, is proving to be a cost-effective solution in specific clinical scenarios. By preventing long-term complications and reducing associated healthcare costs, PT offers value that extends beyond initial treatment expenses.