Focus of the Report: The focus of this Health Technology Assessment (HTA) is to evaluate the safety and effectiveness of proton beam therapy (PBT) for the treatment of breast cancer with no distant metastasis. This HTA also compares the safety and effectiveness of PBT with conventional radiation therapies.

Technology Description: PBT is a type of external radiation treatment in which positively charged subatomic particles (protons) are precisely targeted to a specific tissue mass using a sophisticated stereotactic planning and delivery system. Compared with conventional approaches, PBT may deliver a higher radiation dose to the target tissue while minimizing damage to surrounding healthy tissue.

Controversy: Highly sophisticated methods have been developed for improving the safety and effectiveness of conventional radiation therapy. PBT systems require substantial capital investment, and the cost of PBT to the patient is substantially higher than other therapies. There are currently approximately 40 PBT centers in the United States, which can create significant financial and logistic burdens for patients who need to travel and remain away from home during prolonged treatment.

Key Questions:

  • Is proton beam therapy (PBT) effective for the treatment of breast cancer?

  • How does PBT compare with conventional radiation treatment for breast cancer?

  • Is PBT for the treatment of breast cancer safe?

  • Have definitive patient selection criteria been established for PBT for the treatment of breast cancer?

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