Proton Tx Plus Chemo Seen Beneficial in NSCLC


“The use of proton beam radiotherapy and concurrent chemotherapy may improve clinical outcomes for patients with inoperable stage III non-small cell lung cancer (NSCLC), while reducing the toxic effects of treatment, researchers from MD Anderson Cancer Center have found.

“The researchers, led by Joe Y. Chang, MD, PhD, reported that the median overall survival of 26.5 months observed in their study ‘was encouraging, and in accord with our original statistical goal of 24 months.’ ”

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Proton-Beam Therapy in Limited-Stage SCLC Shows Promising Efficacy


“Proton-beam therapy (PBT) was found to be safe for patients with limited-stage (LS) small-cell lung cancer (SCLC) in the first prospective registry study of the therapy, with only a small number of high-grade toxicities.

” ‘Radiation therapy is essential for the management of limited-stage SCLC,’ wrote study authors led by Jean-Claude M. Rwigema, MD, of the Hospital of the University of Pennsylvania in Philadelphia. ‘When it is given with concurrent chemotherapy, radiation therapy can result in substantial toxicities.’ PBT can reduce the exposure to nearby organs at risk in non–small-cell lung cancer, and is under substantial investigation in that setting; before the new study, though, only a six-patient case series had examined its use in SCLC.”

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Insurers Hesitant To Cover Proton Beam Tx

“Everyone seems to agree that proton beam therapy — a type of radiation that can attack cancerous tumors while generally sparing the surrounding tissue — is an exciting technology with a lot of potential. But some insurers and disease experts say that, until there’s better evidence that proton therapy is more effective at treating various cancers than traditional types of less expensive radiation, coverage shouldn’t be routine.

“That approach doesn’t sit well with proponents, some of whom say that insurance coverage is critical for necessary research of the controversial therapy’s uses.

“Meanwhile, the number of proton therapy centers — huge structures that can cost more than $200 million — continues to increase. Fourteen are in operation in the U.S. and a dozen more under development, according to Leonard Arzt, executive director of the National Association for Proton Therapy.

“Critics assert that the rush to build the centers is putting a very large cart before the horse.

“In general, ‘the evidence has failed to demonstrate that there is a significant improvement in outcomes with proton beams,’ says J. Leonard Lichtenfeld, MD, deputy chief medical officer at the American Cancer Society. ‘It’s fair to question whether the number of facilities that are being constructed really reflect the proven value of proton beam therapy.’ ”

Blue Shield of California to Curb Coverage of Pricey Cancer Therapy

“As hospitals race to offer the latest in high-tech care, a major California health insurer is pushing back and refusing to pay for some of the more expensive and controversial cancer treatments. Blue Shield of California is taking on this high-cost radiation treatment just as Scripps Health in San Diego prepares to open a gleaming, $230-million proton beam therapy center this fall, only the second one in California and the 12th nationwide. This week, Blue Shield began notifying doctors statewide of its new policy for early-stage prostate cancer patients, effective in October. The San Francisco insurer says there’s no scientific evidence to justify spending $30,000 more for proton beam treatment compared with the price it pays for other forms of radiation that deliver similar results.”