An international approach to estimating the indications and number of eligible patients for carbon ion radiation therapy (CIRT) in Australia

Background and purpose:To establish the treatment indications and potential patient numbers for carbon ion radiation therapy (CIRT) at the proposed national carbon ion (and proton) therapy facility in the Westmead precinct, New South Wales (NSW), Australia. Methods:An expert panel was convened, including representatives of four operational and two proposed international carbon ion facilities, as well as NSW-based CIRT stakeholders. They met virtually to consider CIRT available evidence and experience. Information regarding Japanese CIRT was provided pre- and post- the virtual meeting. Published information for South Korea was included in discussions. Results:There was jurisdictional variation in the tumours treated by CIRT due to differing incidences of some tumours, referral patterns, differences in decisions regarding which tumours to prioritise, CIRT resources available and funding arrangements. The greatest level of consensus was reached that CIRT in Australia can be justified currently for patients with adenoid cystic carcinomas and mucosal melanomas of the head and neck, hepatocellular cancer and liver metastases, base of skull meningiomas, chordomas and chondrosarcomas. Almost 1400 Australian patients annually meet the consensus-derived indications now. Conclusion:A conservative estimate is that 1% of cancer patients in Australia (or 2% of patients recommended for radiation therapy) may preferentially benefit from CIRT for initial therapy of radiation resistant tumours, or to boost persistently active disease after other therapies, or for re-irradiation of recurrent disease. On this basis, one national carbon ion facility with up to four treatment rooms is justified for Australian patients. & COPY; 2023 Elsevier B.V. All rights reserved. Radiotherapy and Oncology xxx (2023) xxx-xxx

Automated summary

This study aims to establish the treatment indications and potential patient numbers for carbon ion radiation therapy (CIRT) at a proposed national carbon ion (and proton) therapy facility in New South Wales, Australia. An expert panel, including representatives from operational and proposed international carbon ion facilities, as well as local stakeholders, met virtually to discuss the available evidence and experience. The study concluded that CIRT can be justified in Australia for certain tumor types, including adenoid cystic carcinomas, mucosal melanomas, hepatocellular cancer, liver metastases, base of skull meningiomas, chordomas, and chondrosarcomas. Approximately 1400 Australian patients annually meet the consensus-derived indications.