Referrers

From the Initial Inquiry to Radiation – the Preparation

Do you have a case that you would like to present to indication testing?

Then please contact our Case Management Team for the initial request. They will be happy to assist you with any preparations or to forward your request to our medical team. For a sufficient indication status, our doctors need the following documents from the patient:

Required documents

• Up-to-date letter from the doctor, complete situation/summary (German or English)
• Surgery report
• Laboratory report
• Histological/pathological results
• Radiological diagnosis: MRI/CT images on a CD/DVD in DICOM format incl. the relevant results in writing

Please send all documents to

Westdeutsches Protonentherapiezentrum Essen
Case Management
Am Mühlenbach 1
45147 Essen
Germany
Or via Fax: +49 201 723 5254

Once the proton therapy in the WPE is indicated, the dates will be set for the planning and irradiation in the appointment office. On the planning date, a planning CT or MRI based on a “CT patient model” is performed to plan and simulate the upcoming therapy. The development and optimisation of this treatment plan takes about 3 weeks. Likewise, on this date, the production of special positioning aids for the upcoming irradiation are made.

The Radiation

The actual therapy is usually done on an outpatient basis, but divided into several short sessions (fractions). The most common distribution pattern is the treatment once a day, five times a week for a period of about five to six weeks, depending on the indication.

Regular follow-up appointments are scheduled at the WPE, also in consultation with other doctors. They are intended for monitoring response to treatment and collecting and treating possible long-term side effects as well as detecting a possible return of the tumour early on, also known as a recurrence.

Reimbursement

In Germany and in other European countries, health insurance companies usually accept a request for reimbursement without any problems as long as the appropriate expert recommendation for each indication is presented. However, the WPE wants to motivate more health insurance companies to completely takeover the costs by providing convincing research results. Therefore, the WPE uses the data of the treatments in clinical trials and registries in order to disclose viable arguments to insurance companies for the benefits of proton therapy, so that as many people as possible can have access to this gentle method of treatment.

The Treatment of Children

For the past several years, children are increasingly being irradiated with protons worldwide. They are particularly sensitive to the occurrence of radiation-induced side effects and secondary tumours due to the still-developing tissue. Currently, not only is healing the tumour but also the quality of life after cancer therapy an important goal. Because of this, proton therapy proves to be a promising tool for treating cancer during childhood since the physical properties of protons allow a very limited and well-controlled dosing. Here, the normal tissue is largely spared and it reduces the risk of negative consequences and secondary tumours.

At the WPE, the treatment of children is our priority. Currently, brain tumours and sarcoma tumours in the skull base region and in the region of the spine and pelvis are mostly treated. With precise dose distribution in proton treatment, the immediately adjacent critical organs, which are often at risk, can be highly protected. Since January 2015 and for the first time in Europe, we are able to also routinely offer the so-called craniospinal proton therapy to children under general anaesthesia, i.e. the radiation of the entire central nervous system.

Networking in Paediatric Radiotherapy

Via networking with the Association of Pediatric Radiation Oncology (APRO) and the Society of Pediatric Oncology and Hematology (GPOH), the WPE participates in therapy optimisation studies that are developed by both of these organisations and the treatment centres.

In Germany, approximately 90% of children cancer patients are treated during the therapy optimisation studies performed by the Society of Pediatric Oncology and Haematology. As a result, a comprehensive treatment based on a “gold” standard is ensured. Radiation therapy is firmly positioned directly next to surgery and chemotherapy within the treatment concepts of the GPOH study protocols.

The indication for radiotherapy with protons is provided as part of a multidisciplinary tumour board.

Over the years, we were able to experience how the irradiation areas were becoming increasingly reduced and the treatment doses reduced while improving the tolerance significantly.