Page 32 reluctance for payers to implement costly PT systems on this basis alone , with limited evidence to support any superiority of clinical outcomes warranting an unconvincing incentive to invest in such systems . Advanced IMRT TPS are routinely used for RT however IMPT TPS has yet to undergo as extensive innovation . We predict over the coming years IMPT systems will also incorporate AI and ML to TPS to optimise PT delivery further . The major barrier towards increased adoption of PT are the high costs associated with installing proton accelerators ( synchrotrons and cyclotrons ) in hospitals or RT centres .
Figure 27 : Number of patients treated worldwide by PT and carbon ion RT
The number of patients treated with particles increases year on year
Source : goetzpartners Research
Figure 28 : Number of PT centres worldwide
Source : goetzpartners Research
Challenges to address with PT The clear advantage of PT over standard RT is the innate ability to deposit high-dose radiation at the tumour site . A high RBE at the tumour site is advantageous , although the high RBE at distal edges of the tumour may lead to severe toxicities , thus extremely high-precision TPS is needed to avoid irradiating healthy tissue . This is a particular concern when treating lung cancers , where respiratory motion could result in more significant tissue damage .
PT is more expensive to run than photon RT
High costs are a barrier to improved patient access RT has long been a key treatment option for cancer , meaning there are thousands of centres equipped with LINACs for photon RT . Whilst the full extent of the advantages of PT are still being elucidated , few cancer centres are willing or able to acquire and implement cyclotrons for the technique , especially given the limited evidence of clinical superiority over photon therapy . Thus , for payers , there is not yet a clear cost-effective benefit of rapidly implementing PT . However , the number of patients treated with PT is rising , with almost 280,000 patients treated by 2021 . Likewise , the number of patients treated with other particles such as carbon ion is increasing , although similarly , these systems are extremely expensive to implement . The average cost of particle therapy is $ 24,000 , with standard photon RT only being $ 15,000 . This does however ignore the varying cost of treatments associated with follow-ups due to side effects , which will be substantially larger for photon RT . This therefore places emphasis on the
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