Proton Therapy- Conditions We Treat

How We Select Patients

Proton therapy can be used to treat any condition that can be treated with traditional radiotherapy. However, in some scenarios, it is more advantangeous than others. Therefore, we select patients with conditions who will benefit the most from proton therapy. The MOH-approved list of indications provides a guideline for the selection of patients for proton therapy.

List of Conditions We Treat With Proton Therapy

Fortunately, the Ministory of Health has made a provision for treatment outside of this list; proton therapy providers may convene an ethics board discussion to facilitate this. We currently have an active workflow at Singapore Advanced Medicine for this purpose.

 

For all patients:

 

For patients younger than 25 years old:

  • Retinoblastoma
  • Medulloblastoma
  • Chordoma/ chondrosarcoma base of skull or spine
  • Ependymoma
  • Craniopharyngioma
  • Intracranial germ cell tumour
  • Primitive neuroectodermal tumours
  • Esthesioneuroblastoma
  • Neuroblastoma
  • Pineal parenchymal tumours (not pineoblastoma)
  • Glioma
Proton therapy (right) decreases the overall dose to the brain compared to traditional radiotherapy (left)
Proton therapy (right) decreases the overall dose to the brain compared to traditional radiotherapy (left)
 
Proton therapy (right) decreases the dose to the oral cavity, which lowers the risk of requiring a feeding tube during radiotherapy.
Proton therapy (right) decreases the dose to the oral cavity, which lowers the risk of requiring a feeding tube during radiotherapy.

For all patients:

 

For patients younger than 25 years old:

  • Ewing sarcoma
  • Spinal/ paraspinal bone and soft tissue sarcoma
  • Rhabdomyosarcoma: orbit, parameningeal, head and neck, pelvis
  • Pelvic sarcoma
  • Osteosarcoma

All patients with prostate cancer are eligible if the prognosis is good

Proton therapy for prostate cancer
Proton therapy for prostate cancer

Localised follicular lymphoma

Two of our radiation oncologists were paediatric proton therapy trained in the United States:

 

Central and peripheral nervous system:

  • Retinoblastoma
  • Medulloblastoma
  • Chordoma/ chondrosarcoma base of skull or spine
  • Ependymoma
  • Craniopharyngioma
  • Intracranial germ cell tumour
  • Primitive neuroectodermal tumours
  • Esthesioneuroblastoma
  • Neuroblastoma
  • Pineal parenchymal tumours (not pineoblastoma)
  • Glioma
 

Musculoskeletal

  • Ewing sarcoma
  • Spinal/ paraspinal bone and soft tissue sarcoma
  • Rhabdomyosarcoma: orbit, parameningeal, head and neck, pelvis
  • Pelvic sarcoma
  • Osteosarcoma
 

Salivary gland cancer