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The development of de novo clinical practice guideline (CPG) for proton beam therapy (PBT) in the oncological treatment of children based on an identified health technology assessment (HTA) in the context of very low-quality evidence and lack of RCTs



Rok publikování 2021
Druh Další prezentace na konferencích
Fakulta / Pracoviště MU

Lékařská fakulta

Popis Background The Guarantee Committee of the Czech CPG project, including the Ministry of Health of the Czech Republic, commissioned the CPG of proton beam therapy (PBT) in children due to heterogeneity of practice, the current reimbursement from public sources without underlying scientific evidence, and occasional use of PBT as the first line of treatment. Objective Is PBT more effective and safe than photon radiotherapy (PRT) in children? Methods Guideline development group (GDG) was established in 2019. We searched CPGs in 36 sources in September with no results. In October, we searched eight websites and Epistemonikos for any systematic reviews (SR) and identified exactly one relevant, high-quality HTA (Washington State Authority, 2019). We translated and updated the HTA and drafted recommendations. The expert panel will meet in September 2021. Results The evidence is of very low quality from 15 comparative observational studies and 79 case series (12 and 43 for brain tumors, 1 and 16 for head and neck tumors, 2 and 7 for eye tumors, only case series for lymphomas - 2, sarcomas - 8, bone tumors - 3. None for other tumors) that PBT can be considered for the treatment of some pediatric tumors only as an alternative to PRT. Discussion
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