Indications

The MedAustron Ion Therapy Center offers Proton and Carbon Ion Therapy (summarily referred to as “Particle Therapy”).

MedAustron offers the latest technology in precision Particle Therapy based on spot scanning beam delivery. The majority of technological functions have been successfully implemented in clinical routine. However, MedAustron continuously expands its technological capabilities. As a consequence, MedAustron at present has several limitations in the treatment of some specific disease sites and entities that are treated with Particle Therapy worldwide. Over time these limitations will be removed and the entire spectrum of indications will be treated.

The following lists the disease entities treated at present at MedAustron. Not all histologies are necessarily listed and inquiries about individual patient feasibility for Particle Therapy are encouraged.

Please contact us for diseases currently treated at MedAustron and diseases suitable for particle therapy:
patient@medaustron.at / +432622 26100-300

    Central Nervous System

    The majority of pediatric and many adult CNS tumors (brain and spine) that require radiotherapy are treated with Particle Therapy.

    Examples are: Low Grade Gliomas / Astrocytomas, Pineal Gland Tumors, Craniopharyngiomas, Pituitary Macroadenomas, Meningiomas, Gliomas of optic apparatus, Ependymomas, Neurocytomas, Atypical Teratoid and Rhabdoid Tumors (ATRT), tumors formerly considered PNET’s, Acoustic Neuromas (Vestibular Schwannomas).

    Re-irradiation of recurrent brain tumors after failure of prior conventional radiotherapy will be considered.

    High Grade Gliomas (Glioblastoma Multiforme, Grade IV) only benefit from Particle Therapy in rare exceptions. WHO Grade III tumors will be evaluated individually based on prognostic factors.

    Note: Tumors requiring irradiation of the craniospinal axis (Medulloblastomas a.o.) will be treated in the future once technological functionality is in place.

     

    Ocular and Orbital Tumors

    Ocular Tumors = tumors of the eye. Proton Therapy is an established treatment modality for Uveal Melanomas and other intraocular tumors.

    Note: MedAustron is in the process of establishing a dedicated Ocular Tumor Program. At present, patients with a suitable indication are referred to a facility with a dedicated ocular tumor beamline.

    Orbital Tumors: Particle Therapy is specifically suitable for irradiation of tumors and cancers originating in the orbit or having invaded the orbit.

    Primary Orbital Tumors: Lacrimal Gland Carcinomas (Adenoid Cystic Carcinomas), Carcinomas of eyelids, Rhabdomyosarcomas, Optic Nerve Meningiomas

    Secondary Orbital Invasion: Meningiomas, Esthesioneuroblastomas, Chordomas, Paranasal and Nasal Sinus Carcinomas

     

    Skull Base

    The majority of Skull Base tumors considered for radiotherapy are treated with Particle Therapy: Chordomas, Chondrosarcomas, Pituitary Adenomas, Schwannomas (Neuromas) of various cranial nerves including Acoustic Neuromas, Optic Pathway Gliomas, Paragangliomas, Esthesioneuroblastomas.

    This includes primary Head and Neck tumors extending into the Skull Base: Paranasal Sinus Tumors, Adenoid Cystic Carcinomas.

    Re-irradiation after failure of conventional radiotherapy will be considered on an individual basis.

     

    Spinal and Paraspinal Tumors

    Primary Spinal Tumors: Examples are Ependymomas, Neurofibromas, selected Astrocytomas, a.o.

    Tumors of the Axial Skeleton and Paraspinal Location: Chordomas, Chondrosarcomas, Retroperitoneal and other Paraspinal Soft Tissue Sarcomas, Osteogenic Sarcomas, Ewing’s Sarcomas, Osteoblastomas, recurrent Osteomas, a.o.

     

    Head and Neck

    A large number of malignancies occurring in Head and Neck region such as:

    1. Cancers and tumors of the nasal and paranasal sinuses with or without involvement of the skull base and orbit.
    2. Cancers and tumors of the parotis and other salivary glands.
    3. Re-irradiation with Particle Therapy after failure of conventional radiotherapy will be considered individually and may include other Head and Neck sites, for example larynx and pharynx.
    4. Carbon Ion Therapy is specifically considered for malignant Mucosal Melanomas, high-grade Parotid Cancer and re-irradiation


    Note: Cancers requiring bilateral irradiation of the entire neck are presently treated via combination of photon irradiation with proton boost.

     

    Thorax and Breast

    Note: Due to respiratory motion of the chest and internal thoracic organs a complex system of motion management is required to ascertain accurate dose delivery of spot scanning based Particle Therapy. This is at present still under development. Hence, Particle Therapy is presently not offered for Breast Cancer, Lung Cancer, and Mediastinal Tumors.

    However, tumors of the posterior chest wall and paraspinal areas as well as tumors of the lower neck / thoracic inlet are treated already. Examples: Sarcomas, benign, but aggressive Desmoid Tumors and Fibromatosis, solitary recurrences of lower neck and thoracic inlet and supraclavicular region of various histologies (Breast Cancer, Lymph Node Recurrence etc.)

     

    Abdomen (upper)

    Either Primary Liver Cancer (Hepatocellular Carcinoma = HCC) or in selected cases Liver Metastasis are treated with Particle Therapy.

    Pancreatic Cancer: Indications include borderline resectable tumors, both in neoadjuvant as well as in a definitve setting, locally advanced Pancreatic Cancer (LAPC) and irradiation of the postoperative bed and lymph nodes after resection. In selected cases local failure / recurrence after the initial treatment.

     

    Pelvis

    Sarcomas of the Sacrum and Pelvis: Chordomas, Chondrosarcomas, Osteosarcomas, Ewing’s Sarcomas and Soft Tissue Sarcomas.

    Pelvic side wall: localized pelvic wall recurrence without signs of a systemic disease in Gynecological and Colorectal Tumors.

    Prostate cancer: Low and intermediate risk Prostate cancer. Note: High-risk Prostate Cancer requiring pelvic lymph node irradiation will be offered in early 2020

     

    Sarcomas

    Histologies: Osteogenic Sarcoma, Ewing’s Sarcomas, various Soft-Tissues Sarcomas, Rhabdomyosarcomas, and benign, but locally aggressive Mesenchymal Tumors (for example Neurofibromas, Desmoid Tumors, Osteoblastomas, etc.)

    Locations include Head & Neck, skull base, paraspinal locations (axial skeleton), and sacrum / pelvis as well as thoracic wall and extremities.

    Indications include selected cases in preoperative setting, postoperative Particle Therapy with or without residual disease, or Particle Therapy for unresectable or recurrent diseases. An individual evaluation will be made as to feasibility of Proton versus Carbon Ion Therapy.

     

    Pediatric Malignancies

    The majority of solid tumors of childhood and young adults requiring radiation therapy as part of overall disease management are candidates for Particle Therapy. In cases that patients are treated on study protocols and whenever feasible, the patient stays enrolled on the protocol and treatment will be conducted according to protocol by exchanging photon radiotherapy with protons (applying protocol radiotherapy treatment specifications). Carbon Ion Therapy is considered for unresectable osteogenic sarcomas and unresectable soft tissue sarcomas.

    The majority of indications include (not a complete list):

    1. Brain (= CNS) tumors. Examples are: Pilocytic Astrocytomas, Neurocytomas, Craniopharyngio¬mas, other Low and High Grade Astrocytomas (Gliomas), Ependymomas, ATRT. NOTE: tumors requiring craniospinal irradiation (Medulloblastomas) will be treated at our center starting early 2020.
    2. Rhabdomyosarcomas: specifically Parameningeal Rhabdomysarcomas, Orbital Rhabdomyosarcomas, Sarcomas of the Pelvis, but also extremities.
    3. Non-rhabdo Soft Tissue Sarcomas, Ewing’s Sarcomas, Osteogenic Sarcomas, Chordomas and other Mesenchymal Tumors.
    4. Lymphomas and Hodgkin’s lymphoma upon individual evaluation. Note: Mediastinal Hodgkin’s Lymphoma will be treated once respiratory motion management is established.
    5. Other rare entities upon individual evaluation

     

    Re-Irradiation

    Re-irradiation of local recurrence after failure of prior radiation therapy are challenging situations and highly individualized. Appropriate patient selection is critical to balance benefits versus risks. In general, selection criteria are: curative intention, good performance status, localized disease, at least 12 months since the last irradiation, no evidence of metastasis or oligometastatic disease with long-term life expectancy.

     

    Contact

    We are at your service:

    Call us under +43 / 2622 / 26100 – 300 or send an email to patient@medaustron.at.
    We will get in contact with you within two working days.