Cancer: referral of patients to centres for hadron therapy

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What is hadron therapy?

Hadron therapy is a radiotherapy technique that irradiates tumours with high precision by means of protons or other charged particles (such as carbon ions). In addition, some particles, such as carbon ions, can also be used to treat tumours that are less sensitive to classic photon irradiation.

Where can patients receive hadron therapy?

The NIHDI has a partnership with the following centers for hadron therapy (Belgian or abroad) :

• Protoncentrum UZLeuven (ParTICLe) - https://www.uzleuven.be/en/proton-centre/proton-therapy
• Institut Curie Orsay - https://institut-curie.org/liste/proton-therapy-center
• HIT Heidelberg - https://www.klinikum.uni-heidelberg.de/Welcome.113005.0.html?L=1
• PSI  Villigen - https://www.psi.ch/protontherapy/center-for-proton-therapy-cpt
• WPE Essen  - https://www.wpe-uk.de/?lang=en
  
  

Who is eligible for a hadron therapy treatment?

Only patients meeting the established criteria are eligible to receive a contribution in the treatment costs.
The Scientific Committee and the Agreement Council for hadron therapy drew up a list of indications and additional inclusion criteria. The Health Insurance Committee approved it.

Who can refer patients to a centre for hadron therapy?

Within the context of the compulsory health care insurance, only certified radiotherapy centres that have an agreement with us can refer patients to a specialized hadron therapy centre.

Agreement in French  – Agreement in Dutch 

The following aspects are settled in such an agreement :

•  the procedure to be followed when referring patients
• the requirements to be met by patients in order to receive a contribution
• the arrangement to reimburse travelling costs and accommodation expenses for the patient and the accompanying person if the treatment takes place outside Belgium
• the contribution for the referring centre for coordination of the referral
• the practical aspects in order to pay the specialised hadron centre
  

What is the referral procedure?

To refer a patient to a specialised centre for hadron therapy the attending physician has to follow this procedure :

1. If hadron therapy is the only therapy or the most appropriate one for the patient according to the report of a multidisciplinary oncology consultation (info about MOC in French  – info about MOC in Dutch ), the attending physician can contact one of the radiotherapy centres (in Belgium) that can refer the patient to a specialised hadron therapy centre (in Belgium or abroad).
   A multidisciplinary report is also required in case of non-cancerous disorders that can be considered.
2. If the patient meets the inclusion criteria, the radiotherapy centre files a complete application to us, including the hadron therapy centre that is willing to treat the patient, and the estimated treatment costs.
3. This application file is submitted to the Agreement Council that will decide whether or not a contribution in the treatment costs will be granted and if applicable also the travel and accommodation expenses.
4. After a positive decision from the Agreement Council, the patient can be treated in a hadron therapy centre.
   The radiotherapy centre coordinates the referral.
5. After the treatment, we pay the treatment costs directly to the hadron therapy centre. If applicable, the transportation costs and accommodation expenses are paid to the beneficiary. The referring radiotherapy centre receives an allowance for its coordination efforts.

(*) The transportation costs to and from one of the specialized hadrontherapy centers located on Belgian territory will be subject to the conditions and procedures for interventions provided for cancer patients:
https://www.inami.fgov.be/fr/themes/cout-remboursement/maladies/chroniques/Pages/intervention-frais-deplacement--patients-cancereux.aspx
https://www.inami.fgov.be/nl/themas/kost-terugbetaling/ziekten/chronische-ziekten/Paginas/tegemoetkoming-reiskosten-kankerpatient.aspx
The transportation costs to and from one of the specialized hadrontherapy centers located outside Belgian territory will be covered as specified in the agreement.

Outline scheme and explanations.