Abstract
6599 Background: Proton beam therapy (PBT) is a radiotherapy platform that purports an improved therapeutic ratio by way of a rapid radiation dose fall-off. Despite this technology being hindered by significant capital and patient costs, the number of centres offering PBT is increasing exponentially. Consensus guidelines support PBT use in a limited number of disease sites or on clinical trials. As patients frequently obtain information about PBT from hospital or cancer centre websites, the purpose of this study was to evaluate direct to consumer advertising (DTCA) content and claims made by proton therapy centre (PTC) websites. Methods: English PTC websites worldwide were identified using the Particle Therapy Co-Operative Group website. Data abstraction of website content was performed independently by two investigators. Eight international guidelines were consulted to determine indications for PBT. Univariate and multivariate logistic regression models were used to identify website characteristics that were associated with a higher likelihood to make non-evidence-based claims of PBT such as improved disease control or cure. Results: From the 48 PTCs with 46 English websites, most (58%) did not provide any references for claims made regarding PBT. These included: improved disease control or cure (61%), fewer side effects (85%), or was the standard of care (13%). Prostate (87%), head and neck (87%) and pediatric (83%) cancers were the most frequently listed PBT-indicated disease sites, consistent with international guidelines. However, pancreatobiliary (52%), breast (50%) and esophageal (44%) cancers were frequently advertised despite not being endorsed in any consensus guidelines. On multivariate analysis, an increasing number of listed disease sites and claims of being a regional PTC leader were associated with indicating that PBT offers greater disease control or cure. The availability of PBT through a clinical trial was mentioned on 57% of websites. Conclusions: PTC websites often contain information and DTCA claims inconsistent with international consensus guidelines. As online marketing information may have significant influence on patient decision-making, alignment of such information with accepted guidelines and consensus opinion should be adopted by PBT providers.
Highlights
Cancer patients frequently search the Internet for treatment options, and hospital websites are seen as reliable sources of knowledge
Proton beam therapy (PBT)-specific patient testimonials were present on 43.5% of websites, and 63.0% included a section dedicated to out-of-town patients
The amount of information contained within each website varied greatly, from single webpages only containing general information to detailed discussions about the merits of PBT for specific disease sites
Summary
Cancer patients frequently search the Internet for treatment options, and hospital websites are seen as reliable sources of knowledge. This study aims to evaluate direct-to-consumer advertising content and claims made by proton therapy centre (PTC) websites worldwide. The internet is a widely accessed source of medical information for patients [1,2,3,4,5,6,7,8]. Direct-to-consumer advertising (DTCA) on hospital and healthcare organization websites is common [9], frequently do not adequately support their claims with reference to available evidence [10]. As cancer patients may place more confidence in online information when endorsed by professional bodies and organizations [3, 9], it has been argued that strict guidelines and more
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