{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T06:10:11Z","timestamp":1758694211833,"version":"3.44.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Thailand\u2019s first Proton Beam Therapy (PBT) center became operational in August 2021. Given the high costs and specialized expertise required, evaluating the clinical and economic implications of PBT and planning for its expansion are essential for Thailand\u2019s healthcare system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study projected national PBT demand using data from the Thai PBT center, the Thai Association of Radiation Oncology (THASTRO), national cancer registry reports (Volumes VIII\u2013X), and GLOBOCAN (2022\u20132040). The number of cancer patients requiring PBT was estimated based on: (1) Thailand\u2019s Comptroller General\u2019s Department (CGD) reimbursement guidelines (June 2023), and (2) the American Society for Radiation Oncology (ASTRO) model policy. Infrastructure, personnel, and cost data were collected, with resource gaps assessed using RRCC version 24.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 2022 and 2023, the first PBT center treated 628 patients\u2014approximately 7% of all radiotherapy cases. Under CGD\u2019s limited reimbursement criteria, an estimated 1,454\u20132,797 patients per year would be eligible for PBT, corresponding to a need for 3\u20135 PBT units. However, when reimbursement constraints are excluded, this estimate increases to 6\u201310\u202funits. The ASTRO model suggests even broader eligibility, with 4,471\u20135,430 patients requiring 10\u201320\u202funits. The cost of a basic PBT unit is estimated at USD $30 million (excluding building infrastructure), with a treatment course costing approximately $38,000 (RRCC v.24).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The gap between reimbursement- and need-based demand highlights the tension between clinical benefit and cost. Strategic planning must balance equitable access, financial sustainability, and future growth of PBT in Thailand.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1659275","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T05:42:31Z","timestamp":1758692551000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Estimating proton beam therapy utilization and Investment in Thailand"],"prefix":"10.3389","volume":"13","author":[{"given":"Imjai","family":"Chitapanarux","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ekkasit","family":"Tharavichitkul","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anussara","family":"Prayongrat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patumrat","family":"Sripan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Zubizarreta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yavuz","family":"Anacak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pathomphorn","family":"Siraprapasiri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tharatorn","family":"Tungkasamit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chonsanee","family":"Changmanee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"353","DOI":"10.3390\/cancers7010353","article-title":"Proton radiobiology","volume":"7","author":"Tommasino","year":"2015","journal-title":"Cancers"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1200\/OP.24.00132","article-title":"Proton therapy: current status and controversies","volume":"20","author":"Press","year":"2024","journal-title":"JCO Oncol Pract"},{"key":"ref3","year":""},{"key":"ref4","year":""},{"key":"ref5","year":""},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2528","DOI":"10.1002\/cncr.35233","article-title":"Revolutionizing cancer treatment in India: evaluating the unmet need, economics, and a roadmap for project implementation of particle therapy","volume":"130","author":"Gupta","year":"2024","journal-title":"Cancer"},{"key":"ref7","volume-title":"Model policies","year":""},{"key":"ref8","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1016\/S1470-2045(18)30909-4","article-title":"Estimating the total incidence of global childhood cancer: a simulation-based analysis","volume":"20","author":"Ward","year":"2019","journal-title":"Lancet Oncol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"e151","DOI":"10.1016\/j.ijrobp.2012.10.007","article-title":"Historical trends in the use of radiation therapy for pediatric cancers: 1973-2008","volume":"85","author":"Jairam","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/j.ijrobp.2015.10.025","article-title":"Proton therapy in children: a systematic review of clinical effectiveness in 15 Pediatric cancers","volume":"95","author":"Leroy","year":"2016","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"S21","DOI":"10.1016\/s0167-8140(04)80007-0","article-title":"Medical aspects of the national Centre for oncological hadrontherapy (CNAO - 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