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Technique for comprehensive head and neck irradiation using 3-dimensional conformal proton therapy
Mark W McDonald1, Alexander S Walter2, Ted A Hoene3
1Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health Proton Therapy Center, Bloomington, IN.
Summary
Proton therapy for head and neck cancer significantly reduces radiation dose to organs like the oral cavity and esophagus compared to intensity-modulated photon therapy. This advanced technique offers better sparing of critical structures.
Area of Science:
- Radiation Oncology
- Medical Physics
- Head and Neck Cancer Treatment
Background:
- Matching photon and proton therapy modalities presents technical challenges.
- Comprehensive head and neck radiation requires precise targeting and organ sparing.
Purpose of the Study:
- To develop and implement a 3D conformal proton therapy technique for head and neck radiation.
- To compare the dosimetry of proton therapy with intensity-modulated photon therapy (IMRT) for cervical lymphatics and primary tumor sites.
Main Methods:
- A monoisocentric technique with a 30-cm snout was employed for proton therapy.
- Cervical lymphatics were treated with three fields, with staggered matchlines for nodal and tumor fields.
- Comparative IMRT plans were created for 12 patients to assess organ at risk (OAR) sparing.
Main Results:
- Proton therapy plans showed significant dose avoidance in the oral cavity and midline neck structures.
- Statistically significant reductions in mean and integral radiation dose to the oral cavity, larynx, esophagus, and parotid glands were observed with proton therapy compared to IMRT.
- No significant differences in dose were found for the lesser-spared parotid or submandibular glands.
Conclusions:
- A 3D conformal proton therapy technique for cervical nodal irradiation was successfully developed and implemented.
- Proton therapy offers substantial dose avoidance to the oral cavity and reduced exposure to the larynx and esophagus.
- Proton therapy plans demonstrated superior OAR sparing compared to IMRT for head and neck irradiation.
