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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
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[Proton therapy for head and neck cancers].

P Blanchard1, S J Frank2

  • 1Department of radiation oncology, MD Anderson cancer center, the university of Texas, Houston, Texas, États-Unis; Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France.

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
|September 5, 2017
PubMed
Summary

Proton therapy, particularly intensity-modulated proton therapy (IMPT), offers dosimetric advantages over intensity-modulated radiotherapy (IMRT) for head and neck cancers, potentially reducing toxicity and improving survival in specific cases.

Keywords:
CancerHead and neckIntensity modulationModulation d’intensitéORLProtontherapyProtonthérapieRadiotherapyRadiothérapieVoies aérodigestives supérieures

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Area of Science:

  • Radiation Oncology
  • Medical Physics

Background:

  • Proton therapy offers dosimetric superiority over photon radiotherapy due to its finite range and sharp lateral penumbra.
  • Intensity-modulated proton therapy (IMPT) shows reduced integral dose and organ-at-risk dose compared to intensity-modulated radiotherapy (IMRT).

Purpose of the Study:

  • To review the characteristics of proton therapy.
  • To analyze clinical data for head and neck cancer patients treated with proton therapy.
  • To discuss patient selection and uncertainties associated with proton therapy.

Main Methods:

  • Literature review of dosimetric comparisons and clinical outcomes.
  • Analysis of studies focusing on head and neck cancers.
  • Evaluation of toxicity and survival data.

Main Results:

  • IMPT significantly reduces dose to critical structures like the anterior oral cavity, posterior fossa, visual apparatus, and swallowing structures.
  • Clinical data suggest reduced toxicities such as weight loss and need for feeding tubes with IMPT.
  • Patient survival is comparable to IMRT, with potential advantages in base of skull or sinonasal malignancies.

Conclusions:

  • Proton therapy, especially IMPT, provides significant dosimetric benefits for head and neck cancers, translating to improved clinical outcomes and potentially better survival in select cases.
  • Careful patient selection and understanding of physical and biological uncertainties are crucial for optimizing proton therapy efficacy.