Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

Head Neck. 2016 Apr;38 Suppl 1:E1886-95. doi: 10.1002/hed.24341. Epub 2015 Dec 26.

Abstract

Background: Intensity-modulated proton therapy (IMPT) has the potential to spare dose to organs at risk (OAR) when compared to intensity-modulated radiotherapy (IMRT) while maintaining excellent clinical outcomes.

Methods: Ten patients with nasopharyngeal carcinoma (NPC) were identified for whom IMPT was planned; 9 patients also had a comparison photon-based IMRT plan generated. Dosimetric comparison of mean radiation dose to 29 adjacent OAR was performed. Disease control, survival, and toxicity outcomes were collected from the medical records.

Results: There were significant differences in mean doses in 15 of the 29 OAR; 13 OAR received lower mean dose with proton-based plans. Median follow-up was 24.5 months (range, 19-32 months). Two-year locoregional control was 100% and the 2-year overall survival was 88.9%.

Conclusion: We observed dosimetric advantages conferred by IMPT compared to IMRT. Further study is needed to determine if these translate into reduced toxicity and/or improved disease control. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1886-E1895, 2016.

Keywords: chemotherapy; clinical outcomes; dosimetric planning study; intensity-modulated proton therapy; nasopharyngeal carcinoma; radiotherapy.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Carcinoma / radiotherapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / radiotherapy*
  • Proton Therapy*
  • Radiation Dosage*
  • Radiotherapy Dosage
  • Radiotherapy Planning, Computer-Assisted
  • Radiotherapy, Intensity-Modulated
  • Young Adult