Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience.

Autor:	Gunn GB; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Garden AS; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Ye R; Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Ausat N; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Dahlstrom KR; Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Morrison WH; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Fuller CD; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Phan J; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Reddy JP; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Shah SJ; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Mayo LL; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Chun SG; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Chronowski GM; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Moreno AC; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Myers JN; Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Hanna EY; Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Esmaeli B; Ophthalmic Plastic Surgery, Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Gillison ML; Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Ferrarotto R; Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Hutcheson KA; Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Chambers MS; Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Ginsberg LE; Department of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., El-Naggar AK; Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Rosenthal DI; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Zhu XR; Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA., Frank SJ; Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Jazyk:	angličtina
Zdroj:	International journal of particle therapy [Int J Part Ther] 2021 Jun 25; Vol. 8 (1), pp. 108-118. Date of Electronic Publication: 2021 Jun 25 (Print Publication: 2021).
DOI:	10.14338/IJPT-20-00065.1
Abstrakt:	Purpose: To characterize our experience and the disease control and toxicity of proton therapy (PT) for patients with head and neck cancer (HNC). Patients and Methods: Clinical outcomes for patients with HNC treated with PT at our institution were prospectively collected in 2 institutional review board-approved prospective studies. Descriptive statistics were used to summarize patient characteristics and outcomes. Overall survival, local-regional control, and disease-free survival were estimated by the Kaplan-Meier method. Treatment-related toxicities were recorded according to the Common Terminology Criteria for Adverse Events (version 4.03) scale. Results: The cohort consisted of 573 patients treated from February 2006 to June 2018. Median patient age was 61 years. Oropharynx (33.3%; n = 191), paranasal sinus (11%; n = 63), and periorbital tissues (11%; n = 62) were the most common primary sites. Patients with T3/T4 or recurrent disease comprised 46% (n = 262) of the cohort. The intent of PT was definitive in 53% (n = 303), postoperative in 37% (n = 211), and reirradiation in 10% (n = 59). Median dose was 66 Gy (radiobiological equivalent). Regarding systemic therapy, 43% had received concurrent (n = 244), 3% induction (n = 19), and 15% (n = 86) had both. At a median follow-up of 2.4 years, 88 patients (15%) had died and 127 (22%) developed disease recurrence. The overall survival, local-regional control, and disease-free survival at 2 and 5 years were, respectively, 87% and 75%, 87% and 78%, and 74% and 63%. Maximum toxicity (acute or late) was grade 3 in 293 patients (51%), grade 2 in 234 patients (41%), and grade 1 in 31 patients (5%). There were 381 acute grade 3 and 190 late grade 3 unique toxicities across 212 (37%) and 150 (26%) patients, respectively. There were 3 late-grade 4 events across 2 patients (0.3%), 2 (0.3%) acute-grade 5, and no (0%) late-grade 5 events. Conclusions: The overall results from this prospective study of our initial decade of experience with PT for HNC show favorable disease control and toxicity outcomes in a multidisease-site cohort and provide a reference benchmark for future comparison and study. Competing Interests: Conflicts of Interest: Steven J. Frank, MD, is an Associate Editor of the International Journal of Particle Therapy. Dr Frank is a scientific advisory board member of Breakthrough Chronic Care; he has received research grants from C4 Imaging, Eli Lilly, Elekta, and Hitachi, and he has reported personal fees from Varian Medical Systems, Inc (consultant/advisory board), C4 Imaging (founder and director), Hitachi (honoraria/advisory board), Augmenix (honoraria), and National Comprehensive Cancer Center (board member). Stephen G. Chun, MD, is a consultant for AstraZeneca, PLC. The authors report no other conflicts of interest. (©Copyright 2021 The Author(s).)
Databáze:	MEDLINE
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