scholarly journals Proton re-irradiation of unresectable recurrent head and neck cancers

2020 ◽  
Author(s):  
Konstantin Gordon ◽  
Igor Gulidov ◽  
Alexey Semenov ◽  
Olga Golovanova ◽  
Sergey Koryakin ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Therapy ◽  
Head And Neck Cancers ◽  
Efficient Treatment ◽  
Intensity Modulated Proton Therapy ◽  
Median Total Dose ◽  
Eortc Criteria ◽  
Radiation Induced ◽  
Grade 3 ◽  
Base Of The Skull

Abstract Purpose: This study presents a retrospective analysis (efficacy and toxicity) of outcomes in patients with unresectable recurrence of previously irradiated head and neck cancers, treated with proton therapy.Methods: From November 2015 to January 2020, 30 patients with in-field recurrence of head and neck cancer, who were not suitable for surgery, due to medical contraindications, tumor localization or extent, received re-irradiation with intensity-modulated proton therapy (IMPT). Sites of retreatment included the aerodigestive tract (60%) and base of the skull (40%). The median total dose of prior radiotherapy was 55.0 Gy. The median time to the second course was 38 months. The median re-irradiated tumor volume was 158.1 cm3. Patients were treated with 2.0, 2.4 and 3.0 GyRBE per fraction, with a median EQD2 of 57.6 Gy (α/β=10). Radiation-induced toxicity was recorded according to the RTOG/EORTC criteria.Results: The 1- and 2-years LC, RFS, and OS were 52.6/21.0, 21.9/10.9 and 73.4/8.4%, respectively, with a median follow-up time of 21 months. The median overall survival was 16 months. Acute grade 3 toxicity was observed in 1 patient (3.3%). There were 5 late severe side effects (16.6%), with one death associated with re-irradiation.Conclusion: Re-irradiation with a proton beam can be considered a safe and efficient treatment even for a group of patients with unresectable recurrent H&N cancers.

PO-0930 ROBUSTNESS OF IMPT (INTENSITY MODULATED PROTON THERAPY) COMPARED WITH IMRT FOR HEAD AND NECK CANCERS

2012 ◽  
Vol 103 ◽  
pp. S366-S367
Author(s):  
R. Harding ◽  
J. Lilley ◽  
V.P. Cosgrove ◽  
S.J. Weston ◽  
C.M. Thompson ◽  
...  
Keyword(s):  
Head And Neck ◽  
Proton Therapy ◽  
Head And Neck Cancers ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated

scholarly journals Effectiveness of robust optimization in intensity-modulated proton therapy planning for head and neck cancers

2013 ◽  
Vol 40 (5) ◽  
pp. 051711 ◽  
Author(s):  
Wei Liu ◽  
Steven J. Frank ◽  
Xiaoqiang Li ◽  
Yupeng Li ◽  
Peter C. Park ◽  
...  
Keyword(s):  
Robust Optimization ◽  
Head And Neck ◽  
Proton Therapy ◽  
Head And Neck Cancers ◽  
Therapy Planning ◽  
Intensity Modulated Proton Therapy ◽  
Intensity Modulated

Benzydamine for prophylaxis of radiation induced oral mucositis in head and neck cancers: Double-blind clinical trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9042-9042
Author(s):  
S. Kamian
Keyword(s):  
Placebo Group ◽  
Head And Neck ◽  
Oral Mucositis ◽  
Treated Group ◽  
Head And Neck Cancers ◽  
Control Group ◽  
Oral Rinse ◽  
Neck Tumors ◽  
Radiation Induced ◽  
Grade 3

9042 Background: Oral mucositis is one of the most common adverse effects of radiotherapy in head and neck tumors. We determined the efficacy of oral rinse benzydamine in prevention of radiation induced mucositis. Methods: Patients with head and neck cancers were enrolled in a randomize, placebo-controlled clinical trail to receive either benzydamine or placebo. All the cases received at least 50 Gy radiation to the oral cavity and oropharyngeal areas. The end points were comparison of highest grade of mucositis at the end of radiotherapy, frequency of grade 2 or more, the interval days to establishing grade 2 in the groups. Results: 100 patients with head and neck cancers were randomized in this trail. At the end of the study, 19 patients were excluded of the analysis due to minor side effects of drug, or stopping the radiotherapy. In 39 cases in the treated group, the frequency of mucositis grade 3 or more was 43.6% (17 cases) in contrast to 78.6% (33 cases) in 42 cases in the placebo group, which was significant (p=0.001). Mucositis grade 3 or more was 2.6 times frequent in placebo group (CI=95%, relative risk=1.38–5). At the end of RT, at least 42% of the treated group had mucositis grade 3 or more in contrast to at least 76% in the control group which was statistically significant. Intensity of mucositis was increased up to forth week of treatment in both groups to grade 2. In the treated group the grade of mucositis was approximately constant to the end of therapy; but in the control group it raised to grade 3 (p<0.001). The highest grade of mucositis during the treatment time was significantly different between two groups (p=0.049). The median interval days of establishing grade 2 mucositis was 3.6 days sooner in the placebo group (p=0.12). Conclusions: According to these results it seems that oral rinse benzydamine was effective, safe, and well tolerated for prophylactic treatment of radiation-induced oral mucositis in head and neck tumors. [Table: see text]

scholarly journals Early Clinical Outcomes of Intensity Modulated Radiation Therapy/Intensity Modulated Proton Therapy Combination in Comparison with Intensity Modulated Radiation Therapy Alone in Oropharynx Cancer Patients

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1549
Author(s):  
Han Gyul Yoon ◽  
Yong Chan Ahn ◽  
Dongryul Oh ◽  
Jae Myoung Noh ◽  
Seung Gyu Park ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Proton Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Combination Group ◽  
Intensity Modulated Proton Therapy ◽  
Oropharynx Cancer ◽  
Intensity Modulated ◽  
Before And After ◽  
Grade 3 ◽  
Early Clinical Outcomes

Purpose: To report the early clinical outcomes of combining intensity-modulated radiation therapy (IMRT) and intensity-modulated proton therapy (IMPT) in comparison with IMRT alone in treating oropharynx cancer (OPC) patients. Materials and Methods: The medical records of 148 OPC patients who underwent definitive radiotherapy (RT) with concurrent systemic therapy, from January 2016 till December 2019 at Samsung Medical Center, were retrospectively reviewed. During the 5.5 weeks’ RT course, the initial 16 (or 18) fractions were delivered by IMRT in all patients, and the subsequent 12 (or 10) fractions were either by IMRT in 81 patients (IMRT only) or by IMPT in 67 (IMRT/IMPT combination), respectively, based on comparison of adaptive re-plan profiles and availability of equipment. Propensity-score matching (PSM) was done on 76 patients (38 from each group) for comparative analyses. Results: With the median follow-up of 24.7 months, there was no significant difference in overall survival and progression free survival between groups, both before and after PSM. Before PSM, the IMRT/IMPT combination group experienced grade ≥ 3 acute toxicities less frequently: mucositis in 37.0% and 13.4% (p < 0.001); and analgesic quantification algorithm (AQA) in 37.0% and 19.4% (p = 0.019), respectively. The same trends were observed after PSM: mucositis in 39.5% and 15.8% (p = 0.021); and AQA in 47.4% and 21.1% (p = 0.016), respectively. In multivariate logistic regression, grade ≥ 3 mucositis was significantly less frequent in the IMRT/IMPT combination group, both before and after PSM (p = 0.027 and 0.024, respectively). AQA score ≥ 3 was also less frequent in the IMRT/IMPT combination group, both before and after PSM (p = 0.085 and 0.018, respectively). Conclusions: In treating the OPC patients, with comparable early oncologic outcomes, more favorable acute toxicity profiles were achieved following IMRT/IMPT combination than IMRT alone.

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