Clinical review of proton therapy in the treatment of unilateral head and neck cancers

Robert H. Press, Richard L. Bakst, Sonam Sharma, Rafi Kabarriti, Madhur K. Garg, Brian Yeh, Daphna Y. Gelbum, Shaakir Hasan, J. Isabelle Choi, Chris A. Barker, Arpit M. Chhabra, Charles B. Simone, Nancy Y. Lee

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Radiotherapy is a common treatment modality in the management of head and neck malignancies. In select clinical scenarios of well-lateralized tumors, radiotherapy can be delivered to the primary tumor or tumor bed and the ipsilateral nodal regions, while intentional irradiation of the contralateral neck is omitted. Proton beam therapy is an advanced radiotherapy modality that allows for the elimination of exit-dose through nontarget tissues such as the oral cavity. This dosimetric advantage is apt for unilateral treatments. By eliminating excess dose to midline and contralateral organs at risk and conforming dose around complex anatomy, proton beam therapy can reduce the risk of iatrogenic toxicities. Currently, there is no level I evidence comparing proton beam therapy to conventional photon radiation modalities for unilateral head and neck cancers. However, a growing body of retrospective and prospective evidence is now available describing the dosimetric and clinical advantages of proton beam therapy. Subsequently, the intent of this clinical review is to summarize the current evidence supporting the use of proton beam therapy in unilateral irradiation of head and neck cancers, including evaluation of disease site-specific evidence, unique challenging clinical scenarios, and ongoing clinical trials.

Original languageEnglish (US)
Pages (from-to)248-260
Number of pages13
JournalInternational Journal of Particle Therapy
Volume8
Issue number1
DOIs
StatePublished - Jun 1 2021

Keywords

  • Head and neck cancer
  • Ipsilateral
  • Proton therapy
  • Toxicities
  • Unilateral

ASJC Scopus subject areas

  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging

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