Proton therapy for head and neck squamous cell carcinomas: A review of the physical and clinical challenges.

Proton therapy for head and neck squamous cell carcinomas: A review of the physical and clinical challenges. Radiother Oncol. 2020 Mar 27;147:30-39 Authors: Beddok A, Vela A, Calugaru V, Tessonnier T, Kubes J, Dutheil P, Gerard A, Vidal M, Goudjil F, Florescu C, Kammerer E, Benezery K, Herault J, Poortmans P, Bourhis J, Thariat J, GORTEC, the 3 French proton centers Abstract The quality of radiation therapy has been shown to significantly influence the outcomes for head and neck squamous cell carcinoma (HNSCC) patients. The results of dosimetric studies suggest that intensity-modulated proton therapy (IMPT) could be of added value for HNSCC by being more effective than intensity-modulated (photon) radiation therapy (IMRT) for reducing side effects of radiation therapy. However, the physical properties of protons make IMPT more sensitive than photons to planning uncertainties. This could potentially have a negative effect on the quality of IMPT planning and delivery. For this review, the three French proton therapy centers collaborated to evaluate the differences between IMRT and IMPT. The review explored the effects of these uncertainties and their management for developing a robust and optimized IMPT treatment delivery plan to achieve clinical outcomes that are superior to those for IMRT. We also provide practical suggestions for the management of HNSCC carcinoma with IMPT. Because metallic dental implants can increase range uncerta...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research