Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience
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 bo...
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| Format: | Article |
| Language: | English |
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Particle Therapy Co-operative Group
2021-06-01
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| Series: | International Journal of Particle Therapy |
| Subjects: | |
| Online Access: | https://theijpt.org/doi/pdf/10.14338/IJPT-20-00065.1 |
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Article |
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DOAJ |
| language |
English |
| format |
Article |
| sources |
DOAJ |
| author |
G. Brandon Gunn, MD Adam S. Garden, MD Rong Ye, MSc Noveen Ausat, BA Kristina R. Dahlstrom, PhD William H. Morrison, MD C. David Fuller, MD, PhD Jack Phan, MD, PhD Jay P. Reddy, MD, PhD Shalin J. Shah, MD Lauren L. Mayo, MD Stephen G. Chun, MD Gregory M. Chronowski, MD Amy C. Moreno, MD Jeffery N. Myers, MD, PhD Ehab Y. Hanna, MD Bita Esmaeli, MD Maura L. Gillison, MD, PhD Renata Ferrarotto, MD Katherine A. Hutcheson, PhD Mark S. Chambers, DMD, MS Lawrence E. Ginsberg, MD Adel K. El-Naggar, MD, PhD David I. Rosenthal, MD Xiaorong Ronald Zhu, PhD Steven J. Frank, MD |
| spellingShingle |
G. Brandon Gunn, MD Adam S. Garden, MD Rong Ye, MSc Noveen Ausat, BA Kristina R. Dahlstrom, PhD William H. Morrison, MD C. David Fuller, MD, PhD Jack Phan, MD, PhD Jay P. Reddy, MD, PhD Shalin J. Shah, MD Lauren L. Mayo, MD Stephen G. Chun, MD Gregory M. Chronowski, MD Amy C. Moreno, MD Jeffery N. Myers, MD, PhD Ehab Y. Hanna, MD Bita Esmaeli, MD Maura L. Gillison, MD, PhD Renata Ferrarotto, MD Katherine A. Hutcheson, PhD Mark S. Chambers, DMD, MS Lawrence E. Ginsberg, MD Adel K. El-Naggar, MD, PhD David I. Rosenthal, MD Xiaorong Ronald Zhu, PhD Steven J. Frank, MD Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience International Journal of Particle Therapy proton therapy head and neck cancer toxicity survival |
| author_facet |
G. Brandon Gunn, MD Adam S. Garden, MD Rong Ye, MSc Noveen Ausat, BA Kristina R. Dahlstrom, PhD William H. Morrison, MD C. David Fuller, MD, PhD Jack Phan, MD, PhD Jay P. Reddy, MD, PhD Shalin J. Shah, MD Lauren L. Mayo, MD Stephen G. Chun, MD Gregory M. Chronowski, MD Amy C. Moreno, MD Jeffery N. Myers, MD, PhD Ehab Y. Hanna, MD Bita Esmaeli, MD Maura L. Gillison, MD, PhD Renata Ferrarotto, MD Katherine A. Hutcheson, PhD Mark S. Chambers, DMD, MS Lawrence E. Ginsberg, MD Adel K. El-Naggar, MD, PhD David I. Rosenthal, MD Xiaorong Ronald Zhu, PhD Steven J. Frank, MD |
| author_sort |
G. Brandon Gunn, MD |
| title |
Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience |
| title_short |
Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience |
| title_full |
Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience |
| title_fullStr |
Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience |
| title_full_unstemmed |
Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution Experience |
| title_sort |
proton therapy for head and neck cancer: a 12-year, single-institution experience |
| publisher |
Particle Therapy Co-operative Group |
| series |
International Journal of Particle Therapy |
| issn |
2331-5180 |
| publishDate |
2021-06-01 |
| description |
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. |
| topic |
proton therapy head and neck cancer toxicity survival |
| url |
https://theijpt.org/doi/pdf/10.14338/IJPT-20-00065.1 |
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doaj-a36cc224ecfa4ccab274371253faf9db2021-07-07T17:55:42ZengParticle Therapy Co-operative GroupInternational Journal of Particle Therapy2331-51802021-06-018110811810.14338/IJPT-20-00065.1i2331-5180-8-1-108Proton Therapy for Head and Neck Cancer: A 12-Year, Single-Institution ExperienceG. Brandon Gunn, MD0Adam S. Garden, MD1Rong Ye, MSc2Noveen Ausat, BA3Kristina R. Dahlstrom, PhD4William H. Morrison, MD5C. David Fuller, MD, PhD6Jack Phan, MD, PhD7Jay P. Reddy, MD, PhD8Shalin J. Shah, MD9Lauren L. Mayo, MD10Stephen G. Chun, MD11Gregory M. Chronowski, MD12Amy C. Moreno, MD13Jeffery N. Myers, MD, PhD14Ehab Y. Hanna, MD15Bita Esmaeli, MD16Maura L. Gillison, MD, PhD17Renata Ferrarotto, MD18Katherine A. Hutcheson, PhD19Mark S. Chambers, DMD, MS20Lawrence E. Ginsberg, MD21Adel K. El-Naggar, MD, PhD22David I. Rosenthal, MD23Xiaorong Ronald Zhu, PhD24Steven J. Frank, MD251 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA2 Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA3 Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA3 Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA3 Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA4 Ophthalmic Plastic Surgery, Department of Plastic Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA5 Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA5 Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA3 Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA3 Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX, USA6 Department of Neuroradiology, University of Texas MD Anderson Cancer Center, Houston, TX, USA7 Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA8 Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, TX, USA1 Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USAPurpose: 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.https://theijpt.org/doi/pdf/10.14338/IJPT-20-00065.1proton therapyhead and neck cancertoxicitysurvival |