Table 1.
Studies evaluating IMPT for Head and Neck Cancers
| Study | HN Site | Study Type | Accrual Period | No. of Patients | Median follow up | Outcomes(years) | Toxicities (n, %) and interventions |
|---|---|---|---|---|---|---|---|
| Gunn35 (2016) | OPC | PS | 2011–2014 | 50 IMPT | 29 mo | LRC2.4: 92% OS2: 94.5% PFS2: 88.6% |
Acute: G3 mucositis (29, 58%), G3 dermatitis (23, 46%). Acute vs. late G3 dysphagea (12, 24% vs. 6,12%). G-tube placed in 11 (22%) patients. |
| Blanchard54 (2016) | OPC | RS | 2010–2014 | A) 50 IMPT B) 100 IMRT |
32 mo | A) OS3: 94.3% B) OS3: 89.3% |
G-tube or weight loss >20% (A vs. B) after 3-mo: (9, 18%) vs. 34 (34%) and after 12-mo: 4 (8%) vs. 22 (25%). |
| Lewis63 (2016) | NPC | PS | 2011–2013 | 10 IMPT | 24.5 mo | LRC2: 100% OS2: 88.9% |
Acute: G3 dermatitis (4, 44%), G3 mucositis (1, 11%). Chronic: G2 xerostomia (2, 22%). No chronic G3-G5 toxicities. |
| Holliday64 (2015) | NPC | RS | 2011–2013 | A) 10 IMPT B) 20 IMRT |
21.6 mo | A) LC2: 100% B) LC2: 95% |
G-tube insertion (A vs. B): 2 (20%) vs. 13 (65%). Swallowing dysfunction (A vs. B): 0 vs 3 (15%). |
| Holliday68 (2014) | Sinonasal | PS | 2011–2013 | 16 IMPT | 10.5 mo | LC: 87.5% | Acute: G2 dermatitis (13, 81%), G3 dermatitis (1, 6%), G2 mucositis (5, 31%), G2 dysgeusia (2, 13%). |
| Holliday68 (2014) | Parotid | PS | 2011–2013 | 13 IMPT | 13.2 mo | LC: 100% OS: 100% |
Acute: G2 dermatitis (9, 69%), G3 dermatitis (4, 31%). |
| Holliday68 (2014) | Periorbital | PS | 2011–2013 | 21 proton (9 IMPT) | 27.5 mo | LC: 100% | Acute: G3 dermatitis (7, 33%). Chronic: Visual changes (5, 24%), G3 keratopathy (3, 14%). |
| Holliday (2016) | Periorbital | PS | 2008–2014 | 6 IMPT, 14 PSPT | 27.1 mo | LC: 100% | Chronic: G3 epiphora (3, 15%), G3 exposure keratopathy (3, 15%). Decreased visual acuity (4, 20%) |
| Ares (2009) | BOS | RS | 1998–2005 | 20 IMPT, 44 scanningψ | 38 mo | LC5: 81%a and 94%b OS 100%a and 91%b |
Chronic: G3 optic neuropathy (1, 2%), G4 optic neuropathy (1, 2%), G3 brain necrosis (2, 3%). |
| Phan11 (2016) | Recurrence | RS | 2011–2015 | 15 PSPT, 45 (75%) IMPT | 13.6 mo | OS1: 83.8% PFS1: 60.1% |
Acute G3 toxicities in 18 (30%). G-tube insertion: 13 (22%). |
Abbreviations: BOS, base of skull tumors; G-tube, gastrostomy tube; Mo, months; NPC, nasopharyngeal carcinoma; OPC, oropharyngeal cancer; OS, overall survival; PFS, progression free survival; PS, prospective study; PSPT, passive scatter proton therapy; RS, retrospective study; SCC, squamous cell carcinoma.
ψ
In this study, 44 patients received proton therapy using a spot-scanning technique.
a
Five-year LC and OS rates for chordomas.
b
Five-year LC and OS rates for chondrosarcomas.