Table 2.
NPC and proton therapy acute toxicities ordered by year published.
|
Study (year) |
Proton technique |
IMRT, N (%) |
Proton, N (%) |
P
value |
|||||||||
|
Dermatitis |
Mucositis |
Wt loss |
Feeding tube/ swallowing |
Xerostomia |
Dermatitis |
Mucositis |
Wt loss |
Feeding tube/ swallowing |
Xerostomia |
Others |
|||
| Holliday et al (2015) [17] | IMPT | G1+ 30 (100) | %wt loss = 5.7 | Overall 13 (65)a,b | G1 1 (10) G2 4 (40) G3 4 (40) | %wt loss = 7.6 | Overall 2 (20)a,b | aFeeding tube .015 | |||||
| Lewis et al (2016) [18] | IMPT | G2 5 (50) G3 4 (40) | G2 8 (80) G3 1 (10) | %wt loss = 6 G1 5 (50) G2 3 (30) | Overall 3 (30)b | ||||||||
| McDonald et al (2016) [16] | 3D-PT | Overall 22 (84.6)a | Overall 2 (14.3)a | aFeeding tube <.001 | |||||||||
| Beddok et al (2019) [19] | Mixed-beam EBRTc/ DS-PT | G3 1 (5.9) | Middle ear inflammation 6 (35) | ||||||||||
| Dionisi et al (2019) [20] | 3D-PT | G1 3 (17.6) | G1 4 (23.5), G2 3 (17.6) | G1 hearing 1 (5.9) G1 fatigue 2 (11.7) G1 CN disorder 1 (5.9) G1 pain 3 (17.6) G2 pain 1 (5.9) | |||||||||
| Park et al (2019) [21] | Mixed-beam IMRT/ IMPT | G3+ 2 (3.2) | G2+ 44 (69.8)a | G3+ 5 (14.3) | G2+ 16 (45.7)a | Analgesic use: G2 54 (IMRT) vs 37.1% (mixed beam) | aMucositis .019 | ||||||
| Alterio et al (2020) [23] | Mixed-beam IMRT/IMPT | G1 8 (47.1) G2 9 (52.9) | G1 2 (11.8) G2 2 (11.8) G3 13 (76.4)a | G1 9 (52.9) G2 6 (35.3) | G1 7 (41.2) G2 5 (29.4) G3 4 (23.5) | G1 10 (58.8) G2 6 (35.3) | G1 9 (33.3) G2 15 (55.6) | G1 11 (40.8) G2 13 (48.1) G3 3 (11.1)a | G1 14 (51.8) G2 5 (18.5) | G1 11 (40.8) G2 8 (29.6) G3 4 (14.8) | G1 19 (70.4) G2 2 (7.4) | aMucositis .0002 | |
| Jiri et al (2020) [24]d | IMPT | G1 8 (18.6) G2 29 (67.4) G3 6 (14) | G1 11 (25.6) G2 28 (65.1) G3 3 (7) | Deviation from baseline: >15%: 13 (30.2), 5%–15%: 26 (60.5), <5%: 4 (9.3) | G1 12 (27.9) G2 18 (41.9) G3 4 (9.3) | ||||||||
Abbreviations: NPC, nasopharyngeal cancer; IMRT, intensity-modulated radiation therapy; Wt, weight; IMPT, intensity-modulated proton therapy; G, toxicity grade; -, no information; 3D-PT, 3-dimensional conformal proton therapy; EBRT, external beam radiation therapy; DS-PT, double-scattering proton therapy; CN, cranial nerve; RTOG, Radiation Therapy Oncology Group.
a
Statistically significant.
b
Placement during or after treatment.
c
EBRT=3DCRT or IMRT.
d
Toxicity evaluation using RTOG scale.