Table 3.
NPC and proton therapy late toxicities ordered by year published.
|
Study (year) |
IMRT, N (%) |
Proton, N (%) |
|||||||||
|
Proton technique |
Xerostomia |
Feeding tube/ swallowing |
Hearing |
TLN |
Others |
Xerostomia |
Feeding tube/ swallowing |
Hearing |
TLN |
Others |
|
| Holliday et al (2015) [17] | IMPT | 3 (15)a | G3 2 (10) | G1 2 (10) | 3 (30) | 0a | G1 1(10) G3 1(10) | ||||
| Lewis et al (2016) [18] | IMPT | G1 6 (60) G2 2 (20) | |||||||||
| Beddok et al (2019) [19] | Mixed-beam EBRTb/ DS-PT | 12 (70.6) | Overall 9 (52.9) G3 4 (23.5) | Overall 6 (35.3) G2+ 1 (5.9) | Gr5 necrosis-induced nasopharyngeal bleeding 1 (5.9) | ||||||
| Dionisi et al (2019) [20] | 3D-PT | G2 1 (5.9) G3 1 (5.9) | G3 3 (17.6) | G2 trismus 1 (5.9), G2 soft tissue necrosis 2 (11.8), G2 osteonecrosis 1 (5.9) | |||||||
| Sanford et al (2019) [22] | DS-PT | G3 1 (8.3) | G3 4 (7) | G3 1 (1.6) | G3 CN deficit 1 (1.6), no G2 xerostomia in both modalities | ||||||
| Alterio et al (2020) [23] | Mixed-beam IMRT /IMPT | G0-1 11 (68.8) G2 5 (31.3) | G0-1 16 (100) | G0-1 15 (93.8) G2 1 (6.3) | G0-1 16 (100) | G0-1 16 (61.5) G2 10 (38.5) | G0-1 26 (100) | G0-1 25 (96.2) G2 1 (3.8) | G0-1 26 (100) | Trend to less soft tissue fibrosis (P = .07) | |
| Jiri et al (2020) [24]c | IMPT | G2 3 (7) | G2 2 (5) | G2 3 (7) G3 0 | G3+ 1 (2) | ||||||
Abbreviations: NPC, nasopharyngeal cancer; IMRT, intensity-modulated radiation therapy; TLN, temporal lobe necrosis; IMPT, intensity-modulated proton therapy; -, no information; G, toxicity grade; EBRT, external beam radiation therapy; DS-PT, double scattering proton therapy; 3D-PT, 3-dimensional conformal proton therapy; CN, cranial nerve; 3DCRT, 3-dimensional conformal radiation therapy; RTOG, Radiation Therapy Oncology Group.
a
Swallowing dysfunction evaluated by a speech pathologist of a modified barium swallow.
b
EBRT = 3DCRT or IMRT.
c
Toxicity evaluation using RTOG scale.