Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

Gary D. Lewis; Emma B. Holliday; Esengul Kocak-Uzel; Mike Hernandez; Adam S. Garden; David I. Rosenthal; Steven J. Frank

doi:10.1002/hed.24341

Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

Gary D. Lewis, Emma B. Holliday, Esengul Kocak-Uzel, Mike Hernandez, Adam S. Garden, David I. Rosenthal, Steven J. Frank

Research output: Contribution to journal › Article › peer-review

99 Scopus citations

Abstract

Background Intensity-modulated proton therapy (IMPT) has the potential to spare dose to organs at risk (OAR) when compared to intensity-modulated radiotherapy (IMRT) while maintaining excellent clinical outcomes. Methods Ten patients with nasopharyngeal carcinoma (NPC) were identified for whom IMPT was planned; 9 patients also had a comparison photon-based IMRT plan generated. Dosimetric comparison of mean radiation dose to 29 adjacent OAR was performed. Disease control, survival, and toxicity outcomes were collected from the medical records. Results There were significant differences in mean doses in 15 of the 29 OAR; 13 OAR received lower mean dose with proton-based plans. Median follow-up was 24.5 months (range, 19-32 months). Two-year locoregional control was 100% and the 2-year overall survival was 88.9%. Conclusion We observed dosimetric advantages conferred by IMPT compared to IMRT. Further study is needed to determine if these translate into reduced toxicity and/or improved disease control.

Original language	English (US)
Pages (from-to)	E1886-E1895
Journal	Head and Neck
Volume	38
DOIs	https://doi.org/10.1002/hed.24341
State	Published - Apr 1 2016

Keywords

chemotherapy
clinical outcomes
dosimetric planning study
intensity-modulated proton therapy
nasopharyngeal carcinoma
radiotherapy

ASJC Scopus subject areas

Otorhinolaryngology

MD Anderson CCSG core facilities

Biostatistics Resource Group

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10.1002/hed.24341

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title = "Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes",

abstract = "Background Intensity-modulated proton therapy (IMPT) has the potential to spare dose to organs at risk (OAR) when compared to intensity-modulated radiotherapy (IMRT) while maintaining excellent clinical outcomes. Methods Ten patients with nasopharyngeal carcinoma (NPC) were identified for whom IMPT was planned; 9 patients also had a comparison photon-based IMRT plan generated. Dosimetric comparison of mean radiation dose to 29 adjacent OAR was performed. Disease control, survival, and toxicity outcomes were collected from the medical records. Results There were significant differences in mean doses in 15 of the 29 OAR; 13 OAR received lower mean dose with proton-based plans. Median follow-up was 24.5 months (range, 19-32 months). Two-year locoregional control was 100% and the 2-year overall survival was 88.9%. Conclusion We observed dosimetric advantages conferred by IMPT compared to IMRT. Further study is needed to determine if these translate into reduced toxicity and/or improved disease control.",

keywords = "chemotherapy, clinical outcomes, dosimetric planning study, intensity-modulated proton therapy, nasopharyngeal carcinoma, radiotherapy",

author = "Lewis, {Gary D.} and Holliday, {Emma B.} and Esengul Kocak-Uzel and Mike Hernandez and Garden, {Adam S.} and Rosenthal, {David I.} and Frank, {Steven J.}",

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year = "2016",

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doi = "10.1002/hed.24341",

language = "English (US)",

volume = "38",

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T1 - Intensity-modulated proton therapy for nasopharyngeal carcinoma

T2 - Decreased radiation dose to normal structures and encouraging clinical outcomes

AU - Lewis, Gary D.

AU - Holliday, Emma B.

AU - Kocak-Uzel, Esengul

AU - Hernandez, Mike

AU - Garden, Adam S.

AU - Rosenthal, David I.

AU - Frank, Steven J.

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Background Intensity-modulated proton therapy (IMPT) has the potential to spare dose to organs at risk (OAR) when compared to intensity-modulated radiotherapy (IMRT) while maintaining excellent clinical outcomes. Methods Ten patients with nasopharyngeal carcinoma (NPC) were identified for whom IMPT was planned; 9 patients also had a comparison photon-based IMRT plan generated. Dosimetric comparison of mean radiation dose to 29 adjacent OAR was performed. Disease control, survival, and toxicity outcomes were collected from the medical records. Results There were significant differences in mean doses in 15 of the 29 OAR; 13 OAR received lower mean dose with proton-based plans. Median follow-up was 24.5 months (range, 19-32 months). Two-year locoregional control was 100% and the 2-year overall survival was 88.9%. Conclusion We observed dosimetric advantages conferred by IMPT compared to IMRT. Further study is needed to determine if these translate into reduced toxicity and/or improved disease control.

AB - Background Intensity-modulated proton therapy (IMPT) has the potential to spare dose to organs at risk (OAR) when compared to intensity-modulated radiotherapy (IMRT) while maintaining excellent clinical outcomes. Methods Ten patients with nasopharyngeal carcinoma (NPC) were identified for whom IMPT was planned; 9 patients also had a comparison photon-based IMRT plan generated. Dosimetric comparison of mean radiation dose to 29 adjacent OAR was performed. Disease control, survival, and toxicity outcomes were collected from the medical records. Results There were significant differences in mean doses in 15 of the 29 OAR; 13 OAR received lower mean dose with proton-based plans. Median follow-up was 24.5 months (range, 19-32 months). Two-year locoregional control was 100% and the 2-year overall survival was 88.9%. Conclusion We observed dosimetric advantages conferred by IMPT compared to IMRT. Further study is needed to determine if these translate into reduced toxicity and/or improved disease control.

KW - chemotherapy

KW - clinical outcomes

KW - dosimetric planning study

KW - intensity-modulated proton therapy

KW - nasopharyngeal carcinoma

KW - radiotherapy

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Intensity-modulated proton therapy for nasopharyngeal carcinoma: Decreased radiation dose to normal structures and encouraging clinical outcomes

Abstract

Keywords

ASJC Scopus subject areas

MD Anderson CCSG core facilities

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