ASTRO: Intensity Modulated Proton Therapy May Preserve Quality of Life in Patients With Oropharyngeal Cancer
A new study from researchers at The University of Texas MD Anderson Proton Therapy Center found that the use of feeding tubes in patients with oropharyngeal cancer treated with intensity modulated proton therapy decreased by more than 50% compared to patients treated with intensity modulated radiation therapy. The findings suggest that proton therapy may offer vital quality of life benefits for patients with this disease.
The results, presented today by the lead researcher, Steven J. Frank, MD, Associate Professor of Radiation Oncology at MD Anderson, at the American Society for Radiation Oncology’s 55th Annual Meeting (Abstract 354), also indicate that toxicity levels in patients with oropharyngeal cancer treated with intensity modulated proton therapy are much lower than those treated with intensity modulated radiation therapy.
Proton Therapy Spares Healthy Tissue
Intensity modulated proton therapy delivers a precise dose of protons to tumors embedded in the “nooks and crannies” of the head and neck, including the base of tongue and tonsils. Unlike intensity modulated radiation therapy, which destroys both cancerous and healthy cells, intensity modulated proton therapy has the ability to destroy cancer cells while sparing surrounding healthy tissue from damage. Therefore, important quality of life outcomes such as neurocognitive function, vision, swallowing, hearing, taste, and speech may be preserved in head and neck patients.
“Intensity modulated proton therapy is especially well-suited for patients with the most complicated tumors of the head and neck, precisely painting the protons onto the tumor layer by layer,” said Dr. Frank. “In this way, the treatment team can confine the majority of the tumor-damaging energy to target areas and work to protect normal structures such as the oral cavity and brainstem.”
Study Details
In the study, the researchers evaluated 25 patients with oropharyngeal cancer treated with intensity modulated proton therapy and 25 patients treated with intensity modulated radiation therapy. Five patients treated with intensity modulated proton therapy required the use of feeding tubes (20%) compared to 12 patients treated with intensity modulated radiation therapy (48%).
Intensity modulated proton therapy patients avoided other serious side effects caused by the toxicity of intensity modulated radiation therapy such as vomiting, nausea, hearing problems, and mucositis. In addition, patients could better sustain their nutrition and hydration levels, often leading to faster recovery during and after treatment.
Next Steps
“With a recent epidemic of [human papillomavirus]-associated head and neck cancer among U.S. adults, there is a critical need to minimize the side effects associated with conventional intensity modulated radiation therapy that affect the patients’ courses of treatments, and, ultimately, the rest of their lives,” said Dr. Frank. “Since radiation therapy is the main tool to treat the disease in this fairly young group of patients, we must understand if more advanced technologies will provide additional value to this patient population.”
Based on the results of this study, a phase II/III randomized trial of intensity modulated proton therapy vs intensity modulated radiation therapy for the treatment of oropharyngeal cancer of the head and neck is underway at MD Anderson. Over the next 5 years, MD Anderson aims to enroll 360 patients in the trial, evaluating proton’s ability to reduce toxicity across a range of known side effects and enhance long-term cancer survivorship when compared to conformal radiation therapy.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
