Advanced form of proton therapy offers benefits for head, neck cancer patients

Oral cancer patients with tumors at the back of the throat are half as likely to require a feeding tube when treated with intensity modulated proton therapy (IMPT) compared to patients treated with intensity modulated radiation therapy (IMRT), an MD Anderson study has found.

IMPT, one of the most advanced forms of proton therapy, delivers a precise dose of protons to tumors embedded in the "nooks and crannies" of the head and neck, including oropharyngeal carcinoma, which occurs at the base of the tongue and tonsils.

Unlike IMRT, which destroys both cancerous and healthy cells, IMPT destroys cancer cells while sparing surrounding healthy tissue from damage and, simultaneously, preserving important quality-of-life factors such as neurocognitive function, vision, swallowing, hearing, taste and speech.

The American Cancer Society estimates that 36,000 people in the U.S. are diagnosed with oropharyngeal cancer each year (approximately a 20% increase since 2010). Nearly 70% of cases are HPV (human papilloma virus) - positive. Of the 50 patients enrolled in the study:

• Twenty-five were treated with IMPT and 25 received IMRT.
• Five patients treated with IMPT required the use of feeding tubes (20%) compared to 12 patients treated with IMRT (48%).
• IMPT patients were spared from serious side effects usually caused by IMRT such as vomiting, nausea, hearing problems, and mucositis (inflammation and ulceration of the digestive track).
• IMPT patients also could better sustain their nutrition and hydration levels, often leading to faster recovery during and after treatment.

[youtube id="dgG2P9JzO-Q" align="center" mode="normal"] The results suggest that proton therapy may offer vital quality-of-life benefits for patients with tumors occurring at the back of the throat.

"With a recent epidemic of HPV-associated head and neck cancer among U.S. adults, there is a critical need to minimize the side effects associated with conventional IMRT that affect the patients' courses of treatments, and, ultimately, the rest of their lives," says Steven J. Frank, M.D., associate professor of Radiation Oncology at MD Anderson and lead author on this study.

"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," Frank says.

Based on the results of this study, a Phase II/III randomized trial of IMPT vs. IMRT for the treatment of oropharyngeal cancer of the head and neck is under way at MD Anderson.

Frank presented study results at the American Society for Radiation Oncology's 55th Annual Meeting.

An MD Anderson news release about the study can be viewed