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Proton pencil-beam scanning radiotherapy in the treatment of nasopharyngeal cancer: dosimetric parameters and 2-year results

  • Head and Neck
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European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

 Patients with nasopharyngeal cancer are candidates for proton radiotherapy due to large and comprehensive target volumes, and the necessity for sparing of healthy tissues. The aim of this work is to evaluate treatment outcome and toxicity profile of patients treated with proton pencil-beam scanning radiotherapy.

Materials and methods

 Between Jan 2013 and June 2018, 40 patients were treated for nasopharyngeal cancer (NPC) with IMPT (proton radiotherapy with modulated intensity). Median age was 47 years and the majority of patients had locally advanced tumors (stage 2–8 patients. (20%); stage 3–18 patients (45%); stage 4A–10 patients. (25%); stage 4B–4 patients. (10%). Median of total dose was 74 GyE (70–76 GyE) in 37 fractions (35–38). Bilateral neck irradiation was used in all cases. Concomitant chemotherapy was applied in 34 cases. (85%). Median follow-up time was 24 (1.5–62) months.

Results

Two-year overall survival (OS), disease-free survival (DFS), and local control (LC) were 80%, 75%, and 84%, respectively. Acute toxicity was generally mild despite large target volumes and concurrent application of chemotherapy with skin toxicity and dysphagia reported as the most frequent acute side effects. The insertion of a percutaneous endoscopic gastrectomy (PEG) was necessary in four cases (10%). Serious late toxicity (G > 3. RTOG) was observed in two patients (5%) (dysphagia and brain necrosis).

Conclusion

 IMPT for nasopharyngeal cancer patients is feasible with mild acute toxicity. Treatment outcomes are promising despite the high percentage of advanced disease in this group.

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Funding

The work was supported by the European Regional Development Fund-Project: “Engineering Applications of Microworld Physics” (No. CZ.02.1.01/0.0/0.0/16_019/0000766).

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Authors and Affiliations

  1. Proton Therapy Center Czech, Budínova 1a, 18000, Prague 8, Czech Republic

    Kubeš Jiří, Vondráček Vladimír, Andrlik Michal, Navrátil Matěj, Sláviková Silvia, Vítek Pavel, Dědečková Kateřina, Ondrová Barbora, Rotnáglová Eliška & Lukeš Petr

  2. Department of Oncology, 1st Faculty of Medicine, General University Hospital, Charles University, Kateřinská, 32 121 08, Praha 2, Czech Republic

    Kubeš Jiří & Vítek Pavel

  3. Department of Oncology, 2nd Faculty of Medicine, Charles University Prague and Motol University Hospital, Kateřinská, 32 121 08, Praha 2, Czech Republic

    Kubeš Jiří, Vítek Pavel, Dědečková Kateřina & Prausová Jana

  4. Department of Medical Biophysics and Informatics, 3rd Faculty of Medicine, Charles University, Praha 10 Ruská 87, 100 00, Prague, Czech Republic

    Patzelt Matěj & Rosina Jozef

  5. Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University, Sítná square 3105, 272 01, Kladno, Czech Republic

    Kubeš Jiří, Vondráček Vladimír, Andrlik Michal, Navrátil Matěj & Rosina Jozef

  6. Department of Otorhinolaryngology, Head and Neck Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, V Úvalu 84, 150 06, Prague 5, Czech Republic

    Lukeš Petr

  7. Department of Plastic Surgery, Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Praha 10, Czech Republic

    Patzelt Matěj

  8. Department of Health Protection and Disaster Medicine, Pavlov First Saint Petersburg State Medical University, Lva Tolstogo 6-8, 197020, Saint Petersburg, Russia

    Grebenyuk Alexander

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  1. Kubeš Jiří
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  2. Vondráček Vladimír
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Correspondence to Andrlik Michal.

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Jiří, K., Vladimír, V., Michal, A. et al. Proton pencil-beam scanning radiotherapy in the treatment of nasopharyngeal cancer: dosimetric parameters and 2-year results. Eur Arch Otorhinolaryngol 278, 763–769 (2021). https://doi.org/10.1007/s00405-020-06175-5

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  • DOI: https://doi.org/10.1007/s00405-020-06175-5

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