Intensity modulated proton therapy (IMPT) - The future of IMRT for head and neck cancer.
Head and Neck Neoplasms
/ mortality
Humans
Photons
/ adverse effects
Proton Therapy
/ adverse effects
Radiodermatitis
/ etiology
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Intensity-Modulated
/ adverse effects
Retreatment
Stomatitis
/ etiology
Survival Rate
Treatment Outcome
Head and neck
IMPT
IMRT
Proton therapy
Radiotherapy
Journal
Oral oncology
ISSN: 1879-0593
Titre abrégé: Oral Oncol
Pays: England
ID NLM: 9709118
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
01
11
2018
revised:
11
11
2018
accepted:
12
11
2018
entrez:
9
1
2019
pubmed:
9
1
2019
medline:
27
2
2020
Statut:
ppublish
Résumé
Radiation therapy plays an integral role in the management of head and neck cancers (HNCs). While most HNC patients have historically been treated with photon-based radiation techniques such as intensity modulated radiation therapy (IMRT), there is a growing awareness of the potential clinical benefits of proton therapy over IMRT in the definitive, postoperative and reirradiation settings given the unique physical properties of protons. Intensity modulated proton therapy (IMPT), also known as "pencil beam proton therapy," is a sophisticated mode of proton therapy that is analogous to IMRT and an active area of investigation in cancer care. Multifield optimization IMPT allows for high quality plans that can target superficially located HNCs as well as large neck volumes while significantly reducing integral doses. Several dosimetric studies have demonstrated the superiority of IMPT over IMRT to improve dose sparing of nearby organs such as the larynx, salivary glands, and esophagus. Evidence of the clinical translation of these dosimetric advantages has been demonstrated with documented toxicity reductions (such as decreased feeding tube dependency) after IMPT for patients with HNCs. While there are relative challenges to IMPT planning that exist today such as particle range uncertainties and high sensitivity to anatomical changes, ongoing investigations in image-guidance techniques and robust optimization methods are promising. A systematic approach towards utilizing IMPT and additional prospective studies are necessary in order to more accurately estimate the clinical benefit of IMPT over IMRT and passive proton therapy on a case-by-case basis for patients with sub-site specific HNCs.
Identifiants
pubmed: 30616799
pii: S1368-8375(18)30424-X
doi: 10.1016/j.oraloncology.2018.11.015
pmc: PMC6615027
mid: NIHMS1514217
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
66-74Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Informations de copyright
Copyright © 2018 Elsevier Ltd. All rights reserved.
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