Predicted Secondary Malignancies following Proton versus Photon Radiation for Oropharyngeal Cancers.
HPV-positive
oropharyngeal cancer
protons
radiation therapy
secondary malignancies
Journal
International journal of particle therapy
ISSN: 2331-5180
Titre abrégé: Int J Part Ther
Pays: United States
ID NLM: 101674108
Informations de publication
Date de publication:
2020
2020
Historique:
received:
05
11
2019
accepted:
03
02
2020
entrez:
26
6
2020
pubmed:
26
6
2020
medline:
26
6
2020
Statut:
ppublish
Résumé
There has been a recent epidemic of human papillomavirus (HPV)-positive oropharyngeal cancer, accounting for 70% to 80% of diagnosed cases. These patients have an overall favorable prognosis and are typically treated with a combination of surgery, chemotherapy, and radiation. Because these patients live longer, they are at risk of secondary malignant neoplasms (SMNs) associated with radiation therapy. Therefore, we assessed the predicted risk of SMNs after adjuvant radiation therapy with intensity-modulated proton therapy (IMPT) compared with intensity modulated photon radiation therapy (IMRT) in patients with HPV- positive oropharyngeal cancers after complete resection. Thirteen consecutive patients with HPV-positive oropharyngeal cancers treated with postoperative radiation alone were selected. All patients were treated with pencil beam scanning IMPT to a total dose of 60 Gy in 2 Gy fractions. The IMRT plans were generated for clinical backup and were used for comparative purposes. The SMN risk was calculated based on an organ equivalent dose model for the linear-exponential dose-response curve. Median age of the patient cohort was 63 years (range, 47-73 years). There was no difference in target coverage between IMPT and IMRT plans. We noted significant reductions in mean mandible, contralateral parotid, lung and skin organ equivalent doses with IMPT compared with IMRT plans ( Treatment with IMPT can achieve comparable target dose coverage while significantly reducing the dose to healthy organs, which can lead to fewer predicted SMNs compared with IMRT.
Identifiants
pubmed: 32582814
doi: 10.14338/IJPT-19-00076.1
pii: Customer: THEIJPT-D-19-00076R1
pmc: PMC7302732
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1-10Informations de copyright
©Copyright 2020 The Author(s).
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors have no conflicts of interest to disclose.
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