title: Particle radiotherapy using protons or carbon ions for unresectable locally advanced head and neck cancers with skull base invasion.
abstract: OBJECTIVE
  To study the oncological outcome of the patients with unresectable locally advanced primary head and neck cancers invading the skull base, treated with particle radiotherapy.
  
  
  METHODS
  Fifty-seven patients with unresectable primary head and neck cancers invading the skull base received proton or carbon ion radiotherapy as definitive treatment at Hyogo Ion Beam Medical Center between 2003 and 2009. Forty-seven patients were treated with proton radiotherapy and 10 patients were treated with carbon ion radiotherapy. A retrospective review was performed with clinical charts and recorded imagings.
  
  
  RESULTS
  With a median follow-up of 32 months, the 3-year actual survival and local progression-free rates of all the patients were 61 and 56%, respectively. The 3-year actual survival rates of adenoid cystic carcinoma, squamous cell carcinoma, olfactory neuroblastoma, adenocarcinoma and malignant melanoma were 83, 44, 75, 0 and 38%, respectively. The 3-year actual local control rates of adenoid cystic carcinoma, squamous cell carcinoma, olfactory neuroblastoma, adenocarcinoma and malignant melanoma were 63, 31, 83, 50 and 0%, respectively. Distant metastasis was observed in 13 of 25 patients in adenoid cystic carcinoma, two of 14 patients in squamous cell carcinoma, one of six patients with olfactory neuroblastoma, two of four patients with adenocarcinoma, three of four patients with malignant melanoma and two of three patients with undifferentiated carcinoma. Mucositis and dermatitis were seen as acute toxicities. The most common late toxicity was visual disorder. Grades 2, 3 and 4 visual disorders were observed in seven, five and two patients, respectively.
  
  
  CONCLUSIONS
  Proton and carbon ion radiotherapy resulted in satisfactory local control in patients with locally advanced unresectable primary head and neck cancers invading the skull base.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kobe University, 7-5-2 Kusunoki-Cho, Chuo-Ku, Kobe 650-0017, Japan. nibu@med.kobe-u.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Morimoto
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Demizu
authors.forename: Naoki
authors.initials: N
authors.lastname: Hashimoto
authors.forename: Masayuki
authors.initials: M
authors.lastname: Mima
authors.forename: Kazuki
authors.initials: K
authors.lastname: Terashima
authors.forename: Osamu
authors.initials: O
authors.lastname: Fujii
authors.forename: Naoki
authors.initials: N
authors.lastname: Otsuki
authors.forename: Masao
authors.initials: M
authors.lastname: Murakami
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Fuwa
authors.forename: Ken-Ichi
authors.initials: K
authors.lastname: Nibu
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000532:radiotherapy; D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy; D003536:Cystadenocarcinoma / Q000401:mortality / Q000532:radiotherapy; D018572:Disease-Free Survival; D018304:Esthesioneuroblastoma, Olfactory / Q000401:mortality / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D063193:Heavy Ion Radiotherapy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D009361:Neoplasm Invasiveness; D061766:Proton Therapy / Q000009:adverse effects; D011855:Radiodermatitis / Q000209:etiology; D012189:Retrospective Studies; D019291:Skull Base / Q000473:pathology*; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology
keywords: carbon ion; head and neck cancer; particle radiotherapy; proton; skull base