title: The use of proton therapy in the treatment of head and neck cancers.
abstract: External beam radiation therapy is a commonly utilized treatment modality in the management of head and neck cancer. Given the close proximity of disease to critical normal tissues and structures, the delivery of external beam radiation therapy can result in severe acute and late toxicities, even when delivered with advanced photon-based techniques, such as intensity-modulated radiation therapy. The unique physical characteristics of protons make it a promising option in the treatment of advanced head and neck cancer, with the potential to improve sparing of normal tissues and/or safely escalate radiation doses. Clinical implementation will require the continued development of advanced techniques such as intensity-modulated proton therapy, using pencil beam scanning, as well as rigorous methods of quality assurance and adaptive techniques to accurately adjust to changes in anatomy due to disease response. Ultimately, the widespread adaptation and implementation of proton therapy for head and neck cancer will require direct, prospective comparisons to standard techniques such as intensity-modulated radiation therapy, with a focus on measures such as toxicity, disease control, and quality of life.
authors.affiliation: From the Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Ahn
authors.forename: J Nicholas
authors.initials: JN
authors.lastname: Lukens
authors.forename: Boon-Keng Kevin
authors.initials: BK
authors.lastname: Teo
authors.forename: Maura
authors.initials: M
authors.lastname: Kirk
authors.forename: Alexander
authors.initials: A
authors.lastname: Lin
mesh_terms: D002813:Chondrosarcoma / Q000532:radiotherapy; D002817:Chordoma / Q000532:radiotherapy; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy; D030361:Papillomavirus Infections / Q000150:complications; D010255:Paranasal Sinus Neoplasms / Q000532:radiotherapy; D056888:Patient Positioning / Q000379:methods; D061766:Proton Therapy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D011829:Radiation Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000379:methods; D019292:Skull Base Neoplasms / Q000532:radiotherapy