title: Proton therapy for head and neck cancer.
abstract: OBJECTIVE
  Proton therapy for head and neck cancer is an area of active research as technological advances are increasingly integrated into clinical practice, and also the subject of heightened scrutiny due to the significant associated cost. This article will highlight recent research into proton dosimetry, studies evaluating its clinical benefit relative to other advanced radiotherapy modalities, and key safety and cost considerations.
  
  
  RESULTS
  Recent dosimetric analyses have quantified the potential for the most sophisticated form of proton therapy, intensity-modulated proton therapy (IMPT), to reduce dose to key anatomic structures in the head and neck, and highlight the potential for dose uncertainty with IMPT if not implemented in a careful manner. Clinical contributions demonstrate the potential for protons to yield excellent local control and lower than expected morbidity for tumors adjacent to critical neurological structures. There are promising data in the reirradiation setting, and emerging data for IMPT in oropharyngeal cancer.
  
  
  CONCLUSIONS
  Proton therapy for head and neck cancer holds significant potential, and promising single-institution experiences should be validated, wherever feasible, in prospective randomized clinical trials. In light of the significant associated cost, additional evidence is needed to guide the appropriate allocation of patients to IMPT versus intensity-modulated radiotherapy.
authors: aDepartment of Radiation Oncology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania bDivision of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas, USA.
authors: J Nicholas
authors: JN
authors: Lukens
authors: Alexander
authors: A
authors: Lin
authors: Stephen M
authors: SM
authors: Hahn
mesh_terms: D003362:Cost-Benefit Analysis; D018450:Disease Progression; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D058958:Organs at Risk / Q000528:radiation effects*; D061766:Proton Therapy; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D016032:Randomized Controlled Trials as Topic