title: Proton versus conventional radiotherapy for pediatric salivary gland tumors: Acute toxicity and dosimetric characteristics.
abstract: OBJECTIVE
  We evaluated acute toxicity profiles and dosimetric data for children with salivary gland tumors treated with adjuvant photon/electron-based radiation therapy (X/E RT) or proton therapy (PRT).
  
  
  METHODS
  We identified 24 patients who had received adjuvant radiotherapy for salivary gland tumors. Data were extracted from the medical records and the treatment planning systems. Toxicity was scored according to the Common Terminology Criteria for Adverse Effects 4.0.
  
  
  RESULTS
  Eleven patients received X/E RT and 13 PRT, with a median prescribed dose of 60 Gy in each group. In the X/E RT group, 54% of patients developed acute grade II/III dermatitis, 27% grade II/III dysphagia, and 91% grade II/III mucositis, and the median weight loss was 5.3% with one patient requiring feeding tube placement. In the PRT group, 53% had acute grade II/III dermatitis, 0% grade II/III dysphagia, and 46% grade II/III mucositis, with a median weight gain of 1.2%. Additionally, PRT was associated with lower mean doses to several normal surrounding midline and contralateral structures.
  
  
  CONCLUSIONS
  In this retrospective study of pediatric salivary tumors, PRT was associated with a favorable acute toxicity and dosimetric profile. Continued follow-up is needed to identify long-term toxicity and survival data.
authors.affiliation: Baylor College of Medicine, Houston, United States.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Grant
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: David R
authors.initials: DR
authors.lastname: Grosshans
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Bilton
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: John A
authors.initials: JA
authors.lastname: Garcia
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Mayank
authors.initials: M
authors.lastname: Amin
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Chambers
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Susan L
authors.initials: SL
authors.lastname: McGovern
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Mary F
authors.initials: MF
authors.lastname: McAleer
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: William H
authors.initials: WH
authors.lastname: Morrison
authors.affiliation: Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Winston W
authors.initials: WW
authors.lastname: Huh
authors.affiliation: Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, United States.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Kupferman
authors.affiliation: Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, United States. Electronic address: amahajan@mdanderson.org.
authors.forename: Anita
authors.initials: A
authors.lastname: Mahajan
mesh_terms: D000293:Adolescent; D002648:Child; D003680:Deglutition Disorders / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D052016:Mucositis / Q000209:etiology; D061766:Proton Therapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000532:radiotherapy*
keywords: Parotid tumors; Pediatrics; Proton therapy; Salivary gland tumors